The European College of Veterinary Internal Medicine—Companion Animals (ECVIM‐CA)
Congress and the Journal of Veterinary Internal Medicine (JVIM) are not responsible
for the content or dosage recommendations in the abstracts. The abstracts are not
peer reviewed before publication. The opinions expressed in the abstracts are those
of the author(s) and may not represent the views or position of the ECVIM‐CA. The
authors are solely responsible for the content of the abstracts.
LIST OF ORAL RESEARCH COMMUNICATIONS
European Society of Comparative Gastroenterology
Friday 4 September
14.25‐14.40
ESCG‐O‐1
Novo Baptista, Ana Rita
Gastrointestinal protectants in clinical practice: evaluation of prescription patterns
among general practitioners in Portugal Novo
14.40‐14.55
ESCG‐O‐2
Spencer, Ashley
Evaluation of omeprazole use for the treatment of dysrexia and vomiting in cats with
chronic kidney disease
14.55‐15.10
ESCG‐O‐3
Tilmant, Cyril
Endoscopic features of feline gastrointestinal eosinophilic sclerosing fibroplasia:
A series of 4 cases
15.10‐15.25
ESCG‐O‐4
Pilla, Rachel
Diarrhea has a greater impact on the fecal metabolome of dogs than does dietary intervention
15.25‐15.40
ESCG‐O‐5
Lyngby, Janne
Differential microRNA expression‐profiles in feces and serum of dogs with chronic
inflammatory enteropathy and with gastrointestinal cancer
15.40‐15.55
ESCG‐O‐6
Hammes, Karen
Evaluation of anamnestic and clinicopathologic factors that might explain the poor
correlation between pancreatic lipase concentrations (DGGR‐lipase and Spec cPL) and
ultrasonographic evidence of pancreatitis in dogs
16.30‐16.45
ESCG‐O‐7
Kusano, Koki
Hepatobiliary disorders and elevated blood urea nitrogen during the treatment are
possible prognostic factors for feline pancreatitis
16.45‐17.00
ESCG‐O‐8
Economu, Lavinia
The effect of assisted enteral feeding on treatment outcome in dogs with inflammatory
protein‐losing enteropathy
17.00‐17.15
ESCG‐O‐9
Allenspach, Karin
Short‐term feeding with high‐fat diet induces dysbiosis‐associated changes of fecal
metabolites consistent with changes in serum metabolomics in dogs
17.15‐17.30
ESCG‐O‐10
Caulfield, Sarah
Histopathological concordance of concurrent duodenal and ileal biopsy specimens in
dogs
17.30‐17.45
ESCG‐O‐11
Werner, Melanie
Comparison of interpretation of fecal culture results between three different laboratories
as well as the PCR‐based Dysbiosis Index in dogs
17.45‐18.00
ESCG‐O‐12
Luckschander‐Zeller, Nicole
Canine acute hemorrhagic diarrhea syndrome: A retrospective evaluation of data for
the identification of possible prognostic markers
European Society of Veterinary Cardiology
Thursday 3 September
14.25‐14.40
ESVC‐O‐1
Vezzosi, Tomasso
The Mitral INsufficiency Echocardiographic (MINE) score: A severity classification
of myxomatous mitral valve disease in dogs
14.40‐14.55
ESVC‐O‐2
Franchini, Alessandra
The longitudinal outcome of canine myxomatous mitral valve disease (LOOK‐Mitral) study:
Baseline characteristics
14.55‐14.10
ESVC‐O‐3
Borgarelli, Michele
The prognostic value of clinical, radiographic, echocardiographic variables and biomarkers
levels for assessing risk of the onset of heart failure or cardiac death in dogs with
preclinical myxomatous mitral valve disease: The DELAY Study
14.10‐15.25
ESVC‐O‐4
Menciotti, Giulio
Prevalence of mitral regurgitation in Cavalier King Charles Spaniels with no or low‐grade
murmurs
15.25‐15.40
ESVC‐O‐5
Reimann, Maria Josefine
Polymorphisms in the serotonin transporter gene do not associate with myxomatous mitral
valve disease or circulating serotonin levels in Cavalier King Charles Spaniels
15.40‐15.55
ESVC‐O‐6
Sykes, Katharine Tess
Accuracy of deep learning enabled software to measure vertebral heart size in dogs
with myxomatous mitral valve disease
15.55‐16.10
ESVC‐O‐7
Wesselowski, Sonya
Correlation between radiographic vertebral heart size and vertebral left atrial size
and echocardiographic measurements of left heart size in Cavalier King Charles Spaniels
with preclinical myxomatous mitral valve disease
16.10‐16.25
ESVC‐O‐8
Wilshaw, Jenny
A prospective multicenter study to determine the accuracy of history, physical examination,
biochemical parameters and biomarkers to identify dogs with stage B2 degenerative
mitral valve disease: The HAMLET study
16.25‐16.40
ESVC‐O‐9
Sudunagunta, Siddharth
Echocardiographic parameters to differentiate between pre‐ and postcapillary pulmonary
hypertension
Friday 4 September
14.25‐14.40
ESVC‐O‐10
Lyssens, Aurélie
Utility of cardiovascular point of care ultrasound to detect pre‐capillary pulmonary
hypertension
14.40‐14.55
ESVC‐O‐11
Porteiro Vázquez, Dolores María
Rapid atrial ectopic firing in dog: A retrospective study in 10 cases
14.55‐15.10
ESVC‐O‐12
Prado Checa, Iñaki
Comparison of temporary pacing techniques in dogs undergoing permanent pacemaker implantation
15.10‐15.25
ESVC‐O‐13
Battaia, Stefano
Noninvasive electrocardiographic parameters to assess interventricular dyssynchrony
in dogs with bundle branch blocks
15.25‐15.40
ESVC‐O‐14
Kruckman, Leah
Comparison of three two‐dimensional echocardiographic methods of assessing left ventricular
size in Doberman Pinschers
15.40‐15.55
ESVC‐O‐15
Vollmar, Andrea
ECG abnormalities in Irish wolfhounds
16.30‐16.45
ESVC‐O‐16
Wilshaw, Jenny
A dog's dinner: Evidence of metabolic derangement in dogs with naturally occurring
valvular heart disease and congestive heart failure
16.45‐17.00
ESVC‐O‐17
Dickson, Dave
Differences in left ventricular remodeling secondary to chronic volume loading between
English Springer Spaniels and two other similar athletic breeds
17.00‐17.15
ESVC‐O‐18
Pelander, Lena
Evaluation of cardiac troponin I as a predictor of mortality in critically ill cats
17.15‐17.30
ESVC‐O‐19
Kilkenny, Eoin
Increased cardiac troponin I is a clinically useful indicator of infective endocarditis
17.30‐17.45
ESVC‐O‐20
Dutton, Luke
CRISPR/Cas9 genome engineering to model the R820W mutation effects in iPSC‐derived
cardiomyocytes
17.45‐18.00
ESVC‐O‐21
Mochel, Jonathan
Pharmacodynamics of ACE inhibitors in dogs with cardiac disease, proteinuria or hypertension:
when size matters. A retrospective study of 326 cases
18.00‐18.15
ESVC‐O‐22
Roche‐Catholy, Marine
Pharmacological properties of torasemide in healthy cats Roche‐Catholy
European Society of Veterinary Comparative Nutrition
Wednesday 2 September
16.30‐16.45
ESVCN‐O‐1
Coltherd, Jennifer
A long term feeding trial to aid in establishing No Observed Adverse Effect Levels
(NOAELs) for different sources of phosphorus in feline diets
16.45‐17.00
ESVCN‐O‐2
German, Alexander
Maintenance energy requirements of cats with obesity after a period of controlled
weight reduction
European Society of Veterinary Endocrinology
Friday 4 September
16.30‐16.45
ESVE‐O‐1
Kongtasai, Thirawut
Urinary liver‐type fatty acid binding protein and neutrophil gelatinase‐associated
lipocalin in hyperthyroid cats before and after radioiodine treatment
16.45‐17.00
ESVE‐O‐3
Gilor, Chen
The effect of the ghrelin‐receptor agonist capromorelin on glucose metabolism in healthy
cats
17.00‐17.15
ESVE‐O‐4
Gilor, Chen
A novel once‐a‐week feline recombinant insulin for the treatment of diabetes mellitus
in cats
17.15‐17.30
ESVE‐O‐5
Gilor, Chen
Performance of a flash glucose monitoring system in cats
17.30‐17.45
ESVE‐O‐6
Hulsebosch, Sean
A novel once‐a‐week canine recombinant insulin for the treatment of diabetes mellitus
in dogs
Saturday 5 September
08.15‐08.30
ESVE‐O‐7
Aguiar, Joana
RNA transcriptomic analysis as a novel in vitro hypothesis‐ generating tool to unravel
the pathogenesis of feline hyperthyroidism
08.30‐08.45
ESVE‐O‐8
Scharf, Valery
Clinical features and outcome associated with functional thyroid tumors in 70 dogs
08.45‐09.00
ESVE‐O‐9
Jankovic, Jana
Expression of proteins involved in iodine uptake in canine thyroid tumors and tumor‐derived
organoids
09.00‐09.15
ESVE‐O‐10
Gerou‐Ferriani, Magda
Urine cortisol/creatinine ratio (UCCR) can potentially identify patients with Addison
disease: A pilot study
09.15‐09.30
ESVE‐O‐11
van Bokhorst, Kirsten
Hypophysectomy as successful treatment of feline hypersomatotropism: A case series
of 25 cats
09.30‐09.45
ESVE‐O‐12
Hazuchova, Katarina
Investigation of genetic risk factors for diabetes mellitus in European Burmese cats
using whole genome sequencing technology
09.45‐10.00
ESVE‐O‐13
Linari, Guido
Insulin glargine 300 units/mL for the treatment of feline diabetes mellitus
10.00‐10.15
ESVE‐O‐14
Krämer, Anna Lena
Glycemic variability in diabetic cats with and without concurrent diseases
10.15‐10.30
ESVE‐O‐15
Miceli, Diego
Combined treatment of trilostane and retinoic acid in dogs with pituitary‐dependent
hypercortisolism
11.20‐11.35
ESVE‐O‐16
Sanders, Karin
Canine pituitary adenoma organoids
11.35‐11.50
ESVE‐O‐17
Corsini, Andrea
Calcium and phosphate homeostasis in dogs with naturally occurring hypercortisolism
11.50‐12.05
ESVE‐O‐18
Gomes, Alexandre
Gut microbiome evaluation in dogs with naturally‐occurring hyperadrenocorticism
12.05‐12.20
ESVE‐O‐19
Foster, Sue
Efficacy and safety of tightly controlled hyperadrenocesvorticism in dogs treated
with trilostane in general practice
12.20‐12.35
ESVE‐O‐20
Vedlhuizen, Anouk
MicroRNAs as liquid biomarkers for canine Cushing's syndrome
12.35‐12.50
ESVE‐O‐21
Schofield, Imogen
Machine learning based prediction of dogs with Cushing’s syndrome using primary‐care
veterinary electronic health records
European Society of Veterinary Internal Medicine
Thursday 3 September
12.05‐12.20
ESVIM‐O‐1
Lebastard, Matthieu
Relationship between bronchial collapse and heart size in coughing dogs with heart
murmur studied by computed tomography Lebastard
12.20‐12.35
ESVIM‐O‐2
Bienes, Tom
Aspergillus qPCR testing on nasal swab: A useful tool for diagnosis and follow‐up
of sinonasal aspergillosis in dogs?
12.35‐12.50
ESVIM‐O‐3
Fastrès, Aline
Characterization of the bronchoalveolar lavage fluid by single cell gene expression
analysis in healthy dogs: a promising technique.
12.50‐13.05
ESVIM‐O‐4
De Simoi, Vanessa
Intradermal testing in dogs with eosinophilic bronchopneumopathy
13.05‐13.20
ESVIM‐O‐5
Jaffey, Jared
Effects of calcitriol on oxidative burst, phagocytic function, and cytokine production
in shelter dog leukocytes
14.25‐14.40
ESVIM‐O‐6
Jaffey, Jared
Immune function and serum 25‐hydroxyvitamin D in shelter dogs
14.40‐14.55
ESVIM‐O‐7
Ferreira, Aida
Clinical, clinicopathological and imaging differences between dogs with non‐associative,
associative and precursor immune‐mediated hemolytic anemia
14.55‐15.10
ESVIM‐O‐8
Izquierdo Robert, Laura
Feline leukemia virus false positive results using an in‐house test in cats with immune‐mediated
hemolytic anemia Izquierdo
15.10‐15.25
ESVIM‐O‐9
Ferreira, Aida
Clinical, clinicopathological and imaging differences between cats with non‐associative,
associative and precursor Immune‐Mediated Hemolytic Anemia
15.25‐15.40
ESVIM‐O‐10
Cervone, Mario
Clinical, diagnostic findings and short‐term outcome in 27 cats with non‐regenerative
anemia due to bone marrow disorders
15.40‐15.55
ESVIM‐O‐11
Beaudu‐Lange, Claire
Comparison of Clinical examination, laboratory findings, prognosis and long‐term follow‐up
between client‐owned ill cats naturally infected either by Mycoplasma haemofelis or
Candidatus Mycoplasma haemominutum in a single practice
15.55‐16.10
ESVIM‐O‐12
Cervone, Mario
Clinical and diagnostic findings and outcome in 58 dogs with immune‐mediated polyarthritis
16.10‐16.25
ESVIM‐O‐13
Sparkes, Andrew
The mercury challenge: Feline systolic blood pressure in primary care practice, a
European survey
16.25‐16.40
ESVIM‐O‐14
Guzmán Ramos, Pedro
A proteomic evaluation of greyhound meningoencephalitis using quantitative mass spectrometry
highlights the consideration of viral triggers
European Society of Veterinary Nephrology and Urology
Friday 4 September
09.00‐09.15
ESVNU‐O‐1
Nivy, Ran
Prospective evaluation of urinary alkaline phosphatase and ?: Glutamyl transpeptidase
as diagnostic and prognostic biomarkers of acute kidney injury in dogs
09.15‐09.30
ESVNU‐O‐2
Mortier, Femke
Laboratory variation of feline urinary protein: creatinine ratio
09.30‐09.45
ESVNU‐O‐3
Kongtasai, Thirawut
Liver‐type fatty acid binding protein and neutrophil gelatinase‐associated lipocalin
in feline chronic kidney disease and feline hyperthyroidism
09.45‐10.00
ESVNU‐O‐4
Chen, Hilla
Evaluation of cystatin B as a marker of acute kidney injury in dogs and cats
10.00‐10.15
ESVNU‐O‐5
Sargent, Hannah
Soluble alpha klotho in senior cats
10.15‐10.30
ESVNU‐O‐6
Tang, Pak Kan
Risk factors associated with disturbances of calcium homeostasis following the initiation
of phosphate‐restricted diet in cats with chronic kidney disease
11.20‐11.35
ESVNU‐O‐7
Hindar, Camilla
The effect of bacteriuria on survival and disease progression in cats with azotemic
chronic kidney disease
11.35‐11.50
ESVNU‐O‐8
Ferri, Filippo
Renal AA‐amyloidosis in shelter cats: a retrospective study based on clinico‐pathological
data, light microscopy and ultrastructural features
11.50‐12.05
ESVNU‐O‐9
Dunaevich, Asia
Survival rate and prognostic factors in dogs with acute on chronic kidney disease
European Society of Veterinary Oncology
Saturday 5 September
14.25‐14.40
ESVONC‐O‐1
Marconato, Laura
Prognostic impact of time interval between surgery and initiation of adjuvant chemotherapy
following limb amputation in dogs with appendicular osteosarcoma without distant metastases
14.40‐14.55
ESVONC‐O‐2
Boyé, Pierre
Phase I dose escalation study of 12b80: hydroxybisphosphonate linked doxorubicin—in
dogs with naturally occurring osteosarcoma
14.55‐15.10
ESVONC‐O‐3
Treggiari, Elisabetta
Factors associated with the onset of neutropenia in dogs receiving lomustine‐based
chemotherapy
15.10‐15.25
ESVONC‐O‐4
Beaudu‐Lange, Claire
Prevalence of reproduction pathologies and associated death with survival analysis
among bitches over 6 years of age in a single practice
15.40‐15.55
ESVONC‐O‐6
Attorri, Valeria
Prevalence of peripheral blood and bone marrow infiltration in canine extranodal lymphoma
16.30‐16.45
ESVONC‐O‐7
Mosca, Andrea
A preliminary immunohistochemical study of signal transducer and activator of transcription
3 (STAT3) expression and its prognostic significance in 57 canine anal sac adenocarcinomas
16.45‐17.00
ESVONC‐O‐8
Arendt, Maja
Unravelling tumor‐driving mutations in canine mast cell tumors and metastatic lymph
nodes by next generation sequencing
17.00‐17.15
ESVONC‐O‐9
Kreilmeier‐Berger, Theresa
Alternative lengthening of telomeres in canine histiocytic sarcomas of Bernese Mountain
dogs and other breeds is infrequently used as telomere maintenance mechanism
17.15‐17.30
ESVONC‐O‐10
Best, Matthew
Effect of low dose rate half body irradiation on the remission and survival times
for dogs with metacentric, substage a, B cell lymphoma treated with multiagent chemotherapy
17.30‐17.45
ESVONC‐O‐11
Espada Castro, Laura Sofia
The use of a combined prebiotic and probiotic oral product and its impact on stool
consistency in dogs undergoing radiotherapy
International Society for Companion Animal Infectious Diseases
Thursday 3 September
09.00‐09.15
ISCAID‐O‐1
Eschle, Simone
Canine vaccination in Germany: a survey of owner attitudes and compliance
09.15‐09.30
ISCAID‐O‐2
Bergmann, Michèle
Comparison of four commercially available point‐of‐care tests to detect antibodies
against canine parvovirus in dogs
09.30‐09.45
ISCAID‐O‐3
Brunet, Audrey
Detection of pathogens implicated in canine infectious respiratory disease complex
in dogs without respiratory signs hospitalized in a veterinary teaching hospital
09.45‐10.00
ISCAID‐O‐4
Haaland, Anita Haug
Outbreak of acute hemorrhagic diarrhea in dogs in Norway; is Providencia alcalifaciens
involved?
10.00‐10.15
ISCAID‐O‐5
Taylor, Collette
Demographic risk factors for canine leptospirosis in the UK
10.15‐10.30
ISCAID‐O‐6
Taylor, Collette
Ecological niche modelling to explore probability of presence of canine leptospirosis
in Great Britain
10.30‐10.45
ISCAID‐O‐7
Willesen, Jakob
Increased frequency of exercise intolerance, coagulation and hematological abnormalities
in Angiostrongylus vasorum infected vs. non‐infected dogs
11.05‐11.20
ISCAID‐O‐8
Jousserand, Nicolas
Virulence factors might be implicated in clinical presentation of urinary tract infections
caused by Escherichia coli in dogs and cats
11.20‐11.35
ISCAID‐O‐9
Schmitt, Kira
Extended‐spectrum beta‐lactamase‐producing Enterobacteriaceae (ESBL‐E) In companion
animals and humans: Clinical environment versus households
11.35‐11.50
ISCAID‐O‐10
Pomba, Constança
Extended‐spectrum‐beta‐lactamases‐ and carbapenemase‐producing Enterobacteriaceae
isolated from the gut of sick companion animals in Portugal
11.50‐12.05
ISCAID‐O‐11
Pomba, Constança
Plasmid‐mediated colistin resistance mcr‐1 gene harbored on multi‐drug resistant isolates
from companion animals in Portugal
Society of Comparative Hepatology
Thursday 3 September
09.45‐10.05
SCH‐O‐1
Merino‐Gutierrez, Virginia
Clinical and clinicopathological findings in dogs other than Scottish Terriers with
idiopathic vacuolar hepatopathy
10.05‐10.25
SCH‐O‐2
Serrano, Gonçalo
Comparison of lactulose, metronidazole and hepatic specific diet in controlling clinical
signs in dogs with congenital extrahepatic portosystemic shunts: A randomized clinical
trial
10.25‐10.45
SCH‐O‐3
Gori, Eleonora
Hepatic lead and copper concentrations in dogs with chronic hepatitis
11.20‐11.35
SCH‐P‐1
Johnston, Andrea
Hepatocyte ploidy in cats with and without hepatocellular carcinoma
11.35‐11.50
SCH‐P‐2
Jaffey, Jared
Serum 25‐hydroxyvitamin D in dogs with gallbladder mucocele
11.50‐12.05
SCH‐P‐3
Martinez, Carlos
Use of NanoString technology to evaluate gene expression patterns in dogs with neutrophilic
cholangitis
12.05‐12.20
SCH‐P‐4
Devriendt, Nausikaa
The lidocaine/monoethylglycylxylidide liver function test to assess shunt closure
in dogs with attenuated congenital extrahepatic portosystemic shunts
12.35‐12.50
SCH‐P‐6
Pascual, Mireia
Bile acid and bilirubin measurement in canine peritoneal fluid samples with and without
biliary tract rupture
12.50‐13.05
SCH‐P‐7
Gabriel, Vojtech
Culture and maintenance of well‐differentiated canine hepatic organoids and urinary
bladder organoids
LIST OF POSTER RESEARCH COMMUNICATIONS
European Society of Comparative Gastroenterology
ESCG‐P‐1
Wu, Yu‐An
Correlation between the middle width of the right pancreatic limb and serum trypsin‐like
immunoreactivity or pancreatic lipase immunoreactivity concentrations in cats with
chronic gastrointestinal signs
ESCG‐P‐2
Lukman Hoeyrup, Nina
Effects of cyclosporine treatment on supranormal feline serum pancreatic lipase immunoreactivity
concentrations
ESCG‐P‐3
Cattaneo, Deborah
Oesophageal neoplasia in cats: Retrospective study in 19 patients
ESCG‐P‐4
Bottero, Enrico
Gastro‐duodenal ulceration (GDU) in cats: retrospective study in 63 patients
ESCG‐P‐5
Cristóbal, José Ignacio
Effect of stem cell therapy on serum albumin levels and its clinical effectiveness
in dogs diagnosed with inflammatory bowel disease
ESCG‐P‐6
Cristóbal, José Ignacio
Safety and adverse effects during the stem cell infusion in dogs with inflammatory
bowel disease
ESCG‐P‐7
Gori, Eleonora
Detection of anti‐erythrocyte antibodies in dogs with immunosuppressant‐responsive
enteropathy (IRE)
ESCG‐P‐8
Benvenuti, Elena
Prognostic factors and long‐term follow‐up in Immunosuppressant Responsive Enteropathy
(IRE): Prospective study in 165 dogs
ESCG‐P‐9
Cabrera Garcia, Angela Isabel
Dysregulation of gastrointestinal RAGE (receptor for advanced glycation end products)
expression in dogs with chronic inflammatory enteropathy
ESCG‐P‐10
Herstad, Kristin
Immunohistochemical expression of ß‐catenin, Ki67, CD3 and CD18 in canine colorectal
adenomas and carcinomas
ESCG‐P‐11
Lyngby, Janne
Fecal bile acid profiles in cats with chronic enteropathy, intestinal neoplasia, and
in heathy control cats.
European Society of Veterinary Cardiology
ESVC‐P‐1
Bagardi, Mara
Myxomatous mitral valve disease in Cavalier King Charles Spaniels: A clinical and
genetic study
ESVC‐P‐2
Galizzi, Alberto
Factors affecting the urinary aldosterone‐to‐creatinine ratio in healthy dogs and
dogs with naturally occurring myxomatous mitral valve disease
ESVC‐P‐3
Poissonnier, Camille
Left atrial volume assessment and survival in 160 Cavalier King Charles spaniels with
or without degenerative mitral valve disease (2017‐2019)
ESVC‐P‐4
Bini, Martina
Utility of clinical and electrocardiographic findings in the prediction of the severity
of pulmonic stenosis in dog
ESVC‐P‐5
Alvarado Masis, Maria Paz
Assessment of global and regional right ventricular function in dogs with congenital
pulmonic stenosis using echocardiography, speckle tracking imaging, and two‐dimensional
color tissue Doppler imaging: A prospective study of 105 cases (2013‐2020)
ESVC‐P‐6
Cheng, Wan‐Ching
Von Willebrand factor, endothelial injury and left atrial enlargement in cats with
cardiomyopathy
ESVC‐P‐7
Spina, Fabio
Echocardiographic measurements in a large population of Italian healthy cats: The
Osservatorio Veterinario Italiano Cardiopatie data
ESVC‐P‐8
Analía, Arizmendi
Analysis of PDK4 gene deletion in a population of Doberman Pinschers from Argentina
ESVC‐P‐9
Lee, Junseok
Clinical characteristics for differential diagnosis and prognosis of non‐cardiogenic
pulmonary edema in dogs with concurrent congestive heart failure : 45 cases (2018
~ 2010)
ESVC‐P‐10
Pecjak, Anja
Selected hematological, biochemical and echocardiographic parameters as predictors
of survival in canine patients with mitral valve disease and heart failure
ESVC‐P‐11
Carnabuci, Cristina
Longitudinal Speckle‐Tracking echocardiography of the left and right ventricular myocardium
in trained and untrained Italian blood hound dogs
ESVC‐P‐12
Caivano, Domenico
Assessment of longitudinal left ventricle deformation by 2‐dimensional speckle tracking
echocardiography obtained from different views in cats
ESVC‐P‐13
Grosso, Giovanni
Prognostic significance of left cardiac remodeling in dogs with asymptomatic myxomatous
mitral valve disease
ESVC‐P‐16
Brložnik, Maja
Echocardiographic analysis of dogs before and after the surgical treatment of brachycephalic
obstructive airway syndrome
European Society of Veterinary Comparative Nutrition
ESVCN‐P‐1
German, Alexander
Plasma amino acid and taurine concentrations in cats with obesity before and after
a period of controlled weight reduction
ESVCN‐P‐2
Berman, Chad Farryl
Influence of three different diets on lipid and fructosamine concentrations in a population
of healthy cats
ESVCN‐P‐3
Jergeay, Valérie
Study of blood pressure parameters in lean and obese client‐owned dogs: Preliminary
results Jergeay
European Society of Veterinary Endocrinology
ESVE‐P‐1
Barbosa, Sara Castanho
Evaluation of kidney function in diabetic dogs: Biomarker analysis
ESVE‐P‐2
Borin‐Crivellenti, Sofia
Lack of training on proper use of insulin syringes leads pet‐owners to significant
deviations from target dose
ESVE‐P‐3
Del Baldo, Francesca
Glycemic control and owner preference in insulin delivery in diabetic dogs
ESVE‐P‐4
Mischke, Reinhard
Use of the continuous glucose monitoring system “Freestyle Libre” in diabetic cats
ESVE‐P‐5
Diquélou, Armelle
Reliability assessment of a novel feline glucosuria home screening test
ESVE‐P‐6
Da Riz, Fiona
Bacteriuria in dogs with spontaneous hyperadrenocorticism: A retrospective study of
89 cases (2009‐2019)
ESVE‐P‐7
Carranza, Alejandra
The diagnostic performance of the heat‐stable alkaline phosphatase in dogs with suspected
hyperadrenocorticism
ESVE‐P‐8
Santiago, Raquel
Prevalence of feline hyperthyroidism in a population of 27,893 cats in Spain
ESVE‐P‐9
Corsini, Andrea
Performances of recombinant human thyrotropin stimulation test in dogs with suspected
hypothyroidism: Retrospective evaluation in 130 cases
ESVE‐P‐10
Rebocho, Rita
Use of desoxycorticosterone pivalate by veterinary surgeons: A Western European survey
ESVE‐P‐11
Fernandez Gallego, Ana
Evaluation of basal cortisol testing in dogs with signs consistent with hypoadrenocorticism
European Society of Veterinary Internal Medicine
ESVIM‐P‐1
Gianella, Paola
Respiratory and digestive abnormalities in a population of dogs with chronic idiopathic
lymphoplasmacytic rhinitis
ESVIM‐P‐3
Lam, Man‐Cham
Influence of concurrent lower respiratory tract disease on point‐of‐care lung ultrasound
in small‐breed dogs with mitral valve disease
ESVIM‐P‐4
Warwick, Harry
Signalment, clinical presentation and diagnostic imaging findings in 14 dogs and 3
cats with lobar emphysema
ESVIM‐P‐5
Weber, Corinna
Suitability of commercial human rheumatoid factor rapid tests for detection of rheumatoid
factors in dog serum
ESVIM‐P‐7
Salas García, Andrés
Multiple abdominal granuloma caused by Scedosporium spp in a dog
ESVIM‐P‐9
Brunet, Audrey
Indications and outcomes of feeding tubes in cats : 56 cases (2015‐2018)
ESVIM‐P‐10
Mischke, Reinhard
Central venous catheter associated thrombosis in dogs
ESVIM‐P‐11
Salas García, Andrés
Importance of bone marrow examination in reaching the final diagnosis in a referral
population of dogs with non‐regenerative anemia: 23 cases (2015‐2020)
ESVIM‐P‐12
Corvers, Tim
Thrombocytosis in iron deficient dogs and cats
ESVIM‐P‐14
Palizzotto, Carlo
Clinical and laboratory findings and their association with AA‐amyloidosis in shelter
cats: A retrospective study
ESVIM‐P‐15
Kurtz, Maxime
Alendronate treatment in cats with idiopathic hypercalcemia: A retrospective control
study of 20 cases
European Society of Veterinary Nephrology and Urology
ESVNU‐P‐1
Gianella, Paola
A prospective evaluation of contrast‐induced nephropathy (CIN) in dogs
ESVNU‐P‐2
Vizi, Zsuzsanna
Examination of serum hepcidin concentration in dogs with kidney disease
ESVNU‐P‐3
Kendall, Allison
3D bladder ultrasound for estimation of urine volume in dogs vs. traditional 2D ultrasound
methods
ESVNU‐P‐4
Kendall, Allison
Use of 3D ultrasound for investigation of urinary retention in hospitalized dogs
ESVNU‐P‐5
Ottka, Claudia
Elevated blood creatinine: A biomarker of renal function‐ associates with multiple
metabolic perturbations in dogs
ESVNU‐P‐6
Spencer, Sarah
Effect of hypoxia on mineralocorticoid expression and activation in primary cultures
of feline renal cortical fibroblasts and proximal tubular epithelial cells
ESVNU‐P‐7
Nicolas, Celine
Palatability and tolerance evaluations of a new formulation of a supplement dedicated
to maintain the balance of renal function in dogs and cats (Pronefra)
ESVNU‐P‐8
Kendall, Allison
Use of 3D bladder ultrasound for characterization of urinary incontinence in male
dogs
ESVNU‐P‐9
Testault, Isabelle
Comparison between non‐injected computed tomography and ultrasonography for detection
of ureteral stones in the cat: A prospective study
ESVNU‐P‐10
Nicolas, Celine
Palatability and tolerance of an oral suspension developed to maintain a healthy urinary
tract in cats
ESVNU‐P‐11
Kurtz, Maxime
Usefulness of serum amyloid A in diagnosing pyelonephritis in cats
ESVNU‐P‐14
Kovarikova, Simona
Urine protein to creatinine ratio (UPC) in puppies and young dogs
ESVNU‐P‐15
Kovarikova, Simona
Comparison of two quantitative methods for urine protein measurement used for calculation
of urine protein to creatinine ratio (UPC)
ESVNU‐P‐16
Perondi, Francesca
Erythrocyte and platelet changes in dogs managed with hemodialysis
ESVNU‐P‐17
Méric, Tristan
Retrospective study of cystinic lithiasis in dogs in France
ESVNU‐P‐18
Zambarbieri, Jari
Urinalysis alterations in dogs affected with urinary tract infection: A retrospective
case/control study
ESVNU‐P‐19
Cocci, Andrea
Cystoscopic‐assisted urinary bladder lavage in male cats with recurrent urethral obstructions:
treatment and outcome in 9 cases
ESVNU‐P‐20
Lund, Heidi Sjetne
Increase in canine cystine urolithiasis in Norway
ESVNU‐P‐21
Lund, Heidi Sjetne
Outbreak of acquired Fanconi syndrome in dogs in Norway
European Society of Veterinary Oncology
ESVONC‐P‐1
Gould, Emily
Acid suppressants alter neoplastic mast cell structure and cytokine expression
ESVONC‐P‐2
Törner, Katrin
Do feline solid and cystic pancreas tumors influence different pancreatic lipases?
ESVONC‐P‐3
Purzycka, Katarzyna
Tumours of the retrobulbar space in cats: 31 cases
ESVONC‐P‐4
Chavalle, Thomas
Are severe adverse events commonly observed in dogs during cancer chemotherapy? A
retrospective study on 155 dogs
ESVONC‐P‐5
Pierini, Alessio
Retrospective comparative analysis of some clinical and clinico‐pathological features
of canine lymphoma from Italy and Thailand
ESVONC‐P‐6
Del Castillo, Noemí
Toceranib phsophate in the management of insulinoma in dogs
ESVONC‐P‐8
Agnoli, Chiara
Comparison between oral chlorambucil and dose‐intense chemotherapy for the treatment
of feline transmural low‐grade alimentary T‐cell lymphoma
ESVONC‐P‐9
Ignatenko, Nataliia
The effect of age and body weight on the incidence of neutropenia in dogs receiving
chemotherapy
ESVONC‐P‐10
Iennarella‐Servantez, Chelsea
Collection, culture, and characterization of canine urothelial carcinoma organoids:
Reverse translational clinical research in the veterinary patient
International Society for Companion Animal Infectious Diseases
ISCAID‐P‐1
López, Maria Cristina
Chronic diarrhea as a main clinical sign of canine leishmaniosis: 22 cases
ISCAID‐P‐2
Santiago, Raquel
Prevalence of Babesia spp. in dogs diagnosed by polymerase chain reaction in Northeaster
of Spain
ISCAID‐P‐3
Yu, Jane
A study of 78 new Angiostrongylus cantonensis infections in Australian dogs
ISCAID‐P‐4
Yu, Jane
Pharmacokinetic profile of oral dosing of mefloquine to cats, as a potential treatment
for FIP
ISCAID‐P‐5
Baxarias, Marta
Serological and molecular study of Borrelia infection in dogs from different areas
in Spain
ISCAID‐P‐6
Lizer, Josh
A new in‐clinic titer test detects antibodies to canine distemper, adenovirus type‐2,
and parvovirus in 10 minutes with high accuracy
ISCAID‐P‐7
Brunet, Audrey
Detection of pathogens implicated in feline upper respiratory infections in cats without
respiratory signs hospitalized in a veterinary teaching hospital
ISCAID‐P‐8
Silvestrini, Paolo
Negative or low levels of antibodies in dogs with overt clinical disease associated
with leishmaniasis; 12 cases
ISCAID‐P‐9
Spitmann, Natascha
Development and validation of a species‐independent whole proteome tick‐borne encephalitis
virus antibody detection assay
ISCAID‐P‐10
Monteiro, Marta
Therapeutic approach to glomerulonephritis secondary to canine leishmaniosis in Portugal:
a questionnaire‐based survey
ISCAID‐P‐11
Walker, Hannah
A review of automated hand sanitizer dispensers in a teaching hospital
Society of Comparative Hepatology
SCH‐P‐1
Johnston, Andrea
Hepatocyte ploidy in cats with and without hepatocellular carcinoma
SCH‐P‐2
Jaffey, Jared
Serum 25‐hydroxyvitamin D in dogs with gallbladder mucocele
SCH‐P‐3
Martinez, Carlos
Use of NanoString technology® to evaluate gene expression patterns in dogs with neutrophilic
cholangitis
SCH‐P‐4
Devriendt, Nausikaa
The lidocaine/monoethylglycylxylidide liver function test to assess shunt closure
in dogs with attenuated congenital extrahepatic portosystemic shunts
SCH‐P‐6
Pascual, Mireia
Bile acid and bilirubin measurement in canine peritoneal fluid samples with and without
biliary tract rupture
SCH‐P‐7
Gabriel, Vojtech
Culture and Maintenance of Well‐Differentiated Canine Hepatic Organoids and Urinary
Bladder Organoids
ORAL RESEARCH COMMUNICATIONS
ESCG‐O‐1
Gastrointestinal protectants in clinical practice: Evaluation of prescription patterns
among general practitioners in Portugal
A. R. Novo Baptista1, B. São Braz2, R. A. Oliveira Leal3
1Hospital Escolar Veterinário; Faculdade de Medicina Veterinaria ‐ U.Lisboa, Lisbon,
Portugal; 2Centre for Interdisciplinary Research in Animal Health; Fac.Med.Vet.; U.Lisboa,
Lisbon, Portugal; 3Centro de Investigação Interdisciplinar em Sanidade Animal, Fac
Med Vet U.Lisboa, Lisbon, Portugal
Gastrointestinal protectants (GIP) are indiscriminately prescribed among general‐practitioners.
Proton pump inhibitors (PPIs) have become one of the most commonly prescribed acid
suppressants and concerns about its use has been raised. In 2018, an American College
of Veterinary Internal Medicine consensus statement was published, discussing the
evidence‐based and rational use of GIP.
The aim of this study was to evaluate the current prescription trends of GIP, assessing
if the consensus guidelines are being applied.
An observational cross‐sectional study was conducted using an online uploaded survey,
promoted through social media posts in Portuguese online veterinarian forums. General‐practitioners
answered comprehensive questions related to the most frequently prescribed GIP and
the underlying clinical context for its use. PPIs were detailed with questions assessing
a possible preference comparing to other compounds, frequency of administration and
relation with food intake, length of therapy, withdrawal practices and whether they
are prescribed in monotherapy or in association.
A total of 124 answers were obtained. PPIs were the most frequently prescribed GIP
accounting for 62% of the answers. Histamine type‐2 receptor antagonists (H2RAs) were
preferred in 16% while sucralfate was the option in 22%. The most common reasons evoked
for PPIs prescription were: gastrointestinal erosion or ulceration treatment (98%),
prophylaxis of gastric lesions in animals with nonerosive gastritis (89.5%), prevention
of reflux oesophagitis (80%), prophylaxis of steroid‐induced ulceration (70%) and
pancreatitis (61%). Eighty‐three veterinarians (67%) mentioned they prefer omeprazole
mainly due to a more scientific basis and a better perception of efficacy. 69% prescribe
omeprazole once‐daily while 24% recommend a twice‐daily administration. 91% mention
it should be administered short‐term before or with meal and 7% do not respect it.
Concerning length of therapy, while 51% of general‐practitioners do not extend treatment
for more than three weeks, 49% prescribe it for longer periods. Among them, 59% stop
it abruptly while 41% gradually reduce it. 34% of the veterinarians associate omeprazole
with H2RAs.
Results obtained on this survey support that PPIs, namely omeprazole, are the preferred
choice among Portuguese general‐practitioners. GIP are widely prescribed in gastrointestinal
erosion or ulceration, in accordance with ACVIM consensus recommendations. However,
they are still used prophylactically, when its therapeutic value is discussable. Once‐daily
therapy, the association with H2RAs and an abrupt withdrawal after 3 weeks of use
are incorrectly recommended, stressing the need for a better awareness about GIP use
in daily clinical practice. Further studies are needed to extrapolate these conclusions
to other European countries.
Disclosure
Conflicts of Interest Study funded by: Project UIDP/CVT/00276/2020 (funded by FCT)
(overall, there is no Conflict of interest but a disclosure to report).
ESCG‐O‐2
Evaluation of omeprazole use for the treatment of dysrexia and vomiting in cats with
chronic kidney disease
A. J. Spencer1, J. Quimby2, S. Maclane3, S. Hillsman4, P. Secoura5, J. M. Steiner6,
M. K. Tolbert6
1Small Animal Clinical Sciences, North Carolina State University, Raleigh, USA; 2Ohio
State University, Ohio, USA; 3Appalachian Animal Hospital, USA; 4University of Tennessee,
USA; 5North Carolina State University, Raleigh, USA; 6Texas A&M University, USA
Cats with moderate to advanced chronic kidney disease (CKD) often display gastrointestinal
(GI) signs such as nausea, vomiting, and decreased appetite. Acid suppressants such
as proton pump inhibitors (PPIs; e.g. omeprazole) are one of the most commonly prescribed
medications for the treatment of such clinical signs. There is no evidence that PPI
administration and, in particular omeprazole, will improve the GI signs associated
with CKD in cats. The aim of this study is to evaluate the effect of oral omeprazole
administration on appetite or vomiting in cats with moderate to advanced CKD.
Thirteen client‐owned cats with moderate to advanced CKD showing signs of inappetence
or vomiting were recruited at three academic institutions and one referral hospital
in the United States.
A multi‐institutional, prospective, double‐blinded, randomized, crossover study was
performed. Vomiting frequency and appetite were compared in cats with CKD treated
with either omeprazole or placebo. All cats were randomized to receive omeprazole
(1mg/kg PO q24hr) or placebo (lactose gel capsule PO q24hr) for 14 days. Cats underwent
a 14‐day washout between treatments. A daily log was completed by the owner assessing
appetite and vomiting during and for 14 days before and after each treatment. Appetite
was assessed by scoring system (decreased, unchanged, or increased) and percentage
of food consumed in a day (0%, 25%, 50% and 75%). An ANOVA was performed to determine
if average daily percentage food consumed, average appetite score, vomit percentage,
and total number of times vomited different between treatments.
The average age of the 13 cats was 12.8 years. IRIS staging was as follows: 46% (6/13)
stage II, 46% (6/13) stage III, and 8% (1/13) stage IV. All cats included had signs
of inappetence as noted by owners. A statistically significant difference was observed
for the percentage of food consumed between treatments (P = 0.0322). Post‐hoc analysis
revealed that on average, using least squares means, approximately 3% more food was
consumed with omeprazole treatment compared to placebo. There was no significant difference
in vomiting frequency between treatments.
Overall, this study showed that hyporexic cats with moderate to severe CKD consumed
a small but statistically significantly greater amount of food with omeprazole compared
to placebo; in contrast, no difference in vomiting was seen between the two treatments.
Disclosures
The mentoring author, Dr. Tolbert, is a paid consultant for TriviumVet and a paid
speaker for Kindred Biosciences. However, neither company paid for this study nor
do they have an interest in the study objectives or outcome.
ESCG‐O‐3
Endoscopic features of Feline Gastrointestinal Eosinophilic Sclerosing Fibroplasia:
A series of 4 cases
C. J. M. P. Tilmant1, M. Martineau1, E. Reyes‐Gomez2, G. Benchekroun1, V.G.M. Freiche1
1Internal medicine, Ecole Nationale Veterinaire d'Alfort, Maisons‐Alfort, France;
2Pathology, Ecole Nationale Veterinaire d'Alfort, Maisons‐Alfort, France
Feline Gastrointestinal Eosinophilic Sclerosing Fibroplasia (FGESF) is an uncommon
inflammatory condition of poorly defined etiology. The entity is characterized by
a densely fibrous and eosinophil‐rich intramural mass mainly involving the gastro‐duodenal
or the ileo‐colic junctions. To our knowledge, endoscopic features of FGESF have not
yet been reported. The aim of this retrospective study was to describe the endoscopic
lesions of FGESF. Inclusion criteria were histological diagnosis of FGESF in cats
in which an abdominal ultrasonography and a digestive tract endoscopy had been performed.
Two domestic shorthair cats and two Main Coon were included. The mean age was 3.9
±1.3 years. Animals initially presented with vomiting (n = 3), diarrhea (n = 3) and
weight loss (n = 2). A firm abdominal mass was palpated in 2 cats. Peripheral eosinophilia
was identified in 3 cats. One cat showed hypocobalaminemia and two cats had moderate
hypoalbuminemia. Ultrasonographic examination revealed a mass in the proximal duodenum
(n = 3) or at the ileo‐colic junction (n = 1). A focal thickening of the intestine
wall including a loss of stratification was identified in all cases. Moreover, an
isolated or multifocal abdominal lymphadenomegaly was noted in 3 cats.
Endoscopically, the main findings included a dysplastic and proliferative aspect of
the mucosa (n = 4), a large ulcer with a yellow to green discolored surface (n = 3)
and the identification of trichobezoars (n = 2). Diagnosis of FGESF was achieved after
histopathological analysis of per‐endoscopic biopsies in 2 cats or full‐thickness
surgical biopsies in 2 cats. Typical histological findings were associated to bacteria
within ulcers and intralesional fungi (consistent with phycomycetes) in two and one
cat respectively.
Our results suggest that FGSEF has a characteristic appearance endoscopically with
a dysplastic and proliferative aspect of the digestive mucosa, sometimes associated
with ulcerative lesions displaying yellow‐green discoloration. Therefore, FGESF should
be part of the differential diagnosis of proliferative and ulcerative lesions localized
in the gastro‐duodenal or ileo‐colic junction during endoscopy. Moreover, endoscopy
could guide the therapeutic management and it may even influence whether a surgical
resection is practicable.
Disclosures
No disclosures to report.
ESCG‐O‐4
Diarrhea has a greater impact on the fecal metabolome of dogs than does dietary intervention
R. Pilla1, H. Klein1, M. Schmidt2, A. L. Ziese2, F. Bresciani3, M. Werner2, L. Toresson4,
J. M. Steiner1, J. A. Lidbury1, S. Unterer2, J. Suchodolski1
1Department of Small Animal Clinical Sciences, Gastrointestinal Laboratory, Texas
A&M University, College Station, USA; 2Ludwig Maximilian University of Munich, Munich,
Germany; 3Department of Veterinary Medical Sciences, University of Bologna, Bologna,
Italy; 4Evidensia Specialist Animal Hospital, Helsingborg, Sweden
Diet can impact the canine gut microbiome, and is often investigated in the context
of novel ingredients (e.g., vegetable‐sourced protein, VEG) and/or significant changes
in macronutrient content (e.g., raw‐food diet, RAW). However, the gut microbiome is
intrinsically redundant, with many bacterial species occupying the same niche, or
performing the same functions. It is still unknown how those diets, and the microbial
changes they cause, impact the fecal metabolome, and how they compare to those induced
by gastrointestinal disease.
In this study, we describe the fecal metabolome in healthy dogs fed one of three types
of diet and in dogs with chronic (CE), acute non‐hemorrhagic (AD), or acute hemorrhagic
(AHDS) diarrhea. Fecal samples were collected from healthy dogs fed commercially available
traditional dry dog food (CON; n = 27), VEG (n = 9), or RAW (n = 12) exclusively for
at least 30 days prior to sampling. Fecal samples from dogs with CE (n = 7), AD (n
= 8), and AHDS (n = 10), obtained at the time of diagnosis, were used from previous
clinical trials.
Metabolites were extracted and untargeted liquid chromatography with high resolution
accurate mass spectrometry analysis was performed. Statistics were performed using
MetaboAnalyst 4.0. Significance of FDR corrected P‐values was set at q < 0.05.
A total of 145 named compounds were identified. Of those, only 3 were significantly
different between the diet groups, including solanidine (q < 0.001) and N‐acetyl‐D‐galactosamine
(q < 0.001). When dogs with CE were included in the comparison, a phytochemical, sinapine,
was found to be higher in dogs with CE compared to dogs fed either or the 3 diets.
However, dogs with acute diarrhea showed a strong shift in their fecal metabolic profiles,
with 38 metabolites significantly altered in AD, and 67 in AHDS when compared to CON,
VEG, and RAW. Changes included increases in amino acids such as tryptophan (AD q =
0.001, AHDS q < 0.001) and citrulline (AD and AHDS q < 0.001), tryptophan degradation
metabolites such as kynurenic acid (AD and AHDS q < 0.001) and indoleacrylic acid
(AD q = 0.002, AHDS q < 0.001), and compounds such as N‐acetyl‐L‐tyrosine (AD q =
0.003), which affects tryptophan metabolism by inhibiting the production of melatonin.
These results indicate that the impact of diet on the fecal metabolome, and consequently
in gut function, is smaller than the effect of gastrointestinal disease. Interestingly,
AD cases had been classified as uncomplicated, as they were mild and without any detectable
underlying pathology. These findings reveal that diarrhea, and in particular AD, has
a bigger impact on the fecal metabolome than previously acknowledged.
Disclosures
RP, JMS, JAL and JSS's salaries are paid by the GI Lab, which offers diagnostic tests
on a fee‐per‐service basis.
ESCG‐O‐5
Differential microRNA expression‐profiles in feces and serum of dogs with chronic
inflammatory enteropathy and with gastrointestinal cancer
J. G. Lyngby1, M. Gòdia2, A. T. Kristensen1, M. Fredholm3, E. Skancke4, S. Salavati5,
J. Morris6, D. J. Argyle7, C. R. Bjørnvad1, A. Sanchez8, N. H. Dupont1, S. Cirera9,
L. Nielsen1
1Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg c, Denmark;
2Center for Research in Agricultural Genomics, Universitat Autonoma of Barcelona,
Bellaterra (cerdanyola del vallès), Spain; 3Veterinary and Animal Sciences, University
of Copenhagen, Frederiksberg c, Denmark; 4Companion Animal Clinical Sciences, Norwegian
University of Life Sciences (NMBU), Oslo, Norway; 5Veterinary Clinical Studies, Royal
(Dick) School of Veterinary Studies and Roslin Institute, Midlothian, UK; 6School
of Veterinary Medicine, University of Glasgow, Glasgow, UK; 7Royal (Dick) School of
Veterinary Studies and Roslin Institute, Midlothian, UK; 8Molecular Genetics Veterinary
Service (SVGM), Universitat Autonoma of Barcelona, Bellaterra (cerdanyola del vallès),
Spain; 9Veterinary Animal and Sciences, University of Copenhagen, Frederiksberg c,
Denmark
Differentiating chronic inflammatory enteropathy (CIE) and gastrointestinal (GI) cancer
in dogs is challenging due to the similarities in clinical presentation. Fecal and
serum microRNAs show potential as biomarkers of human colorectal cancer. We hypothesized
that dogs with GI cancer had a different fecal and serum microRNA expression profile
than healthy dogs or dogs with CIE.
Twenty‐one dogs, 6 healthy, 9 with CIE and 6 with GI cancer, were prospectively recruited
based on detailed diagnostic work‐up. Dogs were excluded if they had co‐morbidities
or immunomodulatory medications. Fecal and serum samples were frozen within 1 hour
of collection. RNA was extracted and smallRNAseq was performed. Processed reads were
mapped to the canine genome (CanFam3.1)
Age and gender were not significantly different comparing groups, but cancer dogs
were larger breeds and had a higher body weight (P = 0.04). Differential expression
(DE) of miRNAs comparing GI cancer and CIE were, in feces: miR‐451 (2.25 fold change
(FC), P < 0.01); and in serum, miR‐1 (1.58 FC, P = 0.02), miR‐122 (2.38 FC, P =
0.04), miR‐133a (3.8 FC, P < 0.01), miR‐133c (3.56 FC, P < 0.01), miR‐143 (2.07 FC,
P = 0.02) and miR‐145 (3.38 FC, P < 0.01). Comparing GI cancer and healthy dogs the
same DE miRNAs as above and miR‐194 (‐3.65 FC; P < 0.01) and miR ‐320 (‐2.14 FC; P
= 0.04) were seen in feces. No DE miRNAs were found comparing CIE and healthy dogs.
In conclusion, we identified DE miRNAs associated to CIE and GI cancer. Confirmations
using qPCR on a larger study population is warranted to confirm the applicability
of these miRNAs as diagnostic biomarkers.
Disclosures
This study was funded by the Independent Research Fund Denmark.
ESCG‐O‐6
Evaluation of anamnestic and clinicopathologic factors that might explain the poor
correlation between pancreatic lipase concentrations (DGGR‐lipase and Spec cPL) and
ultrasonographic evidence of pancreatitis in dogs
P. H. Kook1, K. Hammes2
1Clinic for Small Animal Internal Medicine, University of Zurich, Zürich, Switzerland;
2Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
Pancreatic lipase concentrations and pancreatic ultrasound (US) are the two cornerstones
for a clinical diagnosis of pancreatitis in dogs. Multiple studies have shown that
results of both modalities are poorly correlated, which complicates the diagnosis
pancreatitis.
We therefore investigated which anamnestic and clinicopathologic factors affect the
pancreatic US evaluation, and which clinicopathologic parameters correlate best with
an ultrasonographic diagnosis of pancreatitis in dogs.
In this retrospective study, data from dogs presenting with gastrointestinal clinical
signs between 2016‐2020 were included if a DGGR‐lipase and a full abdominal ultrasound
examination were performed within 24h of each other. Spec cPL results were included
when taken from the same blood sample as the DGGR‐lipase. Dogs pretreated with corticosteroids
were excluded. Spearman correlation was used for measuring relationships. Cohens kappa
(k) was used as measure of agreement of two categorical variables. Mann‐Whitney U
test was applied to compare metric variables between US categories. Differences between
pancreatic US diagnosis and categorical variables were assessed using Chi‐square Test.
All tests were performed two‐tailed at a 5% level of significance. Data from 234 dogs
were available for analyses, of which 102/234 dogs also had a Spec cPL measured. DGGR‐lipase
and Spec cPL correlated significantly (ρ = 0.916, P < 0.001). There was only a slight
agreement for Spec cPL>400 mcg/l and US positivity (k = 0.147, 95% CI+/‐ 0.190, and
fair agreement for DGGR‐lipase >216 U/l and US positivity (k = 0.251, 95% CI +/‐ 0.125).
Median DGGR‐lipase, segmented neutrophils, alkaline phosphatase, and alanine aminotransferase
values were significantly higher in dogs with US positivity compared to dogs with
a normal pancreas, however the results of the latter 3 laboratory values were within
reference range. If the radiology submission form contained “suspicion of pancreatitis”
or “increased lipase”, the final US diagnosis was significantly more often positive
than expected. The presence of irregular or rounded contours, a hypoechoic, mixed‐echoic
or hyperechoic pancreas, an enlarged pancreas, hyperechoic mesentery, peripancreatic
effusion, gastric wall thickening, corrugated duodenum, a painful pancreatic area,
and patient age >6 years were also significantly associated with US positivity. DGGR‐lipase
and Spec cPL were significantly higher when rounded contours, an enlarged pancreas,
hyperechoic mesentery, and peritoneal effusion were present. Only DGGR‐lipase was
significantly higher when a hypoechoic pancreas, and significantly lower when a normal
pancreatic echogenicity was present.
Our findings might be useful when designing future studies assessing diagnostic performances
of lipase assays in the absence of a gold standard.
Disclosures
No disclosures to report.
ESCG‐O‐7
Hepatobiliary disorders and elevated blood urea nitrogen during the treatment are
possible prognostic factors for feline pancreatitis
K. Kusano1, K. Hayashi1, S. Ohashi1, S. Suzuki1, M. Okamura1, K. Shirai1, T. Kariya1
1Kariya animal hospital group, Tokyo, Japan
Feline pancreatitis (FP) has been increasingly diagnosed using the feline pancreas‐specific
lipase (Spec‐fPL) test in recent years. There are several reports on the prognostic
factors for FP; however, the information on the utility of those factors or the association
of the prognostic factors with other diseases is limited. In this study, we evaluated
the prognostic impact of the laboratory findings in FP.
The medical records of patients with FP between September 2014 and July 2019 were
reviewed. Seventy‐eight patients hospitalized with FP were included in this study.
The diagnostic criteria for FP included clinical signs, Spec‐fPL results (>3.5 μg/L),
and ultrasonographic findings. The presence of other gastrointestinal disorders or
neoplastic diseases was ruled out via ultrasonography. Fisher’s exact test was performed
to determine the correlation between the mortality and the clinical signs, the findings
of the physical examination, laboratory examination, or imaging. P values less than
0.05 were considered statistically significant.
All patients underwent treatment; 68 patients eventually survived, while 10 died.
Significant correlations were found between mortality and the following variables:
hypothermia (P = 0.04), icterus (P = 0.025), or hyperechogenicity and enlargement
of the liver (P = 0.004) at the first visit; increase in the value of alkaline phosphatase
(P = 0.007), γ‐glutamyltransferase (P = 0.015), or total bilirubin (P = 0.006) 3‐5 days
after the treatment; and elevated white blood cell (P = 0.006), total bilirubin (P
= 0.03), or blood urea nitrogen (P = 0.03) during the treatment. There were no significant
differences in the findings of blood examination between survivors and nonsurvivors
at the first visit.
These results suggest that the increase in the value of hepatic enzymes during treatment
is a possible prognostic factor and hepatobiliary disorders such as extrahepatic biliary
obstruction, cholangiohepatitis, or hepatic lipidosis have an influence on the prognosis
of FP. However, it is difficult to predict the prognosis of FP by blood examination
at the first visit. Therefore, it is important to detect hepatobiliary disorders via
ultrasonography and monitor hemodynamics and inflammation by continuous blood examination
to predict the prognosis of FP.
Disclosures
No disclosures to report.
ESCG‐O‐8
The effect of assisted enteral feeding on treatment outcome in dogs with inflammatory
protein‐losing enteropathy
L. Economu1, A. Kathrani1
1The Royal Veterinary College, North Mymms, UK
Assisted enteral feeding can help improve perioperative outcome in humans with inflammatory
bowel disease. The effects of assisted enteral feeding on treatment outcome have not
been previously investigated in dogs with inflammatory protein‐losing enteropathy
(PLE). Therefore, the aim of this study was to determine if dogs with inflammatory
PLE that had an enteral feeding tube placed had a better outcome to treatment compared
to dogs with inflammatory PLE that did not have an enteral feeding tube placed.
A retrospective study design at a UK referral teaching hospital included 20 dogs with
inflammatory PLE that had enteral feeding tube placement within 5 days of gastrointestinal
biopsy. The comparison group consisted of 37 dogs with inflammatory PLE that did not
have an enteral feeding tube placed. The minimum follow‐up time required after date
of diagnosis was 4 months. Positive outcome was defined as survival time greater than
4 months or death unrelated to PLE. Negative outcome was defined as death related
to PLE less than 4 months after diagnosis.
Dogs in the enteral feeding tube group had a significantly higher canine chronic enteropathy
clinical activity index (CCECAI) compared to dogs in the non‐enteral feeding tube
group (P < 0.001, median (range): enteral feeding tube group = 14 (7‐19); non‐enteral
feeding tube group = 7 (4‐13)) and significantly lower appetite scores (P < 0.001,
enteral feeding tube group = 5 hyporexic, 14 anorexic, 1 unknown; non‐enteral feeding
tube group = 19 unchanged, 10 hyporexic, 7 anorexic, 1 unknown) at diagnosis. In the
enteral feeding tube group, 75% (15/20) had a positive outcome compared to 46% (17/37)
in the non‐enteral feeding tube group. Assisted enteral feeding was associated with
increased odds of a positive outcome in dogs with inflammatory PLE (OR 3.2, 95% CI
1.0‐10.5), with a trend towards significance (P = 0.054).
Despite statistical significance not being reached with treatment outcome between
the two groups, a greater proportion of dogs in the enteral feeding tube group had
a positive outcome compared to dogs in the non‐enteral feeding tube group, despite
the former group having a significantly higher CCECAI at diagnosis. Therefore, this
study suggests assisted enteral support in dogs with inflammatory PLE could be associated
with improved clinical outcome and hence should be actively addressed in these cases.
However, larger studies that account for confounding variables such as disease severity
and appetite are needed to definitively quantify the impact of assisted enteral feeding
on treatment response and outcome in dogs with inflammatory PLE.
Disclosures
No disclosures to report.
ESCG‐O‐9
Short‐term feeding with high‐fat diet induces dysbiosis‐associated changes of fecal
metabolites consistent with changes in serum metabolomics in dogs
K. Allenspach1, J. Suchodolski2, V. Gabriel1, C. Iennarella‐Servantez1, T. Atherly1,
D. Borcherding1, Y.M. Ambrosini1, A. E. Jergens1, L. R. Kilburn3, A. Bourgois‐Mochel1,
M. Rossoni‐Serrao3, J. Mochel1
1Veterinary Clinical Sciences, Iowa State University, Ames, USA; 2Department of Small
Animal Clinical Sciences, Texas A&M University, College Station, TX, USA; 3Department
of Animal Sciences, Iowa State University, Ames, USA
Many chronic diseases leading to high morbidity and mortality in today’s western societies,
including diabetes mellitus, inflammatory bowel disease, and colorectal cancer have
epidemiologically been linked to the consumption of high fat diets (HFD). Of the large
animal models used in translational research, the dog is especially relevant because
canine gut anatomy, physiology and diet have adapted to that of humans during domestication.
Consequently, the composition of the gut microbiota is strikingly similar between
dogs and humans, with 60% taxonomic and functional overlap. We have previously shown
that repeated exposure to HFD triggers dysbiotic changes of the gut microbiome in
dogs, concomitant with changes in the serum metabolome. However, changes of the fecal
metabolome after HFD feeding have not been reported so far.
Fecal samples were collected before (33% fat) and after (47% fat) HFD feeding for
2 weeks in 8 healthy adult Beagle dogs. Untargeted metabolomics analysis was performed
by the West Coast Metabolomics Center at the University of California. Analytes were
separated using an Agilent 6890 gas chromatograph and mass spectrometry was performed
on a Leco Pegasus IV time of flight mass spectrometer. Differences in the abundance
of serum metabolites between study groups were evaluated using a Mann‐Whitney test
in Prism 5. For multivariate analysis, data were normalized to the sum of the total
spectral integral, log transformed, mean centered, and divided by the standard deviation
of each variable prior to multivariate analysis. PCA was performed and a Random Forest
Analysis was generated using MetaboAnalyst 4.0.
A total of 684 metabolites were detected. Of those, 188 were identified metabolites,
while 496 lacked full structural identification. Twenty‐five metabolites differed
significantly between pre‐ and post‐HFD treatment. Of these, 9 were identified metabolites,
namely zymosterol, gamma‐tocopherol, tocopherol‐acetate, levoglucosan, glycerol, dihydrocholesterol,
D‐erythrosphingosin, beta‐sitosterol, and cholesterol. The Random Forest analysis
identified the compounds with the highest degree of separation between groups to be
cholesterol, zymosterol, dihydrocholesterol, beta‐sitosterol and gamma‐tocopherol.
Pathway analysis revealed that 85 and 46 of differential metabolites were implicated
in the steroid and the primary bile acid biosynthesis pathways, respectively. These
results concur with our previous findings of reduced lipid metabolites in the serum
after HFD in dogs.
This is the first report correlating fecal and serum metabolome in dogs after HFD.
Our data show clear effects of HFD‐induced fecal metabolome changes in the cholesterol
and primary bile acid biosynthesis pathways, leading to related lipid metabolism changes
in the serum.
Disclosures
No disclosures to report.
ESCG‐O‐10
Histopathological concordance of concurrent duodenal and ileal biopsy specimens in
dogs
S. J. E. Caulfield1, S. L. Priestnall2, A. Kathrani3
1Queen Mother Hospital for Animals, Royal Veterinary College, Hertfordshire, UK; 2Pathobiology
and Population Sciences, Royal Veterinary College, Hertfordshire, UK; 3Small Animal
Internal Medicine, Queen Mother Hospital for Animals, Royal Veterinary College, Hertfordshire,
UK
Dogs with gastrointestinal signs frequently undergo investigation via collection of
endoscopic or surgical gastrointestinal biopsy. The current evidence in canine chronic
enteropathy (CE) supports concurrent sampling of duodenal and ileal biopsy via endoscopy
to prevent oversight of ileal lesions. However, previous studies have not been performed
in dogs with non‐CE diagnoses or contrasting the concordance between both sites in
full‐thickness biopsy specimens with those of endoscopic biopsy specimens. Therefore,
our objective was to compare histopathological concordance in concurrent duodenal
and ileal biopsies collected via endoscopy or surgical biopsy in all dogs undergoing
this procedure. A second aim was to determine if signalment, clinicopathological variables
and ultrasound abnormalities helped to distinguish concordant from discordant samples
at these two sites.
The electronic medical record database was searched for all canine cases that had
both sites biopsied. One hundred and forty‐one dogs were included, 128 underwent concurrent
endoscopic biopsy of the duodenum and ileum and 13 underwent concurrent surgical biopsy
of both sites. The histopathological concordance of inflammatory cell type (intraepithelial
lymphocytes, lamina propria lymphocytes, plasma cells, eosinophils and neutrophils),
neoplasia and severity (mild, moderate, severe) between the duodenum and ileum was
assessed for each case. A board‐certified veterinary pathologist reviewed all suitable
cases. Comparison of signalment, clinicopathological variables and ultrasound abnormalities
between concordant and discordant cases was performed using logistic regression.
Our results showed that 5 out of 13 (38%) full‐thickness biopsy specimens were fully
concordant in both cell type and severity compared to 62 out of 128 (48%) endoscopic
biopsy specimens. Full discordance for both cell type and severity was demonstrated
in 2 out of 13 (15%) full‐thickness biopsy specimens and in 26 out of 128 (20%) endoscopic
biopsy specimens. Four out of 13 (31%) full‐thickness biopsy specimens demonstrated
discordance in severity alone, whereas 2 out of 13 (15%) had discordant cell type
alone. Nineteen of the 128 (15%) endoscopic biopsy specimens were discordant in severity
alone, whereas 21 out of 128 (16%) cases were discordant in cell type alone; including
3 neoplasia cases solely in the duodenum (1 adenocarcinoma and 2 lymphoma) and 1 lymphoma
case solely within the ileum. There were no significant signalment, clinicopathological
variables or ultrasound abnormalities that distinguished concordant from discordant
samples.
In conclusion, concordance was comparable for full‐thickness and endoscopic biopsy
specimens at both sites. However, the frequency of discordance seen in both full and
endoscopic biopsy specimens necessitates sampling of both sites.
Disclosures
Dr Aarti Kathrani has received or is receiving funding for studies from PetPlan Charitable
Trust, PetSavers, American Academy of Veterinary Nutrition and Waltham and Purina.
Professor Simon Priestnall works as a consultant histopathologist for the Texas A&M
University GI Lab. Dr Sarah Caulfield has no disclosures to report.
ESCG‐O‐11
Comparison of interpretation of fecal culture results between three different laboratories
as well as the PCR‐based Dysbiosis Index in dogs
M. Werner1, J. Suchodolski2, J.A. Lidbury2, J.M. Steiner2, K. Hartmann1, S. Unterer1
1Clinic of Small Animal Internal Medicine, Ludwig‐Maximilians‐Universitaet, Munich,
Germany; 2Gastrointestinal Laboratory, Texas A&M University, College Station, USA
Although the clinical utility of fecal cultures for assessment of dysbiosis is considered
limited in human medicine, they are frequently performed in veterinary medicine. Recently,
a PCR‐based fecal dysbiosis index (DI) has been established to differentiate normo‐
and dysbiosis. The aim of this study was to evaluate the inter‐laboratory variability
in conventional bacteriological fecal culture results between 3 laboratories (A, B,
and C), and to compare the interpretations of culture with those of the PCR‐based
DI.
Fecal cultures were performed in 36 dogs (18 healthy and 18 with chronic diarrhea)
and results interpreted to reflect either normobiosis or dysbiosis. Total bacteria
and 7 bacterial groups (Faecalibacterium, Fusobacterium, Turicibacter, E. coli, Streptococcus,
Blautia, C. hiranonis) were analyzed by qPCR to calculate the fecal DI. The agreement
in interpretation of dysbiosis between the 3 laboratories as well as between the two
different methods (i.e., fecal culture versus DI) was determined using the Cohen’s
Kappa test.
DI differed significantly between dogs with chronic diarrhea and healthy dogs (P =
0.0002), whereas fecal cultures did not show any significant difference between both
groups. ĸ‐values revealed no or only slight agreement between A/B (ĸ = 0.15), B/C
(ĸ = ‐0.06), or A/C (ĸ = 0.07). Moreover, all three laboratories showed no agreement
with the Dysbiosis Index (DI/A: ĸ = −0.21; DI/B: ĸ = −0.33; DI/C: ĸ = −0.25).
The inter‐laboratory variation of bacteriological fecal culture results in this study
population was high Also, the diagnostic value of fecal cultures to assess intestinal
dysbiosis is low.
Disclosures
No disclosures to report.
ESCG‐O‐12
Canine acute hemorrhagic diarrhea syndrome: A retrospective evaluation of data for
the identification of possible prognostic markers
L. Nelkel1, I. Schwendenwein2, A. Tichy3, I. A. Burgener1, N. Luckschander‐Zeller1
1Department for Companion Animals and Horses, Small Animal Internal Medicine, University
of Veterinary Medicine, Vienna, Austria; 2Department for Pathobiology, Central Laboratory,
University of Veterinary Medicine, Vienna, Austria; 3Department for Biomedical Sciences,
Biostatistics, University of Veterinary Medicine, Vienna, Austria
Acute hemorrhagic diarrhea syndrome (AHDS) describes a syndrome of bloody, sometimes
life‐threatening diarrhea. However, there is currently no marker to distinguish uncomplicated
from severe cases. Therefore, the aim of this retrospective study was the identification
of prognostic factors from signalement, history, clinical symptoms (AHDS‐score), laboratory
results and therapeutic regime in order to predict the disease‐course. 191 AHDS‐cases
from 2017 to 2018 were enrolled in this retrospective study. Inclusion criteria consisted
of an acute onset of bloody diarrhea, no previous treatment and no other diagnosed
condition causing bloody diarrhea. For statistical analysis, the SPSS statistic program
was used. P < 0.05 was considered statistically significant.
The incidence of AHDS was higher during winter and springtime. Middle aged and small
dogs were overrepresented. Significantly longer hospitalization was observed in patients
with decreased body temperature (P < 0,001), higher AHDS‐score (P = 0,042), increased
hematocrit (P < 0,001), reduced leukocyte concentration (P = 0,009) and toxic neutrophils
(P < 0,001) at presentation. Older animals (P = 0,005), lower body temperature (P
= 0,015), higher hematocrit (P = 0,001), lower leukocytes (P = 0,031) and a higher
AHDS‐score (P = 0,007) triggered antibiotic treatment. A plasma transfusion was more
likely required in patients with lower bodyweight (P = 0,010), lower body temperature
(P < 0,001), and haemoconcentration (P < 0,001).
Older age and higher AHDS score at time of presentation predicted antibiotic use.
Hypothermia, haemoconcentration and leukopenia are associated with more severe courses
of AHDS and might serve as useful negative prognostic markers.
Disclosures
No disclosures to report.
ESVC‐O‐1
The Mitral INsufficiency Echocardiographic (MINE) score: A severity classification
of myxomatous mitral valve disease in dogs
T. Vezzosi1, G. Grosso2, R. Tognetti2, V. Meucci2, V. Patata3, F. Marchesotti3, O.
Domenech3
1Department of Veterinary Sciences, Department of Veterinary Sciences, University
of Pisa, Pisa, Italy; 2University of Pisa, Pisa, Italy; 3Anicura Istituto Veterinario
di Novara, Novara, Italy
The ACVIM guidelines are commonly used for the clinical classification of dogs with
myxomatous mitral valve disease (MMVD). From an echocardiographic point of view, the
evaluation of MMVD severity is based on cardiac remodeling, quantification of mitral
regurgitation and estimation of left ventricular filling pressure. The aim of this
study was to propose an easy‐to‐use echocardiographic severity classification of mitral
insufficiency in dogs.
This retrospective, multicenter observational study included dogs with MMVD imaged
between 2011 and 2019, of which an updated follow‐up was available in December 2019.
The proposed severity classification was based on four echocardiographic parameters:
left atrium‐to‐aorta ratio (LA/Ao), left ventricular end‐diastolic diameter normalized
(LVIDDn), fractional shortening (FS%) and E‐wave transmitral peak velocity (E‐vel).
Specific echocardiographic cut‐offs were defined based on previous prognostic studies
on MMVD, and severity scores were assigned as follows: mild (score: 4‐5), moderate
(score: 6‐7), severe (score: 8‐12), end‐stage (score: 13‐14). Clinical usefulness
of this score was tested by evaluating the association with survival. Long‐term outcome
was assessed by telephone interviews with the owners. Survival was analyzed using
Kaplan‐Meier curves, logrank tests and Cox’s proportional hazards. The ROC curve analysis
and the Youden index were used to define the best cutoff score to predict cardiac
mortality.
A total of 647 dogs with MMVD were included, 296 in ACVIM stage B1, 189 in ACVIM stage
B2 and 162 in ACVIM stage C‐D. Of these, 181 died for cardiac‐related causes and 104
died for no cardiac‐related causes. Median survival time was significantly different
(P < 0.05) between all the proposed severity classes: mild [2344 days, 95% confidence
interval (CI) 1877‐2810 days], moderate (1852 days, 95%CI 1145‐2559 days), severe
(710 days, 95%CI 597‐819 days) and end‐stage (171 days, 95%CI 107‐235 days). A total
score > 8 was predictive of cardiac death (AUC = 0.83, 95%CI 0.79‐0.87; P < 0.0001;
sensitivity 70% and specificity 82%). According to multivariable analysis, the independent
predictors of cardiac mortality were LA/Ao [hazard ratio (HR) = 2.22; 95%CI 1.45‐3.38;
P = 0.0002], LVIDDn (HR 2.56; 95%CI 1.34‐4.89; P = 0.0005), FS% (HR = 1.02; 95%CI
1.01‐1.04; P = 0.0008) and E‐vel (HR = 4.39; 95%CI 2.52‐7.64; P < 0.0001).
In conclusion the MINE score, proposed as an echocardiographic severity classification
of MMVD, has proven to be clinically effective since it is associated with survival.
This classification provides prognostic information and could be useful for an objective
echocardiographic assessment of MMVD.
Disclosures
No disclosures to report.
ESVC‐O‐2
The longitudinal outcome of canine myxomatous mitral valve disease (LOOK‐Mitral) study:
Baseline characteristics
A. Franchini1, M. Borgarelli2, S. Crosara3, J. Haggstrom4, S. Lahmers2, G. Menciotti2,
W. Tyrrell5, S. Rosenthal5, J. Abbott2
1Small animal clinical science, Virginia‐Maryland College of Veterinary Medicine,
Blacksburg, USA; 2Virginia‐Maryland College of Veterinary Medicine, Blacksburg, USA;
3University of Parma, Parma, Italy; 4Swedish University of Agricultural Sciences,
Uppsala, Sweden; 5CVCA Cardiac Care for Pets, Leesburg, USA
The longitudinal outcome of canine myxomatous mitral valve disease (MMVD) registry
(LOOK‐Mitral registry) was established to describe the natural history and predictors
of outcome in affected dogs. This study is aimed to describe the baseline characteristics
of dogs in the LOOK‐mitral registry. Dogs with echocardiographic evidence of MMVD
were prospectively enrolled by thirteen referral centers. A total of 6,102 with MMVD
were included. Median age was 13 years (2‐22 years) and mixed breed was most common
breed (n = 1.360, 22%). Concomitant diseases were reported in 2,459 dogs with chronic
respiratory diseases occurring most frequently (34%), followed by presence of azotemia
(15%) and orthopedic diseases (13%). With regard to disease severity, 65% of the dogs
were in ACVIM Stage‐B1, 15% in Stage‐B2 and 20% in Stage‐C. Dogs in Stage‐B1 were
younger (P < 0.0001) than dogs in in other stages. Murmur intensity, heart rate during
physical examination and vertebral heart score were positively correlated with severity
of the disease. Dogs in Stage‐C were more likely to have tachypnea (P < .0001), dyspnea
(P < .0001), cough (P < .0001), syncopal episodes (P < .0001) and tachyarrhythmias
(P < .0001) compared to dogs in Stage‐B1 and B2. Echocardiographic indices of size
and function were respectively correlated, positively and negatively with severity
of disease. Interestingly, 243 dogs out of the 333 with an increased normalized end‐systolic
left ventricle internal diameter (>1.26) weighed <20 kg. Concomitant diseases occurred
more frequently in dogs in Stage‐B than in dogs in Stage‐C (P < .0001).This study
describes MMVD in a large population of dogs and provides new findings of clinical
relevance.
Disclosures
Dr. Michele Borgarelli receives financial support from Ceva Sante Animale for studies
unrelated to this Abstract. Dr. Alessandra Franchini receives finical support from
Ceva Sante Animale for her PhD.
ESVC‐O‐3
The prognostic value of clinical, radiographic, echocardiographic variables and biomarkers
levels for assessing risk of the onset of heart failure or cardiac death in dogs with
preclinical myxomatous mitral valve disease: The DELAY Study
M. Borgarelli1, The Delay Study Investigators2
1Small Animal Clinical Sciences, Virginia Maryland College of Veterinary Medicine,
Blacksburg, USA; 2DELAY study investigators, Virginia Maryland College of Veterinary
Medicine, Blacksburg, USA
Introduction: The pre‐clinical phase of myxomatous mitral valve disease (MMVD) includes
a heterogeneous group of dogs and the identification of dogs at higher risk of developing
heart failure (HF) or cardiac death is of clinical relevance. Objectives: to identify
the prognostic value of clinical, radiographic and echocardiographic variables, as
well as cardiac biomarkers N‐terminal pro brain natriuretic peptide (NT‐proBNP) and
cardiac troponin I in dogs with preclinical MMVD. Animals: 168 dogs with pre‐clinical
MMVD and left atrium to aortic root ratio (LA:Ao) >1.6 and normalized left ventricular
end‐diastolic diameter (LVEDDn) >1.7. Methods: Prospective, randomized, multicenter,
single‐blinded, placebo‐controlled study. Clinical parameters radiographic and echocardiographic
variables and cardiac biomarkers levels were compared at different time points. Using
receiving operating curves analysis, best cut off for selected variables were identified
and risk to develop the study end point at 6 months interval was calculated. Results:
LA:Ao > 2.1 (hazard ratio [HR] 3.2 confidence interval [CI] 1.9‐5.6), normalized left
ventricular end‐diastolic diameter > 1.9 (HR 6.3, CI 3.3‐11.8) early transmitral peak
velocity (E peak) > 1 m/sec (HR 3.9 CI 2.3‐6.7) and NT‐proBNP 1.500 ρmol/L (HR 5.7
CI 3.3‐9.5) were associated with increased risk of HF or cardiac death. Dogs with
LA:Ao >2.1, E peak > 1 and NT‐proBNP > 1.500 ρmol/L have a higher risk to reach the
combined end‐point at 12 months. Conclusions: a model including echocardiographic
variables and NT‐proBNP can be used to identify dogs with preclinical MMVD at higher
risk to develop HF or cardiac death at 12 month.
Disclosures
All the other authors have received funding from Ceva Santé Animale within the last
5 years for some or all of the following activities: research, travel, speaking fees,
consultancy fees, and preparation of educational materials. Assessment of N‐terminal
pro‐brain natriuretic peptide was sponsored by IDEXX BioResearch, Vet Med Labor GmbH,
Ludwigsburg, Germany
ESVC‐O‐4
Prevalence of mitral regurgitation in Cavalier King Charles Spaniels with no or low‐grade
murmurs
G. Menciotti1, A. Franchini2, H. Jeong1, J. Abbott3, S. Lahmers1, M. Borgarelli1
1Small Animal Clinical Sciences, VA‐MD College of Veterinary Medicine, Blacksburg,
USA; 2Biomedical and Veterinary Sciences, VA‐MD College of Veterinary Medicine, Blacksburg,
USA; 3Small Animal Clinical Sciences, University of Tennessee, Knoxville, USA
Cavalier King Charles Spaniels (CKCSs) have a higher prevalence of myxomatous valvular
degeneration (MMVD) compared to similarly aged dogs of other breeds. In this study,
we report the prevalence and severity of mitral regurgitation (MR) (defined as presence
of MR every cardiac cycle in at least one echocardiographic view), in CKCSs that have
no or low‐grade murmurs. CKCSs were screened as part of another study. Eligible dogs
were older than 1 year of age, without concomitant cardiac disease, or heart murmurs
>2/6. All dogs underwent cardiac auscultation and if a murmur ≤2/6 was heard, or there
was no murmur, an echocardiogram was performed. The severity of MR was subjectively
assessed by color Doppler echocardiography as trivial, trace, mild, moderate, or severe.
138 dogs were examined. On screening examination, murmur distribution was as follows:
95 = no murmur, 5 = 1/6, 20 = 2/6, 16 = 3/6, and 2 = 4/6. 120 CKCSs met inclusion
criteria, 119 tolerated echocardiography and two of these had small, inaudible patent
arterial ducts. MR severity distribution in the remaining 117 CKCSs was as follows:
40 = no MR, 4 = trivial, 6 = trace, 64 = mild, 3 = moderate. Intensity of murmur was
significantly associated with severity of MR (P = 0.002) and age (P = 0.0004). 79%
(37) of dogs older than 5 years of age and 94% (16) of dogs older than 7 years of
age had more than trivial MR despite no or low‐grade murmurs. 55 (59%) CKCSs with
no murmur had more than trivial MR. In conclusion, we report a high prevalence of
echocardiographically detected MR in CKCSs with no or low‐grade murmurs.
Disclosures
Menciotti, M. Borgarelli, A. Franchini receive research support by CEVA Sante Animale.
The data used in this abstract is acquired as part of a study funded by American Kennel
Club Canine Health Foundation (AKC 02649).
ESVC‐O‐5
Polymorphisms in the serotonin transporter gene do not associate with myxomatous mitral
valve disease or circulating serotonin levels in Cavalier King Charles Spaniels
M. J. Reimann1, K. Meurs2, M. Fredholm3, L. B. Christiansen3, S. E. Cremer4, J. E.
Møller5, J. Häggström6, J. Lykkesfeldt3, L. H. Olsen3
1Veteterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark;
2Clinical Sciences, North Caroline State University, Raleigh, USA; 3Veterinary and
Animal Sciences, University of Copenhagen, Frederiksberg, Denmark; 4Veterinary Clinical
Sciences, University of Copenhagen, Frederiksberg, Denmark; 5Cardiology, Copenhagen
University Hospital Rigshospitalet, Copenhagen, Denmark; 6Clinical Sciences, Swedish
University of Agricultural Sciences, Uppsala, Sweden
The neurotransmitter serotonin has an impact on valvular degeneration and function,
and alterations in serotonin signaling have been reported in dogs with myxomatous
mitral valve disease (MMVD). In Maltese dogs, three single nucleotide polymorphisms
(SNPs) in the serotonin transporter (SERT) gene have been suggested to associate with
MMVD. The aim of this study was to investigate if MMVD severity and/or serum serotonin
concentrations are associated with the SERT polymorphisms in Cavalier King Charles
Spaniels (CKCS). Furthermore, ELISA and HPLC measurements of serum serotonin were
compared.
The study included 72 CKCS (42 females and 30 males; 7.8 [4.8;10.0] years (median
[Q1;Q3]) prospectively enrolled and parentally unrelated, allocated in the following
American College of Veterinary Internal Medicine (ACVIM) groups: A (n = 19), B1 (n
= 20), B2 (n = 20), C (n = 13). TaqMan genotyping assays were designed for the following
polymorphisms: c.814insG; c.1192delT; c.1323A/G in the SERT gene. Serum serotonin
concentration was determined using ELISA and HPLC. Multivariable regression analysis
was used to assess the influence of genotype, ACVIM group, sex and age on serum serotonin
concentration. Spearman correlation, paired t‐test and difference plot were used to
compare serotonin ELISA and HPLC measurements.
Taqman analyses revealed no polymorphisms in any of the selected locations of the
SERT gene in the CKCS. ACVIM group, age and sex did not influence serum serotonin
concentration except for males (432.5 [358.2;535.2] mg/mL), who had higher serum serotonin
concentrations, measured by HPLC analysis, compared to females (342.7 (250.7‐454.3)
mg/mL) (P = 0.03). Serum serotonin concentration measured by ELISA correlated with
HPLC measurements (ρ = 0.87 (P < 0.0001)) but was lower (mean difference = ‐22.00;
P = 0.02). The difference was independent of serum serotonin concentration (P = 0.2).
In conclusion, the selected SERT SNPs associated with MMVD in Maltese dogs were not
found in CKCS dogs and are therefore unlikely to impact MMVD pathophysiology or serum
serotonin concentration in this breed. ELISA and HPLC serum serotonin measurements
indicated good correlation but ELISA underestimated serotonin concentrations (constant
systematic error) compared to HPLC.
Disclosures
No disclosures to report.
ESVC‐O‐6
Accuracy of deep learning enabled software to measure vertebral heart size in dogs
with myxomatous mitral valve disease
K. T. Sykes1, S. Gordon1, J. Craig2, J. Vitt3, M. Rishniw4
1Small Animal Clinical Sciences, Texas A&M University, College Station, USA; 2EponaTech,
LLC, Paso Robles, USA; 3Department of Veterinary Clinical Medicine, University of
Illinois at Urbana‐Champaign, Urbana, USA; 4Veterinary Information Network, Davis,
USA
Clinicians routinely assess cardiomegaly by measuring vertebral heart size (VHS) from
a right lateral radiograph. Although this method has limitations, many clinicians
consider it a first line diagnostic test for staging myxomatous mitral valve disease
(MMVD). One of these limitations is related to the skill of the clinician in consistently
identifying the appropriate landmarks for measurement, both on the cardiac silhouette
and on the vertebrae. Deep‐learning‐enabled software has been developed and validated
in many medical imaging fields including veterinary medicine and in some fields it
is recommended over human measurements due to improved accuracy and repeatability.
Thus, such software may be capable of measuring VHS for clinicians without the need
to identify the landmarks.
The objective of this study was to assess the accuracy of novel deep‐learning‐enabled
software (DL, MetronMind) to measure VHS in dogs with MMVD.
One trained observer measured VHS from right lateral radiographs of 349 dogs with
MMVD of varying severity using two methods. The first method was the same as that
reported in many clinical studies and annotated as the traditional method (VHS‐T),
the second method was modified to mimic the method utilized by the DL and annotated
as modified (VHS‐M). The modification involved using a single measurement of 5 thoracic
vertebrae starting at the cranial aspect of the 4th vertebra, which was then divided
by 5 to establish the average length of 1 vertebra. This vertebral average length
was used to scale the length of the long and short axis dimensions and summed to yield
the VHS‐M. All other landmarks were identical between these two VHS measurement methods.
The VHS measured by DL is annotated as VHS‐DL and utilized the same landmarks as the
VHS‐M method.
Agreement was assessed between methods as follows: #1 VHS‐DL versus VHS‐M, #2 VHS‐DL
versus VHS‐T, #3 VHS‐T versus VHS‐M. Results are expressed as bias, bias standard
error, {95% bias confidence interval} and [95% agreement limits]. #1‐ 0.119(1.1%),
0.455(3.85%), {0.071(0.7%), 0.166(1.5%)}, [‐0.773(‐6.44%), 1.010(8.64%)], #2‐ 0.238(2.09%),
0.43(3.62%), {0.193(1.71%), 0.284(2.47%)}, [‐0.605(‐5.0%), 1.081(9.18%)], #3‐ 0.12
(0.99%), 0.152(1.22%), {0.104(0.86%), 0.136(1.12%)}, [‐0.179(‐1.40%), 0.418(3.38%)].
These results demonstrate good agreement between VHS‐T and VHS‐M performed by a human.
There was also good agreement between the VHS‐DL method and both the VHS‐M and the
VHS‐T. MetronMind DL software measurement of VHS in dogs with MMVD represents a novel
clinically useful tool. Enlargement of the teaching set of radiographs used by the
DL software may improve agreement between methods.
Disclosures
John Craig is the Vice President of EponaTech LLC, dba MetronMind.
ESVC‐O‐7
Correlation between radiographic vertebral heart size and vertebral left atrial size
and echocardiographic measurements of left heart size in Cavalier King Charles Spaniels
with preclinical myxomatous mitral valve disease
S. Wesselowski1, S. Gordon2, A. B. Saunders2, R.C. Fries3, K. T. Sykes2, J.P. Vitt4,
B. G. Boutet5, S. Kadotani4, K. Cusack2, B. W. Janacek2, J. P. Stack4, S. Hubert2,
C. M. Stoner2
1Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA; 2Texas
A&M University, College Station, TX, USA; 3Veterinary Clinical Medicine, University
of Illinois, Urbana, IL, USA; 4University of Illinois, Urbana, IL, USA; 5VETMED Emergency
and Specialty Veterinary Hospital, Phoenix, AZ, USA
Thoracic radiographs are often utilized as a screening tool to assess heart size in
dogs, with vertebral heart size (VHS) and vertebral left atrial size (VLAS) reported
as objective measurements of global heart size and left atrial size, respectively.
Cavalier King Charles Spaniels (CKCS) are predisposed to developing myxomatous mitral
valve disease (MMVD), with radiographs frequently used to screen for evidence of left‐sided
cardiomegaly secondary to MMVD. Normal VHS in CKCS (10.8 +/‐ 0.5) is reportedly higher
than non‐breed‐specific cut‐offs (9.7 +/‐ 0.5). Breed‐specific VLAS cut‐offs have
not been reported in CKCS. If available, use of breed‐specific radiographic cut‐offs
is recommended by the 2019 ACVIM MMVD consensus statement.
The objective of this study was to determine how echocardiographic measurements of
left ventricular and left atrial size correlate to VHS and VLAS in preclinical CKCS
not receiving cardiac medications.
Two‐hundred and thirty asymptomatic CKCS were prospectively enrolled and staged according
to the 2019 ACVIM MMVD consensus statement after undergoing a standard echocardiogram.
There were 14 CKCS in Stage A, 169 in Stage B1 (22 of which had echocardiographic
left ventricular or left atrial enlargement but not both) and 44 in stage B2. A right
lateral thoracic radiograph was obtained for measurement of VHS and VLAS in all dogs.
Spearman rank‐order correlation coefficients (rs) were calculated to determine the
strength of associations between echocardiographic and radiographic measurements.
The VHS was positively, but not strongly, correlated with normalized left ventricular
internal diameter at end‐diastole (LVIDdN) (rs = 0.59; CI:0.49‐0.67; P < 0.0001),
left atrial to aortic root ratio (LA:Ao) (rs = 0.52; CI: 0.40‐0.61; P < 0.0001) and
left atrial volume indexed to body weight (LA Vol/BW) (rs = 0.60; CI:0.50‐0.68; P
< 0.0001). The VLAS was positively and weakly correlated with LVIDdN (rs = 0.40; CI:0.28‐0.51;
P < 0.0001), LA:Ao (rs = 0.41; CI:0.29‐.51; P < 0.0001) and LA Vol/BW (rs = 0.43;
CI:0.31‐0.53; P < 0.0001). Correlation between VHS and a combination of LVIDdN+LA:Ao
(rs = 0.59; CI:0.49‐0.7; P < 0.0001) and LVIDdN+LA Vol/BW (rs = 0.60; CI:0.50‐0.28;
P < 0.0001) were also explored given the global nature of the VHS measurement, with
correlations found to be similar to those derived from individual echocardiographic
variables.
These findings suggest that in CKCS, neither VHS nor VLAS correlate strongly with
selected echocardiographic measurements of left ventricular or left atrial size. The
lack of strong correlation between VHS and VLAS to the echocardiographic measurements
of interest for MMVD staging may impact the performance of thoracic radiographs as
a screening tool in CKCS.
Disclosures
This project was funded by The Cavalier Health Foundation, IDEXX laboratories and
The Texas A&M Gastrointestinal Laboratory. Gordon, Saunders, Fries, Vitt, Boutet,
and Kadotani have received funding from Boehringer Ingelheim Animal Health GmbH within
the last 5 years for some or all of the following activities: research, travel, speaking
fees, consultancy fees, and preparation of educational materials. Gordon, Wesselowski
and Saunders have received funding from IDEXX laboratories within the last 5 years
for some or all of the following activities: research, travel, speaking fees, consultancy
fees, and preparation of educational materials.
ESVC‐O‐8
A prospective multicenter study to determine the accuracy of history, physical examination,
biochemical parameters and biomarkers to identify dogs with stage B2 degenerative
mitral valve disease: The HAMLET study
J. Wilshaw1, S. L. Rosenthal2, G. Wess3, D. Dickson4, L. Bevilacqua5, E. Dutton6,
M. Deinert7, R. Abrantes8, I. Schneider9, M. A. Oyama10, S. Gordon11, J. Elliott12,
D. Xia13, A. Boswood1
1Department of Clinical Science and Services, Royal Veterinary College, Hatfield,
UK; 2CVCA Cardiac Care for Pets, Towson, USA; 3Clinic of Small Animal Medicine, Ludwig‐Maximilians‐University
of Munich, Munich, Germany; 4HeartVets, Porthcawl, UK; 5Stamford Veterinary Centre,
Great Casterton, UK; 6Cheshire Cardiology, Knutsford, UK; 7Tierklinik Am Sandpfad,
Wiesloch, Germany; 8RA Kardiologie, Muehlheim, Germany; 9Tierarzt Ingo Schneider,
Nidderau, Germany; 10Department of Veterinary Clinical Studies, University of Pennsylvania,
Philadelphia, USA; 11College of Veterinary Medicine, Texas A&M University, College
Station, USA; 12Department of Comparative Biomedical Sciences, Royal Veterinary College,
London, UK; 13Research Support Office, Royal Veterinary College, London, UK
Treatment is indicated in dogs with preclinical degenerative mitral valve disease
(DMVD) and cardiomegaly (stage B2). This is best diagnosed using echocardiography,
however relying upon specialist imaging limits access to accurate diagnosis. This
study aimed to evaluate whether cardiac biomarker concentrations could be analyzed
alongside other clinical data to accurately identify dogs with echocardiographically
confirmed stage B2 DMVD.
The study was prospective and cross‐sectional. Client owned dogs (n = 1887) were assessed
by veterinary cardiologists in Germany, the UK and the USA. All patients had a history
taken, underwent physical examination, had a blood sample collected for biochemistry
and cardiac biomarker concentrations and underwent echocardiography. A proportion
(n = 175) underwent thoracic radiography. Clinical observations and bloodwork parameters
were entered in explanatory (multivariable logistic regression) and predictive models
with echocardiographically confirmed stage B2 disease as the outcome. Predictive models
were developed using a subset of data and tested on the remainder. The ability to
identify stage B2 dogs was assessed by ROC analysis.
Age, appetite, alanine aminotransferase (ALT) activity, body condition score, creatinine
concentration, murmur intensity and N‐terminal propeptide of B‐type natriuretic peptide
(NT‐proBNP) concentration were independently associated with the risk of having stage
B2 disease. The discriminatory ability of this model (AUC, .84; 95% CI, .82 – .87)
was superior to using NT‐proBNP (AUC, .77; 95% CI, .74 – .80) or vertebral heart score
alone (AUC, .76; 95% CI, .69 – .83). A predictive logistic regression model could
identify dogs likely to be in stage B2 (AUC test set, .86; 95% CI, .81 – .91).
The findings suggest that widely accessible parameters could be used to screen dogs
with preclinical DMVD. Encouraging at risk patients to seek further evaluation may
result in a greater proportion of dogs being appropriately managed.
Disclosures
This project received funding from Boehringer Ingelheim Animal Health GmbH. J. Wilshaw
is currently undergoing a PhD studentship sponsored by Boehringer Ingelheim Ltd. J.
Elliott has received funding from Consultancies: Elanco Ltd, CEVA Animal Health Ltd,
Boehringer Ingelheim Ltd, Bayer Animal Health, Orion Incorp, Idexx Ltd, Nextvet Ltd,
Waltham Centre for Pet Nutrition; grant funding from Elanco Ltd, Waltham Centre for
Pet Nutrition, Royal Canin Ltd, Zoetis Ltd, CEVA Animal Health, and is a member of
the International Renal Interest Society which receives a grant from Elanco Ltd. A.
Boswood holds a consultancy with Boehringer Ingelheim Ltd and CEVA Animal Health.
He has received research funding from Boehringer Ingelheim, CEVA Animal Health, Nestlé
Purina Petcare and Zoetis.
ESVC‐O‐9
Echocardiographic parameters to differentiate between pre‐ and postcapillary pulmonary
hypertension
S. Sudunagunta1, J. Escalda2, J. Dukes‐Mcewan3, E. Bode4
1Small Animal Clinical Science, Mr, Neston, UK; 2Braid Vets, Edinburgh, UK; 3SATH,
University of Liverpool, UK; 4Chestergates Veterinary Specialists, UK
Pulmonary hypertension (PH) can be categorized as precapillary or postcapillary, or
combined. Recent publications in humans have identified indices that can discriminate
between pre‐ and postcapillary PH by using echocardiographic surrogates for the transulmonary
gradient (TPG) obtained by indexing tricuspid regurgitation velocity (TR) to indices
of left atrial pressure. This study aimed to determine if selected echocardiographic
variables would prove discriminatory between pre‐ and postcapillary PH and combined
PH.
This restrospective study evaluated the following echocardiographic variables: transmitral
E wave velocity (E vel), the ratio of E vel to the isovolumic relaxation time (E:IVRT),
the ratio of E vel to the Tissue Doppler e’ waves (E:e’ lat and E:e’ sep). TPG surrogates
were created by indexing TR to indices of left‐sided filling pressures (TR/E:IVRT,
TR/E:E’ at and TR/E:e’ sep). These were compared between the groups (PH vs control,
precapillary vs postcapillary vs control). Receiver operating characteristic (ROC)
curves were generated to evaluate the ability of each variable to differentiate between
precapillary and postcapillary PH and between pre/postcapillary PH and combined PH.
There were 270 dogs with PH (142 postcapillary, 128 precapillary), 61 control dogs
without PH and 12 dogs with suspected combined PH.
LA:Ao, E vel, E:IVRT, E:e’ lat and E:e’ sep were higher in dogs with postcapillary
PH compared with controls and precapillary PH (all P < 0.001), but did not differ
between precapillary PH and control dogs. TR/E:IVRT was lower in postcapillary PH
compared with precapillary PH and control dogs (all P < 0.001) and lower in control
than precapillary PH (P < 0.001). TR/E:e’ lat was higher in dogs with precapillary
PH than postcapillary PH and control dogs (both P < 0.001). TR/E:e’ sep was higher
in dogs with precapillary PH than postcapillary PH and control dogs (both P < 0.001)
and higher in dogs with postcapillary PH compared with control dogs (P = 0.04).
ROC curves showed similar area under the curve (AUC) for E vel (0.979), E:lVRT (0.979)
and TR/E:IVRT (0.975) for distinguishing precapillary from postcapillary PH. ROC curves
showed similar AUC for E vel (0.825), E:lVRT (0.778) and TR/E:IVRT (0.778) for distinguishing
precapillary PH from combined PH. When differentiating postcapillary PH from combined
PH, ROC curves showed a higher AUC for TR/E:IVRT (0.890) compared with E vel (0.783)
and E:lVRT (0.836).
Surrogate measures of TPG were not more accurate than existing measures of left‐sided
filling pressures for differentiating between pre‐ and postcapillary PH. Surrogate
TPG measures may be of use in differentiating postcapillary from combined PH.
Disclosures
No disclosures to report.
ESVC‐O‐10
Utility of cardiovascular point of care ultrasound to detect pre‐capillary pulmonary
hypertension
A. Lyssens1, A. C. Merveille1, K. Gommeren1, M. Lekane1
1Department of Clinical Sciences, University of Liège, Liège, Belgium
Early recognition of pre‐capillary pulmonary hypertension (PCPH) could benefit affected
dogs, especially moderately to severely affected dogs should receive rapid treatment.
Unfortunately, diagnosis of PH remains challenging in practice. Doppler‐echocardiography,
the non‐invasive gold‐standard to diagnose PCPH, requires specialized equipment and
skills. Thoracic radiographs, largely available to practitioners, lack sensitivity
to detect even severe PCPH. Cardiovascular point‐of‐care ultrasound (CV‐POCUS) is
a reproducible, time‐ and cost‐effective technique, well accepted to assess left heart
chamber size and function. A recent study assessing the caudal vena cava diameter
to detect moderate to severe canine PCPH failed to demonstrate diagnostic benefit.
We hypothesized a 10 point CV‐POCUS pulmonary hypertension score (PHS), differentiates
dogs with various degrees of PCPH, and might have good accuracy to identify patients
with moderate to severe PCPH.
Client‐owned dogs were prospectively included between September 2017 and February
2020. A board‐certified cardiologist performed a complete echocardiography and classified
dogs based on right heart remodeling and/or tricuspid/pulmonic regurgitation gradients
into 4 categories (C1 to C4, being no, mild, moderate, and severe PCPH, respectively).
No and mild PCHP and moderate and severe were regrouped as G1 and G2 respectively.
Four standard CV‐POCUS views were assessed by a blinded non‐cardiologist, who had
received a 2‐hour theoretical PHS‐training. A score of 0 to 2 was assigned for 1)
right atrial (RA) and/or ventricular (RV) enlargement; 2) RV hypertrophy; 3) interventricular
septum (IVS) flattening; 4) pulmonary trunk enlargement; and 5) right‐sided congestive
signs, resulting in a global score between 0 and 10. Global scores were compared between
C1 to C4 and G1 and G2 using non‐parametric tests. A receiver‐operating characteristic
curve was established to determine the ideal cutoff value to differentiate G1 from
G2. Data are expressed as median and range.
Fifty dogs, (C1 = 15, C2 = 5, C3 = 10, and C4 = 20) were included, resulting in G1
= 20 and G2 = 30 dogs, respectively. Global score was significantly higher for C4
(9;7‐10) than C1 (0;0‐4) (P < 0.001), C2 (4; 1‐5) (P = 0.008) and C3 (4.5;2‐8) (P
= 0.023). Global score for C3 was significantly higher than C1 (P = 0.023), but not
C2. Global scores of G2 (8;2‐10) G2 were significantly higher than G1 (0.5;0‐5) (P
< 0.001). Area under the receiver‐operating characteristic curve for PHS indicated
a cut‐off value of 5 discriminated G2 from G1 with a sensitivity of 77% and a specificity
of 100% (AUC: 0.944; P < 0.001).
Moderate to severe PCPH can be detected with good accuracy by non‐cardiologists using
a 10 point CV‐POCUS PHS score.
Disclosures
No disclosures to report.
ESVC‐O‐11
Rapid atrial ectopic firing in dog: a retrospective study in 10 cases
D. M. Porteiro Vázquez1, S. Battaia2, M. Perego2, R. A. Santilli2
1Cardiology, Hospital Veterinario Puchol, Madrid, Spain; 2Cardiology, Clinica Veterinaria
Malpensa, Samarate, Italy
Rapidly focal atrial activity is one of the main mechanisms responsible of atrial
fibrillation (AF) onset in human medicine. The pulmonary veins (VPs) are the main
source of focal activity, although other sites of focal activity have been described.
These foci trigger AF by a burst or firing of rapid discharges. Multiple electrophysiologic
mechanisms have been proposed as the basis for focal PV firing, including abnormal
automaticity, triggered activity, and micro–reentry. Autonomic tone and atrial stretch
play an important role on PV activity. The aim of our study was to describe electrocardiographic
appearance of rapid atrial ectopic firing in the dog. A total of 10 Holter tracings
recorded in dogs with ectopic atrial firing were retrospectively analyzed. The sample
group included dogs of different breeds with an average age of 9.7 years (range 2‐14),
M/F 7:1 and an average body weight of 32.7 Kg (range 7‐50). Five out of ten dogs presented
underlying structural heart disease with variable grade of cardiac remodeling and
congestive heart failure (suspected myocarditis, degenerative mitral valve disease,
dilated cardiomyopathy and heartworm disease) while the remaining had normal cardiovascular
system. All 24‐hour tracings showed a sinus rhythm interrupted by numerous episodes
of self‐limiting or sustained runs of focal atrial tachycardia (FAT) throughout the
recording (average 451 episodes; range 18‐2502). Focal atrial tachycardias were characterized
by an average duration of 183 beats (range 3‐364) and an average cycle length of 233.3
ms (range 190‐250 ms). Episodes of paroxysmal firing atrial activity (range 1 – >800
per 24 hours) with an average duration of 67.16 seconds (range 0.65‐2460) were identified
in all recordings. These episodes were characterized by a rapid atrial activity with
an average atrial cycle length duration of 150.18 ms (range 90‐260), short RP’ (average
116.9 ms; range 50‐250), different atrioventricular conduction ratios (range 1:1 to
12:1), variable atrial depolarization morphology in the orthogonal system (prevalent
positive in all leads) and irregular cycle length. Episodes were triggered by a sinus
beat, premature ventricular ectopic beat or a supraventricular ectopic beat. Three
episodes induced AF. AF was persistent in one case and paroxysmal in 2 cases (6 and
59 min respectively). Electrophysiologic mapping was available in one case, showing
the site of firing at the level of left superior pulmonary veins. The present study
described, as it was reported previously in human medicine, a rapid ectopic atrial
firing as possible mechanism of AF onset in dogs.
Disclosures
No disclosures to report.
ESVC‐O‐12
Comparison of temporary pacing techniques in dogs undergoing permanent pacemaker implantation
I. Prado Checa1, G. Culshaw2, Y. Martínez Pereira2
1Cardiology, Royal Veterinary College, London, UK; 2Cardiopulmonary, Royal (Dick)
School of Veterinary Studies, Edinburgh, UK
Temporary cardiac pacing is commonly performed in bradycardic dogs immediately prior
to permanent pacemaker implantation. This maintains adequate cardiac output under
general anesthesia. Transvenous temporary pacing (TVTP) starts before anesthetic induction
and requires fluoroscopy. Transthoracic temporary pacing (TTTP), after anesthetic
induction, does not need fluoroscopy, is less invasive, and is technically simpler
but may be less reliable in larger dogs.
Although well described in dogs, there are no published studies comparing TVTP and
TTTP directly. We hypothesized that TTTP decreases procedure and fluoroscopy times
compared with TVTP, but also increases risk of failure to capture in larger dogs.
Our aim was to analyses surgical and anesthesia records of pacemaker procedures in
dogs, and compare the success and complication rates associated with both temporary
pacing methods.
Records of patients fitted with a pacemaker in a single referral institution between
December 2012 and June 2019 were retrospectively reviewed. Data collected included
demographics, type of bradyarrhythmia, method of temporary pacing employed, duration
of implantation procedure (pre‐medication to switching off anesthetic vaporizer),
fluoroscopy times, temporary pacing events (failure to capture, iatrogenic tachyarrhythmia),
anesthetic events (spontaneous arrhythmias, cardiac arrest, hypotension, hypothermia,
hypercapnia, hypocapnia, excessive muscle twitching), intra‐ and post‐operative complications,
and morbidity and mortality.
A total of 60 dogs were included for analysis. One third of these had TTTP (n = 20,
33.66%) compared to two thirds with TVTP (n = 40, 66.33%; P = 0.013) and the TTTP
dogs were lighter (TTTP 9.2 kg (6.38‐12.02); TVTP 26 kg (17.1‐34.9); P < 0.001). However,
temporary pacing events were similar for both groups (TTTP, 5/20 (25%); TVTP, 8/40
(20%); P = 0.65).
Although TTTP decreased premedication to induction time (TTTP 65 min (43.5‐86.5);
TVTP 105 min (86.5‐123.5); P < 0.001) and the total procedure duration (TTTP 200 min
(161‐239); TVTP 235 min (203.5‐266.5); P = 0.015), it did not decrease fluoroscopy
time (TTTP, 269.5 min (117.5‐421.5); TVTP, 295 min (157‐433); P = 0.302) and was associated
with an increased rate of anesthetic events (TTTP, 15/19 (78.9%); TVTP, 17/35 (48.6%);
P = 0.03).
Both forms of temporary pacing are reliable. Compared to TVTP, TTTP reduces the time
it takes to implant a pacemaker in a dog. This is mainly because it reduces the delay
between pre‐medication and anesthetic induction rather than the duration of fluoroscopy.
However, this advantage is offset by increased risk of anesthetic events. Importantly,
though, in this retrospective study, the potential influence of bodyweight cannot
be discounted.
Disclosures
No disclosures to report.
ESVC‐O‐13
Noninvasive electrocardiographic parameters to assess interventricular dyssynchrony
in dogs with bundle branch blocks
S. Battaia1, M. Perego1, C. Perciballi1, R.A. Santilli1
1Cardiology, Clinica Veterinaria Malpensa ‐ Anicura, Samarate (VA), Italy
Bundle branch block (BBB) is an anomaly of the conduction of the electrical impulse
along the intraventricular specialized conduction system. The electrocardiographic
diagnosis of BBB in dogs is based on the abnormal duration (>80 ms), axis and morphology
of the QRS complex. In humans, the analysis of R‐peak time (RPT) in precordial leads
has been used to differentiate right from left BBB. In case of BBB, interventricular
dyssynchrony (interD) is present and can be assessed using ECG parameters. The aims
of this study were to define electrocardiographic features of complete BBB in dogs
and the utility of RPT to evaluate interD.
12‐lead electrocardiographic tracings of 40 privately‐owned dogs (20 with right BBB
and 20 with left BBB) were retrospectively reviewed. Each ECG was recorded using the
Wilson’s precordial lead system modified by Santilli et al. For each tracing, duration,
morphology and QRS complex mean electrical axis (MEA) on the frontal plane and RPT
duration in precordial leads (V1‐V6) were analyzed using three randomly selected consecutive
beats. To evaluate interD, the interD index (IDI) was calculated using the formula
V5RPT‐V1RPT/QRS duration (%) as previously reported in human medicine. Normality was
tested using the Shapiro‐Wilcoxon W‐test. To evaluate differences between leads, nonparametric
analysis of variance was performed by Kruskal Wallis test, as data were not normally
distributed. Data are expressed as median and range.
In right BBB, QRS complex duration was 104 ms (81‐139), MEA was ‐111° (‐73.3 ‐ +142),
the commonest morphology in lead II was qrS, and RPT (ms) in V1 was 61 (48‐82), V2
25 (12‐45), V3 25 (12‐45) V4 24 (11‐44), V5 25 (11‐42), V6 25 (11‐43). In left BBB,
QRS complex duration was 107 ms (81‐135), MEA was 75.6° (+23.5 ‐ +86.3), the commonest
morphology in lead II was qR, and RPT (ms) in V1 was 17 (10‐39), V2 49 (17‐73), V3
48.5 (23‐77), V4 52 (31‐78), V5 53 (30‐78), V6 55 (30‐78). In right BBB, RPT was significantly
longer in V1 than in V2‐V6 (P < 0.05) and in left BBB RPT was significantly longer
in V2‐V6 than V1 (P < 0.05). The IDI was significantly increased: ‐33% in case of
right BBB and 32% in case of left BBB.
This study defines ECG features and RPT in dogs with right and left BBB. Like in human
beings, RPT and IDI can be used to define interD in dogs.
Disclosures
No disclosures to report.
ESVC‐O‐14
Comparison of three two‐dimensional echocardiographic methods of assessing left ventricular
size in Doberman Pinschers
L.M. Kruckman1, R.C. Fries1, S. Kadotani1, J.P. Stack2, G. Wallace1
1Veterinary Clinical Medicine, University of Illinois, Urbana, USA; 2Veterinary Clinical
Medicine, University of Illinois, Urbana, USA
Dilated cardiomyopathy (DCM) commonly affects Doberman Pinschers and leads to systolic
dysfunction of the heart. The reference standard for diagnosing DCM includes measuring
left ventricular end‐systolic and end‐diastolic volumes using Simpson’s method of
disks (SMOD), though linear left ventricular end‐diastolic (LVIDd) and end‐systolic
(LVIDs) measurements via short‐axis M‐mode (SA‐MM), long‐axis M‐mode (LA‐MM), and
short‐axis 2D (SA‐2D) have been reported. While it is suspected that these measurements
are similar, no study has directly compared all of these measurements in the same
dog. The purpose of this study was to directly compare linear dimensions in a population
of Doberman Pinschers.
One hundred and forty screening echocardiograms between 2017‐2019 were analyzed. The
LVIDd and LVIDs were evaluated using leading edge to leading edge technique from the
right parasternal short axis view at the level of the papillary muscles (SA‐MM and
SA‐2D). These measurements were also evaluated using the right parasternal long axis
four chamber view using either M‐mode or anatomic M‐mode (LA‐MM). Finally, monoplane
Simpson’s SMOD was used to determine end‐diastolic and end‐systolic left ventricular
volumes from the right parasternal long axis view. All measurements were repeated
over three cardiac cycles. Data were tested for normality using Shaprio‐Wilk and a
Kruskal‐Wallis test with Dunn’s multiple comparisons was used to compare the mean
rank difference between modalities. Bias was evaluated via Bland‐Altman and correlation
was evaluated using Spearman’s correlation. The averages of three linear measurements
were compared with SMOD and sensitivity and specificity for diagnosing occult DCM
were determined.
The mean rank differences were significantly different between all linear dimensions
in both diastole and systole. Short‐axis 2D measurements had significant bias compared
with SA‐MM (diastole +1.19 mm, systole +1.65 mm) and LA‐MM (diastole +4.36 mm, systole
+3.87 mm) as did SA‐MM compared with LA‐MM (diastole +3.17 mm, systole +2.22 mm).
All linear dimensions had moderate positive correlation with SMOD in both diastole
and systole. The sensitivity and specificity of each linear measurement to detect
DCM was as follows: SA‐2D (sensitivity 72.0%, specificity 88.5%), SA‐MM (sensitivity
52.0%, specificity 92.0%), and LA‐MM (sensitivity 37.5%, specificity 99.1%) using
SMOD as a reference standard.
Results of this study suggest that while all the linear measurements are correlated
with each other, there is significant bias between measurements, and they should not
be used interchangeably.
Disclosures
No disclosures to report.
ESVC‐O‐15
ECG abnormalities in Irish wolfhounds
A. C. Vollmar1
1Small Animal Veterinary Clinics Bonn and Wissen, Bonn, Germany
Irish wolfhounds (IW) are commonly affected with dilated cardiomyopathy (DCM) and
atrial fibrillation (AF). The aim of this study was to evaluate the incidence and
clinical significance of abnormalities: ventricular premature depolarizations (VPDs),
notched QRS complexes, fascicular and bundle branch block in this breed.
Data from cardiovascular examinations performed in 1673 IW, including echocardiography
with simultaneous ECG recording and a 3 min, six‐lead ECG registered in right lateral
recumbency, were retrospectively evaluated. Dogs were longitudinally followed, and
owners instructed to report date and circumstances of death.
VPDs (as singles up to 50/min, with bigeminy, as pairs, multifocal, or as runs) were
recorded in 57/433 IW (13.2%) with DCM diagnosis, in 3/60 (5%) with AF, and in 55/1180
(4.7%) IW without DCM. Out of those IW with information on time and cause of death,
sudden cardiac death (SCD) was reported in 13/47 (27.7%) of IW with DCM and VPDs,
in 67/375 (17.9%) of IW with DCM without VPDs, in 3/43 (7%) of IW with AF, and in
2/37 (5.4%) of IW with VPDs but without DCM, compared to 0/543 (0%) of IW without
DCM or VPDs. Runs of supraventricular (SV) tachycardia were detected in 9/433 (2.1%)
and SVPDs as singles in 12/433 (2.8%) IW with DCM with later development of AF in
3 and 6 of these dogs, respectively. Notched QRS complexes (Rr´,RR´,rR`,rr´) were
present in 37/433 (8.5%) of IW with DCM, in 6/60 (10%) of IW with AF, and in 100/1180
(8.5%) of IW without DCM. Left anterior fascicular block was seen in 2/433 IW with
DCM (0.5%), and in 10/1180 (0.85%) without DCM, while right bundle branch block was
detected in 7/433 (1.6%) IW with DCM and in 12/1180 (1%) without DCM. One IW without
DCM had left bundle branch block, and 5/433 (1.2%) had AV‐block I.
While fascicular and branch block abnormalities were more commonly seen within certain
families, there was no apparent association of any of the observed conduction abnormalities
with cardiac morbidity and mortality. While most dogs had multiple (up to ten) cardiac
examinations, an important limitation of this study is that 24 h monitoring was not
performed which would have permitted the best assessment of VPDs.
However, this study suggests that IW with DCM and VPDs during routine echocardiography
and 3 min ECG recordings, have an even higher risk to die from SCD than DCM dogs without
VPDs.
Disclosures
No disclosures to report.
ESVC‐O‐16
A dog's dinner: Evidence of metabolic derangement in dogs with naturally occurring
valvular heart disease and congestive heart failure
J. Wilshaw1, A. Boswood1, Y.M. Chang2, C. J. Sands3, S. Camuzeaux3, M. R. Lewis3,
D. Xia2, D. Connolly1
1Department of Clinical Science and Services, Royal Veterinary College, Hatfield,
UK; 2Research Support Office, Royal Veterinary College, London, UK; 3MRC‐NIHR National
Phenome Centre, London, UK
The myocardium requires continuous ATP production and when healthy, this is predominantly
derived from ß‐oxidation of lipids. Cardiovascular disease affects flux through metabolic
pathways and conditions of stress or ischemia may favor less oxygen demanding pathways.
This manifests as reduced ß‐oxidation and increased dependence upon glucose as a substrate.
This shift is maladaptive; decreasing ATP production and increasing concentrations
of toxic lipid species that can exacerbate myocardial dysfunction. It is hypothesized
that similar processes occur in canine degenerative mitral valve disease, so the aim
of this study was to evaluate changes in the lipidome in the context of worsening
disease severity.
Patients (n = 40) had been longitudinally evaluated at a research clinic (2004–2017)
and paired residual serum samples were selected from visits in ACVIM stage B1: asymptomatic
disease without cardiomegaly, and stage C: congestive heart failure (CHF). Samples
were processed using ultra‐performance liquid chromatography mass spectrometry (UPLC‐MS)
and lipid profiles compared using linear mixed effects models.
Using an adjusted P value (Q < 0.05), 169 UPLC‐MS features were associated with disease
progression. From these, 20 molecules were annotated by comparing tandem‐MS data to
reference databases. In CHF, quantities of some circulating acylcarnitines, lysophosphatidylethanolamines,
phosphatidylethanolamines, phosphoinositols and sphingomyelins increased. Concentrations
of some ceramides and lysophosphatidylcholines decreased.
These results are consistent with altered myocardial metabolism in advanced disease
and certain findings may reflect an accumulation of acyl‐coAs secondary to reduced
ß‐oxidation. There is a need for further research, as therapeutic interventions could
be used to ameliorate metabolic derangement prior to the onset of CHF.
Disclosures
J. Wilshaw is currently undergoing a PhD studentship sponsored by Boehringer Ingelheim
Ltd. A. Boswood holds a consultancy with Boehringer Ingelheim Ltd and CEVA Animal
Health. He has received research funding from Boehringer Ingelheim, CEVA Animal Health,
Nestlé Purina Petcare and Zoetis. D. J. Connolly has received funding from Boehringer
Ingelheim, Royal Canin Ltd and Zoetis. Y.M. Chang, C. Sands, S. Camuzeaux, M.R. Lewis
and D. Xia have no conflicts of interest to declare.
ESVC‐O‐17
Differences in left ventricular remodeling secondary to chronic volume loading between
English Springer Spaniels and two other similar athletic breeds
D. P. Dickson1, L. Bode2, E. Dutton3, J. Harris1, C. Linney4, M. Rishniw5
1HeartVets, Porthcawl, UK; 2Small Animal Teaching Hospital, University of Liverpool,
UK; 3Cheshire Cardiology, UK; 4Willows Referral Centre, Solihull, UK; 5VIN, USA
English springer spaniels (ESS) have larger and rounder ventricles than other breeds.
How this geometry impacts responses to volume overload is not well understood. Therefore,
we compared left ventricular geometry and remodeling between ESS and two similarly
sized athletic breeds (Border collies, BC, and Labrador retrievers, LR) in naturally‐occurring
chronic left ventricular (LV) volume loading conditions (mitral regurgitation, MR,
and patent ductus arteriosus, PDA).
We searched records at four large cardiology referral centers in the UK for cases
of MR (due to either congenital or acquired valve disease) and PDA in the three breeds.
We recorded age, gender, presence of congestive heart failure (CHF), body weight and
specific echocardiographic variables. We then compared echocardiographic normalized
measures of left ventricular size between ESS vs. Non‐ESS dogs. To account for the
possible confounding effects of different disease status, cases with MR were normalized
to left atrial size (by dividing LV measures by the short‐axis left atrium to aortic
ratio (LA:Ao)). Cases with CHF were further examined as a separate group. Medical
treatment was not recorded. Data were assessed for normality and groups were compared
with t‐tests or Mann‐Whitney‐U tests, as appropriate.
165 dogs were included: 129 had MR (46 ESS, 37 BC, 46 LR) and 36 had PDA (12 ESS,
16 BC, 8 LR); 57 cases had CHF. All measures of LV size (internal dimensions and Simpson’s
derived volumes, normalized to body size) were larger in ESS than Non‐ESS in MR cases
(P < 0.0001 for all comparisons), whereas PDA cases did not differ. When considering
only cases of CHF, the differences remained in the MR cases (P < 0.0001 for all comparisons).
In dogs with CHF secondary to PDA, diastolic dimensions and volumes did not differ
between ESS and non‐ESS but ESS had larger systolic dimensions and volumes than non‐ESS
dogs (P < 0.05).
ESS have greater LV dimensions when exposed to chronic MR, compared with BC and LR,
but not when exposed to volume overload from a PDA. However in PDA cases with CHF,
ESS have greater LV systolic dimensions than Non‐ESS dogs. These data suggest that
ESS as a breed have a different LV remodeling phenotype compared with two other similarly
sized athletic breeds, supporting the idea that the ESS has a unique cardiac morphotype.
Disclosures
No disclosures to report.
ESVC‐O‐18
Evaluation of cardiac troponin I as a predictor of mortality in critically ill cats
L. Pelander1, M. Bach2, I. Ljungvall1, J. Häggström1, J. L. Willesen2, J. Koch2, K.
Dreimanis1, R. M. Damsgaard2, A. Telling2, Å. Ohlsson1, R. Langhorn2
1Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala,
Sweden; 2Department of Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg
c, Denmark
Increased serum cardiac troponin I (cTnI), reflecting leakage from or necrosis of
cardiomyocytes, is a negative prognosticator for mortality in critically ill dogs.
This prospective cohort study aimed to examine whether serum cTnI is increased in
critically ill cats, to identify conditions associated with the highest cTnI concentrations,
and to evaluate cTnI as an independent prognosticator for mortality and a potential
co‐prognosticator to the feline Acute Patient Physiologic and Laboratory Evaluation
(APPLE) score.
Cats admitted to intensive care units, irrespective of diagnosis, and healthy cats
were included at two university animal hospitals. Clinical and echocardiographical
examinations were performed, APPLE scores calculated, and cTnI measured in serum obtained
within 24 hours of admission. Outcome was defined as death/euthanasia or survival
to discharge. Prognostic capacity was estimated through receiver operator characteristic
curves and a model combining cTnI and APPLE created through multiple logistic regression.
For 118 critically ill cats, serum cTnI was (median, [IQR]) 0.64 [0.19‐2.68] ng/mL,
higher than the 13 healthy cats (0.015 [0.005‐0.041] ng/mL) (P < 0.0001). Serum cTnI
was higher in the subgroups of cats with serum amyloid A >5 mg/L or structural cardiac
disease than in cats without these respective characteristics (P = 0.009, P = 0.0008).
Neither serum cTnI for all cats or the subgroups (0.562; 95% CI 0.449‐0.676 (n = 118);
0.506;0.360‐0.652 (n = 86); 0.625;0.387‐0.863 (n = 27)), APPLE (0.594;0.479‐0.709
(n = 100)), nor the combined model (0.615;0.498‐0.732 (n = 100)) were significant
prognosticators for mortality.
Increased serum cTnI was common in critically ill cats compared to healthy controls.
Importantly, unlike for dogs, cTnI was not a useful prognosticator for mortality.
Disclosures
This study was funded by Agria and the Swedish Kennel Club´s Research Fund.
ESVC‐O‐19
Increased cardiac troponin I is a clinically useful indicator of infective endocarditis
E. Kilkenny1, C. Watson1, J. Dukes Mcewan2, E. F. Bode2, M. J. Hezzell3, J. R. Payne1,
K. Borgeat1
1Cardiology, Langford Vets, Bristol, UK; 2Cardiology, Institute of Veterinary Science,
University of Liverpool, Liverpool, UK; 3Cardiology, Bristol Veterinary School, University
of Bristol, UK
Diagnosing infective endocarditis can be challenging as the non‐specific clinical
signs and subtle echocardiographic lesions may mimic those of immune‐mediated disease
(IMD) and myxomatous mitral valve disease (MMVD), respectfully. We hypothesized that
serum cardiac troponin I (cTnI) concentration would differentiate dogs with endocarditis
from these two control groups.
Records from two referral centers were reviewed for dogs diagnosed with endocarditis,
MMVD or IMD. Dogs were included if it was possible to measure serum cTnI at time of
diagnosis. Dogs with MMVD were excluded if they had ever experienced CHF and dogs
with IMD were excluded if they were non‐steroid responsive. Comparisons were explored
using Kruskal‐Wallis and Mann‐Whitney U tests. Receiver operator curve analysis was
performed to investigate cTnI cut‐off values. Cox proportional hazards was used to
investigate the association between cTnI and survival.
Seventy‐two patients were included (endocarditis n = 29; MMVD n = 27; IMD n = 16).
Serum cTnI measurements were significantly higher in the endocarditis group (0.69
ng/mL) than the MMVD (0.05 ng/mL) and IMD groups (0.05 ng/mL), (P < 0.001). There
was no significant difference in serum cTnI concentration between the control groups
(P = 0.28). Increased cTnI could differentiate endocarditis from MMVD and IMD with
moderate accuracy (AUC 0.857, P < 0.001). A cut‐off of 0.6ng/mL had 100% specificity
and 52% sensitivity, which was considered practically useful. There was no association
between cTnI concentration and survival time (P = 0.201) in patients with endocarditis.
Our study suggests that in patients with a compatible clinical presentation, a cTnI
concentration ≥0.6ng/mL should increase the suspicion of endocarditis.
Disclosures
No disclosures to report.
ESVC‐O‐20
CRISPR/Cas9 genome engineering to model the R820W mutation effects in iPSC‐derived
cardiomyocytes
L. Dutton1, J. Dudhia1, D. Guest2, D. J. Connolly1
1Clinical Science and Services, The Royal Veterinary College, Hatfield, UK; 2Stem
Cell Research, The Animal Health Trust, Newmarket, UK
Hypertrophic cardiomyopathy (HCM) is the most common heart disease in cats, often
leading to congestive heart failure and death. Although some causative mutations,
such as MYBPC3/R820W in Ragdoll cats, have been identified, the underlying pathological
processes driving disease remain unclear. Using primary cardiomyocytes as a disease
model is limited as they survive poorly in culture. This has been overcome by the
differentiation of induced pluripotent stem cells (iPSC) into cardiomyocytes (iPSC‐CM).
CRISPR/Cas9 based gene editing of iPSCs allows comparison between isogenic cell lines
therefore controlling for background genetic factors. These disease models have led
to significant advancements in the understanding and treatment of human HCM. The development
of similar models would represent a substantial benefit for feline medicine.
Our aim was to study the effects of the R820W mutation using CRISPR/Cas9 engineering
in human iPSC‐derived cardiomyocytes.
IPSCs were nucleofected with Cas9 protein, template DNA and guide RNA. In total 576
single cells were cloned, expanded and genotyped. Next‐generation sequencing identified
34 cell clones that were homozygous (R820W+/+) and 35 clones that were heterozygous
(R820W+/‐). Six clones (three R820W+/+ and three R820W‐/‐) were differentiated into
cardiomyocytes (iPSC‐CMs). Homozygous (R820W+/+) iPSC‐CMs had a larger cell area compared
to WT cells (2804 ± 120 μm2 vs. 2170 ± 112 μm2, mean ± SEM, P < 0.001), indicating
hypertrophy of mutant cells. Immunocytochemistry showed cells in both groups expressed
cMyBPC at the protein level and this was incorporated into the A‐band of sarcomeres
as expected. Interestingly motion analysis of contracting cardiomyocytes showed that
mutant cells had a longer relaxation phase (580.5 ± 23.5 ms vs. 472.1 ± 17.8 ms, P < 0.001),
longer contraction duration (753.9 ± 24.7 ms vs. 642.4 ± 18.4 ms, P < 0.001) and lower
contraction amplitude (10749 ± 758.2 a.u. vs. 16434 ± 1139.0 ms, P < 0.001) compared
to WT cells. The time to peak contraction was not different between the two groups
(174.4 ± 5.6 ms vs. 169.9 ± 5.7 ms, homozygous vs. WT, P = 0.576). This indicates
that the R820W+/+ mutant cells have a normal initiation of contraction, but cells
have impaired relaxation and reduced contractile distance.
These results show that CRISPR mediated knock in of R820W+/+ in iPSC‐CMs effectively
recapitulates functional features characteristic of HCM. This provides new evidence
for the direct effects of the R820W mutation in isogenic cell lines, and creates a
platform to screen novel therapeutics for feline HCM.
Disclosures
Abstract work supported by Boehringer Ingelheim, The Winn Feline Foundation and The
Beryl Evetts and Robert Luff Animal Welfare Trust David Connolly has also been awarded
grants by The PetPlan Charitable Trust, BBSRC, The Cat Welfare Trust, The Dogs Trust
Debbie Guest hold grant awarded by HorseraceBetting Levy Board, Petplan Charitable
Trust, Racing Foundation Jay Dudhia has receive grant funding from PetPlan Charitable
Trust, BBSRC, MRC.
ESVC‐O‐21
Pharmacodynamics of ACE inhibitors in dogs with cardiac disease, proteinuria or hypertension:
When size matters. A retrospective study of 326 cases
J. P. Mochel1, Y. Chou2, L. Yu1, J. P. Ward2
1Biomedical Sciences, Iowa State University, Ames, USA; 2Veterinary Clinical Sciences,
Iowa State University, Ames, USA
Angiotensin converting enzyme inhibitors (ACEi) are standard‐of‐care medications for
the treatment of cardiac disease, systemic hypertension and proteinuria in veterinary
medicine; however, no consensus exists regarding the ideal dose of ACEi in dogs. The
objective of this retrospective analysis was to determine the effect of varying dosing
schedules of ACEi (i.e. dose amount and/or frequency) on short‐term and long‐term
outcome variables in dogs.
A total of 326 dogs presented to a veterinary teaching hospital between 2005 and 2018
were included in the analysis: 148 dogs received ACEi for management of cardiac disease;
and 178 dogs for treatment of non‐cardiac diseases (hypertension [N = 50], proteinuria
[N = 45], or both [N = 83]). The study included 3 consecutive visits: (i) initial
ACEi prescription (Visit 1); (ii) next follow‐up (~15 days after Visit 1); and (iii)
long‐term follow‐up for dogs with cardiac disease. Dogs receiving ACEi treatment prior
to Visit 1 were excluded. Data were analyzed using linear regression methods for continuous
variables, logistic regression for categorical variables, and Cox proportional hazards
models for survival data. P < 0.05 were considered statistically significant.
The majority of dogs received enalapril (>80%) and B.I.D dosing (58%) at inclusion,
with a median initial daily dose of 0.65 mg/kg ACEi. Study results showed a mild dose‐response
effect of ACEi on BP in dogs, with higher doses (and/or B.I.D dosing) resulting in
an average ~15mmHg decrease in BP (P < 0.04), compared to ~5mmHg decrease for lower
doses (and/or S.I.D dosing). This effect was most pronounced in proteinuric dogs.
In the subgroup of hypertensive dogs, B.I.D dosing was associated with a greater decrease
in urine protein:creatinine ratio compared to S.I.D dosing (P = 0.03). In dogs with
cardiac disease, both ACEi dose and frequency had a significant effect on prolonged
survival from Visit 1 to all‐cause mortality. This retrospective study also confirmed
the safety and tolerability of ACEi across a wide dosing range, with only4.3% incidence
of dose decrease or discontinuation due to side effects.
Overall, these results suggest that higher dose and/or more frequent dosing of ACEi
are associated with positive short‐term and long‐term outcomes in dogs with cardiac
and non‐cardiac diseases. Further research is warranted to determine whether these
effects are primarily driven by an increase in ACEi dose amount or frequency.
Disclosures
No disclosures to report.
ESVC‐O‐22
Pharmacological properties of torasemide in healthy cats
M. Roche‐Catholy1, F. Woehrlé2, A. Alcala3, A. Hellemans1, D. Paepe1, P. Smets1
1Ghent University, Merelbeke, Belgium; 2Vetoquinol, France; 3AvogadroLS, France
In dogs, torasemide has been shown to have a more potent and longer‐lasting diuretic
activity compared to furosemide. Very little information is available regarding the
pharmacological properties of torasemide in cats. We aimed to describe the basic pharmacokinetic
parameters of torasemide in healthy cats, along with the effects of its oral and intravenous
administration on diuresis, blood pressure, electrolyte concentration, creatinine
and renin‐angiotensin‐aldosterone system activation.
Six healthy cats were included in a randomized crossover design, and divided into
4 dosing groups of torasemide, administered either per os (PO) at 0.1, 0.2 or 0.4
mg/kg or intravenously (IV) at 0.2 mg/kg. Laboratory and clinical parameters were
assessed at regular intervals for 48 hours following single administration.
Maximum plasma concentration was reached 30‐45 min after PO administration. Torasemide
administration lead to a dose‐dependent diuresis, with a peak effect between 2 and
8 hours after dosing, depending on the dose and route of administration. A transient
dose‐dependent decrease in serum potassium concentration was observed. After 24 hours,
torasemide administration was associated with a significant increase in urinary aldosterone‐to‐creatinine
ratio in most groups. There was no significant change in blood pressure or serum creatinine
after administration and no difference between groups. No adverse effects were observed.
This study shows absence of adverse effects after single administration of torasemide
up to 0.4 mg/kg and provides new insight into its pharmacological properties in healthy
cats. The results are a stepping stone for future studies in cats with congestive
heart failure.
Disclosures
This study was financially supported by Vetoquinol.
ESVCN‐O‐1
A long term feeding trial to aid in establishing No Observed Adverse Effect Levels
(NOAELs) for different sources of phosphorus in feline diets
J. Coltherd1, J. Alexander2, C. Pink2, J. Elliott3, R. Haydock2, L. Carvell‐Miller2,
V. Biourge4, L. Molina4, R. Butterwick2, D. W. Logan2, P. Watson2, A. M. Bakke2
1Nutrition, Mars Petcare, Waltham on the Wolds, UK; 2Waltham Petcare Science Institute,
Waltham on the Wolds, UK; 3Royal Veterinary College, London, UK; 4Royal Canin SAS,
Aimargues, France
High dietary phosphorus (P), particularly added as soluble salts, may contribute to
the development of chronic kidney disease (CKD) in cats. There is currently no guidance
for safe maximum limits of P in cat foods. Consequently it is important to establish
safety for different dietary P sources. The aim of this study was therefore to establish
the safety of P supplied at 1g/1000kcal from a highly soluble P salt, at two different
total P levels, in feline diets.
Seventy‐five healthy adult cats (n = 25/group) were fed either a low P control diet
with no P salt added (1.4g/1000 kcal; Ca:P 0.97) or a test diet formulated with either
moderate (Test 1 ‐ 4g/1000 kcal; Ca:P 1.04) or high (Test 2 ‐ 5g/1000 kcal; Ca:P 1.27)
total P for a period of 30 weeks in a randomized parallel design. Both test diets
contained sodium tripolyphosphate (STPP) providing 1gP/1000 kcal of total P. Blood,
urine and faces samples were collected, glomerular filtration rate (GFR) determined,
and renal ultrasound and bone density (DXA) scans performed at baseline and at regular
time points to assess health. Following transition back to a commercial diet (total
P – 2.34g/1000kcal, Ca:P 1.3), further blood and urine samples were collected after
4 weeks. Responses were analysed via linear mixed effects models with fixed effects
of diet group, time point (weeks), and their interaction, including cat as a random
effect.
There was no significant effect of diet on GFR, DXA or ultrasound data and all blood
and urine parameters remained within physiological reference ranges. However, urea,
creatinine and fibroblast growth factor‐23 (FGF‐23) significantly increased in cats
fed test diets from week 2 onwards (P < 0.001, P ≤ 0.041 and P ≤ 0.028, respectively).
P and calcium balance were increased in the test diet groups at week 27 (P < 0.001).
On transition back to a commercial diet, data indicated that plasma urea, creatinine,
FGF‐23 and parathyroid hormone (PTH) levels were all influenced by the diet change.
The present data suggest that feline diets containing 1gP/1000kcal from STPP and providing
a total phosphorus level of 4 and 5g/1000kcal were safe to feed for 30 weeks. Differences
in physiological parameters observed during the trial were most likely regulatory
responses needed to maintain mineral homeostasis and/or differences in dietary factors
other than P levels. These data will assist industry, regulators and professional
bodies in developing guidance on safe maximum dietary levels of P for healthy adult
cats.
Disclosures
All authors were employed or contracted by Mars Petcare at the time of this study.
ESVCN‐O‐2
Maintenance energy requirements of cats with obesity after a period of controlled
weight reduction
A. J. German1, G. R. T. Woods1, J. Flanagan2, V. Biourge3
1Institute of Ageing and Chronic Disease, University of Liverpool, Neston, UK; 2Royal
Canin Research Center, Royal Canin, Aimargues, France; 3Royal Canin, Aimargues, France
Weight regain after successful weight loss is a well‐known phenomenon both in humans
and companion animals with obesity, and a possible reason for this is that energy
requirements after weight reduction are less than they were. The aim of the current
retrospective observational study was to estimate post‐weight reduction maintenance
energy requirements (MER) in a group of pet cats with obesity that had successfully
lost weight and whose weight remained stable during the subsequent weight maintenance
phase.
The study protocol was approved by two different Research and Ethics Committees from
two institutes, and all owners gave informed written consent. For inclusion, at least
2 months of follow‐up data (including bodyweight and food intake via owners’ diary
records) had to be available for review, and weight had to remain stable during the
weight maintenance period (within ±2% of the weight recorded at the end of weight
reduction). Post‐weight‐loss MER was indirectly estimated from records of dietary
energy intake during this stable weight period. All owners measured dry food using
electronic gram scales, whilst wet food was fed as whole pouches. The Friedman test
was used to compare bodyweight and energy intake at different stages of weight management,
whilst simple and multiple linear regression was used to identify factors associated
with post‐weight‐reduction MER.
The median (interquartile range) duration of weight maintenance was 179 days (119‐408
and, during this time, MER was 159 kJ (134‐178; 38 [32‐42] kcal) per kg ideal bodyweight
(IBW) per day. The average MER during the weight maintenance phase was greater than
energy intake at the end of the weight reduction period (134 [126‐151] kJ per kg IBW;
32 [30‐36 kcal per kg IBW, P < 0.001), but not energy intake at the start of the weight
reduction period (142 [130‐151] kJ per kg IBW; 34 [31‐36] kcal per kg IBW, P = 0.148).
Using simple and multiple linear regression, the only factor that was significantly
associated with MER during the maintenance period was the mean energy intake during
weight reduction (R2 = 0.349, P = 0.008).
Maintenance energy requirements after weight reduction in cats with obesity, are typically
only 20% greater than energy intake at the end of the weight reduction period, and
not significantly different from energy intake at the start of weight reduction. As
a result, it is advisable to feed a diet with a lesser energy density to provide low
energy requirements during this phase.
Disclosures
ALEX GERMAN Current academic post financially supported by Royal Canin (2002 to current).
This author has also given talks related to the topic for Royal Canin, Mars Petcare,
BSAVA, Hills, NAVC/VMX, BVA, Nestle Purina, Pfizer/Zoetis, ICC/ISFM, AAFP, FEDIAF,
and PFMA. The author's research relating to the topic has been funded by Royal Canin,
Mars Petcare, BSAVA, and Dogs Trust. GEORGIA WOODS: This author is an employee of
the University of Liverpool but her post is financially supported by Royal Canin.
This author has also given talks related to the topic for Royal Canin, Mars Petcare,
BSAVA, Battersea Dogs Home, Guide Dogs, and PFMA. John Flanagan and VINCENT BIOURGE
are both employees of Royal Canin.
ESVE‐O‐1
Urinary liver‐type fatty acid binding protein and neutrophil gelatinase‐associated
lipocalin in hyperthyroid cats before and after radioiodine treatment
T. Kongtasai1, E. Meyer2, F. Mortier1, L. Stammeleer1, E. Vandermeulen3, L. Duchateau4,
P. Defauw1, S. Daminet1
1Small Animal Department, Ghent University, Merelbeke, Belgium; 2Department of Pharmacology,
Toxicology and Biochemistry, Ghent University, Merelbeke, Belgium; 3Department of
Medical Imaging of Domestic Animals, Ghent University, Merelbeke, Belgium; 4Biometrics
Research Group, Ghent University, Merelbeke, Belgium
Progressive azotemia can occur in cats after radioactive iodine treatment of hyperthyroidism.
This process can contribute to reduced survival times in cats with iatrogenic hypothyroidism.
Effective parameters to predict progressive azotemia in feline hyperthyroidism are
lacking. Liver‐type fatty acid binding protein (L‐FABP) and neutrophil gelatinase‐associated
lipocalin (NGAL) are promising biomarkers for detection of early kidney insult in
humans and cats. The objective of this study was to assess urinary L‐FABP (uL‐FABP)
and urinary NGAL (uNGAL) in hyperthyroid cats before and after radioiodine treatment.
Blood and urine samples from 49 cats at 3 different time points i.e. before (T0) (n
= 49), 1 month after (T1) (n = 49) and 11‐29 months (T2) (n = 26) after radioiodine
treatment were analysed. Urinary L‐FABP‐to‐creatinine ratio (uL‐FABP/Cr) and urinary
NGAL‐to‐creatinine ratio (uNGAL/Cr) were compared between T0, T1 and T2 using Wilcoxon
signed‐rank test using median [min‐max] values. Correlations between uL‐FABP/Cr or
uNGAL/Cr and serum creatinine (sCr), total thyroxine (TT4) and glomerular filtration
rate (GFR) using plasma exogenous Cr clearance test were determined for all time points
together using Spearman’s correlation.
Urinary L‐FABP/Cr significantly decreased from T0 to T1 (n = 49; 0.88 [0.03‐896.00]
versus 0.20 [0.03‐2.40] μg/g, respectively; P < .001) and from T0 to T2 (n = 26; 0.68
[0.03‐896.00] versus 0.19 [0.02‐76.41] μg/g, respectively; P < .001). Urinary L‐FABP
was detectable in 40/49 cats at T0, 11/49 at T1 and 14/26 cats at T2. There was no
significant change of uNGAL/Cr between time points. Of 26 cats followed from T0 to
T2, only 2 cats were azotemic at T2. The first of these cats had markedly high uL‐FABP/Cr
at T0 (270.86 μg/g), and remained at the highest uL‐FABP/Cr value of all 26 cats at
T2 (76.41 μg/g), while the second azotemic cat had relatively low uL‐FABP/Cr both
at T0 (0.88 μg/g) and T2 (0.17 μg/g). There were a moderate and significant correlation
between uL‐FABP/Cr and TT4 (rs = .33; P < .001) and between uL‐FABP/Cr and GFR (rs
= .49; P = .003). Serum Cr was negatively correlated with uL‐FABP/Cr (rs = −.28; P
= .001). Urinary NGAL/Cr was not correlated with sCr, TT4, and GFR.
Urinary L‐FABP is upregulated in hyperthyroid cats suggesting ischemic/oxidative stress
in feline kidneys during hyperthyroidism. However, uL‐FABP is not present in all hyperthyroid
cats and resolved when euthyroidism was obtained. Therefore, the ability of uL‐FABP
to predict progressive azotemia in hyperthyroid cats remains unclear. Also, uNGAL
is not a reliable biomarker for the detection of early kidney injury in hyperthyroid
cats.
Disclosures
No disclosures to report.
ESVE‐O‐3
The effect of the ghrelin‐receptor agonist capromorelin on glucose metabolism in healthy
cats
C. Gilor1, J. Pires2, R.L. Greathouse2, N. Quach2, M. O. Huising2, K. Crakes2, M.
Miller2
1University of Florida, Gainesville, USA; 2University of California, Davis, Davis,
USA
Somatostatin secretion from islet delta‐cells is important in maintaining low glycemic
variability (GV) by providing negative feedback to beta‐cells and inhibiting insulin
secretion. Capromorelin is a ghrelin‐receptor agonist that activates the growth hormone
secretagogue receptor on delta‐cells. We hypothesized that in cats, capromorelin administration
will result in decreased GV at the expense of reduced insulin secretion and glucose
tolerance. Seven healthy cats were treated with capromorelin from days 1‐30. After
the first day, fasting blood glucose increased (+13 ± 3 mg/dL, P < 0.0001), insulin
decreased (+128 ± 122 ng/dL, P = 0.03) and glucagon was unchanged. Blood glucose was
increased throughout an intravenous glucose tolerance test on day 1 with blunting
of first phase insulin response ([FPIR] 4931 ± 2597 ng/L/15min) compared to day ‐3
(17437 ± 8302 ng/L/15min, P = 0.004). On day 30, FPIR was still blunted (9993 ± 4285
ng/L/15min, P = 0.045) but glucose tolerance returned to baseline. Mean interstitial
glucose was increased (+19 ± 6 mg/dL, P = 0.03) on days 2‐4 but returned to baseline
by days 27‐29 (P = 0.3). On days 2‐4 GV was increased (SD = 9.7 ± 3.2) compared to
baseline (SD = 5.0 ± 1.1, P = 0.02) and returned to baseline on days 27‐29 (SD = 6.1
± 1.1, P = 0.16). In summary, capromorelin caused a decline in insulin secretion and
glycemic control and an increase in glucose variability early in the course of treatment,
but these effects diminished towards the end of 30 days treatment.
Disclosures: The senior author has served as a consultant to Aratana Therapeutics.
This study was partially funded by Elanco Animal Health
ESVE‐O‐4
A novel once‐a‐week feline recombinant insulin for the treatment of diabetes mellitus
in cats
C. Gilor1, S. Hulsebosch2, J. Pires3, J. Bannasch2, R. Ragupathy4, A. Delpero4, N.
Shah4, J. Haworth4, S. Murikipudi4, T. Sathiyaseelan4, T. Lancaster4, T. Zion4
1University of Florida, Gainesville, USA; 2Veterinary Medicine and Epidemiology, University
of California, Davis, Davis, USA; 3University of California, Davis, Davis, USA; 4Akston
Biosciences Corp., USA
Treatment of diabetes mellitus (DM) in cats typically requires q12h‐q24h insulin injections,
posing a major compliance issue for pet owners. Novel treatments enabling decreased
frequency of injection while maintaining safety are highly desirable. In this pilot
study, we assessed an ultra‐long‐acting novel formulation of recombinant fusion protein
of feline insulin and feline Fc (AKS‐267c) administered subcutaneously weekly. Five
cats with spontaneous DM (and normal IGF‐1) that were controlled on stable doses of
standard q12h insulin were transitioned to AKS‐267c. The dose of AKS‐267c was titrated
for 7 weeks as needed based on continuous flash glucose monitoring (FGM). Clinical
signs, body weight, fructosamine and mean interstitial glucose (IG) concentrations
were used to compare glycemic control at baseline (week zero, on standard insulin
therapy) vs. week 7 (after 7 weeks of once‐weekly AKS‐267c therapy). Data were assessed
for normality and compared using parametric or non‐parametric (as appropriate) paired
tests. After 7 weeks of once‐weekly injection, compared to baseline, there were no
changes in clinical signs and body weight (mean [±SD] body weight gain = 0.2 ± 0.3
Kg, P = 0.3). There were no significant changes in fructosamine (‐61 ± 199 mmol/L,
P = 0.5) and mean IG concentrations (median [range] change = ‐6.2 [‐9.3 – +3.1] mmol/L,
P = 0.2). There were no adverse reactions associated with AKS‐267c administration.
In conclusion, successful maintenance of glycemia was achieved with this once‐weekly
novel insulin therapy. The efficacy and safety of this novel formulation should be
further assessed in a large clinical trial.
Disclosures: Akston Biosciences has donated materials for this study and has funded
another study performed by the authors.
ESVE‐O‐5
Performance of a flash glucose monitoring system in cats
C. Gilor1, J. Pires2, A. Herndon3
1University of Florida, Gainesville, USA; 2University of California, Davis, Davis,
USA; 3University of Queensland, Australia
The FreeStyle Libreâ (Abbott Laboratories) is a flash glucose monitoring system (FGMS)
that measures interstitial glucose (IG) and stores this data onboard until scanned
by the reader. The sensors are factory‐calibrated, and the system is user‐friendly,
inexpensive, and could be extremely useful for monitoring diabetes but has not yet
been validated for use in cats. We compared blood glucose (BG) concentrations (measured
by AlphaTrakâ) to IG (measured by the FreeStyle Libre®), during 16 IV glucose tolerance
tests (IVGTT) in seven purpose‐bred laboratory cats, across the eu‐ and hyper‐glycemic
range (184 samples). Correlation between BG and IG was assessed using Pearson’s r
and the accuracy was assessed against BG as the reference standard using the Bland‐Altman
method. In the immediate 30 minutes following intravenous bolus of glucose when BG
concentrations were declining rapidly (@ 2%/min), IG increased slowly, resulting in
a difference of as much as 32.2 mmol/L (579 mg/dL), and no positive correlation between
BG and IG. At baseline and between minutes 45‐180 of the IVGTT, when BG was stable
or rate of decline slow (@ 0.5%/min), there was a strong positive correlation between
BG and IG (r = 0.97 [95% CI = 0.96 – 0.98]) with a consistent bias (across the BG
range) towards underestimating BG by the Libre (mean ± SD bias 1.3 ± 1.0 mmol/L [23.3
± 18.1 mg/ml]). In conclusion, the FreeStyle Libre® may be appropriate to monitor
diabetic cats, but consideration should be made for the lag between IG and BG during
periods of rapid change.
Disclosures
No disclosures to report.
ESVE‐O‐6
A novel once‐a‐week canine recombinant insulin for the treatment of diabetes mellitus
in dogs
C. Gilor1, S. Hulsebosch2, J. Pires3, J. Bannasch2, A. Delpero4, R. Ragupathy4, N.
Shah4, J. Haworth4, S. Murikipudi4, T. Sathiyaseelan4, T. Lancaster4, T. Zion4
1University of Florida, Gainesville, USA; 2Veterinary Medicine and Epidemiology, University
of California, Davis, Davis, USA; 3University of California, Davis, Davis, USA; 4Akston
Biosciences Corp., USA
Treatment of diabetes mellitus (DM) in dogs typically requires q12h‐q24h insulin injections,
posing a major compliance issue for pet owners. Novel treatments enabling decreased
frequency of injection while maintaining safety are highly desirable. In this pilot
study, we assessed an ultra‐long‐acting novel formulation of recombinant fusion protein
of canine insulin and canine Fc (AKS‐218d) administered subcutaneously. Four dogs
with spontaneous DM, controlled on stable doses of standard q12h insulin, were transitioned
to AKS‐218d. The dose of AKS‐218d was titrated for 8 weeks based on continuous flash
glucose monitoring (FGM). Clinical signs, body weight, fructosamine and mean interstitial
glucose (IG) concentrations were compared between baseline (week zero, on standard
insulin therapy) and week 8. Data were assessed for normality and compared using parametric
or non‐parametric (as appropriate) paired tests. After 8 weeks of once‐weekly injection,
compared to baseline, there were no changes in clinical signs and body weight (mean
[±SD] body weight change = 0.05 ± 0.96 Kg, P = 0.9). There were no changes in fructosamine
(‐34 ± 145 mmol/L, P = 0.9) and mean IG concentrations (‐0.7 ± 10.0 mmol/L, P = 0.9).
Low IG (<3.9 mmol/L) was recorded in 2 dogs at week zero (1% and 23% of readings)
and 2 dogs at week 9 (5% and 6% of readings). There were no adverse reactions to AKS‐218d.
In conclusion, successful maintenance of glycemia was achieved with this once‐weekly
novel insulin therapy. The efficacy and safety of this novel formulation should be
further assessed in a large clinical trial.
Disclosures: This work was funded by Akston Biosciences.
ESVE‐O‐7
RNA transcriptomic analysis as a novel in vitro hypothesis: Generating tool to unravel
the pathogenesis of feline hyperthyroidism
J. Aguiar1, T. Hiron2, R. C. Fowkes1, H. M. Syme1, L. J. Davison1
1Royal Veterinary College, London, UK; 2Wellcome Trust Centre for Human Genetics,
University of Oxford, UK
Feline hyperthyroidism is highly prevalent amongst geriatric cats. Causal mechanisms
in this disease are not fully understood. Identification of key driving factors in
thyroid hyperplasia and autonomous production of thyroid hormone has the potential
to reveal novel treatment targets.
RNA‐sequencing (RNA‐seq) is an unbiased technique for examining the transcriptome
of a tissue, to identify genes that are differentially expressed between tissues.
We hypothesised that thyroids from hyperthyroid and euthyroid cats would have a different
transcriptome and that differentially expressed genes would offer novel targets for
management of feline hyperthyroidism.
In this pilot study, RNA was extracted from four archived feline thyroid glands, obtained
with owner consent and ethical approval, either immediately after euthanasia, or during
surgical thyroidectomy and frozen at ‐80 degrees after fixation in RNAlater. Two glands
were from euthyroid cats, one from a medically treated hyperthyroid cat, and one from
an untreated hyperthyroid cat. After a ribosomal RNA depletion step, a barcoded RNA‐seq
library was prepared from each sample and the pooled libraries were sequenced on a
single lane of a HiSeq4000.
Sequencing reads were mapped to the feline reference genome (FelCat9.0) and bioinformatic
differential expression analysis was undertaken using a bespoke pipeline and high‐performance
computing cluster. Principal component analysis (PCA) revealed that the 2 euthyroid
cats clustered together, separately to the two hyperthyroid cats. The treated and
untreated hyperthyroid cats were also separated by the PCA. In total, 1068 genes were
significantly differently expressed between hyperthyroid and euthyroid cats. Differentially
expressed genes included those related to thyroid hormone synthesis (e.g. SLC5A5,
PSMP8), general cell growth (e.g. VEGFA, CNTN1), cell activity (e.g. G6PD, SRXN1)
and calcium metabolism (e.g. CYP27B1, CAMK1G).
This pilot study demonstrates that RNA‐seq is feasible in archived feline thyroid
glands and has exciting potential to unravel the pathogenesis of feline hyperthyroidism,
as well as to reveal new targets for therapy.
Disclosures: This study was performed as part of a PhD funded by PetPlan Charitable
Trust.
ESVE‐O‐8
Clinical features and outcome associated with functional thyroid tumors in 70 dogs
V. F. Scharf1, M. Oblak2, K. Hoffman3, O.T. Skinner4, O. Neal5, C. J. Cocca6, D.J.
Duffy7, M. Wallace8
1Department of Clinical Sciences, North Carolina State University, Raleigh, USA; 2Ontario
Veterinary College, Canada; 3Duke University, USA; 4University of Missouri, USA; 5,
USA; 6University of Illinois, USA; 7North Carolina State University, Raleigh, USA;
8University of Georgia, USA
Due to the historically low incidence of tumor‐associated hyperthyroidism in dogs,
literature describing the presentation and treatment of this subset of thyroid tumors
is limited. The purpose of this study was to review cases of dogs presenting with
thyroid masses and concurrent hyperthyroidism in order to describe the clinical behavior
of functional thyroid tumors. A secondary objective was to identify any prognostic
factors affecting outcome in this population. In this multi‐institutional retrospective
study, 70 dogs diagnosed with a thyroid mass and concurrent hyperthyroidism were included.
Clinical data regarding presentation, treatment, outcome, and functional thyroid status
were retrieved. Clinical variables were assessed for effect on survival. Overall median
survival of dogs with functional thyroid tumors was 35.1 months (95% Confidence Interval
(CI) 23.3 – not reached (NR)), and 1‐ and 3‐year survival rates were 83% (95% CI 74
‐ 93) and 49% (95% CI 35 ‐ 69), respectively. Histopathologically‐confirmed metastasis
was identified in 3% of dogs. The magnitude of initial thyroxine elevation had no
effect on the development of post‐treatment hypothyroidism (P = 0.53) but was associated
with decreased survival (Hazards Ratio (HR) 2.73, CI 1.05 – 7.32, P = 0.040). Median
survival time of dogs treated with surgical excision (72.6 months, 95% CI 34.1 ‐ NR)
was significantly longer than that of dogs who did not receive surgery (15.7 months,
95% CI 4.8 ‐ NR) (P = 0.014). Of the 50 dogs treated with surgery for which thyroid
status was known following treatment, 64% developed hypothyroidism post‐operatively.
This study suggests that dogs with functional thyroid tumors may attain good long‐term
survival with surgical excision, although post‐operative hypothyroidism is common.
Higher initial thyroid hormone elevation is associated with reduced survival.
Disclosures
No disclosures to report.
ESVE‐O‐9
Expression of proteins involved in iodine uptake in canine thyroid tumors and tumor‐derived
organoids
J. Jankovic1, M. Dettwiler2, M. Gonzáles Fernández3, E. Tièche1, K. Hahn3, S. Scheemaeker4,
S. L. April‐Moon5, M. Dettmer5, M. Kessler6, S. Daminet4, S. Rottenberg3, M. Campos1
1Department of Clinical Veterinary Science, University of Bern, Bern, Switzerland;
2Institute. of Animal Pathology, University of Bern, Bern, Switzerland; 3Institute
of Animal Pathology, University of Bern, Bern, Switzerland; 4Small Animal Department,
Ghent University, Ghent, Belgium; 5Institute of Pathology, Faculty of Medicine, Bern,
Switzerland; 6Tierklinik Hofheim, Tierklinik Hofheim, Hofheim, Germany
Research on modulation of iodine uptake by thyroid cells could help improve radioiodine
treatment of dogs with thyroid tumors. It is therefore important to be able to evaluate
the expression of proteins involved in iodine uptake (Thyrotropin Receptor (TSHR),
Sodium Iodide Symporter (NIS), Pendrin and Thyroid Peroxidase (TPO)) in canine tissue.
Organoids derived from canine thyroid carcinoma could provide a unique model for this
research. The aims of this study were to establish immunohistochemistry (IHC) protocols
for TSHR, NIS, Pendrin and TPO on canine tissue and to evaluate their expression in
canine thyroid tumors and tumor‐derived organoids.
Antibodies directed against human proteins were selected according to epitope homology
to the canine proteins. Antibody specificity was confirmed by Western blot (WB) using
lysates of the HTori‐3 thyroid human cell line and healthy canine thyroid gland. IHC
was validated using formalin‐fixed paraffin‐embedded (FFPE) micro‐cell‐blocks of HTori‐3
cells and the following canine FFPE tissues as positive controls: thyroid gland for
all markers, complementary salivary gland and stomach for NIS and skin for TSHR. Healthy
canine skin, liver, brain, lymph nodes and small intestine served as negative controls.
IHC was performed in 25 canine follicular cell thyroid carcinomas (FTC) (follicular,
follicular‐compact, compact), 8 medullary thyroid carcinomas (MTC) and 3 organoid
lines derived from FTCs. A scoring system (staining intensity x distribution) was
used to evaluate IHC in canine thyroid tumors and tumor‐derived organoids.
WB revealed specific bands for TSHR, NIS, Pendrin and TPO in HTori‐3 cells and healthy
canine thyroid gland. IHC in HTori‐3 cells and healthy thyroid gland showed specific
cytoplasmic staining in follicular cells for all antibodies. NIS also showed basolateral
membranous staining in follicular cells. NIS was expressed in salivary gland by ductal
epithelial cells and in stomach by mucous neck epithelial cells. TSHR was expressed
in skin by epidermal and hair follicle keratinocytes. In FTCs, Pendrin was more expressed
in follicular tumors while NIS was less expressed in compact tumors. Expression of
all four proteins was higher in tumors from hyperthyroid dogs compared to those of
euthyroid dogs. All four proteins were highly expressed in organoids derived from
FTC. All four proteins were expressed in MTC.
In conclusion, human antibodies for thyroid proteins involved in iodine uptake are
suitable to identify the canine orthologues by IHC. TSHR, NIS, Pendrin and TPO are
highly expressed in thyroid tumors causing hyperthyroidism. Organoids derived from
canine FTC conserve the expression of these proteins.
Disclosures
No disclosures to report.
ESVE‐O‐10
Urine cortisol/creatinine ratio (UCCR) can potentially identify patients with Addison
disease: A pilot study
M. Gerou‐Ferriani1, C. Palizzoto2, W. Bertazzolo3
1Medicine, The Ralph Veterinary Center, Marlow, UK; 2Medicine, Instituto veterinario
di Novara, Novara, Italy; 3Laboratorio Veterinario La Vallonea, Milan, Italy
Addison disease (hypoadrenocorticism) occurs from a deficiency of mineralocorticoid
and /or glucocorticoids secretion from the adrenal glands. Young animals seem to be
more susceptible to the disease. Clinical signs may vary from life threatening collapse
(Addisonian crisis) to milder clinical signs such as vomiting, diarrhea and weakness.
Diagnosis is based on identifying low serum cortisol levels on a pre and post adenocorticotropin
hormone (ACTH) stimulation test.
The aim of the study was to assess if UCCR can be a useful marker of Addison disease.
Our hypothesis was that UCCR will be low in patients with Addison disease.
This was a prospective study between 3 different institutions (2 private clinics and
one national laboratory). Three groups of dogs were included in the study and each
included 4 animals. One group with confirmed Addison disease (hypoadrenocorticism
group), one control group of healthy animals (healthy control group) and a second
control group of sick animals with diseases other than hypoadrenocorticism (control
sick group). The groups were closely matched for sex, weight and age. Residual urine,
from a free catch sample, from all sick patients was used to measure UCCR.
Animals from the hypoadrenocorticism group received a Complete Blood Count (CBC),
full biochemistry (fBC), urinalysis, ACTH stimulation test and a UCCR. Based on the
clinician’s discretion also imaging (abdominal and thoracic) was performed. No patient
received prednisolone prior to admission. Animals from the control sick group received
CBC and fBC, along with other relevant tests based on their underlying pathology,
and upon the clinician’s decision. Animals from the healthy control group, were considered
such based on history and physical examination, and were subject to UCCR measurement
from urine collected at home by their own carers.
All animals from the hypoadrenocorticism group had low UCCR with mean value of 2.67
and median value of 2.55 (range from 1.8 ‐ 3.8 and laboratory ref. range 7.8 ‐ 38.8).
UCCR was high on both the healthy control group and the control sick group, with mean
value for the healthy control group of 19.075 (range 13.2‐27.5) and a mean value of
96.45 (range 22.3‐180.4) for the sick control group. The median value for the healthy
control group was 17.8 and for the control diseased group was 91.55.
UCCR could potentially be used for the diagnosis of Addison disease and could perhaps
be useful for early diagnosis in stable animals. Further, larger, prospective studies
are necessary to confirm this.
Disclosures: A grant was taken from the Veterinary Laboratory La Vallonea. Magda Gerou‐Ferriani
is a consultant for the same Laboratory. Walter Bertazzolo also works as clinical
pathologist and he is the scientific director for the same laboratory
ESVE‐O‐11
Hypophysectomy as successful treatment of feline hypersomatotropism: A case series
of 25 cats
K. L. van Bokhorst1, S. Galac1, H. S. Kooistra1, C. Valtolina1, B. P. Meij1
Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine,
Utrecht University, Utrecht, The Netherlands
Hypersomatotropism is caused by a functional growth hormone (GH)‐secreting pituitary
adenoma and is recognized with increasing frequency as a cause of diabetes mellitus
in cats. Successful treatment by transsphenoidal hypophysectomy has been described,
however larger cohort studies are lacking. In this retrospective study the hormone
analysis and survival of 25 cats with hypersomatotropism that underwent hypophysectomy
between 2008 and 2020 are described.
Diagnosis of hypersomatotropism was based on clinical signs, plasma insulin‐like growth
factor‐1 (IGF‐1) levels (median 1600 ng/mL, range 780‐4387) and computed tomography
or magnetic resonance imaging of the pituitary gland (median height 5.1mm, range 3.6‐13.3).
Median age at presentation was 9.7 years (range 4.6‐12.5). Most cats (n = 21) were
neutered males and the remainder neutered females. At presentation, 24/25 cats were
diabetic and treated with exogenous insulin. Cats were hospitalized in the Intensive
Care Unit for preoperative regulation of their blood glucose levels and hydration
status. Hypophysectomy was performed as described previously and histopathology confirmed
a somatotroph adenoma in most cases. Postoperative care consisted of regulation of
electrolyte and fluid balance, tight monitoring of the patient’s blood glucose levels
and tapering of insulin doses accordingly. Postoperative hormone substitution consisted
of cortisone acetate, levothyroxine and desmopressin. GH and IGF‐1 levels were measured
repeatedly in the immediate postoperative period and after discharge.
Postoperative mortality, defined as death within 4 weeks after surgery irrespective
of the cause, was restricted to 1 cat (4%). Cats were discharged from the hospital
after a median of 7 days (range 3‐18). Postoperative complications consisted of decreased
tear production (n = 11), clinical signs of hypoglycemia after discontinuation of
exogenous insulin (n = 4) and palate wound dehiscence (n = 3). Plasma GH levels decreased
significantly 5 hours postoperatively (median 3.8 ng/mL, range 0.6‐13.0). Remission
of hypersomatotropism, as defined by normalization of IGF‐1 levels, was demonstrated
in 23/24 cats (median 34 ng/mL, range 14‐240). In one cat no IGF‐1 levels were determined
after discharge, however her survival of 822 days without exogenous insulin supports
remission. After tapering insulin dosages postoperatively, 22/24 (92%) cats entered
diabetic remission. Median survival time was 1057 days (range 11‐3180) and the overall
1‐, 2‐ and 3‐year true survival 72%, 68%, and 44%, respectively.
This study shows the positive outcome of hypophysectomy in cats with hypersomatotropism.
When cats survived the critical postoperative period of 2‐3 months, prognosis was
excellent with a high percentage of diabetic remission and definitive cure.
Disclosures
No disclosures to report.
ESVE‐O‐12
Investigation of genetic risk factors for diabetes mellitus in European Burmese cats
using whole genome sequencing technology
K. Hazuchova1, M. Wallace1, R. Gostelow1, B. Catchpole1, L. Davison1, Consortium 99Lives2
1Royal Veterinary College, Hatfield, UK; 2Consortium 99Lives, USA
Burmese cats in Europe and Australia are predisposed to developing diabetes mellitus
(DM), but the DM susceptibility genes are yet to be identified. Whole genome sequencing
(WGS) enables comprehensive interrogation of genome‐wide variation and has been useful
in identifying DM susceptibility variants in people. In cats, WGS has been successful
in understanding monogenic disorders, but it has not yet been employed to investigate
complex diseases such as DM.
The aim of this pilot study was to identify candidate genetic DM susceptibility variants
in the Burmese breed using WGS. DNA was extracted from EDTA blood from 4 diabetic
Burmese cats with no evidence of hypersomatotropism, 4 non‐diabetic elderly Burmese
and 2 non‐diabetic elderly DSH cats. Samples were surplus to clinical requirements
and obtained with owner consent and ethical permission. Paired‐end WGS was performed
(30X coverage on Illumina HiSeqX) and the data were analysed using a bespoke GATK‐based
bioinformatics pipeline. Variants were called against the FelCat9.0 reference genome
and annotated according to predicted impact on gene function. Allele frequencies (AF)
of 282 Burmese and non‐Burmese cats included in the 99Lives database were used to
help prioritize selected exonic variants identified in the WGS. Selected exonic variants
were further filtered based on AF in diabetic and non‐diabetic Burmese cats, as well
as predicted impact. In addition, DM‐associated variants within genes known to be
involved in glucose homeostasis or DM in humans were prioritized.
In total, over 30 million variants were identified; 9.9 million were Burmese‐exclusive,
of which ca. 20,000 were exonic. Using filtering based on AF, predicted impact and
gene function, a final list of 130 DM candidate susceptibility variants was established.
This included variants within genes coding for transcription factors, growth factors,
receptors and signaling cascade molecules. For some variants, a plausible functional
link to DM was immediately obvious. However, several novel candidate DM genes were
identified by the presence of high or moderate impact variants segregating with affected
Burmese cats in genes not previously associated with DM. Genotyping of 100 additional
diabetic and non‐diabetic cats at the 130 candidate susceptibility variants further
refines the list of regions associated with DM risk in Burmese cats. This approach
illustrates the potential value of WGS in feline complex disease genetics and provides
new insights into the genetic basis of DM in Burmese cats. All the variants identified
by WGS in this group of cats represent a valuable resource for future genetic studies.
Disclosures
This study was supported by a grant from ECVIM Clinical Studies Fund. Katarina Hazuchova`s
PhD was funded by Boehringer Ingelheim and Beryl Evetts and Robert Luff Animal Welfare
Trust.
ESVE‐O‐13
Insulin glargine 300 units/ml for the treatment of feline diabetes mellitus
G. Linari1, L. Fleeman2, C. Gilor3, L. Giacomelli4, F. Fracassi4
1Departement of Veterinary Medical Sciences, Università di Bologna, Firenze, Italy;
2Animal Diabetes Australia, Australia; 3College of Veterinary Medicine, University
of Florida, USA; 4Department of Veterinary Medical Sciences, Università di Bologna,
Italy
Insulin glargine (IGla) 300U/ml (IGla‐U300) is longer acting and associated with less
risk of hypoglycemia in comparison with IGla‐U100 in people. IGla‐U300 was evaluated
in healthy cats, resulting in a flat time‐action profile. This prospective study aimed
to evaluate the efficacy and safety of IGla‐U300 in cats with diabetes mellitus.
Client‐owned cats diagnosed with DM were enrolled. Cats treated with corticosteroids
during the previous 60 days or with relevant concurrent disorders (e.g. hypersomatotropism,
neoplasia) were excluded. Subcutaneous IGla‐U300 was administered with an insulin
dosing pen at a starting dose of 0.5 U/kg q12h. All cats were fed the same low‐carbohydrate
diet for the study period. Owners performed a 16‐hour blood glucose curve (BGC) once
a week at home for 8 weeks, and assigned a score from 1 to 10 for each clinical sign
(polyuria, polydipsia, polyphagia, weight loss, general demeanor, and lethargy) related
to DM. In‐clinic evaluations, including serum fructosamine concentrations, were scheduled
within 3 days of the 1st, 3rd, 6th and 8th BGCs. Remission was defined as the absence
of clinical signs and glycemia <160 mg/dL for at least 4 weeks after cessation of
insulin therapy. Glycemic variability was assessed by calculating the standard deviation
of each BGC. The data were analyzed using nonparametric tests.
Twelve cats were recruited; 4 were subsequently excluded with IGF‐1 >1000 ng/mL. Eight
cats (5 newly diagnosed) completed the study. At the 8th BGC, improved or absent polyuria,
polydipsia, polyphagia, weight loss, general demeanor, and lethargy) were reported
in 7/8 (87%), 7/8 (87%), 6/8 (75%), 6/8 (75%), 7/8 (87%) and 6/8 (75%) cats, respectively.
Two cats achieved remission after 29 and 53 days. Another 2 cats went into remission
after the end of the study (day 82 and 96). All cats that achieved remission (4/8;
50%) were newly diagnosed diabetics (4/5; 80%). Median glucose of BGCs and serum fructosamine
concentrations significantly decreased when comparing the 1st and the 8th week of
treatment (P < 0.01 and P = 0.02, respectively). Glycemic variability was significantly
lower at the 5th BGC when comparing cats that achieved remission with cats that did
not achieve remission (P = 0.03). Hypoglycemia (nadir <60 mg/dL) was detected in 10/64
(16%) BGCs, while clinical signs consistent with hypoglycemia were not reported. Median
(range) IGla‐U300 dose in cats still receiving insulin at the 8th BGC was 1.14 (0.17‐4.00)
U/kg/day.
IGla‐U300 is effective and safe for the treatment of feline diabetes.
Disclosures
Disclosures Federico Fracassi Financial support: Dechra, MSD Speaking & consultancies:
Boehringer Ingelheim, Dechra, MSD, Royal Canin, Hill’s, Nestlé Purina, La Vallonea.
Linda Fleeman: No pertinent financial support Chen Gilor pertinent financial support:
Akston Biosciences, Elanco. Guido Linari: No pertinent financial support. Lucia Giacomelli:
No pertinent financial support.
ESVE‐O‐14
Glycemic variability in diabetic cats with and without concurrent diseases
A. L. Krämer1, T. A. Lutz2, E. Zini3, C. E. Reusch1
1Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University Zurich,
Zürich, Switzerland; 2Institute of Veterinary Physiology, Vetsuisse Faculty, University
of Zurich, Zürich, Switzerland; 3Department of Animal Medicine, Production and Health,
University of Padova, Legnaro (PD), Italy
Glycemic variability (GV) refers to glycemic excursions with episodes of hypoglycemia
and hyperglycemia throughout the day or on different days and has become an important
marker of glycemic control in people. Increased GV is linked to the development of
multiple diabetic complications and therefore treatment aims to minimize glycemic
fluctuations in humans.
It is currently assumed that any concurrent disease may have a negative impact on
diabetes mellitus (DM) management in pets. However, the influence of concurrent diseases
on GV has not been studied yet. The objective of this study therefore was to evaluate
GV in diabetic cats with and without concurrent diseases.
Blood glucose curves from newly diagnosed diabetic cats between 2010 and 2019 were
retrospectively evaluated for GV during three phases (1 = 0‐3 weeks, 2 = 4‐8 weeks,
3 = 9‐12 weeks) after starting therapy. Standard deviations (SD) as a marker for GV
were calculated and compared between cats with and without concurrent diseases. Furthermore,
comparisons were made between diabetic cats with chronic kidney disease (CKD), chronic
gingivostomatitis (CGS), pancreatitis and without any other obvious disease. Data
was analyzed using non‐parametric tests.
Fifty‐two cats with newly diagnosed DM were included, 29 of which had at least one
concurrent disease with associated clinical signs (6, 6 and 7 cats with CKD, CGS and
pancreatitis, respectively) and 23 were without concurrent disease. In the non‐concurrent
disease group, GV decreased over time (mean SD in phase 1: 3.5 mmol/l; phase 2: 2.8 mmol/l;
phase 3: 2.4 mmol/l) and reached significance in phase 3 compared to phase 1 (P = .03),
while GV did not decrease in the non‐concurrent disease group (mean SD in phase 1:
2.6 mmol/l; phase 2: 2.7 mmol/l; phase 3: 2.5 mmol/l). The comparison between diabetic
cats without concurrent disease and with concurrent diseases in general and CKD, CGS
and pancreatitis, revealed no significant difference in any of the three time phases.
In conclusion, diabetic cats without concurrent disease show improvement of GV after
at least 9 weeks of therapy in contrast to diabetic cats with concurrent diseases.
In this rather small cohort of diabetic cats, concurrent CKD, CGS and pancreatitis
do not seem to increase GV in the first 12 weeks after diagnosis. We hypothesize that
GV is increased in newly diagnosed diabetic cats and differences only become apparent
later in the course of the disease.
Disclosures
Anna Lena Krämer: none Thomas Lutz: Blücare, Prolynx (Speaking & consultancies) Eric
Zini: none Claudia Reusch: Nestlé Purina, Hill’s, Provet, Antlia SA, Glycemicon, Novartis
Animal Health, Clinical Studies fund of the ECVIM‐CA, Society of Comparative Endocrinology
(Grants/research); Boehringer Ingelheim, Dechra, Royal Canin, Hill’s, Novartis Animal
Health, Waltham (Speaking & consultancies)
ESVE‐O‐15
Combined treatment of trilostane and retinoic acid in dogs with pituitary‐dependent
hypercortisolism
D. D. Miceli1, P. N. Vidal1, O. Pignataro2, V. A. Castillo1
1University of Buenos Aires (UBA), Buenos Aires, Argentina; 2Institute of Experimental
Biology and Medicine, Argentina
Pituitary‐Dependent Hypercortisolism (PDH) is a severe metabolic disorder and represents
80‐85% of cases of spontaneous hypercortisolism in dogs. Trilostane is a potent inhibitor
of an early stage of adrenal steroidogenesis, but has no therapeutic effects on pituitary
tumor. Retinoic acid (RA) inhibits proliferation, invasion and tumor growth, reducing
ACTH production and tumor size. The aim of this study was to evaluate the combined
effect of trilostane and RA to control hypercortisolism and tumor growth. In this
prospective study, 8 dogs with PDH with “partial response” to trilostane ‐persistence
of clinical signs and biochemical abnormalities‐ were included. The diagnosis of PDH
was made according to: clinical signs, urine cortisol creatinine ratio (UCCR), low‐dose
dexamethasone suppression test, plasma ACTH, abdominal ultrasound and MRI. Dogs received
RA (2 mg/Kg/day) for 6 months, while continuing with trilostane (3‐4 mg/Kg/12hrs).
The concentrations of ACTH, cortisol, UCCR and routine laboratory were evaluated at
the beginning of trilostane treatment, at the beginning of combined treatment of trilostane
with RA, and at 3 and 6 months of combined treatment. MRI was performed at the beginning
of the combined treatment and at 6 months. Statistical analysis performed by Wilcoxon
test, expressed as median and ranges (P < 0.05). ACTH concentrations showed significant
increases after treatment with trilostane (P < 0.01). With the addition of RA, ACTH
concentrations were reduced at 3 months (P < 0.01), and normalized in 6/8 cases. UCCR
was reduced with trilostane (P < 0.01), but were further reduced with the combined
treatment (P < 0.01). The concentrations of cholesterol, triglycerides, ALP and ALT
were significantly reduced with trilostane (P < 0.01), but were further reduced with
the combined treatment (P < 0.05). The combination of trilostane and RA achieved a
complete clinical remission in 5/8 cases. In dogs that underwent MRI (4/8), a significant
reduction in pituitary tumor size was observed at 6 months (P < 0.05). No adverse
effects were observed during the study. The combined treatment of trilostane with
RA is effective to control clinical signs and biochemical abnormalities of PDH. This
study suggests that this combination allows optimizing pharmacological treatment of
PDH‐affected dogs, since it controls not only hypercortisolism, but also the activity
and proliferation of pituitary tumor.
Disclosures
No disclosures to report.
ESVE‐O‐16
Canine pituitary adenoma organoids
K. Sanders1, F.C.A. Ringnalda2, M.L. van de Wetering2, H.S. Kooistra1, B.P. Meij1,
H. Clevers2, S. Galac1
1Department of Clinical Sciences, Utrecht University, Faculty of Veterinary Medicine,
Utrecht, The Netherlands; 2Princess Máxima Center for Pediatric Oncology, Utrecht,
The Netherlands
Pituitary‐dependent hypercortisolism (PDH) is one of the most common endocrine disorders
in dogs, and is caused by an ACTH‐secreting pituitary adenoma. Hypophysectomy and
radiation therapy are good treatment options, but can only be performed in a limited
number of specialized clinics worldwide. Many patients therefore rely on medical treatment
with trilostane, which inhibits cortisol production but not pituitary adenoma growth.
Pituitary adenoma‐targeting medical treatment options have shown unsatisfactory results
so far. Finding and testing new pituitary adenoma‐targeting drugs is hampered by the
lack of suitable in vitro models that contain species‐specific proliferating pituitary
adenoma cells.
The aim of this study was to establish canine pituitary adenoma organoid culture.
Organoids are miniature three‐dimensional (3D) structures grown from stem cells, that
closely resemble the organ or tumor they originate from, and could therefore be used
to reliably and efficiently identify pituitary adenoma‐targeting drugs.
Pituitary adenomas were collected from five dogs that underwent hypophysectomy at
our University Clinic. All dogs were diagnosed with PDH based on clinical signs, endocrine
testing, and diagnostic imaging. Pituitary adenoma cells were cultured in ice‐cold
basement membrane extract (BME) with previously established anterior pituitary organoid
medium, which was refreshed twice a week. The canine organoids were characterized
with histopathology and RT‐qPCR.
From all pituitary adenomas, structures resembling organoids formed. Both cystic and
dense organoid structures were observed. The organoids were successfully cultured
up until passage number 5 and then frozen down. On average, the organoid cultures
could be passaged once every week. Histopathology showed that the organoid cells morphologically
resemble pituitary adenoma cells, and all organoid cultures expressed mRNA of pituitary
stem cell markers SOX2 and SOX9, confirming that we are indeed growing pituitary cells.
This study shows that organoids can be cultured from pituitary adenomas, something
not previously published in any species. Because organoids closely resemble the primary
tumor in many aspects, we expect that this culture model will pave the way to reliably
and efficiently identify new pituitary adenoma‐targeting drugs for dogs with PDH.
Disclosures
No disclosures to report.
ESVE‐O‐17
Calcium and phosphate homeostasis in dogs with naturally occurring hypercortisolism
A. Corsini1, S. Golinelli2, D.G. Serio2, S. Zamagni2, F. Dondi2, F. Fracassi2
1Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia
(BO), Italy; 2University of Bologna, Ozzano dell'Emilia (BO), Italy
Hyperphosphatemia is a common finding in dogs with hypercortisolism and was reported
as a negative prognostic factor for survival. Previous studies observed that dogs
with hypercortisolism frequently show hyperphosphatemia, increased serum parathormone
(PTH) concentration, decreased phosphaturia, and increased calciuria. However, concurrent
evaluation of all these variables was never performed. In humans, hypercortisolism
increases both calciuria and phosphaturia, thus differing from dogs.
The aim of this study was to evaluate calcium and phosphate metabolism in dogs with
hypercortisolism. Serum PTH (sPTH), 25‐hydroxyvitamin D (25D) and calcitriol (1,25D)
concentration along with urinary fractional excretion (%) of phosphate (FEP) and calcium
(FECa) were concurrently evaluated in dogs with hypercortisolism.
Dogs with newly diagnosed hypercortisolism (pituitary or adrenal‐dependent), before
treatment, without severe comorbidities (e.g. diabetes mellitus, other neoplasia),
were enrolled (December 2018‐January 2020). Age and body weight matched‐healthy dogs
were included as control group (CG). Dogs receiving drugs or diets (e.g. renal diet)
affecting calcium and phosphate balance were excluded. Hematology and chemistry profile
including ionized calcium (iCa), and urinalysis with urinary electrolytes were performed
in all dogs. FEP and FECa were calculated. sPTH, 25D, and 1,25D concentrations were
measured using radioimmunoassays validated in dogs. All blood and urine samples were
collected for diagnostic purpose and non‐routine analysis were performed on left‐over
samples. Data were reported as median and range, and analyzed using nonparametric
statistics (α = .05).
Twenty hypercortisolism and 12 CG dogs were included. Serum phosphate concentration
was significantly higher in hypercortisolism dogs compared with CG (4.9[3.4‐5.7] vs
3.7[3‐4.9] mg/dL, P < .002). FEP and iCa concentrations did not differ between groups.
Dogs with hypercortisolism had higher FECa and sPTH concentration compared with CG
(4.7[0.2‐18] vs 1.2[0.5‐2.8], P < .03 and 6[2.6‐54] vs 2.7[0.6‐8.4] pmol/L, P < .004,
respectively). No significant correlation was found between serum phosphate and sPTH
concentrations. Serum 25D concentration was lower in hypercortisolism compared with
CG (159[31‐434] vs 269[134‐391] nmol/L, P < .02), while serum 1,25D concentration
did not differ between groups (396[156‐527] vs 397[230‐507] pmol/L). The 1,25D/25D
ratio was higher in hypercortisolism dogs with increased sPTH concentration (2.8[1.1‐13.4])
compared both with ones having sPTH concentration within reference interval (1.4[0.8‐8.0],
P < .01) and with CG (1.3[1‐3.4], P < .01).
Hypercortisolism seems to influence vitamin D metabolism in dogs, as described in
humans treated with corticosteroids or affected by spontaneous hypercortisolism. Elevated
sPTH concentration could increase vitamin D‐hydroxylation rate, as suggested by the
increased 1,25D/25D ratio, thus explaining normal serum 1,25D concentration. The mechanisms
causing hyperphosphatemia in dogs with hypercortisolism remain unclear.
Disclosures
Federico Fracassi Financial support: Dechra, MSD , Monge, Candioli Speaking & consultancies:
Boehringer Ingelheim, Dechra, MSD, Royal Canin, Hill’s, Nestlé Purina, Zoetis, La
Vallonea.
ESVE‐O‐18
Gut microbiome evaluation in dogs with naturally‐occurring hyperadrenocorticism
A. Gomes1, R.A. Oliveira Leal2, A. Belas2, A.J. Amaral2, C. Aboim3, C. Pomba2
1Hospital Escolar Veterinário, Fac. Med. Vet, U.Lisboa, Lisboa, Portugal; 2Centro
de Investigação Interdisciplinar em Sanidade Animal,Fac.Med.Vet.,U.Lisboa, Lisboa,
Portugal; 3House Vet ‐ Hospital Veterinário de Oeiras e Paço de Arcos, Oeiras, Portugal
Gut microbiome has a vital role in the host physiologic and immunologic processes.
As shown in humans, lipopolysaccharides can stimulate the production of ACTH, questioning
its role on the hypothalamic‐pituitary‐axis. In veterinary medicine, little is known
about the influence of naturally‐occurring canine hyperadrenocorticism (NO‐HAC), on
gut microbiome.
This study aims to assess if fecal microbiome is modified in dogs with NO‐HAC in comparison
with healthy dogs.
A cross‐sectional study was performed, including healthy dogs and dogs recently diagnosed
with NO‐HAC and not yet submitted to medical treatment (Ethical approval CEIE 01/2019).
NO‐HAC was diagnosed taking into account clinical and laboratorial signs, ultrasonographic
findings and at least one positive confirmatory test (low‐dosage dexamethasone suppression
test and/or ACTH stimulation test). Dogs were excluded if they were treated with antibiotics
and probiotics over the last six months, if they were hospitalized or vaccinated during
the previous month or even if they had a concurrent gastro‐intestinal disease.
A total of 18 dogs were enrolled: 9 healthy and 9 dogs with NO‐HAC. A fecal sample
was obtained from all dogs. DNA extraction was performed using PowerSoil Isolation
Kit. The V4 region of the 16S rRNA gene was amplified (primers 515f‐806r), followed
by sequencing (Illumina MiSeq). Sequencing data analysis was conducted using the platform
QIIME2. For statistical purpose, the exact Fisher the ANCOM tests were performed.
When compared to healthy dogs, NO‐HAC dogs showed a significant increase on the relative
abundance of the phylum Proteobacteria (P < 0,001), namely Enterobacteriaceae family,
Pseudomonadacaeae family and the genus Campylobacter (P < 0,001, W = 1, W = 1, respectively).
These dogs also showed a significant decrease in the phylum Bacteroidetes (P < 0,001),
particularly the genus Prevotella (P = 0,011) and Bacteroides (P < 0,001). Within
the Firmicutes phylum, there was a relative decrease of the families Erysipelotrichaceae
(P = 0,009) and Clostridiaceaea (P = 0,010), and from the genus Robinsoniella (P = 0,011)
and Ruminococcus (W = 30). In this same phylum, a significant increase of the genus
Streptococcus (from the class Bacilli) occurred (P < 0,001).
This study highlights that dogs with NO‐HAC display significant changes on their gut
microbiome, when compared to healthy dogs. The identified changes of the phylum Proteobacteria,
Bacteroidetes and the family Erysipelotrichaceae are in agreement with what has been
observed in other endocrine diseases, namely human Diabetes Mellitus. Further studies
are needed to better understand why Streptococcus and Clostridiaceaea are modified,
correlating these findings with metabolomic data.
To the author’s knowledge, this is the first study that describes gut microbiome changes
in dogs with NO‐HAC.
Disclosures
Study funded by: Project UIDP/CVT/00276/2020 (funded by FCT).
ESVE‐O‐19
Efficacy and safety of tightly controlled hyperadrenocorticism in dogs treated with
trilostane in general practice
S. Foster1, L. M. Fleeman2, K. F. A. Langner3, J. A. Braddock1
1Vetnostics, North Ryde, Australia; 2Animal Diabetes Australia, Mulgrave, Australia;
3The Animal Hospital Murdoch University, Murdoch, Australia
There is no agreement about ideal control of hyperadrenocorticism in dogs treated
with trilostane. Many veterinarians select sub‐optimal control of hyperadrenocorticism
to limit the possibility of clinical hypoadrenocorticism. The aim of this study was
to assess clinical responses in dogs treated in general practice with tight control
as defined by an ACTH‐stimulated cortisol concentration of <70 nmol/L (Advia Centaur)
when test performed 4‐6h after trilostane.
Between August 2017 and February 2019, dogs with confirmed hyperadrenocorticism that
had a minimum 12 month period of tight control were identified. Owners were provided
with a published questionnaire relating to the period(s) of tight control. Data from
the laboratory submissions and owner questionnaires were analysed for age, sex, breed,
duration of treatment, duration of tight control, adverse effects and clinical scores.
For each period of tight control, the percentage of basal and ACTH‐stimulated cortisols
within the following a priori categories were determined: <14, 14‐29 nmol/L.
There were 44 periods of tight control in 43 dogs. Age at end of tight control was
5.5‐17.5 years (median 12.5). All dogs were neutered (23 female, 20 male). Twenty
five (58%) were purebred dogs and 11 (25%) were Maltese dogs and their crosses. Tight
control period ranged from 12‐36 months (median 19). Total treatment time was 16‐60
months (median 30). Median survival time was not reached. Dogs were treated once daily
(32), twice daily (10) both (1) or other (1). Mean interval between ACTH stimulation
tests was 3.8 months. Twenty four percent (51/216) and 46% (100/216) basal cortisols
were <14 and <30 nmol/L respectively. Six percent (15/269) and 36% (98/269) post‐stimulation
cortisols were <14 and <30 nmol/L respectively. There was no association between frequency
of “sickness or diarrhea” and dogs’ percentages of results <14 or 14‐29 nmol/L.
Clinical score was excellent (4‐11) in 28, reasonable (12‐16) in 13 and poor (>17)
in 2; median score 10. Median scores for drinking, urinating, appetite and skin/coat
were 1 (normal). Median score for general assessment was 2 and median score for exercise
was 3. Clinical score was impacted by the exercise assessment which many owners considered
unrelated to hyperadrenocorticism or its treatment.
Tight control of hyperadrenocorticism assessed by an ACTH stimulation test 4‐6h after
trilostane resulted in excellent clinical scores in most dogs. Tight control did not
impact negatively on dogs’ health. An ACTH‐stimulated cortisol of 30‐70 nmol/L on
this assay appears a safe and efficacious monitoring goal in general practice.
Disclosures
This project was not funded. SF Foster and JA Braddock are both consultants to Vetnostics,
North Ryde, NSW 2113 and QML Vetnostics, 11 Riverview Place Metroplex on Gateway,
Murarrie QLD 4172. Both laboratories use the Advia Centaur cortisol assay. LM Fleeman
has funding from Dechra on an unrelated project. KFA Langner has no disclosures.
ESVE‐O‐20
MicroRNAs as liquid biomarkers for canine Cushing's syndrome
A. Veldhuizen1, S. Galac1, K. Sanders1
1Departement of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University,
Utrecht, The Netherlands
Cushing's syndrome, also known as hypercortisolism, is a common endocrine disorder
in dogs. In 80‐85% of cases, it is caused by an ACTH‐secreting pituitary adenoma (pituitary‐dependent
hypercortisolism; PDH). PDH can be treated surgically or medically. However, the pituitary
adenoma can recur after surgery. During medical treatment with trilostane, the pituitary
tumor can continue to grow and induce space‐occupying neurological abnormalities and
significant deterioration of life quality. Additionally, finding the correct trilostane
dose remains challenging. Non‐invasive biomarkers that could detect early recurrence,
correlate with pituitary adenoma size and assess efficacy of medical therapy would
therefore greatly improve patient care. MiRNAs show great potential as liquid biomarkers
because their expression patterns have been shown to change during disease, and they
have been found to be relatively stable in circulating blood.
The aim of this study is to identify miRNAs correlating with steroidogenesis and tumorigenesis
of PDH, which would be differentially expressed between dogs with or without PDH.
Serum/EDTA samples of dogs with PDH (n = 3), cortisol‐secreting adrenocortical tumors
(csACT: n = 5), hormonally silent ACTs (n = 3) and healthy dogs (n = 3), were analyzed
in leftover samples, for the expression levels of 40 target miRNAs and 5 reference
miRNAs. The miRNAs were selected based on previous miFinder experiments and literature.
Seven miRNAs were expressed at higher levels in dogs with PDH compared to the healthy
dogs (miRs 18‐5p, 21‐5p, 122‐5p, 132, 141, 375 and 483‐3p), while three were expressed
at lower levels (miRs 218‐5p, 223‐3p and 503). Of these miRNAs, miR‐18‐5p and miR‐132
were expressed at higher levels in dogs with both PDH and csACTs, compared to healthy
dogs and dogs with hormonally silent ACTs, potentially indicating hypercortisolism.
Additionally, miR‐218‐5p and miR‐503 were also expressed at lower levels in dogs with
PDH compared to dogs with ACTs and could therefore be PDH‐specific.
This study shows that several miRNAs are differentially expressed between dogs with
PDH, (cs)ACTs and healthy dogs, which can be combined into a unique canine PDH miRNA
profile. This profile has the potential to assist in the monitoring of medical treatment
of hypercortisolism, to assist in early detection of recurrence after hypophysectomy,
and might even be linked to pituitary adenoma size.
Disclosures
No disclosures to report.
ESVE‐O‐21
Machine learning based prediction of dogs with Cushing's syndrome using primary‐care
veterinary electronic health records
I. Schofield1, D. C. Brodbelt1, N. Kennedy1, D. B. Church1, S. J. M. Niessen1, R.
F. Geddes1, D. G. O'Neill
1Royal Veterinary College, London, UK
Cushing’s syndrome (CS) is a commonly diagnosed endocrine disease in dogs with an
estimated UK prevalence of 0.28%. Although certain laboratory tests are commonly used
to increase confidence in the diagnosis of Cushing’s syndrome, there is no single
highly accurate test. Novel methods to aid the diagnosis of Cushing’s syndrome are
warranted. Use of machine learning‐based classification algorithms for disease prediction
are increasingly reported and offer the potential to aid the diagnosis of Cushing’s
syndrome. This study aimed to use machine learning methods utilizing clinical variables
collected from primary‐care veterinary electronic patient records (EPRs), to predict
a later confirmed diagnosis of Cushing’s syndrome at the point of first suspicion
in dogs.
A nested case‐control study design used records from a VetCompassTM population of
905,544 dogs. Confirmed CS diagnoses required supportive laboratory test results recorded
within the EPRs. Controls were initially suspected CS cases where an alternate diagnosis
was made using diagnostic laboratory testing. Random forest and support vector machine
(SVM) methods were developed for prediction of a diagnosis of CS using demographic,
clinical signs and routine laboratory data available within the EPRs at the point
of first suspicion of CS. Internal validation used a randomly selected, independent
hold‐out sample of dogs not used to develop the models. Predictor variable importance
was analysed in the random forest model and overall model performance was assessed
in both models.
The study included 547 CS cases, 541 controls and 27 predictor variables. The random
forest model demonstrated good discrimination on the hold‐out sample (AUROC = 0.74,
sensitivity = 77.3%, specificity = 60.4%). Breed and the presence of a potbelly showed
the highest importance within the model to explain the diagnosis of Cushing’s syndrome.
The SVM model demonstrated an AUROC = 0.76, sensitivity = 69.5% and specificity =
71.0% on the hold‐out sample.
This study demonstrates that machine learning algorithms can predict a later diagnosis
of CS at the point of first suspicion using data collected from primary‐care veterinary
practices. These methods could be applied to improve clinical decision‐making and
increase confidence in the diagnosis of Cushing’s syndrome. These methods also have
future application for the early detection of a wide range of other diseases.
Disclosures
I Schofield: PhD scholarship funded by Dechra Veterinary Products Ltd.; N. Kennedy:
financial support of research by Dechra Veterinary Products Ltd.; S. Niessen: consultancy
for Dechra Veterinary Products Ltd.
ESVIM‐O‐1
Relationship between bronchial collapse and heart size in coughing dogs with heart
murmur studied by computed tomography
M. Lebastard1, K. Le Boedec1, M. Howes2, S. Joslyn2, J. S. Matheson2, R. T. Obrien2
1CHV FREGIS, Arcueil, France; 2University of Illinois, Urbana, USA
Heart disease has long been regarded as a common cause of coughing in dogs, due to
dilated left atrium (LA) or cardiomegaly compressing the bronchi. However, some authors
suggested that coughing might be more due to an underlying respiratory disease (ie,
bronchomalacia or chronic bronchitis) than to LA enlargement causing airway collapse.
The study aim was to evaluate the association between LA enlargement/cardiomegaly
and bronchial collapse in coughing dogs with heart murmur using computed tomography
(CT).
Twenty‐four client‐owned coughing dogs with heart murmur were prospectively recruited
over 4 months. Tracheal and thoracic radiography, echocardiography, and thoracic CT
were performed in enrolled dogs without general anesthesia. Fourteen historical control
dogs, with normal thoracic CT and no history of heart murmur and coughing, were searched
from the Radiology database. Bronchial to aorta (Ao) ratio was blindly measured by
3 radiologists, and the bronchi that were significantly narrowed in dogs with murmur
compared to controls were identified. The relationship between degree of collapse
and LA/Ao and Vertebral Heart Scale (VHS) was evaluated in dogs with murmur via mixed‐effects
regression model.
The left‐sided bronchi and caudal most right‐sided bronchi were significantly narrower
in dogs with murmur than in controls. Increasing LA size was only associated with
accessory lobe bronchus narrowing. However, increasing VHS was significantly associated
with narrowing of all left‐sided bronchi and accessory and right caudal lobe bronchi.
Results indicate an association between cardiomegaly and airway collapse in dogs with
heart murmur, and support heart size exacerbation of cough in these dogs.
Disclosures
No disclosures to report.
ESVIM‐O‐2
Aspergillus qPCR testing on nasal swab: A useful tool for diagnosis and follow‐up
of sinonasal aspergillosis in dogs?
T. Bienes1, A. Fastrès1, E. Vangrisven1, F. Billen1, M. Garigliany2, C. Clercx1
1Department of Clinical Sciences, Faculty of Veterinary Medicine, FARAH, Uliège, Liège
University, Liège, Belgium; 2Department of Veterinary Pathology, Faculty of Veterinary
Medicine, FARAH,Uliège, Liège University, Liège, Belgium
Polymerase chain reaction (PCR) testing either for Aspergillus.spp or for Aspergillus
fumigatus is now available; however, the interest of such tests in the diagnosis of
canine sinonasal aspergillosis (SNA) has not yet been assessed. The aim of this study
was to evaluate the presence of fungal material using qPCR targeting Aspergillus.spp
(PanAsp) and A. fumigatus (Aspfum) in samples obtained from nasal cavities of dogs
with various nasal diseases and healthy dogs.
In SNA dogs, Aspfum and PanAsp were positive in 13/20 and 14/20 dogs with a mean cycle
threshold (Ct) of 30.6 [range 23,2 ‐ 33,3] and 28.3 [24,3 ‐ 34,5], respectively. The
PanAsp was also positive in 3 non‐SNA dogs: one with cured SNA, one with LPR and one
with nasal tumor, but at very low load (Ct>33). Results between both qPCR were highly
correlated (r = 0.8, P < 0.01). For Aspfum and PanAsp, the sensitivity was 65% and
70% and the specificity was 100% and 94%, respectively.
Aspfum qPCR test on deep blinded nasal swabs appears highly specific but only moderately
sensitive to diagnose canine SNA. In some dogs fungal plaques are exclusively found
in the frontal sinus and are probably not reached by blinded sampling. Since A. fumigatus
is the most common etiological agent of canine SNA (96.7% of isolates), Aspfum testing
appears appropriate; however, PanAsp testing is a non‐negligible tool to detect the
small percentage of SNA cases related to other Aspergillus species. Results also show
that healthy predisposed dogs do not seem to be carriers and confirm that A. fumigatus
does not appear to have a major role in LPR. The negative results found in cured SNA
dogs show a good correlation with clinical and rhinoscopic findings.
In conclusion, Aspfum and/or PanAsp (qPCR testing) on deep nasal blinded swabs can
be useful for the detection of SNA at diagnosis and after cure.
Disclosures
No disclosures to report.
ESVIM‐O‐3
Characterization of the bronchoalveolar lavage fluid by single cell gene expression
analysis in healthy dogs: a promising technique.
A. Fastrès1, D. Pirottin2, L. Fievez2, T. Marichal2, C.J. Desmet2, F. Bureau2, C.
Clercx2
1Clinical Sciences, University of Liège, Liège, Belgium; 2University of Liège, Liège,
Belgium
Single‐cell mRNA‐sequencing (scRNA‐seq) is a technique which enables unbiased, high
throughput and high‐resolution transcriptomic analysis of the heterogeneity of cells
within a population. This recent technique has been described in humans, mice and
other species in various conditions to cluster cells in populations and identify new
subpopulations, as well as to study the gene expression of cells in various tissues,
conditions and origins. In dogs, a species for which markers of cell populations are
often limiting, scRNA‐seq presents with elevated yet untested potential for the study
of tissue composition.
As a proof of principle, we used scRNA‐seq to identify cellular populations of the
bronchoalveolar lavage fluid (BALF) in healthy dogs (n = 4).
Cells in suspension isolated from fresh BALF were loaded into the ChromiumTM and were
directly encapsulated with unique barcoded primers using the drop‐sequencing method.
Cells were lysed and reverse transcription of mRNAs took place into vesicles. cDNA
was amplified after the breakage of the vesicles and sequenced on an Illumina NextSeq500.
The analysis of the results and statistical analysis were performed using Cell Ranger
software (v1.2.0), Seurat package in RStudio (v3.1.2) and the gene set enrichment
analysis tool (GSEA‐P).
A total of 5710 cells were obtained and analyzed. Fourteen distinct clusters of cells
were identified, further identified as alveolar macrophages (AMs) (3 clusters) and
monocytes‐derived macrophages (1 cluster). The first cluster of AMs composed by the
majority of cells exerted functions involved in immune defense and response, the second
cluster exerted functions involved in immune response regulation and the third exerted
functions involved in metal ions homeostasis. Clusters of CD8+ and CD4+ T cells were
also found (1 cluster each) as well as clusters of mature and immature dendritic cells
(1 cluster each) and clusters of ciliated or non‐ciliated epithelial cells (1 cluster
each). Finally, subpopulations of B cells, neutrophils, basophils and cycling cells
were also identified (1 cluster each).
We used for the first time in dogs the scRNA‐seq to investigate cellular subpopulations
of the BALF. This study hence expands our knowledge on dog lung immune cell populations,
paves the way for the investigation at single‐cell level of lower respiratory diseases
in dogs, and establishes that scRNA‐seq is a powerful tool for the study of dog tissue
composition.
Disclosures
No disclosures to report.
ESVIM‐O‐4
Intradermal testing in dogs with eosinophilic bronchopneumopathy
V. de Simoi1, T. M. S. A. Böhm1, R. S. Müller1, J. Palic2, Y. Zablotski1, B. Schulz1
1Clinic of Small Animal Internal Medicine, LMU University of Munich, Munich, Germany;
2Idexx GmbH, Ludwigsburg, Germany
The etiology of canine eosinophilic bronchopneumopathy (EBP) has not been clarified
to date, however, underlying allergic disease has been suggested. The aim of this
prospective study was to investigate positive reactions on intradermal testing (IDT)
in dogs with EBP and healthy control dogs.
The study included 20 dogs diagnosed with EBP and 22 healthy control dogs. Inclusion
criteria for EBP patients were typical clinical signs, eosinophilic inflammation in
the lower airways with more than 14% eosinophils in the bronchoalveolar‐lavage‐fluid
and exclusion of pulmonary parasites. IDT was performed with 43 allergens in both
groups of dogs. Positive IDT reactions after five and 15 minutes were compared between
groups using Pearson’s Chi‐squared test. The level of significance was ≤0.05.
While dogs in the EBP‐group showed a mean of 8.9 positive reactions to all allergens
tested, the control group had a mean of 7.6 positive reactions. Dogs with EBP showed
significantly more overall positive reactions than dogs in the control group (P < 0.001).
In addition, dogs with EBP had significantly more positive reactions for single allergens.
These included tabanus (P = 0.001), plantago lanceolata (ribwort) (P = 0.004), acarus
siro (P = 0.003), lolium (ryegrass) (P = 0.031), and beech (P = 0.005).
The results of the study suggest that EBP might be associated with allergen‐specific
IgE‐production compatible with allergic disease in some dogs.
Disclosures
No disclosures to report
ESVIM‐O‐5
Effects of calcitriol on oxidative burst, phagocytic function, and cytokine production
in shelter dog leukocytes
J. A. Jaffey1, M. Bessette1, Z. Tao1, N. Bradley‐Siemens2
1Specialty Medicine, Midwestern University College of Veterinary Medicine, Glendale,
USA; 2Pathology and Population Medicine, Midwestern University College of Veterinary
Medicine, Glendale, USA
Calcitriol, the hormonally active metabolite of vitamin D, has been shown across many
species (e.g., humans, dogs, mice, chickens, cows) to augment innate immune responses
and dampen aberrant proinflammatory cytokine production. Community acquired infections
including canine infectious respiratory disease complex are common in shelters and
consume limited shelter resources, impact adoption rates, and can result in unnecessary
euthanasia. Prophylactic oral vitamin D supplementation decreases the incidence and
severity of upper and lower respiratory tract infections in humans. Before a clinical
trial investigating the clinical benefit of oral vitamin D supplementation in shelter
dogs can be pursued, an in vitro study evaluating the immunomodulatory effects of
calcitriol in blood from shelter dogs is needed. Therefore, the objective of this
study was to determine if incubation of whole blood obtained from healthy shelter
dogs housed in a shelter for ≥ 7 days with calcitriol would alter granulocyte/monocyte
(GM) oxidative burst and phagocytic function as well as pathogen‐associated molecular
pattern (PAMP)‐stimulated leukocyte production of tumor necrosis factor (TNF)‐α, and
interleukin (IL)‐6, and IL‐10.
Ten healthy dogs housed in in a shelter for ≥ 7 days were enrolled in a prospective
cohort study. Whole blood from these dogs was incubated with calcitriol (10‐7 M) or
ethanol (control) for 24 h. Subsequent to this incubation phagocytosis of opsonized‐Escherichia
coli (E. coli) and E. coli‐induced oxidative burst were evaluated via flow cytometry.
In addition, leukocyte production of TNF‐α, IL‐6, and IL‐10 were measured using a
canine‐specific multiplex assay. Two‐way repeated measures analysis of variance and
paired t‐tests were used to assess leukocyte cytokine production and phagocytosis/oxidative
burst, respectively. Calcitriol significantly decreased leukocyte TNF‐α production
(P = 0.009) but not IL‐6 (P = 0.12), irrespective of type of PAMP exposure. Calcitriol
significantly increased IL‐10 when cells were exposed to LTA (P = 0.002). Tumor necrosis
factor‐α‐to‐IL‐10 ratio was significantly decreased with calcitriol when cells were
exposed to LPS (P < 0.001) or LTA (P = 0.004). Calcitriol did not significantly affect
GM oxidative burst (P = 0.16) or phagocytic function (P = 0.25).
These data indicate that calcitriol attenuates proinflammatory immune responses without
affecting GM oxidative burst or phagocytic function in vitro in whole blood obtained
from healthy dogs housed in shelters.
Disclosures
No disclosures to report.
ESVIM‐O‐6
Immune function and serum 25‐hydroxyvitamin D in shelter dogs
J. A. Jaffey1, L. Allison2, Z. Tao1, N. Bradley‐Siemens3, R. C. Backus4
1Specialty Medicine, Midwestern University College of Veterinary Medicine, Glendale,
USA; 2Department of Specialty Medicine, Midwestern University College of Veterinary
Medicine, Glendale, USA; 3Pathology and Population Medicine, Midwestern University
College of Veterinary Medicine, Glendale, USA; 4Department of Veterinary Medicine
and Surgery, University of Missouri Veterinary Health Center, Columbia, USA
There is a high prevalence of infections in shelter dogs that consume a substantial
amount of limited resources, impacts adoption rates, and can result in euthanasia.
The cause for this high rate of infections is largely unknown including if immune
dysfunction or vitamin D could be contributory factors. This study had two objectives:
1) to establish a baseline understanding of several immune function parameters in
shelter dogs and 2) to determine if serum vitamin D concentrations are associated
with immune function.
Ten apparently healthy shelter dogs and 10 healthy, non‐shelter, age, breed, and sex‐matched
control dogs were included. Serum 25‐hydroxyvitamin(OH)D, the major circulating vitamin
D metabolite was measured using high performance liquid chromatography. Whole blood
samples were stimulated with lipopolysaccharide (LPS), lipoteichoic acid (LTA), or
phosphate buffer solution (negative control) and tumor necrosis factor (TNF)‐α, interleukin
(IL)‐6, and IL‐10 were measured with a canine‐specific multiplex bead‐based assay.
Granulocyte/monocyte (GM) phagocytosis of opsonized‐E. coli and E. coli‐induced oxidative
burst were evaluated with flow cytometry. Serum 25(OH)D concentrations, GM phagocytic
and oxidative burst capacities were compared between shelter dogs and non‐shelter
dogs using two‐tailed, unpaired t‐tests. Two‐way repeated measures analysis of variance
(ANOVA) was performed to asses leukocyte cytokine production and simple linear regression
analysis was used to investigate if serum 25(OH)D concentration could predict immunologic
outcomes.
Shelter dogs had significantly decreased percentage of GM that had phagocytized opsonized‐E.
coli (P = 0.019) and performed E.coli‐induced oxidative burst (P = 0.011) compared
to non‐shelter control dogs. There was not a significant difference in TNF‐α, IL‐6,
IL‐10, or 25(OH)D concentrations between shelter and non‐shelter dogs. Serum 25(OH)D
concentrations had a weak positive significant association with the intensity of GM
E. coli‐induced oxidative burst (r2 = 0.23, P = 0.03). There was a moderate inverse
significant association between serum 25(OH)D concentration and LPS‐stimulated production
of TNF‐ɑ in shelter dogs (r2 = 0.40, P = 0.04).
These results demonstrate dogs housed in a shelter have immune dysfunction. While
serum 25(OH)D concentrations did not differ between shelter and non‐shelter dogs,
significant associations between 25(OH)D concentration and immune function parameters
were identified.
Disclosures
No disclosures to report.
ESVIM‐O‐7
Clinical, clinicopathological and imaging differences between dogs with non‐associative,
associative and precursor immune‐mediated haemolytic anemia
A. C. Ferreira1, A. I. Ferreira2, A. Paul3
1Internal Medicine, Anderson Moores Veterinary Specialists, Winchester, UK; 2Analytics
Department, Transferwise, London, UK; 3Internal Medicine, Anderson Moores Veterinary
Specialists, Winchester, USA
A retrospective assessment was made of dogs with immune mediated hemolytic anemia
(IMHA) from 2015 to 2019.
The study compared clinical, clinicopathological and imaging findings between dogs
with either non‐associative, associative or precursor‐mediated IMHA to determine if
there were significant differences between the 3 groups of disease, and identify any
potential predictors of mortality. We hypothesised that we were more likely to have
observed imaging pathology in cases of associated anemia.
Age, breed, sex, physical examination at presentation, haematology, biochemistry,
blood type, imaging type and findings, concurrent diseases, number of blood transfusions,
survival time and cause of death were recorded.
One hundred and thirty dogs, out of 304 diagnosed with IMHA, were included. Seventy
five were diagnosed with non‐associative IMHA (group 1), 18 with associative (group
2), and 36 with pIMA (group3). There were statistically significant breed dispositions,
with Cocker spaniels overrepresented in group 1 (P = 0.01) and Labrador retrievers
in group 3 (P = 0.012). Dogs diagnosed with concurrent thrombocytopenia had a significantly
increased mortality rate in all 3 groups (P = 0.006). In all groups, increased urea,
bilirubin and AST activity was associated with decreased survival (P = 0.01, 0.008
and 0.04, respectively).
Urea and AST activity were both significantly higher in group 2 (P = 0.005 and P =
0.03); bilirubin was higher in group 1 over groups 2 and 3 (P = 0.02) and platelet
count was lower in group 2 and higher in group 3 (P = 0.0001).
No statistically significant difference was seen between groups comparing ultrasonographic
and radiographic findings. Hepatosplenomegaly was the most common imaging finding
in all groups.
Neoplasia was diagnosed in 38.8% of cases in group 2, with 28.5% of these localized
to the liver.
Seventy seven percent of dogs survived beyond 30 days (56% group 1, 11% group 2 and
32% in group 3). Of the dogs not surviving to 30 days, a mean survival of 16.7 days
was identified (73% euthanized, 27% natural death). No significant difference was
found between PCV on presentation and mortality (P = 0.19). Number of blood transfusions
given had no influence on survival (P = 0.65).
This study provides further evidence of the poor prognostic indicators previously
described in the literature. A lower mortality rate was noted in this study than is
often reported; a reason could not be identified. Our hypothesis was rejected. Changes
detected on imaging alone could not predict to which group a dog would be diagnosed.
Disclosures
No disclosures to report.
ESVIM‐O‐8
L. Izquierdo Robert1, L. J. Feo Bernabé1, M. Seth2, J. Puig Prats1
1Internal Medicine, Ars Veterinaria Hospital, Barcelona, Spain; 2Internal Medicine,
Dick White Referrals, Six Mile Bottom, Cambridgeshire, UK
Point‐of‐care (POC) Feline Leukemia Virus (FeLV) screening tests are routinely performed
in veterinary practice because of their wide availability, high sensitivity and specificity,
and rapid results. FeLV testing is often performed in cats with immune mediated hemolytic
anemia (IMHA) as part of the investigation into comorbidities or triggering factors.
Here we report a number of cats with IMHA where POC FeLV testing was positive but
concurrent polymerase chain reaction (PCR) results did not identify FeLV proviral
DNA.
Between 2018 and 2019 eight cats diagnosed with IMHA had positive results using POC
FeLV test. All cats included had severe anemia, positive direct agglutination test
and no other triggering factors for IMHA were identified on screening including hemitropic
Mycoplasma PCRs and abdominal imaging.
POC tests using bidirectional flow p27 antigen enzyme‐linked immunosorbent assay (ELISA)
were performed according to manufacturer instructions. Additional quantitative real
time DNA PCR testing was performed. In 6 out of 8 cats (75%) FeLV proviral DNA PCR
was negative. POC test errors were excluded by repeat testing from different lots.
POC test were replicated in 4 patients using left‐over samples of serum, plasma and
whole blood. A concurrent p27 ELISA was performed at a reference laboratory in one
cat with a positive result. Besides severe anemia (median hematocrit 9,8%, range 3,7‐19,4%)
mild to moderate thrombocytopenia was present in all patients (median 109K/μL, range
42‐182K/μL) and hyperbilirubinemia was present in 4 of 6 patients. Five of 6 patients
responded to immunosuppressive treatment and one case was euthanized due to economical
constraints. Six months after diagnosis, two patients (including the cat that had
a positive result using the external ELISA) were re‐tested using the same POC test.
Both of them had negative results in the POC and direct agglutination test.
In conclusion, this study identified false positive results using a POC test in cats
with IMHA. These results reaffirm the recommendation that cats testing positive using
a POC FeLV test should be re‐tested using further methods, especially if IMHA is present.
Disclosures
No disclosures to report.
ESVIM‐O‐9
Clinical, clinicopathological and imaging differences between cats with non‐associative,
associative and precursor immune‐mediated hemolytic anemia
A.C. Ferreira1, A. Paul2
1Internal Medicine, Anderson Moores Veterinary Specialists, Winchester, UK; 2Internal
medicine, Anderson Moores Veterinary Specialists, Winchester, UK
A retrospective assessment was made of cats with immune‐mediated hemolytic anemia
(IMHA) from 2015 to 2019.
The study compared clinical, clinicopathological and imaging findings between cats
with either non‐associative, associative or precursor‐mediated IMHA (pIMA), to determine
if there were significant differences between the 3 forms of disease and identify
significant predictors of mortality.
Thirty one cats, out of 60 diagnosed with IMHA, were included. Ten achieved a diagnosis
of non‐associative IMHA, 7 associative, and 13 pIMHA. Age, breed, sex, physical findings
at presentation, hematology, biochemistry, blood type, imaging type and findings,
concurrent diseases, number of blood transfusions, survival time and cause of death
were recorded.
No statistically significant difference was seen between type of IMHA and ultrasonographic
and radiographic findings. Splenic extra‐medullary hematopoiesis was identified by
cytology most commonly in all forms of IMHA.
No significant breed disposition of this cohort was found (P = 0.57). Of all cases,
40% were Domestic Short Hair, 16.7% British Short Hair and 36.7% other pure breeds.
Of patients diagnosed with associative IMHA, neoplasia, specifically lymphoma, was
diagnosed in 42.8% of cases. Other causes seen included infection (42.8%), such as
FeLV, FIP and Mycoplasma felis.
Cats diagnosed with concurrent thrombocytopenia did not have a significantly increased
mortality rate (P = 0.29). No significant difference was found between PCV on presentation
and mortality (P = 0.20), number of blood transfusions given and mortality (P = 0.07),
blood type and mortality (P = 0.88) or number of blood transfusions and IMHA type
(P = 0.89).
Of the biochemical findings, an increased AST and creatinine kinase were associated
with decreased survival (P = 0.01 and 0.04, respectively).
A lower mean survival time (MST) was observed if younger than median age of 8 years
(603 versus 800 days, respectively). MST in cats with non‐associative IMHA was 1190 days,
with associative IMHA 225 days and pIMHA 567 days. Seventy one percent of cats survived
beyond 30 days (90% non‐associative, 57% associative and 69% with pIMA). Of the cats
not surviving to 30 days, a mean survival of 7 days was identified (62.5% euthanized,
37.5% natural death).
A mean of 4.78 hospitalization days was seen, with 4.7 days if non‐associative, 7
if associative and 4.1 if pIMHA, and a mean of 59.5 days for PCV to reach 30% after
treatment initialization was observed (69, 45 and 21 days, respectively).
This study provides further evidence of poor prognostic indicators previously described
in the literature and provides further assessment of the various forms of hemolytic
anemia.
Disclosures
No disclosures to report.
ESVIM‐O‐10
Clinical, diagnostic findings and short‐term outcome in 27 cats with non‐regenerative
anemia due to bone marrow disorders
M. Cervone1, J. L. Cadoré1, C. Pouzot‐Nevoret2, E. Krafft1, L. Chabanne1
1Département clinique des animaux de compagnie de loisir et de sport, Université de
Lyon, VetAgro Sup, Campus vétérinaire de Lyon, Marcy l'Etoile, France; 22Intensive
Care Unit (SIAMU), Université de Lyon, VetAgro Sup, Campus vétérinaire de Lyon, Marcy
l'Etoile, France
Little information is available about clinical picture, diagnostic findings and outcome
of feline immune‐mediated (IM) and (pre‐)neoplastic (PN) non‐regenerative anemia (NRA).
This retrospective study aimed to describe and compare the clinical and diagnostic
features, and the short‐term outcome between cats with IM‐NRA and PN‐NRA.
Our database was searched for cats diagnosed with NRA (PCV <24% and reticulocyte count
<50,000 mL) between March‐2011 and October‐2019. Inclusion criteria were available
bone marrow cytology results and known FIV‐FeLV status. Included cats were classified
in two groups: PN‐NRA [myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML)],
and IM‐NRA [pure‐red cell aplasia (PRCA), non‐regenerative immune‐mediated hemolytic
anemia (NRIMHA), and secondary dysmyelopoiesis (SD)]. Cats with myelophthisis resulting
from extra‐medullary neoplasia were excluded. Signalment, clinical signs, diagnostic
investigations, treatments, short‐term survival (within 30 days after the first presentation)
and remission (resolution of anemia within 2 months) rates were recorded and compared
between groups. The level of significance was set at P < 0.05.
Twenty‐seven cats were included (21 with IM‐NRA and 6 with PN‐NRA). Definitive diagnoses
were: NRIMHA (16), PRCA (3), MDS (4), SD (2), and AML (2). The median age was 2 years.
History revealed lethargy (96%), hyporexia (63%), weight loss (22%), digestive (15%)
and respiratory (11%) signs, and pica (7%). Physical examination showed systolic heart
murmur (63%), respiratory abnormalities (46%), abnormal body temperature (44%), and
icterus (15%). The overall median PCV was 10% (ranging from 4.1 to 23.3). Concomitant
CBC findings included macrocytosis (63%), severe thrombocytopenia (12%) and leukopenia
(12%). Six cats were found positive for infectious agents [FeLV (2), FIV (1), coronavirus
(1) and Mycoplasma haemofelis (2)]. Biochemistry revealed increased ALT (62%), hyperbilirubinemia
(43%) and hypoalbuminemia (35%). Imaging findings included cardiomegaly (57%), abdominal
lymph nodes enlargement (58%), splenomegaly (42%), hepatomegaly (33%) and abdominal
effusion (29%). No difference was found between groups about frequency of these clinical
and diagnostic findings. Cats were managed with whole blood transfusion (17), prednisolone
(27), cyclosporine (2) and/or cytarabine (2). Median duration of hospitalization (DH)
was 4 days. DH was negatively correlated with PCV (rho = ‐0.55; P < 0.05). Sixty‐one
% experienced remission within a median of 14 days. Remission rate was more frequent
in cats with IM‐NRA (67%) compared to PN‐NRA (0%) (P < 0.05). Short‐term survival
rate (89% and 20%, respectively) was also higher in cats with IM‐NRA (P < 0.05).
In this study, IM‐NRA and PN‐NRA presented with similar clinical and diagnostic findings.
However, the remission and short‐term survival rates were higher among cats with IM‐NRA.
Disclosures
No disclosures to report.
ESVIM‐O‐11
Comparison of Clinical examination, laboratory findings, prognosis and long‐term follow‐up
between client‐owned ill cats naturally infected either by Mycoplasma haemofelis or
Candidatus Mycoplasma haemominutum in a single practice
C. Beaudu‐Lange1, E. Lange2, K. Lecoq3, J. Andrejak4, C. Boucrault‐Baralon5
1Clinique vétérinaire de la pierre bleue, Pipriac, France; 2Clinique Vétérinaire de
la Pierre Bleue, Clinique vétérinaire de la pierre bleue, Pipriac, France; 3Clinique
vétérinaire, Clinique vétérinaire de la pierre bleue, Pipriac, France; 4AFVAC, AFVAC,
Paris, France; 5Scanelis, SCANELIS, Colomiers, France
Feline Hemoplasma chronic carriage has been largely described. We lack information
about clinical examination, laboratory findings, prognosis, relapse and long‐term
follow‐up in naturally infected ill cats. We hypothesized they would differ between
cats infected either by Mycoplasma haemofelis (Mhf) or by Candidatus Mycoplasma haemominutum
(Mhm).
In order to compare both groups, we retrospectively included 63 ill client‐owned cats
from 2008 to 2020, with positive hemoplasma PCR, BCC, biochemistry and FeLV/FIV status
at diagnosis. Treatment was based on saline infusion, dexamethasone (0,2 mg/kg/d/IV/3d)
and doxycycline (10mg/kg/d/30d).
Mhf positive cats (28 cases) had acute anorexia (96,4%), digestive symptoms (35,7%),
syncopa (14,3%), ataxia (14,3%), dyspnea (7,1%), urinary incontinence (7,1%); most
were young (median 2yr [0,75‐13]) non‐medicalized males (85,1%), with jaundice (64,3%),
pale mucous membrane (32,1%), and systolic heart murmur (2‐4/6, 39,3%). Few were infected
by FeLV or FIV (14,3% each, 1 coinfection). Mean hemoglobinemia was 5,1g/dl (NR 9‐15).
ALT were abnormal in 50% (median 222 UI/l, NR <100) and median Alb/Glob ratio was
0,57 (NR > 0,8). Two cats died (pulmonary edema, FIP coinfection). Twenty six cats
were discharged from hospitalization. Three non‐compliant cats respectively relapsed
at 3 weeks, 3, and 6 months (good response to second treatment), 2 cats had Mhm anemia
later on. Five died from another cause (mean follow‐up 4,2yr), 13 were still alive
at study end (follow‐up 4,4yr), (8 lost to follow‐up).
Compared to Mhf cats, Mhm positive cats (28 cases, 67,8% males, 32,1% FIV+, 7,1% FeLV+,
1coinfection) were acutely ill (67,8%), emaciated (32,1%) older (median age 7yr, P
< 0,001) with weakness (39,3%), fever (median 40°C, P < 0,05). Mean Hemoglobinemia
was 8,2g/dl (low, but higher than Mhf, P < 0,001). ALT always was in normal range
(P < 0,001). Severe comorbidities were present in 35,7% of cases (leukemia, lymphoma,
hyperthyroidism, stomatitis, panleukopenia, pericardial effusion, cardiomyopathy,
lipidosis). All cats were discharged from hospitalization. The 7 cats that died within
1‐7 months without clinical response to treatment were cachectic at diagnosis. Thirteen
cats died thereafter from another cause (mean follow‐up 3,5yr). Five cats were still
alive at study end (follow‐up 5,7yr), (3 lost to follow‐up).
Seven other cases had coinfection (Mhf+Mhm).
Mhf and Mhm induced anemia in naturally infected cats, with more severe anemia in
the former, whatever FeLV/FIV status. ALT often were increased in Mhf cats. Severe
comorbidities were frequent in Mhm cases, cachexia being a predictive factor of death,
but a large majority of affected cats were long‐term survivors without relapse in
both groups.
Disclosures
No disclosures to report.
ESVIM‐O‐12
Clinical and diagnostic findings and outcome in 58 dogs with immune‐mediated polyarthritis
M. Cervone1, L. Chabanne1, E. Krafft1, J. L. Cadoré1
1Département clinique des animaux de compagnie de loisir et de sport, Université de
Lyon, VetAgro Sup, Campus vétérinaire de Lyon, Marcy l'Etoile, France
Paucity of information exists about differences in features and outcome between dogs
with idiopathic (i‐) and reactive (r‐) immune‐mediated polyarthritis (IMPA).
The aim of this retrospective study was to compare the clinico‐biological picture
and outcome between dogs with i‐IMPA and r‐IMPA.
Our database was searched for dogs diagnosed with both erosive and non‐erosive IMPA
between June‐2004 and January‐2020. Diagnosis of IMPA was based on the presence of
aseptic neutrophilic inflammation of ≥2 joints at cytology. Idiopathic IMPA was diagnosed
after exclusion of underlying infectious, inflammatory or neoplastic diseases and/or
based on positive response to immunomodulatory therapy. Dogs with systemic lupus erythematous,
polyarthritis‐polymyositis syndrome, and steroid‐responsive meningitis‐arteritis were
excluded. Signalment, clinical signs, diagnostic findings and outcome were recorded
and compared between dogs with i‐IMPA and r‐IMPA (level of significance set at P < 0.05).
Fifty‐eight dogs (median age 4.7 years) were included (43 dogs with i‐IMPA and 15
dogs with r‐IMPA). Dogs with r‐IMPA had leishmaniasis (7), digestive disorders (3),
eosinophilic bronchopneumopathy (3), bacterial infection (1) and gossypiboma (1).
Dogs with r‐IMPA were more frequently large breed dogs (P = 0.02). Overall, common
clinical and physical abnormalities included lameness/stiffness (79%), hyperthermia
(72%), peripheral adenomegaly (72%), and lethargy (67%). Joint swelling, pain and/or
heat were present in all dogs, involving carpi (87%), tarsi (53%), stifles (54%),
elbows (47%), and hips (14%). No significant differences were found between dogs with
i‐IMPA and r‐IMPA. Frequent biological abnormalities were leukocytosis (47%), anemia
(30%), hypoalbuminemia (61%), hyperproteinemia (28%) and increased C‐reactive protein
(CRP; 90%). Overall, a significant negative correlation was observed between serum
albumin concentration and the number of affected joints (rho = ‐0.31; P = 0.04). Hyperproteinemia
(P = 0.02) was more frequent in dogs with r‐IMPA, while leukocytosis (P = 0.002) was
more frequent in dogs with i‐IMPA. Forty‐seven dogs were treated with immunomodulatory
drugs [prednisolone (45), leflunomide (5), cyclosporine (3), and mycophenolate mofetil
(1)]; their administration was more frequent among dogs with i‐IMPA (P < 0.001). Clinical
follow‐up was available for 42 dogs (30 i‐IMPA and 12 r‐IMPA). Seventy‐four% experienced
complete remission (CR; no physical abnormalities), while 21% experienced partial
remission (persistence of physical abnormalities).The mean time to CR was 38 days
and it was significantly shorter in dogs with i‐IMPA (29 days) compared to those with
r‐IMPA (50 days). There was no correlation between CRP‐to‐albumin ratio and time‐to‐remission.
Our results suggest that clinico‐biological picture and outcome are similar in dogs
with i‐IMPA and r‐IMPA. The duration to achieve CR was shorter in dogs with i‐IMPA.
Disclosures
No disclosures to report.
ESVIM‐O‐13
The mercury challenge: Feline systolic blood pressure in primary care practice, a
European survey
A. Sparkes1, C. Garelli‐Paar2, E. Guillot2
1Simply Feline Veterinary Consultancy, Shaftesbury, UK; 2Ceva Santé Animale, Libourne,
France
Systemic hypertension is an important condition in cats, but there is a paucity of
data on systolic blood pressure (SBP) values measured in cats attending primary care
practices. This convenience survey was designed to collect SBP data from a large number
of cats across numerous European countries.
From June 2018, Ceva Santé Animale invited primary care clinics to record data from
cats aged ≥7 years who had SBP measured as part of their routine veterinary care.
Owners gave permission for anonymised information from the cats to be recorded on
a central database (mercurychallenge.ceva.com), including basic demographic data,
information on concomitant disease and/or medications, SBP values, and any antihypertensive
therapy given.
By March 2020, data was available from >9100 cats from 17 countries. Of these data,
there were 5262 unique entries from cats ≥7 years of age that were receiving no concomitant
prescribed therapies. Analysis of these data revealed that according to ACVIM criteria,
36% of the cats were normotensive (SBP < 140 mmHg), 28% were pre‐hypertensive (140‐159 mmHg),
17% were hypertensive (160‐179 mmHg) and 18% were severely hypertensive (>180 mmHg).
172 cats (3.3%) had hyperthyroidism, 780 (14.8%) had CKD and 28 (0.5%) had both. Median
SBP in cats with CKD (157 mmHg), hyperthyroidism (157 mmHg) or both (167 mmHg) were
significantly higher than in cats without these conditions (146 mmHg). Excluding the
data from cats with CKD or hyperthyroidism, there was a small but significant correlation
between SBP and age (Spearman r = 0.261, P < 0.0001), a very low negative correlation
with bodyweight (Spearman r = ‐0.033, P = 0.038), but sex had no significant effect
on median SBP values. SBP values measured by oscillometry (median 151 mmHg) were significantly
higher (P < 0.0001) than those measured by Doppler (median 145 mmHg). Subjective assessment
of stress was significantly (P < 0.0001) related to SBP with nervous/aggressive cats
(median SBP 160mmHg) having higher values than anxious (153 mmHg) or calm cats (140 mmHg).
SBP measurement was reported to take <5 minutes in 51%, 5‐10 minutes in 41% and >10
minutes in 8% of cases. These data suggest SBP can be readily measured in primary
care practice and demonstrate a high prevalence of cats with potential hypertension.
Cats reported to have CKD or hyperthyroidism had significantly higher median SBP values
and both methodology and subjective assessment of stress may assist interpretation
of SBP values.
Disclosures
This survey was supported by Ceva Santé Animale.
ESVIM‐O‐14
A proteomic evaluation of greyhound meningoencephalitis using quantitative mass spectrometry
highlights the consideration of viral triggers
P. J. Guzmán Ramos1, J. C. Carolan2, B. Gerald1, C. M. Nolan3, J. J. Callanan4, C.
T. Mooney1, R. E. Shiel1
1School of Veterinary Medicine, University College Dublin, Dublin, Ireland; 2Maynooth
University, Maynooth University, Maynooth, Ireland; 3School of Zoology, University
College Dublin, Dublin, Ireland; 4Ross University, Ross University, Basseterre, Barbados
A unique form of breed‐restricted meningoencephalitis has been previously reported
in Irish greyhounds. This condition typically affects multiple littermates, consistent
with an underlying genetic, infectious or environmental trigger, or a combination
thereof. However, attempts to identify a cause using genome‐wide association and sequencing
studies, PCR‐ and serology‐based infectious disease screening, and environmental assessment,
have been unrewarding.
The aim of this study was to characterize the cerebral inflammatory response on the
proteomic level in dogs with greyhound meningoencephalitis (GHME) using mass spectrometry.
Samples were collected from young greyhounds with GHME (n = 7) and age‐ and breed‐matched
controls (n = 7). Samples were collected within 30 minutes of euthanasia. Control
dogs were euthanized for reasons other than neurological disease and had unremarkable
brain histopathology. Proteins from each cerebral tissue were extracted, quantified
and digested. A label‐free, quantitative proteomic analysis was conducted on 1μg of
the purified peptide from each sample using high resolution‐accurate mass spectrometry.
The relative fold change (RFC) in protein expression was determined. Principal component
analysis (PCA) was conducted to identify outliers and clusters of samples with similar
expression profiles. Student’s t‐tests were performed to determine statistically significant
differentially abundant (SSDA) proteins.
PCA resolved two distinct clusters. 592 SSDA proteins were identified in cerebral
samples compared to controls: 346 and 246 proteins with increased and decreased abundances,
respectively. Proteins with the most differentially increased abundance included many
associated with immunity such as interferon‐induced GTP‐binding protein Mx1 (Q9N0Y3;
RFC 471); ISG15 ubiquitin‐like modifier (E2R7R1; RFC118); two MHC class I DLA proteins
(O46882, RFC 60; O46880, RFC 45); beta‐2‐microglobulin (E2RN10, RFC 57.6); transglutaminase‐2
(F1Q435, RFC 43) and integrin beta (Q9TU04; RFC 42). Proteins with decreased abundance
included two hyaluronan and proteoglycan link proteins (E2QS06, RCF 19; F1P6Q9, RCF
4); two cytochrome c oxidase subunits (V5LJV4, RCF 12; E9NIU8, RCF 4) and aggrecan
core protein (F1PWT9, RCF 9).
The top upregulated genes are known to be responsive to interferon production. This
suggests a potential response to virus infection. ISG15, for example, has been shown
to act against multiple viruses including influenza and Chikungunya viruses by binding
and either altering function or targeting proteins for degradation. Similarly, MX1
plays an anti‐viral role by binding to and disrupting the function of virus proteins
such as the influenza virus ribonucleoprotein complex. These results support previous
gene expression studies. Further exploration of potential viral causes of GHME, and
potentially other forms of meningoencephalitis of unknown origin in dogs, is warranted.
Disclosures
The study has been performed with the support of AKC Canine Health Foundation. Grant
number 02470‐A.
ESVNU‐O‐1
Prospective evaluation of urinary alkaline phosphatase and γ ‐glutamyl transpeptidase
as diagnostic and prognostic biomarkers of acute kidney injury in dogs
R. Nivy1, Y. Bruchim1, I. Aroch1, G. Segev1
1Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Tel‐Aviv, Israel
Urinary alkaline phosphatase and γ‐glutamyl transpeptidase activity, normalized to
urinary creatinine (uALP/uCr and uGGT/uCr, respectively), increase in naturally‐occurring
acute kidney injury (AKI). Previous studies, mostly retrospective, included mainly
azotemic dogs. We aimed to examine the performance of these markers at presentation
for predicting AKI development in hospitalized, non‐azotemic dogs, at risk for AKI,
including, among others, cases of acute pancreatitis, left congestive heart failure,
sepsis, SIRS and surgery (ASA status ≥3) within 24 hours of enrollment.
The study included 20 healthy controls, and 120 hospitalized dogs, of which 15 (12.5%)
developed AKI. Twenty‐three dogs (19%) died, including seven with AKI. Median (IQR)
uALP/uCr of the AKI, non‐AKI ill and healthy control groups were 0.573 (0.692), 0.312
(0.535) and 0.033 (0.044), respectively (P < 0.001), and for uGGT/uCr, 1.990 (1.304),
1.155 (1.129) and 0.280 (0.279), respectively (P < 0.001). In post‐hoc analysis, urinary
levels of both uALP/uCr and uGGT/uCr significantly differed between the healthy controls
and either AKI or ill, non‐AKI groups (P < 0.001 for both), but only uGGT/uCr level
differed between the AKI and, ill, non‐AKI groups (P = 0.029). The area under the
ROC curve (AUC) for uGGT/uCr for predicting AKI was 0.68 (95%CI, 0.55‐0.80).
Median (IQR) uALP/uCr in the survivor and non‐survivor dogs (irrespective of AKI occurrence)
was 0.303 (0.503) and 0.533 (0.903), respectively (P = 0.027). The ROC AUC for uALP/uCr
for predicting death was 0.65 (95%CI, 0.52‐0.78).
Both biomarkers significantly differentiated healthy and ill dogs. Nevertheless, neither
was a good predictor of outcome or development of AKI, notwithstanding statistically
significant group differences
Disclosures
*The study was supported by the ECVIM‐CA clinical studies fund. **One of the coauthors
has a different unrelated study of different urinary biomarkers, which is supported
by IDEXX.
ESVNU‐O‐2
Laboratory variation of feline urinary protein: Creatinine ratio
F. Mortier1, S. Daminet1, L. Duchateau2, K. Demeyere3, E. Meyer3, D. Paepe1
1Small Animal Department, Ghent University, Merelbeke, Belgium; 2Department of Nutrition,
Genetics and Ethology, Ghent University, Merelbeke, Belgium; 3Department of Pharmacology,
Toxicology and Biochemistry, Ghent University, Merelbeke, Belgium
Proteinuria is an important prognostic factor and therapeutic target in cats with
chronic kidney disease. Nevertheless, studies on analytical factors that could affect
feline urinary protein: creatinine ratio (fUPC) results are scarce.
The current study aimed to quantify the inter‐ and intra‐laboratory variability of
fUPC and to additionally assess the agreement between laboratories with respect to
the proteinuria substage according to the International Renal Interest Society (IRIS)
classification in cats.
Urine samples were collected by cystocentesis from 60 cats (30 healthy, 30 diseased)
and aliquoted. To assess inter‐laboratory variability, urine from each cat was analysed
in four of nine collaborating laboratories. Two of these laboratories received two
aliquots per cat, in order to determine intra‐laboratory variability. The analytical
method for urine protein determination was either turbidimetry based on benzethonium
chloride (n = 5) or colorimetry based on pyrogallol red molybdate (n = 4). Urine centrifugation
before analysis was performed in five laboratories.
The fUPCs showed good interclass correlation (ICC‐inter = 0.90) and excellent intraclass
correlation (ICC‐intra = 0.99). The fUPCs obtained with turbidimetry versus colorimetry
did not significantly differ, nor did centrifugation of urine samples before analysis
affect fUPC results significantly. Agreement on IRIS substages was moderate (Fleiss’
к coefficient = 0.55) with cats being classified in the same proteinuria substage
in 75% of cases.
The present study shows that choosing a different laboratory to assess feline urine
samples does not significantly affect UPC values, but it can lead to a different classification
of proteinuria according to IRIS guidelines in 25% of cases.
Disclosures
This study is part of a PhD project that is financially supported by IDEXX Laboratories
Inc.
ESVNU‐O‐3
Liver‐type fatty acid binding protein and neutrophil gelatinase‐associated lipocalin
in feline chronic kidney disease and feline hyperthyroidism
T. Kongtasai1, D. Paepe1, S. Marynissen1, E. Buresova1, E. Meyer2, K. Demeyere2, E.
Stock3, L. Duchateau4, S. Daminet1
1Small Animal Department, Ghent University, Merelbeke, Belgium; 2Department of Pharmacology,
Toxicology and Biochemistry, Ghent University, Merelbeke, Belgium; 3Department of
Medical Imaging of Domestic Animals, Ghent University, Merelbeke, Belgium; 4Biometrics
Research Group, Ghent University, Merelbeke, Belgium
Liver‐type fatty acid binding protein (L‐FABP) and neutrophil gelatinase‐associated
lipocalin (NGAL) are potential biomarkers for early detection of pathophysiological
changes in feline kidneys. The detection of chronic kidney disease (CKD) in hyperthyroid
cats remains challenging. Early renal biomarkers, in particular in feline hyperthyroidism,
are still lacking. The aim of this study was to evaluate L‐FABP and NGAL in cats with
CKD or hyperthyroidism.
Serum and urine samples from 103 cats, of which 9 azotemic CKD cats (serum creatinine
> 2.3 mg/dL and urine specific gravity < 1.035), 49 non‐azotemic hyperthyroid cats
and 45 healthy cats, were included in this cross‐sectional study. Serum L‐FABP (sL‐FABP),
serum NGAL (sNGAL), urinary L‐FABP (uL‐FABP), and urinary NGAL (uNGAL) concentrations
were measured by commercial ELISAs validated for use in feline serum and urine samples.
Concentrations of uL‐FABP and uNGAL were reported as a ratio to urinary creatinine
(uL‐FABP/Cr and uNGAL/Cr). The biomarkers were compared between the three groups by
Wilcoxon rank sum test and reported as median values. Correlations between both serum
and urinary biomarkers and urinary protein‐to‐creatinine ratio (UPC), and between
serum and urinary biomarkers were assessed in all cats using Spearman’s correlation.
The sensitivity and specificity of L‐FABP and NGAL for the detection of azotemic CKD
were determined based on receiver operating characteristic (ROC) analysis.
CKD cats had significantly higher sL‐FABP (13.50 ng/mL; P = .013) and uL‐FABP/Cr (4.90
μg/g; P < .001) than healthy cats (4.26 ng/mL and 0.09 μg/g, respectively). Hyperthyroid
cats had significantly increased uL‐FABP/Cr (0.88 μg/g; P < .001) and sNGAL (38.24
ng/mL; P < .048) compared to healthy cats (sNGAL: 31.33 ng/mL). There was no significant
difference of uNGAL/Cr between groups (CKD cats: 3.34 μg/g; hyperthyroid cats: 2.98
μg/g; healthy cats: 3.19 μg/g). Sensitivity and specificity for the detection of azotemic
CKD were 55.6% and 88.9% for sL‐FABP (cutoff 13.50 ng/mL) and 100% and 90.9% for uL‐FABP/Cr
(cutoff 0.18 μg/g). The correlation between sL‐FABP and uL‐FABP/Cr was moderate and
significant (rs = 0.36; P < .001), but there was no correlation between sNGAL and
uNGAL/Cr (rs = ‐0.02; P = .81). A strong and significant correlation was observed
between uL‐FABP/Cr and UPC (rs = 0.78; P < .001).
In conclusion, L‐FABP rather than NGAL seems a potential biomarker for early detection
of CKD in cats and may also be a promising early renal biomarker in hyperthyroid cats.
Disclosures
No disclosures to report.
ESVNU‐O‐4
Evaluation of cystatin B as a marker of acute kidney injury in dogs and cats
H. Chen1, Y. Avital2, S. Peterson3, M. Yerramilli3, I. Aroch2, G. Segev2
1Internal medicine, Koret School of Veterinary Medicine, The Hebrew University of
Jerusalem, Rehovot, Israel; 2Koret School of Veterinary Medicine, The Hebrew University
of Jerusalem, Rehovot, Israel; 3IDEXX Laboratories, Inc., Westbrook, ME, USA
Early diagnosis of AKI and CKD is challenging. Our aim was to evaluate the diagnostic
utility of urinary Cystatin B (uCysB) as a kidney injury biomarker. Surplus urine
samples were collected from dogs and cats divided into 4 groups: AKI, CKD, healthy‐controls,
and lower urinary tract diseases [urinary tract infection (UTI) in dogs or urethral
obstruction (UO) in cats]. Eighty‐eight dogs and 76 cats were included. In dogs, uCysB
was higher in the AKI and CKD groups compared with the control and UTI groups (both,
P < 0.002). Receiver operator characteristic curve (ROC) analysis of uCysB for predicting
AKI in dogs had an area under the curve (AUC) of 0.91 (95%CI, 0.82‐0.99, sensitivity
89%, specificity 100%). In dogs with AKI, non‐survivors had higher uCysB compared
with survivors (P = 0.007). ROC of uCysB as an AKI outcome predictor had an AUC of
0.77 (95%CI, 0.61‐0.94), and a 1200 ng/mL cut‐off point corresponded to sensitivity
of 78% and specificity of 67%. Cats with AKI had higher uCysB compared with control
(P < 0.001), CKD (P = 0.001) and UO (P = 0.004). ROC analysis of uCysB for predicting
AKI had an AUC of 0.92 (95%CI, 0.84‐1.0, sensitivity 90%, specificity 92%). uCysB
in cats was higher in non‐survivors compared with survivors of AKI. ROC analysis of
uCysB as an AKI outcome predictor had an AUC of 0.84 (95%CI, 0.56‐1.0), and 469 ng/mL
corresponded to a sensitivity of 100% and specificity of 75%. In conclusion, uCysB
is a sensitive and specific marker as well as a prognostic marker for AKI in both
species.
Disclosures
Sarah Peterson and Murthy Yerramilli are IDEXX employees. The analysis of Cystatin
B was performed at IDEXX Laboratories, Inc as a part of a research collaboration
ESVNU‐O‐5
Soluble alpha klotho in senior cats
H. Sargent1, J. Elliott1, Y. M. Chang1, R.E. Jepson1
1Royal Veterinary College, London, UK
Soluble alpha klotho (sαKl) correlates positively with eGFR in humans. This study
aimed to examine the relationship between plasma sαKl and chronic kidney disease (CKD)
in senior cats.
Clinicopathological information from cats ≥9 years old (n = 143), was sourced from
the records of two first opinion practices (2011‐2016). Inclusion criteria were availability
of stored EDTA plasma and a concurrent plasma FGF23 measurement. Cats with chronic
systemic disease or plasma thyroxine > 40nmol/L were excluded. Cats were categorized
into four groups: healthy (n = 54), IRIS CKD Stage 1 if plasma SDMA >14ug/dL (n =
21) and IRIS Stages 2 (n = 42) and 3 (n = 19). Stored samples were used to quantify
sαKl using a commercially available ELISA that was validated as part of the study.
Group comparisons were made by Mann‐Whitney U tests and relationships between numerical
variables were evaluated using Spearman’s correlation. Data are presented as median
[25th, 75th percentile].
Intra and inter assay variability were <10% and dilutional parallelism was observed.
Plasma FGF23 concentrations increased with IRIS stage (healthy: 195 [134, 271] pg/mL,
Stage 1: 234 [177, 430] pg/mL, Stage 2: 498 [261, 872] pg/mL, Stage 3: 1357 [538,
4692] pg/mL) and were significantly different between all groups (P < 0.05). Plasma
sαKl concentration did not differ between groups. There was no correlation of plasma
sαKl with plasma creatinine or FGF23.
The lack of association between CKD and sαKl requires further investigation to elucidate
whether this finding is due to species differences in pathophysiological mechanisms
or methods of sαKl quantification.
Disclosures
H.J. Sargent is supported by a grant from Royal Canin SAS. J. Elliott received funding
from Consultancies: Elanco Ltd, CEVA Animal Health Ltd, Boehringer Ingelheim Ltd,
Orion Incorp, Idexx Ltd, Nextvet Ltd, Waltham Centre for Pet Nutrition; Kindrid Biosciences
Inc, Invetx Inc.; grant funding from Idexx Ltd, Elanco Ltd, Waltham Centre for Pet
Nutrition, Royal Canin SAS, Zoetis Ltd, CEVA Animal Health, Member of the International
Renal Interest Society which receives a grant from Elanco Ltd. R. Jepson received
funding from PetPlan, Feline Foundation for Renal Research, RVC Internal Grant, PetSavers,
and consultancy agreements: Boehringer Ingelheim, Merial, CEVA. Speaking honoraria:
Boehringer Ingelheim, Hills Pet Nutrition, CEV.
ESVNU‐O‐6
Risk factors associated with disturbances of calcium homeostasis following the initiation
of phosphate‐restricted diet in cats with chronic kidney disease
P. K. Tang1, R. Geddes2, Y. M. Chang3, R. Jepson2, J. Elliott1
1Department of Comparative Biomedical Sciences, Royal Veterinary College, London,
UK; 2Department of Clinical Science and Services, Royal Veterinary College, London,
UK; 3Research Support Office, Royal Veterinary College, London, UK
Dietary phosphate restriction improves survival in cats with chronic kidney disease
(CKD). However, feeding a phosphate‐restricted diet may contribute to development
of hypercalcemia. This study aimed to identify risk factors associated with increasing
plasma total calcium concentrations (TCa) following transition onto a phosphate‐restricted
diet in CKD cats.
Records from two first‐opinion practices were reviewed to identify cats with CKD transitioned
onto a renal diet. Change in TCa, 200 days following diet change, were assessed using
linear regression and dichotomized into “uptrend” (regression gradient >0) and “non‐uptrend”
(gradient ≤0) groups. Clinical data are presented as median [25th, 75th percentile].
Baseline variables were compared (Mann‐Whitney U and logistic regression) to explore
risk factors for increasing TCa.
Seventy‐one euthyroid cats (IRIS CKD stages 2 [n = 54] and 3 [n = 17]) were enrolled.
Forty cats had “uptrend” TCa and 31 were “non‐uptrend”. Significantly different variables
at baseline (uptrend vs. non‐uptrend) included potassium (3.72 [3.46, 4.01] vs. 4.08
[3.82, 4.29] mmol/L; P = 0.003), phosphate (1.20 [1.09, 1.47] vs. 1.39 [1.23, 1.54]
mmol/L; P = 0.034) and sodium (150 [148, 153] vs. 152 [150, 155] mmol/L; P = 0.036).
No significant differences in TCa, ionized calcium, creatinine, FGF23 and PTH were
found. In multivariable logistic regression, baseline potassium (OR = 1.19 per 0.1 mmol/L;
P = 0.003) and phosphate (OR = 1.15 per 0.1 mmol/L; P = 0.014) remained independent
risk factors for uptrend calcium status.
A lower baseline potassium and/or phosphate concentration is independently associated
with increasing TCa in CKD cats fed renal diet, suggesting involvement of these analytes
in renal calcium reabsorption may contribute to hypercalcemia in some cats.
Disclosures
P.K. Tang received PhD studentship funded by Royal Canin SAS. R. Geddes received funding
from Petplan and an RVC Internal Grant; has a consultancy agreement with Boehringer
Ingelheim; speaking honoraria from Boehringer Ingelheim. Y.M. Chang had no conflicts
of interest to declare. R. Jepson received funding from PetPlan, Feline Foundation
for Renal Research, RVC Internal Grant, PetSavers, and consultancy agreements: Boehringer
Ingelheim, Merial, CEVA. Speaking honoraria: Boehringer Ingelheim, Hills Pet Nutrition,
CEVA. J. Elliott received funding from Consultancies: Elanco Ltd, CEVA Animal Health
Ltd, Boehringer Ingelheim Ltd, Orion Incorp, Idexx Ltd, Nextvet Ltd, Waltham Centre
for Pet Nutrition, Kindred Biosciences Inc, Invetx Inc; grant funding from Elanco
Ltd, Waltham Centre for Pet Nutrition, Royal Canin SAS, Idexx Ltd., Zoetis Ltd, CEVA
Animal Health, Member of the International Renal Interest Society which receives a
grant from Elanco Ltd.
ESVNU‐O‐7
The effect of bacteriuria on survival and disease progression in cats with Azotemic
chronic kidney disease
C. Hindar1, Y.M. Chang2, R.E. Jepson1
1Department of Clinical Science and Services, Royal Veterinary College, Hatfield,
UK; 2Research Support Office, Royal Veterinary College, Hatfield, UK
Cats with chronic kidney disease (CKD) have an increased prevalence of positive urine
cultures (PUC). To date there is limited information available regarding the prognosis
of cats with CKD and concurrent PUC. The aim of this study was to determine the effect
of PUC on survival time and disease progression in cats with CKD.
Client owned cats with azotemic CKD were retrospectively identified by searching medical
records between 1997‐2018. Selected cats were classified as having “no‐PUC” or “PUC”
based on serial urine culture results. PUC cats were further classified as having
one or multiple PUC, and were also classified based on the presence or absence of
clinical signs of urinary tract infection (UTI). All cats with PUC received standardized
antibiotic treatment irrespective of the presence or absence of clinical signs of
UTI. CKD progression was defined as a plasma [creatinine] increase of ≥ 25% within
365 days of CKD diagnosis; PUC also had to have occurred within this timeframe. Survival
time and frequency of CKD progression were compared between groups.
There was no significant difference in survival time between cats with no‐PUC and
cats with any number of PUC (P = .908), or between cats with no‐PUC, one PUC and multiple
PUC (P = .367). There was also no significant difference in the frequency of CKD progression
between the PUC and no‐PUC cats (P = .504), or between no‐PUC, one PUC and multiple
PUC cats (P = .22). When assessing cats with clinical signs of UTI, there was no significant
difference in the frequency of CKD progression between cats with true UTI, subclinical
bacteriuria and no‐PUC (P = .797).
This study demonstrated that when treated with antibiotics, PUC in cats with CKD do
not affect disease progression or survival time.
Disclosures
Rosanne Jepson has funding from the PetPlan Charitable Trust and the Foundation for
Feline Renal Research, and has consultancy agreements with Boehringer Ingelheim and
CEVA.
ESVNU‐O‐8
Renal AA‐amyloidosis in shelter cats: A retrospective study based on clinico‐pathological
data, light microscopy and ultrastructural features
F. Ferri1, C. Palizzotto1, S. Ferro2, S.L. Benali3, L. Aresu4, F. Porporato1, F. Rossi1,
V. Fiore5, C. Callegari1, C. Guglielmetti6, M. Mazza6, E. Zini7
1Internal Medicine, Istituto Veterinario di Novara, Granozzo con Monticello (NO),
Italy; 2Department of Comparative Biomedicine and Food Science, University of Padua,
Legnaro (PD), Italy; 3La Vallonèa, Laboratorio di Analisi Veterinarie, Passirana di
Rho (MI), Italy; 4Department of Veterinary Science, University of Turin, Grugliasco,
Italy; 5La Cincia, Italy; 6Istituto Zooprofilattico Sperimentale del Piemonte, Liguria
e Valle d'Aosta, Italy; 7Vetsuisse Faculty, University of Zurich, Zürich, Switzerland
Systemic AA‐amyloidosis is a protein misfolding disease characterized by extracellular
deposition of non‐soluble fibrils arising from the acute phase protein serum amyloid
A; the kidney is one of the target organs. In cats, systemic AA‐amyloidosis is described
in the familial form in Abyssinian and Siamese breeds, and rarely in the reactive
form in domestic shorthairs. Recently, a prevalence of systemic AA‐amyloidosis ranging
from 46.1‐71.4% has been reported in shelter cats. Proteinuria and azotemia are hallmarks
of renal AA‐amyloidosis in dogs and humans; similarly, chronic kidney disease (CKD)
is observed in Abyssinian cats with AA‐amyloidosis. Whether shelter cats with renal
AA‐amyloidosis have CKD is unknown. Hence, aims of this study are to describe kidney
laboratory, histopathological and ultrastructural findings in shelter cats with renal
AA‐amyloid deposits.
Cats from one shelter were considered if necropsy was performed within 6 hours from
death and kidney samples were collected. Routine histochemistry was used to diagnose
and score amyloid deposits and characterize tubulointerstitial damage, electron microscopy
to differentiate glomerular lesions. Cats were included if renal‐AA amyloidosis was
diagnosed and had laboratory data available within 5 weeks before death.
Eleven cats were included. All were domestic shorthairs, 5 were male and 6 females.
The mean age was 7.9 years (range: 2‐13). All cats had blood analyses available, 9
urinalyses. Mean serum creatinine concentration was 3.1 mg/dL (range: 1.5‐7.0); 1
cat was in CKD IRIS stage I, 5 in stage II, 3 in stage III, and 2 in stage IV. SDMA
concentration was 32.5 mg/dL (range: 17‐69). Ten cats had anemia (hematocrit: 20.9%;
15.8‐29), 9 hypoalbuminemia (2.3 g/dL; 1.2‐2.9). All urinalyses showed proteinuria
(urine protein‐to‐creatinine ratio: 3.66; 0.5‐10.6); in 6 cats proteinuria was >2.
One cat repeatedly presented normoglycemic glycosuria. Urinary specific gravity was
1020 (1010‐1046). Ten cats had amyloid deposits in the glomeruli and all in the tubulo‐interstitium.
Seven cats had concurrent interstitial nephritis, one renal lymphoma and one membranoproliferative
glomerulonephritis. Interestingly, two cats with interstitial nephritis and proteinuria
>2, had severe tubulo‐interstitial amyloidosis and only mild glomerular amyloidosis.
In conclusion, renal AA‐amyloidosis is associated with azotemia and proteinuria in
shelter cats. Additionally, amyloid deposits are observed both in the glomeruli and
tubulo‐interstitium. Of note, some cats with prominent tubulo‐interstitial lesions
may have severe proteinuria. Whether tubulo‐interstitial amyloid justifies glycosuria
in one cat remains unclear. Renal AA‐amyloidosis should be included in the differential
diagnoses of shelter cats with CKD.
Disclosures
The research project received the BIRD 2019 from the University of Padua (Italy) and
the 2019 AniCura Research Fund.
ESVNU‐O‐9
Survival rate and prognostic factors in dogs with acute on chronic kidney disease
A. Dunaevich1, H. Chen1, D. Musseri2, M. Mazaki‐Tovi1, S. Kuzi1, I. Aroch1, G. Segev1
1Internal Medicine, Koret Veterinary School, Rishon Lezion, Israel; 2Koret Veterinary
School, Rishon Lezion, Israel
Chronic kidney disease (CKD) is the most common urinary tract disease in small animals,
with estimated canine prevalence of 0.5%‐7%. Acute exacerbation of CKD (ACKD) is common,
however, its etiologies, risk‐factors and prognosis have not been described. The aims
of this study were to characterize the etiology, clinical and laboratory findings,
short‐ and long‐term prognosis of dogs with ACKD. The study included 100 dogs with
ACKD, diagnosed and hospitalized in a veterinary teaching hospital. Median age was
144 months (range, 18‐288 months). There was no difference in age between survivors
(155 months, range, 24‐225 months) and non‐survivors (132 months, range,18‐288 months)
(P = 0.349). Pyelonephritis was the most common identified etiology. There was no
difference in mortality rate among etiologies (P = 0.464). Median hospitalization
time was 5 days (range, 2‐29 days) and was significantly longer in survivors (6 days,
2‐29 days) compared with non‐survivors (4 days, range, 2‐20 days) (P < 0.001). IRIS
AKI grade was associated (P = 0.009) with the short‐term survival. In a multivariable
analysis, increased respiratory rate (P = 0.012), CK activity (P = 0.005) and serum
creatinine concentration (P = 0.041) at presentation were associated with outcome.
The median survival time of dogs discharged was 105 days (95%CI, 25‐184), with 35
and eight dogs surviving up to 6 and 12 months respectively. The etiology (P = 0.16)
and serum creatinine concentration (P = 0.59) at discharge were not predictors of
long‐term survival. In conclusion, the short‐term outcome of dogs with ACKD is comparable
to AKI, however, long‐term prognosis is guarded. IRIS AKI grade is a prognostic indicator
of the short‐term outcome.
Disclosures
No disclosures to report.
ESVONC‐O‐1
Prognostic impact of time interval between surgery and initiation of adjuvant chemotherapy
following limb amputation in dogs with appendicular osteosarcoma without distant metastases
L. Marconato1, P. Buracco2, G. Polton3, R. Finotello4, D. Stefanello5, S. Sabattini1
1Department of Veterinary Medical Sciences, University of Bologna, Ozzano nell'Emilia,
Italy; 2Department of Veterinary Sciences, University of Torino, Grugliasco, Italy;
3North Downs Specialist Referrals, Bletchingley, Surrey, UK; 4Department of Small
Animal Clinical Science, Institute of Veterinary Science, University of Liverpool,
Neston, UK; 5Dipartimento di Medicina Veterinaria, University of Milan, Lodi, Italy
Adjuvant chemotherapy should be initiated in a timely manner following surgery to
maximally impact residual neoplasia. However, optimal timing remains unknown. The
aim of this retrospective study was to examine whether there was a measurable prognostic
impact of the time interval to adjuvant systemic chemotherapy (TI) in dogs with appendicular
osteosarcoma following limb amputation. The objectives of the study were to evaluate
whether any relationship existed between TI and prognosis and, if so, whether there
was an optimal TI or a TI after which the benefit of treatment decreases.
Dogs were included if they underwent limb amputation for a histologically‐confirmed
appendicular osteosarcoma; had no evidence of distant metastases; had a body weight
>15 kg; received at least 4 cycles of adjuvant dose‐intense chemotherapy, and had
complete clinico‐pathologic and follow‐up data. The following clinico‐pathological
factors were analyzed: breed; age; sex; weight; symptom duration; site of osteosarcoma;
lymph node metastasis; distant metastasis; alkaline phosphatase; monocytes; lymphocytes;
type of imaging; chemotherapy protocol; number of cycles; chemotherapy‐related toxicity,
and cause of death.
Dogs were classified into 8 groups based on whether they received chemotherapy 3,
5, 7, 10, 15, 20, 30 days or >30 days after surgery. Survival analyses was performed
to identify potential prognostic factors.
One‐hundred and thirty dogs were included. The median TI was 14 days (range, 1‐70).
TI of 7 days was associated with the greatest survival benefit: dogs receiving chemotherapy
8 or more days after surgery had a risk 1.8 times higher for death from osteosarcoma‐related
causes (P = 0.008).
Median time to progression (TTP) for dogs receiving chemotherapy within 7 days [440
(95% CI, 334‐546)] was significantly higher than that for dogs being treated after
7 days [243 (95% CI, 200‐286)]; P = 0.026]. Median overall survival (OS) for dogs
receiving chemotherapy within 7 days [533 (95% CI, 397‐668)] was significantly higher
than that for dogs being treated after 7 days [281 (95% CI, 248‐314)]; P = 0.007].
No other potential prognostic factors were associated with TTP or OS.
Findings from our study indicate that the timing of chemotherapy initiation is an
important prognostic variable. Based on these data, we recommend that great efforts
should be made to minimize post‐surgical recovery time to enable starting adjuvant
chemotherapy within 7 days post‐surgery. TI of 7 days was associated with a significant
survival benefit in our population of dogs with non‐metastatic appendicular osteosarcoma.
Disclosures
No disclosures to report.
ESVONC‐O‐2
Phase I dose escalation study of 12b80: Hydroxybisphosphonate linked doxorubicin—in
dogs with naturally occurring osteosarcoma
P. Boyé1, E. David2, R. Le Bot2, F. Serres3, L. Marescaux4, D. Tierny5
1Department of Oncology, Oncovet, Villeneuve‐d'Ascq, France; 2Atlanthera, Saint Herblain,
France; 3Department of Cardiology, Oncovet, Villeneuve‐d'Ascq, France; 4Department
of Diagnostic Imaging, Oncovet, Villeneuve‐d'Ascq, France; 5OCR (Oncovet‐Clinical‐Research),
Loos, France
Comparative oncology has revealed that spontaneous occurring osteosarcoma in dogs
provides a singular opportunity for preclinical modelling. The molecule 12b80 is a
new antineoplastic compound, combining doxorubicin to a bone targeting hydroxybisphosphonate
vector using a pH‐sensitive linker, designed to specifically trigger doxorubicin release
in acid bone tumor microenvironment. In in vivo study, 12b80 displays a stronger antitumor
activity on rodent orthotopic osteosarcoma compared with doxorubicin/zoledronate combination.
This phase I study was aimed to determine the safety and toxicity profiles of 12b80
in dogs with spontaneous occurring osteosarcoma, with the objective to translate findings
from dogs to humans.
Ten client‐owned dogs with naturally occurring osteosarcoma were enrolled in a prospective,
open‐label, phase I dose escalation study using an accelerated dose‐titration design
followed by 3+3 design. Four dose levels were evaluated: 4 mg/kg (n = 1), 6 mg/kg
(n = 2), 8 mg/kg (n = 3), 10 mg/kg (n = 4). The protocol consisted of three cycles
of 12b80 intravenous (IV) injections, administered every three weeks. After completion
of the three cycles, dogs underwent a complete end‐staging (day 56) including whole‐body
computed tomography and bone tumor biopsy. Endpoints included safety, tolerability,
maximum tolerated dose (MTD), and dose‐limiting toxicity (DLT) evaluated according
to VCOG criteria. Preliminary antitumor activity of 12b80 was also evaluated.
The MTD of 12b80 was 8 mg/kg (i.e. equivalent calculated dose of doxorubicin of 110
mg/m2, range: 93 – 126). No DLT was observed at this dose level. Most adverse events
included grade ≤ 2 gastrointestinal disorders and hypersensitivity reactions. No hematologic
DLT were observed at any dose level tested. No cardiac DLT was reported on follow‐up
echocardiogram (day 56) and postmortem cardiac biopsy. Stable disease without evidence
of metastatic disease was reported in two (2/10, 20%) dogs at D56. Histopathology
analysis of the bone tumor biopsies following three cycles of 12b80 revealed a stable
mitotic index in two dogs and increased necrosis in bone tumor biopsy in five dogs.
The median survival for six (6/10, 60%) dogs who completed the three cycles of 12b80
was 157 days (range: 56 – 766).
This study suggests that 12b80 is overall well tolerated in dogs, expanding the therapeutic
index of doxorubicin up to four times the standard dose of 30 mg/m2 in dogs without
associated DLT. The results show potential translational relevance for further clinical
development of 12b80 in dog and human osteosarcoma.
Disclosures
No disclosures to report.
ESVONC‐O‐3
Factors associated with the onset of neutropenia in dogs receiving lomustine‐based
chemotherapy
E. Treggiari1, G. Cossu2, P. Valenti3, A. Taylor4
1Centro Specialistico Veterinario, Milan, Italy; 2Willows Veterinary Centre and Referral
Service, UK; 3Clinica Veterinaria Malpensa, Italy; 4Royal Veterinary College, Queen
Mother Hospital for Animals, UK
Lomustine (CCNU) is an oral alkylating agent in the nitrosourea subclass. A known
adverse effect is myelosuppression and particularly neutropenia, and its onset remains
unpredictable. The aim of this study is to evaluate a population of dogs treated with
CCNU, to define the frequency of neutropenic events and to identify predictive factors.
Following a medical record database search of various European institutions from 2007
to 2019, dogs receiving CCNU for different malignancies were identified. All dogs
were required to have a complete blood cell count prior to and 7‐10 days following
treatment. Dogs were excluded if they had hematologic changes consistent with cytopenia(s)
prior, or if they received other chemotherapeutics within 14 days of CCNU. Variables
included breed, gender, age, body weight, total dose of chemotherapy, use of concurrent
steroids, CCNU used as single agent or as inclusion in multidrug protocols, and use
of CCNU as first line or in the rescue setting. The effect of neutropenia on median
survival time (MST) and progression‐free survival (PFS) was also evaluated.
One‐hundred and fifteen cases were included. Median age was 7 years (range 1‐14 years)
and median body weight was 27.6 kg (range 3‐74 kg). Median CCNU dose was 63.5 mg/m2
(range 27.8‐84.9 mg/m2). The most common clinical diagnosis was lymphoma in 70 cases
(60.9%), followed by histiocytic sarcoma in 31 (27%), mast cell tumor in 12 (10.4%)
and undifferentiated round cell tumor in 2 cases (1.7%). CCNU was used as single agent
in 75 cases (65.2%), whilst it was part of a multidrug protocol in 40 (34.8%); in
72 cases (62.6%) it was used as first line and as a rescue in 43 cases (37.4%). Neutropenia
was recorded in 75 cases (65%) with events classified as VCOG grade I (28%), II (16%),
III (29%) and IV (27%). Tumor type (histiocytic sarcoma), use of CCNU as first line
and total dose (>70 mg/m2) were significantly associated with an increased risk of
developing neutropenia, including grade III and IV events. The MST of neutropenic
patients was not significantly different compared to non‐neutropenic patients (129
vs. 131 days, respectively) nor was PFS (63 vs. 62 days, respectively).
In conclusion, when CCNU is administered to dogs with histiocytic sarcoma, used first
line and at a total dose over 70 mg/m2 there may be an increased risk of neutropenia,
and deserves consideration in order to minimize severe and potentially life‐threatening
adverse events.
Disclosures
No disclosures to report.
ESVONC‐O‐4
Prevalence of reproduction pathologies and associated death with survival analysis
among bitches over 6 years of age in a single practice
C. Beaudu‐Lange1, E. Lange2, K. Lecoq3, S. Larrat4
1Clinique vétérinaire de la pierre bleue, Pipriac, France; 2Clinique Vétérinaire de
la Pierre Bleue, Clinique vétérinaire de la pierre bleue, Pipriac, France; 3Clinique
vétérinaire, Clinique vétérinaire de la pierre bleue, Pipriac, France; 4Clinique vétérinaire,
Clinique vétérinaire Benjamin Franklin, Brech, France
Very few data is available concerning reproduction pathologies (RP) morbidity and
mortality among bitches in a context of low sterilization rate. We hypothesized that
RP morbidity and mortality would be higher among unspayed compared to spayed females,
and looked for RP effect on life expectancy.
Female medical records born from 2000 to 2003 were reviewed in a single practice.
Cases were included if at least one complete visit was done from 6 years of age, with
known sterilization status (< or >2 years). Ovariectomy was systematically advised
at puberty and unilateral complete mastectomy with ovariectomy as soon as any mammary
tumor (MT) was discovered. Among 602 included cases (IC), main RP (pyometra, MT) were
statistically compared regarding sterilization status. 293 females were followed up
until death (UD) with a last clinical examination. Females considered dead due to
RP presented either with invasive MT or pulmonary metastasis confirmed with X‐ray,
or severe pyometra with poor general condition. The age at the last consultation was
used for the survival analysis, with data considered right censored for individuals
lost to follow‐up (n = 309). The effects of early spaying and of mammary tumors on
survival was analyzed with Kaplan‐Meier and Cox‐model analysis.
Among IC, 8,3% were spayed before‐2, 40,5% later, 51,2% weren’t. Seventy‐nine females
(13,1%) were presented with a pyometra, of which 15 died. Hundred and sixty‐three
females (27,1%) developed MT (median age 10), 60 had surgery (36,8%, median age 9).
Among UD group, 36,2% presented MT during their life of which 18,4% deceased from
MT, 4,4% were euthanized without identified cause of death and 13,3% died from another
cause.
Early spaying was significantly associated with lower incidence of MT and associated
mortality (Fisher’s exact test, respective odds ratio = 0.1,P < 0.001; odds ratio
= 0,P = 0,016). The survival analysis did not show any significant effect of the diagnosis
of MT or early spaying on survival (P = 0.47 and P = 0.92 respectively). Among females
presenting MT, undergoing surgery significantly increased the survival by a factor
of 2.6 (cox model, P < 0.001). The age at which MT was discovered had a significant
negative effect on survival, with each additional year decreasing the survival by
a factor of 1.35 (cox model, P < 0.001).
Reproduction pathologies caused mortality in 23% of females in this low‐sterilization
rate cohort. Early spaying was statistically associated with lower mammary tumors
incidence and mortality but did not change life expectancy.
Disclosures
No disclosures to report.
ESVONC‐O‐6
Prevalence of peripheral blood and bone marrow infiltration in canine extranodal lymphoma
V. Attorri1, F. Riondato2, A. Dentini3, P. Valenti4
1Veterinary Hospital I Portoni Rossi, Zola Predosa, Italy; 2Dipartimento di Scienze
Veterinarie, Grugliasco, Italy; 3Clinica Veterinaria Tyrus, Terni, Italy; 4Clinica
Veterinaria Malpensa, Samarate, Italy
Extranodal lymphomas (LSA) account for less than 20% of canine lymphoma cases; this
group includes heterogeneous forms classified as stage 5 based on the WHO clinical
staging system, regardless of peripheral blood (PBI) and bone marrow involvement (BMI).
Most recent studies have focused on the evaluation of PBI/BMI in multicentric LSA
cases but its prevalence and prognostic role in canine extranodal LSA has not been
documented in detail. The aim of our study was therefore to evaluate PBI/ BMI in canine
extranodal LSA cases. For inclusion into the study, patients were required to have
cytological or histological diagnosis of LSA, complete blood count, biochemical examination,
chest x‐ray study, abdominal ultrasound and flow cytometry evaluation on peripheral
blood (PB) and bone marrow (BM). A cut‐off of 0,56% (PBI) and 2,45% (BMI) was used
in case of large B or large T immunophenotype; no cut‐off was adopted in case of aberrant
T immunophenotypes. Seventeen cases were enrolled in the study, including 4 alimentary,
3 spinal, 3 cutaneous, 2 mediastinal, 2 splenic, 1 renal, 1 intra‐abdominal and 1
nasal. Sixteen cases were intermediate‐large cell LSA and 1 was a small cell LSA.
Eight out of the 12 immunophenotyped cases were T‐LSA (66,7%) and 4 were B‐LSA (33,3%);
in 5 cases the immunophenotype of neoplastic cells was not available and PBI and BMI
were defined on the presence of atypical and/or large lymphoid cells. At the time
of diagnosis, 3 cases (17,7%) showed both BMI and PBI (1 alimentary, 1 cutaneous,
1 intra‐abdominal), 2 (11,8%) had only BMI (1 spinal, 1 mediastinal) and 1 (5,9%)
only PBI (cutaneous). All these patients except the last one showed one or more hematologic
abnormalities. No BMI or PBI were detected in 11 cases (64,7%); hematologic abnormalities
were present in 6 cases. Due to the moderate prevalence of PBI/ BMI, our preliminary
results suggest that a complete staging including BM aspiration could not be always
necessary for canine extranodal LSAs. Unfortunately, hematologic abnormalities do
not appear to be predictive of the BMI. Further studies to define the prognostic value
of BMI are needed to clarify the role of BM evaluation in extranodal LSA.
Disclosures
No disclosures to report.
ESVONC‐O‐7
A preliminary immunohistochemical study of signal transducer and activator of transcription
3 (STAT3) expression and its prognostic significance in 57 canine anal sac adenocarcinomas
A. Mosca1, J. M. Dobson1, K. Hughes1
1The University of Cambridge, Cambridge, UK
Prognostication in canine anal sac adenocarcinomas (ASACs) is difficult due to conflicting
evidence regarding metastatic rates and median survival times (MST). The transcription
factor signal transducer and activator of transcription 3 (STAT3) is a prognostic
predictor in several human cancers. The aim of this retrospective study was to assess
STAT3 expression in ASAC and explore its association with clinical presentation and
outcome. We hypothesized that STAT3 expression would distinguish tumors with early
versus late metastasis.
Records from “Institute A” were searched for dogs diagnosed with ASACs from 2008 to
2019. Immunohistochemical expression of phosphorylated STAT3 (pSTAT3) was assessed
in primary tumors (n = 52) and metastatic lymph nodes (n = 31) and MST were calculated
for cases with low and high pSTAT3 expression.
Of the 57 cases assessed, 27 presented with primary tumors with no metastasis and
30 with primary and local metastatic disease. Nuclear pSTAT3 expression occurred in
a minority of neoplastic cells of 55/57 cases, mainly in the tumor periphery. Expression
of pSTAT3 showed no significant difference between metastatic cases at presentation
and cases that metastasized after 6 months or never metastasized. There was no significant
difference between MST in cases with high and low pSTAT3 expression. Cases that presented
with metastatic disease had shorter MST (395 days) than those with primary tumors
alone (623 days).
pSTAT3 is variably expressed in primary and metastatic ASACs cells, however in this
study pSTAT3 did not provide prognostic information for canine ASACs.
Disclosures
No disclosures to report.
ESVONC‐O‐8
Unravelling tumor‐driving mutations in canine mast cell tumors and metastatic lymph
nodes by next generation sequencing
M. L. Arendt1, K. Wong2, F. Constantino‐Casas3, J. M. Dobson3, D. Adams2
1University of Copenhagen, Frederiksberg c, Denmark; 2Wellcome Trust Sanger Institute,
Hinxton, UK; 3Department of Veterinary Medicine, University of Cambridge, Cambridge,
UK
Mast cell tumors are one of the most common canine neoplasms. Although progress has
been made understanding this neoplasm, mast cell tumors can still behave unpredictably
and at times be a clinical challenge. In addition the presence or absence of metastatic
disease can be difficult to conclude as the differentiation between reactive and neoplastic
mast cells based on cytology and histology is challenging. It has been shown that
some mast cell tumors carry mutations in the KIT oncogene in exon 8, 9 or 11 however
little is known about additional somatic variants driving oncogenesis and metastasis.
In order to investigate this further, with the view to identify somatic variants which
could shed light on the biological behavior of mast cell tumors and potentially be
used for prognostication or detection of metastasis, we performed exome sequencing
on paired tumor and normal DNA from 18 mast cell tumors and 11 paired metastatic lymph
nodes based on achieved FFPE tissues and peripheral blood samples. All samples consisted
of surplus diagnostic material stored with owner consent. Data was aligned to CanFam
3.1 following the GATK best practices and somatic variants called using Mutect 1,
MAC and Strelka with appropriate filtering of normal variants and false positive calls.
After filtering for quality and sequencing coverage, data was available for 13 primary
mast cell tumors and (9 cutaneous, 3 subcutaneous, 1 intramuscular) and 10 lymph nodes.
The most commonly mutated gene detected in the mast cell tumors was SETD2, which carried
loss of function mutations in 4 tumors (31%). SETD2 is a known tumor suppressor gene,
which has previously been shown to be implicated in canine osteosarcoma and in high‐grade
human mast cell neoplasia. Only 3 (23%) tumors carried mutations in the KIT gene in
exon 8, 9 and 11 respectively. In general very few coding mutations where identified
in the metastatic lymph nodes which could be related to low tumor cell cellularity
in the sequenced lymph nodes. More sensitive methods should be applied for detection
of mast cell tumor specific mutations in lymph nodes.
Disclosures
This research is funded by the ECVIM Clinical studies fund.
ESVONC‐O‐9
Alternative lengthening of telomeres in canine histiocytic sarcomas of Bernese Mountain
dogs and other breeds is infrequently used as telomere maintenance mechanism
T. Kreilmeier‐Berger1, H. Aupperle‐Lellbach2, M. Reifinger3, K. Holzmann4, M. Kleiter1
1Department for Companion Animals and Horses, University of Veterinary Medicine Vienna,
Vienna, Austria; 2Laboklin GmbH & Co. KG, Bad Kissingen, Germany; 3Department of Pathobiology,
University of Veterinary Medicine Vienna, Vienna, Austria; 4Department of Medicine
I, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
Some human sarcoma subtypes use the telomerase‐independent telomere maintenance mechanism
(TMM) alternative lengthening of telomeres (ALT) more frequently than other cancers
to overcome senescence. Previously, ALT activity was identified in 6/64 various canine
sarcomas including 2/5 (40%) histiocytic sarcomas (HS). The aim of this retrospective
study was to analyze the prevalence of ALT in a larger canine cohort of HS including
a sub‐cohort of Bernese Mountain dogs (BMDs).
Sixty‐seven dogs with HS including 50 BMDs from two centers were evaluated. ALT‐positive
canine and human tumor samples served as controls. DNA was extracted by commercial‐kit
(Nexttec) from archived formalin‐fixed paraffin‐embedded (FFPE) samples submitted
for routine diagnostic and quantified by fluorescence dye. ALT activity was examined
through extrachromosomal telomeric DNA‐circles using radiolabel C‐circle (CC) assay.
Following published recommendations, after background correction and normalization
on input DNA signals of abundant Alu‐elements, levels above 5fold background were
defined as ALT‐positive and between 2‐to‐5fold as borderline.
Samples of two BMDs showed weak ALT activity 5.1 and 5.5fold above background compared
to 232fold above background detected from control human osteosarcoma cell line U2OS.
Two non‐BMD‐samples revealed borderline ALT‐positive signals of 2.2fold above background
each. Other samples were ALT‐negative. Positive controls showed CC‐signals in expected
ranges, important to exclude false‐negatives.
The results indicate contrary to the previous study that HS seem to use weak ALT activity
with prevalences of 4% in BMDs and ≤9% in other breeds. Future studies may demonstrate
high prevalence of the other TMM telomerase activity with potential as prognostic
marker and therapeutic target.
Disclosures
No disclosures to report.
ESVONC‐O‐10
Effect of low dose rate half body irradiation on the remission and survival times
for dogs with multicentric, substage a, B cell lymphoma treated with multiagent chemotherapy
M. P. Best1, R. C. Straw2, E. Gumpel2, D. Fry2
1Eastcott Referrals, Swindon, UK; 2Brisbane Veterinary Specialist Centre, Brisbane,
Australia
Multiagent chemotherapy has proven highly effective at inducing remission in dogs
with multicentric, B cell lymphoma but, despite efforts to extend response durations,
current literature suggests average first remission durations are less than one year.
Several published studies of dogs treated with half body irradiation show longer survival
times but they lack control groups to confirm these results. The aim of this study
was to investigate the benefit of half body irradiation to dogs with substage a, B
cell lymphoma being treated with chemotherapy.
Nine dogs with stage 3 or higher, substage a, B cell lymphoma who achieved complete
remission after the first cycle of a chemotherapy protocol were enrolled in the study
prospectively. All cases treated at the same institution with the same inclusion criteria
from the preceding 5 years were enrolled retrospectively and from this retrospective
cohort 9 individuals were selected as case controls by a blinded, independent, European‐boarded
specialist in oncology based upon signalment and common influences on prognosis.
All dogs in the study were treated with the same chemotherapy protocol (UW‐19 without
prednisolone) while the prospective study dogs had the second cycle of chemotherapy
substituted with two low dose rate half body irradiation treatments two weeks apart
and separated by a single dose of L‐asparaginase. The cranial half body irradiation
was administered two weeks after the first dose of doxorubicin with L‐asparaginase
one week later and the caudal half body irradiation delivered the following week.
This was followed by two further cycles of chemotherapy. The primary outcome was first
remission duration and the secondary outcome was overall survival. The patients were
censored at 2 years within our study design.
Dogs in the control group had a median remission time of 261 days and a median survival
of 286 days with 0/9 dogs remaining in first remission at 2 years and only 1/9 dogs
surviving >730 days. Within the study group 5/9 dogs were in first remission at 2 years
and 7/9 dogs were still alive at 2 years resulting in median remission and survival
times both >730 days. The differences in remission and survival times were statistically
significant with P values of P = 0.011 and P = 0.015 respectively.
This study suggests that there is a significant extension in remission duration and
survival time for dogs when low dose rate half body irradiation is included in their
treatment protocol.
Disclosures
The study received funding from the Australian Animal Cancer Foundation which was
paid directly to an external biometrician for input to study design and statistical
analysis.
ESVONC‐O‐11
The use of a combined prebiotic and probiotic oral product and its impact on stool
consistency in dogs undergoing radiotherapy
L.S. Espada Castro1, S. Nécová2, L.N. Domingues Duarte3, C. Scudder4, J. Benoit5,
A. Cauvin6, L. Matthewman7
1Southfields Veterinary Specialists, Basildon, UK; 2Oncology, Southfields Veterinary
Specialists, Basildon, UK; 3Anicura de Tweede Lijn, Netherlands; 4Internal Medicine,
Southfields Veterinary Specialists, Basildon, UK; 5Radiation Oncology, Oncovet, France;
6CVC Ltd, UK; 7Pathobiology and Population Sciences, Royal Veterinary College, UK
Diarrhea is a common complication in canine radiotherapy patients unrelated to the
radiation treatment. Stress due to the hospitalization most likely contributes to
the development of diarrhea in these patients. Probiotics have been shown to mitigate
stress‐induced diarrhea in cats and dogs. A synbiotic (combination of pre‐ and probiotic)
preparation might have a similar effect in dogs undergoing radiotherapy.
The aim of this prospective, double blinded randomized placebo‐controlled study was
to evaluate the effect of once daily administration of an oral synbiotic preparation
(Enterococcus faecium NCIMB 10415 4b1707, fructo‐oligosaccharide, gum Arabic, mannan‐oligosaccharide
and beta‐glucans) on diarrhea, in dogs undergoing radiotherapy. Clinical parameters
evaluated included stool consistency, body weight, appetite and vomiting frequency.
Dogs receiving radiotherapy to the pelvic area and those with intestinal parasitism
identified on an in‐house faucal flotation test were excluded. Dogs were fed a bland
commercial diet unless their owners requested a specific diet, or the dog required
an alternative diet for health reasons. Data were assessed for normality using Shapiro‐Wilk
test, and differences between groups analyzed using chi‐squared test, T‐test or Mann
Whitney U test where appropriate.
Thirty‐one dogs were recruited. There were 16 dogs within group A which received the
synbiotic and 15 dogs in group B which received the placebo. The duration of treatment
ranged from 11 to 30 days, and there was no difference between groups (median for
group A 22 days vs median for group B 22 days, P = 0.49). There was no significant
difference between stool scores, (mean for group A 5 vs mean for group B 10, P = 0.11),
nor percentage of days of abnormal stools (median for group A 18 days vs median for
group B 17 days, P = 0.40). There was no difference between groups for the frequency
of vomiting (P = 0.682), weight loss (P = 0.432) or appetite score (median for group
A 1 vs median for group B 0, P = 0.47).
The use of the synbiotic product did not provide a clinical benefit compared to a
placebo in dogs undergoing radiotherapy.
Disclosures
No disclosures to report.
ISCAID‐O‐1
Canine vaccination in Germany: A survey of owner attitudes and compliance
S. Eschle1, K. Hartmann1, A. Rieger1, M. Bergmann1
1Medical Small Animal Clinic, Ludwig‐Maximilians‐University, Munich, Germany
Vaccination is the most important measure for protection against canine infections.
There are no studies on vaccination compliance of dog owners in European countries,
except UK. Aims of the study were to determine the compliance of German dog owners
towards vaccination and identify influencing factors.
Data were collected from August 2018 to February 2019 using an online survey targeted
at German dog owners. Owners ≤16 years of age, of dogs <8 weeks of age, and veterinarians
were excluded. A total of 3,881 questionnaires were evaluated. Factors influencing
the vaccination status of dogs were determined by a linear logistic regression model.
McNemar’s test and Cohen’s kappa statistics were used to evaluate correspondence between
the questionnaire and 340 voluntarily submitted vaccination passports.
In total, 46.8% (n = 1,818/3,881; 95% confidence interval (CI): 45.3‐48.4) of the
dogs were vaccinated with core vaccines according to current vaccination guidelines.
Young age (16 weeks to 15 months) (n = 294/3,881; odds ratio (OR): 3.08; 95%CI: 2.05‐4.68),
using the dog as working dog (n = 137/3,881; OR: 2.06; 95%CI: 1.22‐3.53) and travelling
abroad within the previous 36 months (n = 172/3,870; OR: 1.82; 95%CI: 1.12‐2.96) had
the strongest positive influence on the vaccination status. Veterinarians’ recommendation
not to vaccinate against leptospirosis had the strongest negative influence (n = 221/3,861;
OR: 0.08; 95%CI: 0.04‐0.18).
For the dog owners’ vaccination decisions and thus for the achievement of a sufficient
vaccination rate in Germany, age of the dogs, purpose of keeping the dogs, trips abroad
and vaccination recommendations by veterinarians are decisive.
Disclosures
No disclosures to report.
ISCAID‐O‐2
Comparison of four commercially available point‐of‐care tests to detect antibodies
against canine parvovirus in dogs
M. Bergmann1, Y. Zablotski1, A. Rieger1, S. Speck2, U. Truyen2, K. Hartmann1
1Clinic of Small Animal Medicine, LMU Munich, Munich, Germany; 2Institute of Animal
Hygiene and Veterinary Public Health, University of Leipzig, Leipzig, Germany
Measuring antibodies to determine immunity in dogs against canine parvovirus (CPV)
is a useful tool to avoid unnecessary re‐vaccinations. Since recently, 4 point‐of‐care
(POC) tests for detection of CPV antibodies are available in Europe but their performance
has not been compared. The aim of this study was to evaluate quality and practicability
of these 4 POC tests in the field.
Sera of 198 dogs were included. For antibody detection, virus neutralization (VN)
was performed as reference standard (VN titer ≥10 was considered positive). Sensitivity,
specificity, positive (PPV), negative predictive values (NPV), and overall accuracy
(OA) were determined. To assess agreement among POC tests, Cohen´s kappa statistic
was performed.
Prevalence of CPV antibodies in VN was 97%. The FASTest® and CanTiCheck® were easiest
to perform. The Immunocomb® Canine Vaccicheck had a sensitivity, specificity, PPV,
NPV, and OA of 70%, 50%, 98%, 5%, and 70%; the FASTest® CPV/CDV of 95%, 33%, 98%,
18%, and 93%; the TiterCHECK® CDV/CPV of 63%, 67%, 98%, 5%, and 63%; the CanTiCheck®
of 80%, 83%, 99%, 12%, and 80%, respectively. Agreement in the number of positive
results between all tests was poor (kappa: TiterCHECK®/FASTest® 0.124; TiterCHECK®/Immunocomb®
0.162; CanTiCheck®/Immunocomb® 0.285; CanTiCheck®/TiterCHECK® 0.344; CanTiCheck®/FASTest®
0.267; FASTest® and Immunocomb®: 0.052).
The CanTiCheck® would be the POC test of choice when considering specificity as most
important. However, differences in the number of false positive results were minimal
between the 4 POC tests due to the high CPV antibody prevalence in the field population.
Disclosures
Katrin Hartmann has given talks for MSD, Merial, Boehringer Ingelheim, and Idexx.
She participated in research funded by or using products from MSD, Merial, Boehringer,
Zoetis, Megacor, Biogal, and Scil. Michèle Bergmann has given talks for Merial. She
participated in research funded by or using products from MSD, Merial, Boehringer,
Zoetis, Megacor, Biogal, and Scil. There is no commercial conflict of interest as
the information generated here is solely for scientific dissemination. Point‐of‐care
tests were kindly provided for free by Biogal (Immunocomb®), Fassisi (CanTiCheck®),
and Megacor (FASTest®, TiterCHECK®). Biogal, Fassisi, and Megacor played no role in
the interpretation of data or in the decision to submit the manuscript for publication.
There is no commercial conflict of interest as the information generated here is solely
for scientific dissemination.
ISCAID‐O‐3
Detection of pathogens implicated in canine infectious respiratory disease complex
in dogs without respiratory signs hospitalized in a veterinary teaching hospital
A. Brunet1, M. Baldasso2, M. Cervone1, L. Chabanne1, J.L. Cadoré1, J. Yugueros Marcos2,
P. Gracieux2, E. Krafft1
1Département des animaux de compagnie de loisir et de sport, Université de Lyon, VetAgro
Sup, Campus vétérinaire de Lyon, Marcy l'Etoile, France; 2Centre Diagnostic Moléculaire
Christophe Mérieux, BioMérieux S.A., Grenoble, France
Canine infectious respiratory disease complex (CIRDC) is a major cause of respiratory
signs and morbidity due to various pathogens. All are contagious and can be harbored
by healthy or recovering carriers. Hospitals represent a potential transmission source,
especially in large teaching institutions with high density and constant animals and
students’ turnover.
This study aimed to evaluate the detection rate of pathogens implicated in CIRDC,
in hospitalized dogs without respiratory signs, at a veterinary teaching hospital.
Conjunctival and oropharyngeal swabs were prospectively sampled from 125 dogs between
February and June 2019. Samples were evaluated for CIRDC agents’ detection using multiplex
PCR. All positive results were verified by simplex PCR. Descriptive statistics were
used.
Detection rate by multiplex testing was 31,2% for influenza A (FluA), 22,4% for canine
parainfluenza, 20,8% for Streptococcus equi subsp. zooepidemicus (Sz), 16% for Mycoplasma
cynos (Mc), 14,4% for canine adenovirus 2 (CAV2), 11,2% for Bordetella bronchiseptica
(Bb), 3,2% for canine pneumovirus (CPnV), 0,8% for canine distemper (CDV) and canine
herpes virus 1 (CHV1) and 0% for canine respiratory coronavirus, FluA H3N2 and H3N8.
Detection was confirmed in less cases by simplex PCR, leading to a detection rate
of 13,6% for FluA, 12,8% for Sz and Mc, 1,6% for CAV2 and 0,8% for CPnV. Simplex PCR
did not confirm the detection of CDV, CHV1 and Bb. The non‐confirmed detections were
close to the sensitivity threshold of the multiplex test. 32,8% of dogs tested positive
for at least 1 pathogen. Among them, 1, 2 and 4 agents were isolated respectively
in 70,7%, 24,9 and 4,9%.
The detection rate of traditional agents implicated in CIRDC was low, except for Mc;
while unusual agents (Sz and FluA) were frequently found. Whether these detections
could be associated with mechanical transient carriage or true infection and possible
persistent carriage remains to be elucidated. The FluA detected in our cohort was
different from those previously isolated during canine outbreaks (specific canine
FluA types H3N2 and H3N8) and was only detected during winter months, concurrently
to flu outbreak in humans. Further studies are required to determine if owners or
hospital members could be the source of infection. This study is also the first to
report isolation of Sz in a large cohort of dogs without clinical signs of CIRDC.
Sz can be carried by horses. Equine dedicated services are present in our teaching
hospital, raising concerns about potential Sz transmission through hospital members.
Disclosures
This research was funded by bioMérieux S.A. (France) and its affiliate BioFire Diagnostics
LLC (USA), a private company which, among others, develops molecular testing tools.
Three of the authors (M. Baldasso, J. Yugueros Marcos and P. Gracieux) are current
employees of bioMerieux S.A. and the PCR experiments were run at bioMerieux S.A.,
Centre Christophe Mérieux. Travel grants for the ECVIM 2020 congress will be granted
to A. Brunet and E. Krafft by bioMerieux S.A. Audrey Brunet also received travel grants
from Royal Canin SA.
ISCAID‐O‐4
Outbreak of acute hemorrhagic diarrhea in dogs in Norway: Is Providencia alcalifaciens
involved?
A. H. Haaland1, K. Herstad1, S.F. Nøstebø1, S. Rodriguez1, A. Espenes1, H. Wisløff2,
M. Valheim2, H. Jørgensen2, C. S. Sakse2, E. Skancke1
1Norwegian University of Life Sciences (NMBU), Oslo, Norway; 2Norwegian Veterinary
Institute, Norway
Acute hemorrhagic diarrhea syndrome (AHDS) is characterized by sudden onset of profuse
hemorrhagic diarrhea, often accompanied by vomiting, lethargy, hyporexia, hypothermia
and/or hemoconcentration. Young to middle‐aged, small‐ and toy breeds seem prone to
the disease. The etiology is often unidentified.
During the autumn of 2019, an unusually high occurrence of severe AHDS, also affecting
atypical breeds, was reported by veterinary hospitals in Oslo and Southeastern Norway.
The aim of this retrospective study was to compare AHDS in dogs at our hospital from
August to October in 2018 and 2019, describe the clinical presentation and investigate
a possible common cause in the 2019 cases.
There were 127 cases in 2019 compared to 19 cases in 2018, but no differences in age,
sex, body weight or breeds were found. In the 2019 outbreak, clinical signs were observed
a few hours to nine days before presentation. In some dogs, an abrupt aggravation
occurred after days with moderate disease. Diarrhea, vomiting, hyporexia and hypothermia
were the most common signs. Hematemesis was observed in 16.7 %. Twenty‐four percent
were critically‐ or severely ill. English Setters, Irish Setters and Dachshund (rabbit
size) constituted 57.0 % of the critically ill. Hemoconcentration and increased CRP
were the most common changes on blood examination. Diagnostic imaging demonstrated
various degrees of functional ileus. Three dogs developed severe acute gastric tympany.
Treatment was symptomatic. Intensive monitoring was often necessary. One dog died
and five were euthanized due to poor prognosis and/or economic considerations. Necropsy
revealed diffuse hyperemia and variable mucosal necrosis in the small and large intestine.
A range of possible infectious causes and intoxications were ruled out based on clinical
and pathological findings, microbiological culture and molecular diagnostics. The
most common observation was the isolation of Providencia alcalifaciens (Pal) (62.0
%) and Clostridium perfringens (Cpe) (62.0 %). Co‐presence of Pal and Cpe was found
in 36.9 %. There was no correlation of presence of Cpe alpha‐toxin, enterotoxin, net
F/E and severity. Pal was cultivated from all critical cases except two. Mucosal invasion
by Pal was confirmed by FISH analysis. Pal is associated with diarrhea in humans and
dogs, and a putative cytolethal distending toxin may be involved in virulence.
Connections between the diarrheal cases have not been found, but preliminary whole
genome sequencing (WGS) of Pal isolates gives suspicion of common source. The presence
of Pal may play a role in disease outcome in dogs with AHDS.
Disclosures
No disclosures to report.
ISCAID‐O‐5
Demographic risk factors for canine leptospirosis in the UK
C. S. Taylor1, D. G. O'Neill1, B. A. Catchpole1, D. Brodbelt1
1Pathobiology and Population Science, Royal Veterinary College, Brookmans Park, UK
Leptospirosis is an important global disease with wide ranging clinical presentations
and diagnostic interpretation challenges. Additionally, risk factors associated with
canine leptospirosis in the UK are not well understood. This study aimed to explore
demographic risk factors for disease diagnosis in dogs in the UK.
A retrospective case‐control study compared 243 confirmed cases of leptospirosis based
on samples submitted to reference laboratories between 2013‐2019 against a VetCompass
denominator population of 905,543 dogs. Of the cases, 106 (44%) were confirmed using
the microscopic agglutination test (MAT) and 137 (56%) using PCR. Multivariable logistic
regression was used to evaluate age, breeds with >5 cases, Kennel Club (KC) breed
group, sex and neuter status as risk factors for leptospirosis diagnosis (P < 0.05).
All age categories >1 year old had increased odds when compared to dogs <1 year old,
with dogs >8‐<20 years having nearly 3 times the odds of leptospirosis (OR 2.84, 95%
CI 1.02‐2.00) Four KC breed groups had increased odds compared to non‐KC recognized
dogs: Terriers (1.27 OR, 95%CI 0.74‐2.17), Toy (24.32 OR 95%CI 3.34‐175.71), Utility
(2.42 OR, 95%CI 1.14‐5.13) and Working (1.18 OR, (95%CI 0.50‐2.75). When compared
to crossbreeds, all purebreed types examined had reduced odds of infection. Neutered
dogs had 1.43 higher odds of infection than entire dogs (95%CI 1.02‐2.00). Sex was
not significantly associated with infection (P = 0.30).
This research identifies risk factors for leptospirosis specific to the UK dog population,
which will aid veterinarians to develop a better index of suspicion for potential
cases. The increased odds of diagnosis in older and certain dog breed groups provides
further evidence to help inform the index of suspicion and encourage increased use
of confirmatory diagnostic testing. Although no individual breeds were identified
of high risk, the high odds seen with toy breeds here may reflect reduced vaccine
uptake or increased rodent contact in urban settings.
Disclosures
PhD student co‐funded by MSD and BBSRC.
ISCAID‐O‐6
Ecological niche modelling to explore probability of presence of canine leptospirosis
in Great Britain
C. S. Taylor1, K. Stevens1, B. A. Dobson2, B. A. Catchpole1, D. Brodbelt1
1Pathobiology and Population Science, Royal Veterinary College, Brookmans Park, UK;
2Imperial College London, Imperial College London, London, UK
Leptospirosis is an important global zoonotic disease that affects a wide range of
mammalian species. Although outbreaks are common after flooding, and therefore clear
environmental drivers exist, risk factors for canine leptospirosis in Great Britain
(GB) have not been examined in this context. Using a presence‐only machine learning
algorithm (MaxEnt), this study explored the contribution of temperature, rainfall,
livestock density (horses,cattle,pigs, sheep), land coverage and urban‐rural classification
to the probability of presence of canine leptospirosis in GB. Cases were positive
test submissions to a reference laboratory between 2009‐18 (n = 322). Each variable’s
contribution was used to create a map of probability of presence of leptospirosis.
We then conducted further separate analysis of cases seropositive to the three most
frequent serogroups amongst submissions: Australis, Icterrohaemorrhagiae and Saxkoebing.
Our overall final leptospirosis model had a high predictive accuracy (area under the
curve, AUC = 0.81), as did our final models for Australis (AUC = 0.92), Icterrohaemorrhagiae
(AUC = 0.89) and Saxkoebing(AUC = 0.84). For most models ,land coverage classification
and temperature were the greatest contributors to predictive accuracy. Within these
two explanatory variables the factors that increased probability of leptospirosis
the most were: urban/suburban land coverage, temperatures between 6.5 and 10.5°C and
higher densities of livestock species. However, for the Australis model, increased
horse density from 0 to 400 heads/km2 was the most important variable.
There was wide‐ranging variation in probability of leptospirosis presence around GB
and distribution of areas of high probability of presence differed between the individual
serogroup models. Highest probability of presence was seen in the South East, West
Midlands and the South West regions of GB. Additionally, areas of the north of England
were identified as suitable for the Icterrohaemorrhagiae and Saxkoebing serogroup.
Identification of environmental risk factors for different serogroups can potentially
be used to inform vaccination strategies at a local level. Urban/suburban land types
being the most important factor for the presence of leptospirosis adds further support
to the notion that the demographic background and location of cases is shifting from
a historically rural bias. Additionally, the association between increased probability
of presence of leptospirosis with increasing density of horses may indicate their
potential importance in the transmission of canine leptospirosis.
Disclosures
PhD student co‐funded by MSD and BBSRC.
ISCAID‐O‐7
Increased frequency of exercise intolerance, coagulation and hematological abnormalities
in Angiostrongylus vasorum infected vs. non‐infected dogs
J. L. Willesen1, C. Becskei2, S. P. Mahabir2
1Department of Veterinary Clinical Sciences, University of Copenhagen, University
Hospital for Companion Animals, Frederiksberg c, Denmark; 2Zoetis, Veterinary Medicine
Research and Development, Zaventem, Belgium
Canine angiostrongylosis may cause severe disease and death. Diagnosis may be challenging
due to the spectrum of non‐specific clinical signs in infected dogs.
A prospective study was conducted in highly endemic areas of Denmark (16 clinics)
and Italy (14 clinics) to further characterize the clinical signs and risk factors
of A. vasorum infection in dogs. The clinical signs and/or abnormal laboratory findings
and possible risk factors were collected from dogs tested for A. vasorum at the selected
clinics. The distributions of the risk factors and diagnostically relevant clinical
findings were compared in infected vs non‐infected animals using Fisher’s exact test.
During the 14 month study, 1628 dogs were tested by fecal and/or serological methods
for A. vasorum infection. In total, 1000 dogs (61.6%) were tested because they showed
clinical signs consistent with A. vasorum infection while the remaining dogs were
tested because they were considered at risk of infection. From the 198 (12.2%) positive
dogs, 171 (86.4%) showed clinical signs. Coughing, dyspnea and tachypnea were among
the most commonly reported clinical signs in 58.1%, 30.8% and 24.2% of the dogs that
tested positive and in 48.9%, 20.8% and 17.0% of the dogs that tested negative, respectively.
While the proportions of dogs showing each of these signs was significantly greater
in the infected dogs (P < 0.019), the difference was not large vs the non‐infected
population. Twice as many infected dogs had exercise intolerance (50.5%) and abnormal
lung auscultation (39.9%) vs. non‐infected dogs (24.5% and 19.4%, respectively) (P
< 0.0001). Bleeding disorders, pale mucous membranes, petechia/ecchymosis were reported
in three to six times as many (P < 0.0001) infected dogs (15.7%, 27.3% and 12.6%,
respectively) vs. non‐infected dogs (3.7%, 7.4% and 2.1%, respectively). Hematological
abnormalities (most often anemia, eosinophilia, thrombocytopenia, basophilia) were
reported in more than three times as many positive (27.3%) dogs than in negative (8.8%)
dogs (P < 0.0001). Among the risk factors evaluated, significantly more positive dogs
had previous history of A. vasorum infection in their household (19.7%) vs. non‐infected
dogs (8.6%) (P < 0.0001).
It is concluded that while respiratory signs may be the most commonly reported clinical
abnormality in A. vasorum infected dogs, these may be not considered to be discriminative
enough because non‐infected dogs often show similar signs. In contrast, exercise intolerance,
coagulation and hematological abnormalities were reported several times more frequently
in infected vs. non‐infected dogs, suggesting that these may be more specific to A.
vasorum infection, particularly when coupled with respiratory signs.
Disclosures
The study was funded by Zoetis. The presenting authors role was local study monitor.
Co‐authors are employed by Zoetis.
ISCAID‐O‐8
Virulence factors might be implicated in clinical presentation of urinary tract infections
caused by Escherichia coli in dogs and cats
N. P. Jousserand1, A. Diquélou1, B. S. Reynolds2, V. Leynaud2, H.J. Boulouis3, G.
Benchekroun4, M. Canonne‐Guibert4, C. Maurey4, S. Beurlet5, A. Drut6, L. Cavalié7,
E. Oswald7, R. Lavoué1
1Internal Medicine, National Veterinary School of Toulouse & IRSD (INSERM, INRAE,
ENVT, UPS), Toulouse, France; 2Internal Medicine, National Veterinary School of Toulouse,
Toulouse, France; 3Bacteriology Unit, National Veterinary School of Alfort, Maisons‐Alfort,
France; 4Internal Medicine, National Veterinary School of Alfort, Maisons‐Alfort,
France; 5Laboratoire Vebio, Arcueil, France; 6Internal Medicine, Oniris ‐ Nantes Atlantic
National College of Veterinary Medicine, Food Science, Nantes, France; 7Laboratoire
de Bactériologie‐Hygiène Hospitalière, Institut Fédératif de Biologie, Hôpital Purpan,
CHU de Toulouse, Toulouse, France
Urinary tract infection (UTI) is mainly caused by Escherichia coli. Asymptomatic UTI
is frequent in pets, but retrospective studies failed to identify factors associated
with clinical presentation.
Purposes of this prospective study were to investigate putative risk factors on clinical
presentation of E. coli bacteriuria and on antimicrobials resistance. Dogs and cats
diagnosed with E. coli UTI in 3 French veterinary hospitals were included. Prior exposure
to antimicrobials, hospitalization, urine catheterization, and clinicopathological
data were recorded. Animals with confounding factor(s) preventing the allocation to
symptomatic or asymptomatic group were excluded. Multiplex PCR were used to determine
presence of the followed virulence factor genes : siderophores (fyuA, iutA, iroN),
adhesins (papG allele I, II and III, sfa/foc, uclD), toxins (sat, hlyA, cnf1, pks,
mcmA/mchB). E. coli were stored and standardized antimicrobial sensitivity testing
were performed. Logistic regressions were used to assess relationship between risk
factors, clinical presentation and antimicrobial resistance.
Ninety‐seven animals (72 dogs, 25 cats) were recruited; 48% were asymptomatic; 6.2%
and 1% of E. coli, respectively, were MDR and had extended spectrum betalactamase.
None of the historical, epidemiological or clinicopathological factors was associated
with clinical presentation. UclD gene (F17‐like adhesin) was the only factor that
significantly increased the probability of symptomatic UTI (P = 0.047), while prior
exposure to antimicrobials increased the likelihood to harbor penicillin (P = 0.049),
quinolone (P = 0.041) and multidrug resistant E. coli (P = 0.048).
This is the first description on the putative role of F17‐like adhesin in the clinical
presentation of UTI in pets, which might represent a therapeutic target.
Disclosures
Doctor Stéphanie Beurlet is the scientific director of Vebio Lab (Arcueil, France)
that performed bacteriological analysis of samples from a recruitment site. Professor
Henri‐Jean Boulouis is the head of bacteriology unit of the National Veterinary School
of Alfort, France that performed bacteriological analysis of samples from a recruitment
site.
ISCAID‐O‐9
Extended‐spectrum beta‐lactamase‐producing Enterobacteriaceae (ESBL‐E) in companion
animals and humans: Clinical environment versus households
K. Schmitt1, S. P. Kuster1, K. Zurfluh1, R. S. Jud1, R. Stephan1, B. Willi1
1University of Zurich, Zürich, Switzerland
Data on transmission dynamics of antibiotic resistant microorganisms (ARM) in companion
animal clinics and the spread in households after patients’ discharge is scarce. This
study analyzed transmission of extended‐spectrum beta‐lactamase‐producing Enterobacteriaceae
(ESBL‐E), ARM that pose a public health threat, in a clinical high‐risk environment
and in the patients’ households after hospitalization.
Rectal swabs from 49 dogs and 25 cats hospitalized in an intensive care unit (ICU)
in Switzerland, hand swabs before and after patient contact from 37 veterinary personnel
and swabs from 298 high‐touch surfaces in the ICU were analyzed for ESBL‐E. Total
viable counts (TVC) on environmental and hand swabs, hand hygiene adherence and the
use of gloves was assessed. Two colonized dogs (Dogs 7 and 12) were retested by screening
the index patient, its household contacts and the household environment. Whole genome
sequencing of selected isolates was conducted to determine their relatedness.
A total of 12 (24%) dogs and 5 (20%) cats were colonized with ESBL‐E, but no hand
swabs tested positive. A total of 10 (3%) high‐touch surfaces were ESBL‐E positive;
7/10 were sampled on the same day. Klebsiella pneumoniae ST307, a rapidly emerging
high risk human pathogenic clone, predominated in clinic samples and was isolated
from eight environmental swabs and six hospitalized patients on five different sampling
days. ESBL‐E genes bla
CTX‐M‐14 and bla
CTX‐M‐15 outweighed in the clinic. HH compliance was 31% and gloves were worn in 51%
of patient contacts. Mean TVC on hands was lower before than after patient contact,
but not different on gloved hands. Dog 7 tested repeatedly positive at home for 77 days,
Dog 12 tested negative. The owner of Dog 7 and one of the two owners of Dog 12 were
colonized with ESBL‐E. The isolates of the owners and their dogs belonged to the same
cluster. A total of 24% of the surfaces in the household of Dog 7 tested positive
for ESBL‐E and 0% in the household of Dog 12 where only the owner was colonized at
the time of retesting.
Transmission chains for high‐risk ESBL‐E clones in ICU settings occur. After hospitalization,
persistently colonized dogs might contribute to extensive household contamination
and transmission of ARM. The study highlights the need to limit ESBL‐E spread in companion
animal clinics and to further address household transmission of ARM with the goal
to provide evidence‐based recommendations on hygiene measures for the household environment.
Disclosures
No disclosures to report.
ISCAID‐O‐10
Extended‐spectrum‐beta‐lactamases‐ and carbapenemase‐producing Enterobacteriaceae
isolated from the gut of sick companion animals in Portugal
C. Pomba1, J. Menezes2, I.S. Cunha‐Silva2, P.S. Silva2, H.P. Pereira3, R.A. Oliveira
Leal2, A.M. Lourenço2, A. Belas2
1Clinics, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisboa, Portugal;
2CIISA, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisboa, Portugal;
3Hospital Escolar Veterinário, Faculdade de Medicina Veterinária, Universidade de
Lisboa, Lisboa, Portugal
Extended‐spectrum‐beta‐lactamases (ESBL)‐ and carbapenemase (CP)‐producing Enterobacteriaceae
isolates are a public health concern. The role of companion animals (CAs) as potential
sources and reservoirs of antimicrobial resistant bacteria represents a growing concern.
Therefore, our study aimed to evaluate the presence Enterobacteriaceae with relevant
beta‐lactamases in fecal samples from CAs with skin/soft tissue infections (SSTIs)
and urinary tract infections (UTIs) living in close contact with humans in Portugal.
Between February 2018 and February 2020, 22 households (HDs) with CAs diagnosed with
SSTIs (cats‐1; dogs‐21) and 18 HDs with CAs diagnosed with UTI (cats‐2; dogs‐16) were
enrolled. The pet owners gave their informed written consent (Ethical approval CEBEA
027/2018). Samples were screened on MacConkey agar plates supplemented with 1.5 μg/mL
cefotaxime, 1.0 μg/mL meropenem, and antibiotic discs containing temocillin (30μg)
and CAT‐ID™ (mastdiscs™ ID for screening of CP). Beta‐lactam genes were screened by
PCR and sequenced. Resistance phenotype was determinate by microdilution with MicroScan®
Neg MIC Panel Type 44 (Siemens). The bacterial species identification was performed
by PCR.
Concerning SSTIs HDs, 45.46% (10/22) presented Escherichia coli harboring the following
beta‐lactamase genes: ESBL bla
CTX‐M‐1group genes (5 isolates, associated with bla
TEM‐135, or bla
TEM‐1, and in another case associated with the carbapenemase encoding gene bla
OXA‐181), bla
ACC (one isolate), bla
SHV‐12 (one isolate), bla
CTX‐M‐9group + bla
TEM‐1 genes (one isolate), bla
TEM‐135 (one isolate). Of those ESBL, 60% (6/10) presented multi‐drug resistance (MDR)
profiles.
Regarding UTI HDs, 13 ESBL isolates were obtained from 12 HDs. Two MDR ESBL‐producing
K. pneumoniae were isolated with β‐lactamase genotypes (bla
TEM‐1 and bla
TEM‐1 + bla
SHV‐187). Nine E. coli isolates ESBL producers were obtained from different UTIs HDs
and harbored the genes: bla
CTX‐M‐9group (3 isolates, in one case associated with bla
TEM‐1, in other with bla
CMY‐2), bla
CTX‐M‐1group (five isolates, in one case associated with bla
TEM‐122) and bla
CMY‐2(one isolate). Of that E. coli, 66.67% (6/9) presented MDR profiles. One UTI
cat presented simultaneously an ESBL‐producing Klebsiella pneumoniae and an MDR E.
coli, they carried the bla
TEM‐1 gene and bla
CMY‐2 + bla
TEM‐1 + bla
SHV‐12 genes, respectively.
These findings highlight that sick CAs are frequent carriers of multidrug‐resistant
Enterobacterales harboring mostly ESBLs but also Carbapenemase genes. These results
represent an emerging problem and are crucial to demonstrate the importance of interventional
antimicrobial stewardship measures to avoid antimicrobial therapy selective pressure
and antimicrobial resistance transmission between pets and humans.
Disclosures
This work was supported by JPIAMR/0002/2016 Project ‐ PET‐Risk Consortium and FEDER
funds through the Programa Operacional Factores de Competitividade ‐ COMPETE and by
National funds through the FCT ‐ Fundação para a Ciência e a Tecnologia‐ CIISA Project
(UID/CVT/00276/2020). Adriana Belas holds an FCT PhD grant SFRH/BD/113142/2015. Juliana
Menezes holds an FCT research grant supported by the JPIAMR/0002/2016 Project.
ISCAID‐O‐11
Plasmid‐mediated colistin resistance mcr‐1 gene harbored on multi‐drug resistant isolates
from companion animals in Portugal
C. Pomba1, J. Menezes2, I.S. Cunha‐Silva2, P.S. Silva2, H.P. Pereira3, A.M. Lourenço2,
R.A. Oliveira Leal2, A. Belas2
1Clinics, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisboa, Portugal;
2CIISA, Faculdade de Medicina Veterinária, Universidade de Lisboa, Lisboa, Portugal;
3Hospital Escolar Veterinário, Faculdade de Medicina Veterinária, Universidade de
Lisboa, Lisboa, Portugal
The global spread of human nosocomial multi‐drug resistant Gram‐negative bacteria
has led to the use colistin for patient treatment in ICUs. Hence, the report of different
plasmid‐mediated colistin resistance worldwide raises a serious concern. Little is
known on colistin resistance in companion animals (CA). Here, we report the screening
of fecal samples from CA in Portugal to determine the prevalence of colistin resistant
bacteria (Ethical approval CEBEA 027/2018). Between February 2018 and March 2020,
fecal samples were collected from dogs and cats. Samples were plated after prior pre‐enrichment
in peptone water onto SuperPolymyxin medium. Isolates were identified by PCR. Minimal
inhibitory concentrations (MICs) for colistin were confirmed, by broth microdilution
(SensititreTM FRCOL, Thermo Fisher Scientific, Wesel, Germany) for species without
intrinsic resistance. All isolates were screened by PCR for the presence of five colistin
resistance genes (mcr‐1 to mcr‐5) and Sanger sequencing. MIC determination for other
antibiotics was done with MicroScan® Neg MIC Panel Type 44 (Siemens, Sacramento, CA,
US).
In total, 102 CAs belong to 80 households were included for this study: 42 healthy
dogs and 20 cats; 21 dogs and 1 cat with skin and soft tissue infection (SSTI); 15
dogs and 3 cats with urinary tract infection (UTI). Of these, 33 fecal samples (healthy‐17,
SSTI‐9 and UTI‐6) were positive for Proteus spp. in the SuperPolymyxin medium; 15
samples (healthy‐12, SSTI‐1 and UTI‐2) for Enterococcus spp.; 83 samples (healthy‐52,
SSTIs‐18 and UTI‐13) were positive for Escherichia coli; 2 samples (SSTI‐1 and UTI‐1)
for Klebsiella pneumoniae and 2 fecal samples from healthy dogs were positive for
Pseudomonas aeruginosa. Broth microdilution confirmed colistin resistance, with MICs
between 2‐8 mg/L, for 7.23% (6/83) of the E. coli isolates (healthy‐2, SSTIs‐3 and
UTI‐1) from all dogs, and for 1 out of the 3 P. aeruginosa from a healthy dog. Molecular
analysis revealed that four of these E. coli isolates carried the mcr‐1 gene (healthy‐1,
SSTIs‐2 and UTI‐1). This four E. coli also presented a multi‐drug resistance phenotype
profile. The remaining isolates showing resistant phenotype but lacking the studied
resistance genes should be screening for other mcr‐gene variants (mcr‐6 to mcr‐9)
to determine the exact spread of these genes in companion animals. There is also the
possibility of having chromosomal mutations leading to resistance.
These results raise great animal and public health concerns since companion animals
may act as reservoirs of plasmid‐mediated colistin resistance for humans, highlighting
the need of a careful monitoring.
Disclosures
This work was supported by JPIAMR/0002/2016 Project ‐ PET‐Risk Consortium and FEDER
funds through the Programa Operacional Factores de Competitividade ‐ COMPETE and by
National funds through the FCT ‐ Fundação para a Ciência e a Tecnologia‐ CIISA Project
(UID/CVT/00276/2020). Adriana Belas holds an FCT PhD grant SFRH/BD/113142/2015. Juliana
Menezes holds an FCT research grant supported by the JPIAMR/0002/2016 Project.
SCH‐O‐1
Clinical and clinicopathological findings in dogs other than Scottish Terriers with
idiopathic vacuolar hepatopathy
V. Merino‐Gutierrez1, A. Hrovat‐Vernik1
1Internal Medicine, Pride Veterinary Centre, Derby, UK
Idiopathic vacuolar hepatopathy (IVH) is a well described syndrome in Scottish Terriers
(ST) but the etiology, progression and specific treatment for this condition remain
unknown. Less is known about the IVH in other dog breeds. The aim of this retrospective
study was to describe clinical and clinicopathological features of IVH in breeds other
than ST.
Medical records of dogs with cytologically or histologically confirmed hepatic vacuolar
changes were searched from 2014‐2019. To be included in the study, a complete history,
physical examination, a full blood analysis (including adrenal function testing),
urinalysis, and abdominal imaging were also required. Dogs with systemic diseases
and history of receiving medication previously associated with development of vacuolar
hepatopathy (VH) were excluded. ST were excluded as well.
Fourteen dogs fulfilled the inclusion criteria. Breeds included were West Highland
White Terrier (n = 5), Border Terrier (n = 1), Jack Russell Terrier (n = 1), Siberian
husky (n = 1), Shetland sheep dog (n = 1), Doberman (n = 1), Labrador (n = 1), Cocker
Spaniel (n = 1), Bichon Frise (n = 1) and Japanese Spitz (n = 1). There were 9 spayed
females, 3 sexually intact males, 1 intact female, and 1 neutered male. The median
age for all dogs at the time of presentation was 10 (range, 7‐13 years). Four dogs
(4/14) presented with PU‐PD, 1/14 had polyphagia, and the rest were asymptomatic.
Blood pressure (SBP) measurement was available for 9/14 dogs, which were all hypertensive
(median 180 mm Hg; range, 160‐210 mm Hg). All dogs had increased median serum ALP
(755; range 298‐2840 U/L) and AST concentrations (33; range, 22‐82 U/L). Ten dogs
(10/14) had increased cholesterol (9.49, range 5.6‐15.5 mg/dL) and 5/14 dogs had increased
triglycerides serum concentration (1.4; range 0.8‐5.01 mg/dL). Urinalysis revealed
persistent proteinuria (UPCR > 0.5) in 12/14 dogs (median 2.4; range 0.13‐5.9), without
azotaemia and normal SDMA. All dogs presented with mild to moderate amount of mobile
gall bladder sludge and heterogeneous and hyperechoic liver parenchyma based on abdominal
ultrasound.
The results of this small study revealed that IVH with associated hyperphosphatasemia,
lipidosis, proteinuria and hypertension can affect different dog breeds, predominantly
terrier breeds. In view of VH progression and high incidence of hepatocellular carcinoma
in ST, close monitoring of dogs with this syndrome is strongly encouraged.
Disclosures
No disclosures to report.
SCH‐O‐2
Comparison of lactulose, metronidazole and hepatic specific diet in controlling clinical
signs in dogs with congenital extrahepatic portosystemic shunts: A randomized clinical
trial
G. Serrano1, N. Devriendt2, H. de Rooster2, D. Paepe2
1Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke,
Belgium; 2Small Animal Department, Faculty of Veterinary Medicine, Ghent University,
Merelbeke, Belgium
Current medical management of dogs with congenital extrahepatic portosystemic shunt
(cEHPSS) comprises the use of hepatic specific diet (HSD), lactulose and/or antibiotic
therapy, aiming to control clinical signs of hepatic encephalopathy (HE). Meta‐analysis
of people suffering from type C HE disclosed that antibiotic and disaccharide therapy
are equally effective in controlling HE symptoms.
A triple‐arm randomized clinical trial was designed to compare the efficacy of different
treatment combinations [HSD and lactulose (HSD + LACT), HSD and metronidazole (HSD
+ METRO), and solely HSD] in controlling the clinical signs in dogs suffering from
cEHPSS. Dogs were not allowed to be receiving medical therapy at the time of inclusion.
The allocated ‘initial’ treatment was continued for 4 weeks. Subsequently, all dogs
received the combined treatment with HSD, LACT and METRO for an additional 2 weeks.
Standardized questionnaires (assessing neurologic, gastrointestinal and urinary signs)
were completed by the owners and a clinical score was calculated at diagnosis and
at 4 and 6 weeks.
Thirty‐six dogs were included, 12 were allocated to each group. Two dogs, 1 from HSD
+ LACT group and 1 from HSD + METRO groups were subsequently excluded due to concomitant
diseases. Thirty‐three dogs had their clinical scores available at the 4‐weeks recheck
and 27 dogs completed the trial until week 6 (10 HSD + LACT, 9 HSD + METRO, and 8
HSD). At diagnosis, the clinical scores were similar in all treatment groups (P = 0.89).
Dogs in the “HSD + METRO” as well as the “HSD + LACT” group had a significant reduction
in their clinical scores after the initial treatment compared to at diagnosis (P = 0.03
and P = 0.002, respectively). In contrast, no clinical improvement was observed in
the HSD group (P = 0.401). At 6 weeks, a trend to improvement was noticed in the HSD
group (P = 0.06), but no further improvement of the clinical score was detected in
both other groups (P = 1).
Combination of HSD + LACT or HSD + METRO effectively reduces the clinical scores in
cEHPSS dogs, while sole HSD therapy is not sufficient to control the same clinical
signs.
Disclosures
No disclosures to report.
SCH‐O‐3
Hepatic lead and copper concentrations in dogs with chronic hepatitis
E. Gori1, A. Pierini1, V. Meucci1, F. Abramo1, V. Marchetti1
1University of Pisa, Pisa, Italy
Copper (Cu) influence on chronic hepatitis (CH) have been thoroughly studied in dogs,
while a few information on other metals accumulation is currently available. Both
Cu and lead (Pb) may cause hepatic injury if their hepatic metabolization is defective
or due to oxidative stress mechanisms linked to their presence within hepatocytes,
especially for Pb. The aim of the study was to evaluate liver Pb and Cu concentration
in dogs with CH. Retrospective evaluation of the Teaching Hospital clinical database
was performed searching for dogs with CH and hepatic copper ([Cu]) concentrations,
on which lead concentrations ([Pb]) were measured. CH was defined using current ACVIM
consensus. [Cu] and [Pb] were evaluated using square wave anodic stripping voltammetry
(SWASV; limit of detection (LOD) 10ppm and 6 ppm, respectively). Dogs were divided
into two groups based on hepatic [Cu]: Group A <400ppm and Group B 3400ppm. [Pb] and
[Cu] were correlated using a Spearman correlation test. [Pb] and alanine aminotransferase
(ALT) were compared between Group A and Group B using Welch’s t‐test and Mann‐Whitney
U‐test, respectively. Thirty‐six dogs were screened for eligibility and the final
population was composed by 29 dogs, since 7 dogs had [Pb] < LOD and they were censored
(6 dogs of Group A and 1 dog of Group B, respectively). The median age was 9 years
(range 1‐15 years), equally divided between males and females, mainly Labrador Retrievers
and Cocker Spaniels (n = 3 each), followed by mixed‐breed (n = 9). Twenty‐one dogs
(58%) were assigned to Group A, while the remaining 15 dogs were in Group B. [Pb]
and [Cu] were strongly positively correlated (P = 0.0002; r = 0.65). Group A had a
mean [Cu] and [Pb] of 236.6±98 and 44±22.3 ppm respectively, whereas Group B had a
[Cu] and [Pb] of 1289±1944 and 103.1±59.8 ppm, respectively. Group B showed a significantly
higher [Pb] than Group A (P = 0.003). ALT was not significantly different between
groups (159 vs. 94 ppm groups A and B, respectively). Although further studies are
needed to better understand the clinical role of hepatic [Pb], dogs with hepatic abnormal
[Cu] may also have higher [Pb] than dogs with normal [Cu], which may be a concomitant
storage defect or a direct consequence of Cu hepatic accumulation. However, since
few data are available a concomitant oxidative damage caused by increased [Pb] cannot
be excluded.
Disclosures
No disclosures to report.
POSTER RESEARCH COMMUNICATIONS
ESCG‐P‐1
Correlation between the middle width of the right pancreatic limb and serum trypsin‐like
immunoreactivity or pancreatic lipase immunoreactivity concentrations in cats with
chronic gastrointestinal signs
Y. Wu1, G. Norsworthy2, J. Lidbury1, J. Suchodolski1, J. Steiner1
1Gastrointestinal Laboratory, Texas A&M University, College Station, USA; 2Alamo Feline
Health Center, San Antonio, USA
Based on anecdotal clinical experience, cats with chronic GI signs occasionally have
a small pancreas during laparotomy, some of which turn out to have a low normal or
a subnormal serum feline trypsin‐like immunoreactivity (fTLI) concentration. The aim
of this study was to evaluate the correlation of gross pancreatic size and serum fTLI
concentration in cats with chronic GI signs.
Ninety‐nine cats with chronic GI signs underwent laparotomy for the purpose of collection
of pancreatic, intestinal, and hepatic biopsy, as part of the diagnostic workup. Intraoperative
photos were taken with a sterile stainless‐steel ruler held beside the middle portion
of the right pancreatic limb and the width was measured with an image analysis software.
Serum fTLI and feline pancreatic lipase immunoreactivity (fPLI) concentrations were
measured in surplus serum samples that had been obtained at the time of surgery. The
relationships between pancreatic widths and serum fTLI and fPLI concentrations were
assessed using Spearman’s rank correlation. The widths of the pancreata of cats in
the subgroups detailed below were compared using Kruskal‐Wallis tests. Statistical
significance was set at P < 0.05.
Three cats had a serum fTLI concentration ≤ 8 μg/L suggesting exocrine pancreatic
insufficiency and no cats had a serum fTLI concentration between 8 and 12 μg/L, which
is considered equivocal. The width of the middle portion of the right pancreatic limb
(median: 1.2 cm, range: 0.6 – 2.2 cm) was weekly correlated with body weight (ρ =
0.3, P = 0.005), but not significantly different between cats with a body condition
score that was suboptimal (1 – 3/9, 8/99 cats), optimal (4 – 5/9, 75/99 cats), or
high (6 – 9/9, 16/99 cats) (P = 0.90). There was no significant correlation between
the width of the middle portion of the right pancreatic limb and serum fTLI (P = 0.74)
or fPLI concentrations (P = 0.43) in the 99 cats, nor in the subgroups of cats with
a normal or abnormal pancreatic, intestinal, or hepatic biopsy results. Also, the
width of the middle portion of the right pancreatic limb was not significantly different
between cats with a serum fPLI concentration ≤ 3.5 μg/L (68/99 cats), a fPLI concentration
3.6 – 5.3 μg/L (10/99 cats), or a fPLI concentration ≥ 5.4 μg/L (21/99 cats) (P =
0.92).
This study suggests that the gross pancreatic size might not significantly correlate
with serum fTLI or fPLI concentrations in cats with chronic GI signs.
Disclosures
Norsworthy is the owner of Alamo Feline Health Center. Drs. Wu, Lidbury, Suchodolski,
and Steiner are employed by the Gastrointestinal Laboratory at Texas A&M University,
which offers laboratory testing, including fTLI and fPLI testing on a fee‐for‐service
basis. Dr. Steiner serves as a paid consultant for Idexx Laboratories, who offers
fPLI testing on a fee‐for‐service basis. Drs. Lidbury, Suchodolski, and Steiner serve
as paid consultants and provide CE lectures on behalf of a variety of organizations
and companies. None of these relationships should have any impact on the data presented
here.
ESCG‐P‐2
Effects of cyclosporine treatment on supranormal feline serum pancreatic lipase immunoreactivity
concentrations
N. Lukman Hoeyrup1, T. Spillmann2, L. Toresson1, L. Torreson2
1Evidensia Specialist Animal Hospital Helsingborg, Helsingborg, Sweden; 2University
of Helsinki, Helsinki, Finland
Chronic pancreatitis (CP) is a common disease in middle‐aged to older cats. Treatment
with corticosteroids has been suggested, but clinical data on efficacy is lacking.
In a study in mice, cyclosporine treatment significantly reduced the severity of experimentally‐induced
autoimmune pancreatitis. Thus, cyclosporine is an interesting treatment option in
feline CP.
The aim of this retrospective study was to evaluate the efficacy of cyclosporine on
supranormal serum specific feline pancreatic lipase immunoreactivity (s‐Spec fPL)
concentrations in cats with suspected CP treated at Evidensia Specialist Animal Hospital
Helsingborg, Sweden, during 2013‐2019. Inclusion criteria were a history and clinical
findings suggestive of CP, s‐Spec fPL concentrations above 5.4 mg/L (reference 0‐3.5
mg/L) on at least two occasions and treatment with cyclosporine for at least three
weeks. Exclusion criteria were incomplete clinical records. Spec fPL was analyzed
at Idexx Laboratories, Ludwigsburg, Germany. Nineteen cats aged 6.9‐17.5 years (median
11.6) were included. The most common breed was Domestic Short Hair (n = 10). Sixteen
cats were neutered males (84%) and three neutered females. Chronic enteropathy was
confirmed with histopathology in 6/19 cats. In nine additional cats, chronic enteropathy
was suspected based on ultrasonography and/or hypocobalaminemia. Other comorbidities
were common, including but not limited to, hepatobiliary disease (n = 15) and diabetes
mellitus (n = 7). Ultrasonography of the pancreas was performed in 18 cats. 13/18
had an ultrasonographically abnormal pancreas. Pancreatic biopsies were not collected
from any of the cats.
Median (range) s‐Spec fPL concentration at baseline was 14.2 mg/L (6.1‐43.3) and 6.7
mg/L (0.9‐23.6) at follow‐up. Cyclosporine treatment (5.0‐7.9 mg/kg orally SID) was
associated with a significant reduction in s‐Spec fPL concentrations (P = 0.0008)
at follow‐up after 23‐206 days (median 35) compared with baseline. In three cats,
no reduction in s‐Spec fPL concentrations occurred. In cats responding to cyclosporine,
dose tapering (n = 7) or withdrawal (n = 4) was associated with a significant increase
in s‐Spec fPL concentrations from median 4.5 mg/L (1.5‐8.8) to 9.3 mg/L (2.1‐27.0)
(P = 0.012). Adverse effects were reported for 12 cats. The most common was hypersalivation
and poor drug palatability (n = 6).
This study has several limitations, including unstandardized treatment length and
dose, no control group and lack of pancreatic biopsies. Despite the limitations, our
results suggest that cyclosporine treatment reduces supranormal s‐Spec fPL concentrations
in cats with CP and dose reduction can lead to increasing s‐Spec fPL concentrations.
Future studies are warranted to investigate the effect of cyclosporine on chronic
pancreatic inflammation and clinical outcome of cats with confirmed CP.
Disclosures
No disclosures to report.
ESCG‐P‐3
Esophageal neoplasia in cats: Retrospective study in 19 patients
D. Cattaneo1, E. Bottero1, P. Ruggiero1, E. Benvenuti1
1Endovet Italia Professional Association, Roma, Italy
Primary esophageal neoplasms are rarely reported in cats. Squamous Cell Carcinoma
is the most common primary malignant tumor. The aim of this work is to evaluate the
clinical, diagnostic and follow‐up aspects of cats with esophageal neoplasia.
All cats with esophageal neoplasia detected by endoscopy between January 2008 and
December 2019 were included in this metacentric retrospective study. Esophageal neoplasia
were found in 19 cats on 2462 (0,77%) upper digestive endoscopies performed. Domestic
short hairs cats (DSH) were over‐represented (17/19), while two cats were Maine Coon.
The median age was 12 years old (6‐18 years); 13 were males (11 neutered) and 6 sterilized
females. The median BCS was 3 (2‐5; range 1‐9) and the median body weight 3,63 Kilos
(1,83‐4,3 kilos). Regurgitation was the main symptom in 18/19 cats (94,74%), related
to weight loss in 13/19 (68,42%) and dysorexia in 6/19 (32%) cases. Survey radiographs
were performed in 16 patients (84,21%), showing changes in 14 cases (73,68%). 9 cats
(47,37%) had contrast radiography, but only 5 (26,32 %) showed an intraluminal filling
defect. Endoscopy highlighted cardia proliferative lesions in 14 cats (73,68%), with
complete lumenal occlusion in 13 cases (68,42%). Findings were (73,68%) consistent
with a sessile base proliferative mass with friable, ulcerated reddish surface in
all cases that afterwards turned out to be carcinoma; multiple nodular‐like lesions
in lymphoma cases (11,1%); single pale mass in leiomyosarcoma one; pink proliferative
mass in adenocarcinoma case. Cytology, performed in 16 patients, found a match with
histopathology in 14 cases (87,5%). Histopathology, performed on 18/19 cats (94,74%)
revealed: 14 (73,68%) squamous cell carcinoma; 2 (11,1%) lymphoma; 1 (5,26%) adenocarcinoma;
1 (5,26%) leiomyosarcoma. 6 cats (31,58%) were immediately euthanized because of poor
general conditions and prognosis; 1 cat died a natural death after 35 days. 1 patient
with lymphoma received chemotherapy, showing best survival time (120 days). Others
cats were euthanized with median survival time of 32 (10‐60) days.
This study confirms that esophageal neoplasms are rare in cats and Squamous Cell Carcinoma
is the most frequent form, with high mortality rate. It appears to be more present
in DSH and older cats. The regurgitation is the most frequent symptom, progressively
leading to poor general conditions and bad prognosis. Endoscopy provides direct display
of the lesion, selective samples and accurate assessment of the lumenal patency. Moreover,
endoscopic findings combined with cytology can provide useful advice on prognosis
waiting for histological confirmation.
Disclosures
No disclosures to report.
ESCG‐P‐4
Gastro‐duodenal ulceration (GDU) in cats: Retrospective study in 63 patients
E. Bottero1, P. Ruggiero1, D. Cattaneo1, A. Campanile1, E. Benvenuti1
1Associazione Professionale Endovet Italia, Roma, Italy
Gastroduodenal ulcer (GDU) is a rare disease in cats. GDUs are erosive changes in
the gastric and duodenal mucosa that result in exposure of the submucosa or deeper
layers. In literature, the most reported cause of GDU is neoplasia (mainly lymphoma)
but studies are limited to a few cases. The aim of our work is to evaluate the clinical,
diagnostic, histological and follow‐up aspects of cats with GDU.
In this multicenter retrospective study all cats with one or more ulcerative lesions,
of at least 5 mm in diameter, detected by endoscopic examination were included. The
information collected relates to signaling, anamnesis, clinical signs, radiographic,
ultrasound, endoscopic and histological examinations and follow‐up of at least 6 months
as a minimum duration. GDUs were detected in 63 patients (5.14% of the 1224 total
endoscopic examinations performed between January 2016 and January 2020). The median
age was 9 years (0.6‐16 years), 33 were females (32 sterilized) and 30 males (28 sterilized).
Vomiting was the main symptom (sole symptom in 16 cats and associated with other symptoms
in 42 cats). Hematemesis was present in 13 (20.6%) cats. Ultrasound changes were present
in 40 (63.4%) patients. The endoscopic examination shows single ulcerative lesions
in 35 (55.5%) cats and multiple lesions in 28 (44.4%) cats. In 55 (87.3%) patients,
ulcers were localized only in the stomach and in 8 (12.7%) cats only in the duodenum
and in none of the patients were at both locations. In 20 (31.7%) cats, ulcerative
lesions were exclusively in the anthro‐pyloric area. The histological examination
revealed benign lesions (lymphoplasmacytic, eosinophilic, neutrophilic inflammation)
in 33 (52.38%) cases and malignant lesions (4 carcinoma and 26 lymphoma) in 30 (47.6%).
Duodenal lesions were all inflammations except one lymphoma. In the six‐month follow‐up
after diagnosis, 25 (39.6%) cats were dead, 23 (36.5%) were alive and in good condition
while 15 (23.8%) were alive but with persistent symptoms.
The current work highlights that GDUs are present only in a minimal percentage of
patients (5.14%) with digestive symptoms. 52% of cats had benign GDUs unlike what
is reported in the literature in which lymphoma is reported as the most frequent cause
of GDU ulcers. Excluding the neoplastic cause, the most frequent etiology is the idiopathic
one followed by the eosinophilic inflammatory one. Furthermore, in our case history
duodenal ulcers were all benign except one lymphoma. All affected patients with benign
ulceration were alive at six months.
Disclosures
No disclosures to report.
ESCG‐P‐5
Effect of stem cell therapy on serum albumin levels and its clinical effectiveness
in dogs diagnosed with inflammatory bowel disease
J.I. Cristóbal1, F.J. Duque2, C. Zaragoza2, R. Barrera2, P. Ruiz2, J.M. Usón3, E.M.
Pérez3
1Medicina Interna, Hospital Clínico Veterinario de la Universidad de Extremadura,
Cáceres, Spain; 2Internal Medicine, Hospital Clínico Veterinario de la Universidad
de Extremadura, Cáceres, Spain; 3Surgery, Hospital Clínico Veterinario de la Universidad
de Extremadura, Cáceres, Spain
Hypoalbuminemia in dogs with inflammatory bowel disease (IBD) has been shown to be
a poor prognostic factor. The CCECAI (canine chronic enteropathy clinical activity
index) scoring system includes albumin concentration value and is the most accurate
index in predicting the prognosis of patients with IBD. The treatment of these patients
is challenging, and stem cell therapy is currently being investigated as a possible
alternative. Our objective is to evaluate serum albumin concentration together with
CCECAI in dogs with IBD after stem cell treatment. A total of 20 dogs diagnosed with
IBD were included in the study, which was approved by the ethics committee. These
animals had gastrointestinal symptoms for more than 3 weeks, did not respond to diet,
antibiotics, or immunosuppressants, and the presence of intestinal inflammation was
confirmed after the histologic exam of endoscopic gastrointestinal biopsies. A single
infusion of allogeneic mesenchymal stem cells of adipose origin (MSCs) was carried
out at doses of 2 x106 cells per kilogram of weight. Serum albumin levels were determined
prior to the administration of stem cells and one month, 3, 6 and 12 months after.
The clinical evolution was evaluated using the CCECAI clinical activity index (normal
values <3). Saphiro‐Wilk test and a repeated measures One‐Way ANOVA followed by a
Dunns or a Holm Sidak post‐hoc test were used to assess differences between pre‐ and
post‐treatment. Statistical significance was set at P < 0.05.
Before the treatment, 35% of the dogs (7/20) were hypoalbuminemic (<2 g/dL). Statistical
analysis of albumin concentration identified significant differences between pre‐treatment
values (2.23±0.54 g/dL) and those at 3 (2.91±0.43 g/dL), 6 (2.98±0.57 g/dL) and 12
(3.24±0.36 g/dL) months after the treatment (P < 0.05), but not between pre‐treatment
and one month‐after value (2.69±0.51 g/dL). Treatment significantly decreased CCECAI
(10.48±3.55) at each control, obtaining values of 3.85±3.81 (1 month), 2.29±1.57 (3
months), 1.38±0.74 (6 months) and 1.00±0.47 12 months after treatment.
Our results support an improvement after the administration of MSCs in serum albumin
values in dogs with IBD. This albumin increase is associated with a clinical improvement
demonstrated by the CCECAI index. MSCs therapy should be considered an alternative
treatment in patients with IBD due to its positive short and long term effects.
Disclosures
No disclosures to report.
ESCG‐P‐6
Safety and adverse effects during the stem cell infusion in dogs with inflammatory
bowel disease
J. I. Cristóbal1, F. J. Duque2, C. Zaragoza2, R. Barrera2, P. Ruiz2, J. M. Usón3,
E. M. Pérez3
1Medicina Interna, Hospital Clínico Veterinario de la Universidad de Extremadura,
Cáceres, Spain; 2Internal Medicine, Hospital Clínico Veterinario de la Universidad
de Extremadura, Cáceres, Spain; 3Surgery, Hospital Clínico Veterinario de la Universidad
de Extremadura, Cáceres, Spain
The administration of mesenchymal stem cells (MSCs) is a therapy that is constantly
being investigated, especially in the treatment of immunomediated diseases, such as
inflammatory bowel disease (IBD), both in human and veterinary medicine. The route,
dose and infusion rate are not yet established. The carcinogenic and immunogenic effects
and their distribution after infusion have been studied, however, the immediate adverse
effects after intravenous administration are not well described. In human medicine,
adverse effects have been reported, consistent with type I hypersensitivity reactions
(fever, rashes and pruritus) and headache in some patients. A high risk of pulmonary
thrombosis has been observed in mice by rapidly administering high amounts of MSCs
intravenously. In veterinary medicine, little studies report secondary effects during
stem cells infusion. Apparently, they have been administered to treat atopic dermatitis,
feline gingivostomatitis, IBD and other immunomediated pathologies, without any side
effects. However, in a feline medicine study, after infusion of MSCs in cats with
chronic kidney disease, vomiting, salivation, and increased respiratory rate were
observed. Finally, only one dog had clinical signs (vomiting) during MSCs transplantation
in an experimental study.
The objective of this work is to evaluate the safety of intravenous administration
of allogeneic adipose MSCs in dogs with IBD, as well as to describe the resulting
adverse effects.
A total of 20 dogs were included in the study approved by the ethics committee. These
animals presented gastrointestinal symptoms longer than 3 weeks, did not respond to
diet, antibiotics or immunosuppressants and the inflammatory process was confirmed
in the biopsy obtained by digestive endoscopy, thus diagnosing IBD. All were administered
intravenously MSCs at doses of 2x106 per kilogram of weight in a time of 30 minutes
In most animals (15/20) the infusion of MSCs happened without complications, however,
a small number of animals presented adverse effects (5/20). These events were vomiting
(3/5), hyperthermia (2/5), bradycardia with hypotension (2/5), pruritus (2/5) and
hypersalivation (1/5). Diphenhydramine (Antihistamínico Syva®) was administered to
animals with adverse effects at a dose of 1 mg/kg intravenously and the infusion of
MSCs was continued more slowly, thus disappearing the symptoms.
The results show that the administration of MSCs can be carried out safely. However,
we must consider the side effects that may occur. Therefore, it would be necessary
to carry out further studies to know exactly the specific dose, the infusion rate
and all factors that affect the safety of administration of this therapy.
Disclosures
No disclosures to report.
ESCG‐P‐7
Detection of anti‐erythrocyte antibodies in dogs with immunosuppressant‐responsive
enteropathy (IRE)
E. Gori1, A. Pierini1, M. Nesci1, E. Benvenuti1, G. de Feo1, G. Lubas1, V. Marchetti1
1University of Pisa, Pisa, Italy
Immunosuppressant‐responsive enteropathy (IRE) is a chronic gastrointestinal inflammation
with a significative immune system involvement. Several extra‐intestinal manifestations
are reported in human IBD, including immune‐mediated cytopenias, while they are not
documented in dogs. The aim of the study was to evaluate the erythrogram, as part
of complete blood count (CBC), and the presence of anti‐erythrocyte antibodies in
dogs with IRE. IRE was diagnosed with the following criteria: chronic gastrointestinal
signs, no improvement with diet trial, evidence of inflammatory infiltration on intestinal
histology and subsequent improvement after immunosuppressant therapy. Canine Chronic
Enteropathy Activity Index Score (CCECAI) was recorded for each dog, as well as WSAVA
endoscopic and histopathological score. Each dog had a CBC evaluation prior the endoscopic
procedure as part of the routine care. CBC was performed using Procyte® Hematology
analyzer (IDEXX Laboratories) and blood smears were reviewed by a single clinical
pathologist and the presence of nucleated RBC (nRBCs), anisocytosis, polychromasia,
and Howell‐Jolly bodies was recorded. Anti‐erythrocyte antibodies (IgG) were evaluated
on the same blood sample with flow cytometry (Cytomics FC 500 Beckman Coulter®). The
presence of anti‐erythrocyte antibodies was associated with CCECAI score, endoscopic
and histological score of IRE dogs using Chi‐square test. Seventeen dogs with IRE
were enrolled. Eight out of 17 dogs (47%) had anemia which was normocytic normochromic
(62%), followed by microcytic normochromic (25%) and macrocytic normochromic (13%).
The main alterations in blood smears were: presence of nucleated RBC (57.1%), anisocytosis
(42.9%), polychromasia (28.6%), and Howell‐Jolly bodies (28.6%). Anti‐erythrocyte
antibodies were revealed (IgG>0.2%) in 70.6% of the study population and in 87.5%
of anemic dogs, although they were not statistically associated with CCECAI, endoscopic
and histopathological score.
The present study revealed a high frequency of positive cases for anti‐erythrocyte
antibodies in dogs with IRE. Moreover, about the half of the entire population study
showed some hematologic features of RBC regeneration (e.g., polychromasia, NRBCs,
anisocytosis) in addition to chronic inflammation hematologic findings (e.g., microcytemia).
Although prospective, larger‐scale studies are needed, the presence of anti‐erythrocyte
antibodies and signs of erythroid regeneration may suggest a possible immune‐mediated
hemolysis that can induce anemia in dogs with IRE, together with the chronic inflammation.
Disclosures
No disclosures to report.
ESCG‐P‐8
Prognostic factors and long‐term follow‐up in Immunosuppressant Responsive Enteropathy
(IRE): Prospective study in 165 dogs
E. Benvenuti1, A. Pierini2, E. Bottero1, M. Pietra3, E. Gori2, S. Salvadori4, V. Marchetti2
1Associazione Professionale Endovet Italia, Rome, Italy; 2Department of Veterinary
Science, University of Pisa, San Piero a Grado, Pisa, Italy; 3Department of Veterinary
Clinical Sciences, University of Bologna, Ozzano dell'Emilia (BO), Italy; 4Institute
of Clinical Physiology, National Research Council (CNR), Pisa, Italy
Canine immunosuppressant‐responsive enteropathy (IRE) is defined as an idiopathic,
multifactorial intestinal inflammation. The study aimed to evaluate negative prognostic
factors to predict clinical response, relapse or mortality in IRE dogs.
In a multicentric prospective study on 165 dogs with IRE, canine chronic enteropathy
clinical activity index (CCECAI) score was evaluated at presentation and respectively
1, 3, 6, 12 and 18 months from diagnosis. Body condition score (BCS), serum total
proteins (TP), albumin (ALB), cholesterol (COL) and C‐reactive protein (CRP), endoscopic
and histopathological WSAVA score were also evaluated at T0. The presence/absence
of duodenal crypts distension (CD), intraepithelial lymphocytes (IEL), mucosal fibrosis
(MF), lacteal dilation (LD) and the sum (SUM) of the histopathological lesions reported
above were also recorded. Response to treatment was evaluated based on the comparison
of CCECAI calculated at presentation and 1 month after it. Dogs with a CCECAI reduction
≥25% were classified as responders. Relapse was evaluated from 3 to 18 months after
diagnosis in dogs presented with a CCECAI >3 and evaluating the difference (Δ) of
the CCECAI (T3, T6, T12 and T18) with the previous closest time point. If Δ was ≥2,
the dog was included in the relapse group.
Dogs were divided into groups based on outcome as follows: responders/non‐responders,
survivors/non‐survivors, relapsed/non‐relapsed. Chi‐square with z‐test for column
comparisons and Bonferroni adjustment for multiple comparisons were calculated to
test the association between outcome groups and histopathological score groups. Association
between outcome groups and other categorical variables was evaluated using Fisher’s
or Chi‐square test. Continuous variables were compared between outcome groups using
an unpaired t‐test or Mann‐Whitney U‐test, depending on data distribution.
At T0 non‐responders showed significantly lower TP, ALB, COL and BCS and higher CCECAI,
histopathological and endoscopic score together with a significantly higher frequency
of IEL and LD than responders. Non‐survivors showed significantly lower TP, ALB, COL,
BCS, higher CCECAI, endoscopic and histological score and SUM than survivors. The
relapse group showed significantly lower TP, ALB and COL than non‐relapse.
A lower TP, ALB, COL and BCS, a higher CCECAI, endoscopic and histopathological score
and SUM and a higher presence of IEL and LD at the presentation resulted as negative
prognostic factors for the response to treatment, relapse and mortality of IRE dogs.
Disclosures
No disclosures to report.
ESCG‐P‐9
Dysregulation of gastrointestinal RAGE (receptor for advanced glycation end products)
expression in dogs with chronic inflammatory enteropathy
A. I. Cabrera Garcia1, R. M. Heilmann2, M. Protschka3, J. Kacza4, S. Kather5, J. M.
Steiner6, G. Alber3
1Internal Medicine, Small Animal Clinic, Leipzig University, Leipzig, Germany; 2Internal
Medicine, Department for Small Animals, Veterinary Teaching Hospital, College of Veterin,
Germany; 3Institute of Immunology, College of Veterinary Medicine, Biotechnological‐Biomed,
Germany; 4BioImaging Core Facility, College of Veterinary Medicine, Saxon Incubator
for Cl, Germany; 5Department for Small Animals, Veterinary Teaching Hospital, College
of Veterin, Germany; 6Gastrointestinal Laboratory, College of Veterinary Medicine
and Biomedical Scien, Germany
Chronic inflammatory enteropathies (CIE) are an important disease group in dogs, the
pathogenesis of which involves dysregulated signaling mechanisms in innate immune
responses. The receptor for advanced glycation end products (RAGE), an innate immune
pattern recognition receptor, plays a role in chronic inflammatory responses. Abrogation
of proinflammatory transmembrane RAGE signaling by ligand‐soluble RAGE (sRAGE) binding
might present a therapeutic avenue. Serum sRAGE levels are decreased in dogs with
CIE, normalize with clinical remission, and correlate with the severity of histologic
lesions. However, tissue RAGE expression has not been investigated in canine CIE.
Aim of the study was to evaluate the gastrointestinal mucosal RAGE expression in dogs
with CIE and its association with serum sRAGE concentrations and other disease markers.
Epithelial RAGE expression was evaluated in gastric, duodenal, ileal, and colonic
biopsies from 15 dogs with CIE and 9 healthy control dogs. After fluorescence‐labelling,
RAGE expression was quantified using photon counting based on laser scanning microscopy.
RAGE expression was compared between the two groups of dogs and was tested for an
association with patient characteristics, clinical variables, histologic lesion severity,
and biomarkers of extra‐gastrointestinal diseases, systemic or gastrointestinal inflammation,
function, or protein loss. Statistical significance was set at P < 0.05.
RAGE positivity was detected in all biopsies from healthy dogs and dogs with CIE.
Gastric epithelial RAGE expression was significantly lower in dogs with CIE than in
healthy dogs (P = 0.0066). Compared to healthy controls, RAGE expression in dogs with
CIE was higher in the duodenum and lower in the ileum, but both differences did not
reach statistical significance. No differences were observed in the colon. A shift
towards more apical epithelial RAGE expression was detected in the stomach, duodenum,
and colon in dogs with CIE (all P < 0.05). RAGE expression in the ileum and duodenum
was inversely correlated with clinical disease activity (both P < 0.03), in the duodenum
it was associated with serum sRAGE (P = 0.0240), albumin (P = 0.0163), total calcium
(P = 0.0047), and C‐reactive protein concentrations (P = 0.0074), and in the ileum
it was correlated with the severity of histologic lesions (P = 0.0403).
This study showed a dysregulation of epithelial RAGE expression, along the gastrointestinal
tract in canine CIE. These findings suggest that RAGE signaling plays a role in canine
CIE, but RAGE overexpression was seen with less severe disease and was paralleled
by higher anti‐inflammatory decoy receptor sRAGE levels.
Disclosures
No disclosures to report.
ESCG‐P‐10
Immunohistochemical expression of β‐catenin, Ki67, CD3 and CD18 in canine colorectal
adenomas and carcinomas
K. Herstad1, G.G. Gjermund2, R.R. Rortveit2, O. Kolbjørnsen3, L. Tran3, E. Skancke1
1Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine,
Norwegian University of Life Sciences (NMBU), Oslo, Norway; 2Department of Preclinical
Sciences and Pathology, Faculty of Veterinary Medicine, Norwegian University of Life
Sciences (NMBU), Norway; 3Department of Animal Health, Section for Biohazard and Pathology,
Norwegian Veterinary Institute, Norway
Inflammation is believed to influence the human colorectal carcinogenesis and may
have impact upon prognosis and survival. High presence of tumor‐infiltrating T‐cells,
evaluated by the CD3 marker is associated with a better outcome in humans with colorectal
cancer. The mucosal immunophenotype in dogs with colorectal cancer is poorly described.
The aim of this study was to characterize and quantify mucosal histiocytes and T‐cells,
using immunohistochemistry (IHC) scoring of CD18 and CD3, respectively, in colorectal
adenoma and adenocarcinoma of dogs. β‐catenin and Ki67 were evaluated, as markers
for tumor progression.
The study was a retrospective case‐control study. Tissue samples from dogs with colorectal
adenoma (n = 18) and adenocarcinoma (n = 5) were collected retrospectively from archived
samples. These samples were collected for clinical purposes, and yielding tissue samples
were archived. Control samples were healthy colonic tissue collected from dogs euthanized
of reasons not involving the gastrointestinal tract (n = 9).
IHC scoring of CD3, CD18 and β‐catenin were compared between dogs with tumors and
control dogs.
The tumor samples had significantly lower numbers of intraepithelial CD3 positive
cells (Wilcoxon test, P = 0,0006), as well as significantly lower expressions of CD18
positive cells in the lamina propria, compared to control samples (Wilcoxon test,
P = 0,001). The Ki67 positive cells showed a strong signal in adenomas and adenocarcinomas.
There was no clear distinction with regards to expression levels of the markers for
tumor progression (β‐catenin, and Ki67) between adenoma and adenocarcinoma. Colonic
samples from control dogs had uniform staining of β‐catenin within the cytoplasm.
When compared with normal colonic cells, the expression levels of cytoplasmic β‐catenin
were significantly higher in adenomas and adenocarcinomas (Wilcoxon test, P = 0,0002).
None of the control samples showed positive staining of β‐catenin in the nucleus of
colonic cells. In contrast, adenocarcinoma and adenoma showed moderate or strong staining
of the cell nucleus.
Colorectal adenomas were more common in dogs than adenocarcinomas in this study. β‐catenin
and Ki67 were not useful markers in distinguishing adenomas from adenocarcinomas.
The lower presence of CD18‐ and CD3 positive cells in tumors compared to controls,
indicates a reduced presence of T‐cells, which may be of importance in the development
of canine colorectal cancer.
Disclosures
The Norwegian Research Foundation for Canine Cancer provided financial support.
ESCG‐P‐11
Fecal bile acid profiles in cats with chronic enteropathy, intestinal neoplasia, and
in heathy control cats.
J. G. Lyngby1, A. E. Hovland2, C. S. Due2, S. Cirera3, J. A. Lidbury4, J. M. Steiner4,
J. Suchodolski4, C. R. Bjørnvad1, L. Nielsen1
1Veterinary Clinical Sciences, University of Copenhagen, Frederiksberg c, Denmark;
2University of Copenhagen, Frederiksberg c, Denmark; 3Veterinary Animal and Sciences,
University of Copenhagen, Frederiksberg c, Denmark; 4Gastrointestinal Laboratory,
Texas A&M University, College Station, USA
Feline intestinal neoplasia is challenging to distinguish from chronic enteropathy
(CE), and reliable non‐invasive biomarkers are needed. Altered fecal bile acid (fBA)
profiles have been reported in humans and dogs with enteropathy or intestinal neoplasia
and may have diagnostic potential in cats. We aimed to investigate fBA profiles as
a biomarker to differentiate feline CE from intestinal neoplasia.
Fecal samples were collected from healthy cats (n = 12), cats with chronic lymphocytic‐plasmacytic
enteropathy (n = 4), or intestinal neoplasia (n = 3; 1 with large‐cell and 2 with
small‐cell lymphoma). Fecal unconjugated bile acids were measured using gas chromatography
and mass spectrometry, and profiles included both concentrations and proportions of
total‐, primary‐, and secondary fBAs, as well as five individual fBAs. Differences
between groups were tested using Fischer’s exact and Kruskal‐Wallis tests, and P < 0.05
was considered statistically significant.
Sex and breed distribution were similar between groups, but healthy cats were younger
(median: 45 months; range: 14‐133 months) compared to the CE group (109 months; 77‐149
months) and the intestinal neoplasia group (87 months; 77‐202 months) (P = 0.014).
Although the concentrations of total fBAs (P = 0.013), deoxycholic acid (P = 0.038),
and the proportion of ursodeoxycholic acid in the intestinal neoplasia group (0.05%;
0‐0.09) compared to the healthy group (0.26%; 0.09‐3.34), and the CE group (0.53%;
0.08‐1.66) were statistically different, the post‐hoc analyses failed to show significant
differences comparing groups.
Though we were not able to distinguish CE from intestinal neoplasia using fecal bile
acid profiles in our study, future studies with larger groups and age‐matched controls
should be performed.
Disclosures
This study was funded by the Independent Research Fund Denmark and Agria and SKK Research
Foundation.
ESVC‐P‐1
Myxomatous mitral valve disease in Cavalier King Charles Spaniels: a clinical and
genetic study
M. Bagardi1, A. Bionda1, C. Locatelli1, M. Cortellari2, S. Frattini2, A. Negro2, P.
Crepaldi2, P.G. Brambilla1
1Veterinary Medicine, University of Milan, Lodi, Italy; 2Agricultural and Environmental
Sciences, University of Milan, Milan, Italy
Cavalier King Charles Spaniels (CKCSs) show a genetic predisposition to myxomatous
mitral valve disease (MMVD) development, even at an early age. It is estimated that
50% of CKCSs before 6‐7 years of age and almost 100% over 11 years are interested
by MMVD, against 14% in other breeds. The aim of this study was to characterize the
clinical and echocardiographic features of healthy and MMVD affected CKCSs, through
the description of MV morphology, prolapse and annulus. A cohort of 90 healthy and
affected by MMVD at different stages (B1, B2, C) CKCSs was analyzed and phenotypic,
pedigree and echocardiographic parameters were recorded. Log10 body weight indexed
length (AMVL), width (AMVW) and area (AMVA) of the anterior mitral valve leaflet,
prolapse, diameters of the mitral valve annulus in diastole (MVAd) and systole (MVAs)
and sphericity index (SI) were measured. In the whole sample AMVL was significatively
longer in class B2 than class A (P = 0.04) and B1 (P < 0.001) and in class C than
B1 (P = 0.02); AMVW and AMVA were higher in classes B2 and C than A and B1 (P < 0.05).
LA/Ao (P = 0.01), MVAd (P < 0.01), MVAs (P = 0.001) and left ventricle longitudinal
end‐diastolic diameter (P = 0.03) were higher in males. MVAd was significantly higher
in neutered‐females than in intact‐females (P = 0.02). Subjects in class B1 were classified
in age‐related classes: under 3 y (group 1, 15.6%), between 3 and 6 y (group 2, 46.9%)
and over 6 y (group 3, 37.5%). AMVW and AMVA were greater in group 3 than 1 (both
P = 0.02). MVAd and MVAs were higher in group 3 compared to 2 (P = 0.02, P = 0.01).
SI was lower in group 3 than 2 (P < 0.01). A subset of 34 CKCSs, non‐relatives in
direct line, was genotyped with Canine 230K SNP BeadChips to evaluate genomic regions
of interest useful to distinguish between case and control groups of dogs. The first
study was created according to age and ACVIM classification, the second to auscultation
findings. These analyses highlighted, beside known regions on CFA 4‐17 and 13‐14,
new regions of interest on several chromosomes (CFA 2‐11‐14‐19‐21‐25). Although further
investigations of the genes are needed, these results may contribute to disentangle
the complexity of the etiopathogenic mechanism involved in early development and rapid
progression of MMVD in CKCSs. Essential will be the follow up of the subjects in class
B1 which will allow us to uniquely characterize the association between the genetics
and the ventricular and valvular echocardiographic characteristics.
Disclosures
No disclosures to report.
ESVC‐P‐2
Factors affecting the urinary aldosterone‐to‐creatinine ratio in healthy dogs and
dogs with naturally occurring myxomatous mitral valve disease
A. Galizzi1, M. Bagardi1, D. Scavone1, A.M. Zanaboni2, V. Borromeo1, P.G. Brambilla1,
C. Locatelli1
1Veterinary Medicine, University of Milan, Lodi, Italy; 2Informatic Department, University
of Milan, Milan, Italy
Chronic renin‐angiotensin‐aldosterone system (RAAS) activation in course of heart
diseases contributes to cardiac remodeling and congestive heart failure. The urinary
aldosterone‐to‐creatinine ratio (UAldo:C) reflects RAAS activation in dogs and might
be an important marker of disease progression. Data about this parameter in dogs with
myxomatous mitral valve disease (MMVD) needs to be expanded. The aims of this study
were to assess UAldo:C in healthy dogs and dogs with MMVD and determine if associations
with certain clinical, echocardiographic and laboratory variables exist.
All dogs enrolled in this prospective study underwent complete physical examination,
systemic pressure measurement, echocardiography, urinalysis, serum urea and creatinine
analysis. Dogs with MMVD were classified according to ACVIM guidelines. Urinary aldosterone
was measured on left‐over urine samples with an enzyme‐linked‐immunosorbent‐assay,
previously validated in dogs.
One hundred fifty‐one dogs were included, 49 healthy, 40 stage B1, 20 stage B2 and
42 stage C. At the enrolment, 11/20 B2 dogs were already receiving pimobendan. There
were no significant differences in UAldo:C among healthy (1.75 IQR 0.83‐4.02 μg/g),
B1 (1.64 IQR 0.71‐2.99 μg/g), B2 (1.93 IQR 1.02‐4.13 μg/g) and C (2.03 IQR 1.16‐4.85
μg/g) dogs. Urinary aldosterone‐to‐creatinine ratio was not significantly different
between untreated B2 dogs (2.27 IQR 1.51‐6.84 μg/g) and those receiving pimobendan
(1.17 IQR 0.81‐2.49 μg/g). Excluding those taking spironolactone (n = 20), C dogs
treated with ace‐inhibitors for 6 months or more had significantly higher UAldo:C
(n = 8; 1.75 IQR 1.45‐3.80 μg/g) than those treated for less than 6 months (n = 14;
1.09 IQR 0.78‐2.68 μg/g). Intact females and Chihuahua, Cavalier King Charles Spaniel
and Jack Russell had significantly higher UAldo:C than other sexes and breeds respectively
in healthy and B1 dogs. A significant moderate negative correlation was found between
UAldo:C and age in healthy (ρ = ‐0.346) and B1 (ρ = ‐0.589) dogs. In the entire study
population, UAldo:C showed a significant, but weak, positive correlation with left
atrium‐to‐aortic ratio (ρ = 0.166) and with urinary protein‐to‐creatinine ratio (ρ
= 0.286).
Preclinical MMVD seems not to lead to a significant RAAS activation and chronic administration
of pimobendan appears not to significantly interfere with neurohormonal activity.
In stage C dogs, longer ace‐inhibitors treatment seems to be associated with an increase
in aldosterone secretion, suggesting the risk of the aldosterone breakthrough phenomenon.
Moreover, UAldo:C showed high individual variability within both healthy and MMVD
dogs and was affected by demographic factors (age, sex, breed). Individual serial
monitoring of this parameter, instead of the use of a population‐based reference value,
should be considered.
Disclosures
No disclosures to report.
ESVC‐P‐3
Left atrial volume assessment and survival in 160 Cavalier King Charles spaniels with
or without degenerative mitral valve disease (2017‐2019)
C. Poissonnier1, P. Foulex1, M.P. Alvarado1, E. Trehiou‐Sechi1, V. Saponaro1, P. Passavin1,
L. Desquilbet2, V. Chetboul1
1Alfort Cardiology Unit, National Veterinary School of Alfort, Maisons‐Alfort, France;
2Clinical Epidemiology and Biostatistics Unit, National Veterinary School of Alfort,
Maisons‐Alfort, France
Degenerative mitral valve disease (DMVD) is the most common acquired canine heart
disease, with a high predisposition of the Cavalier King Charles Spaniel (CKC) breed.
Echocardiographic evaluation of canine DMVD includes measurement of left atrial (LA)
size, which is one of the strongest prognostic factors for survival or disease worsening.
The LA size is usually assessed using a linear measurement from a two‐dimensional
image, and then indexed to the aortic diameter (left atrium‐to‐aortic ratio, LA:Ao).
As LA enlargement can happen in various directions, quantification of LA volumes (LAV)
using the biplane Simpson’s method of discs (SMOD) and area‐length method has recently
been suggested. A previous study on DMVD demonstrated that a category of asymptomatic
DMVD CKCs without apparent cardiac remodeling (B1 dogs, ACVIM 2009 guidelines) actually
shows LA dilation, as detected by LAV calculation despite LA:Ao values within reference
range.
The aims of this prospective study were therefore: 1) to investigate the predictive
value of selected clinical and echocardiographic variables, including LAV (biplane
SMOD), regarding cardiac‐related death (CD) in CKCs with DMVD, and 2) to assess among
ACVIM B1 CKCs the association between these variables and the time to congestive heart
failure (CHF), i.e., radiographically confirmed pulmonary edema.
The study sample consisted of 160 CKCs (132 with DMVD and 28 healthy ACVIM stage A),
prospectively recruited (2017‐2019). No ACVIM stage A dog died during the study period.
Among the 92/132 DMVD CKCs for which a follow‐up was available, 34/92 (37%) died,
with CD in 29/34 (85%) dogs. Median time to CD was 32.3 months [CI95% = 28.5;NC].
Univariate Cox proportional hazard analysis among DMVD CKCs revealed that age, ACVIM
stage, murmur grade, regurgitation fraction (RF) assessed by the PISA method, systolic
pulmonary arterial pressure (SPAP) > 50 mmHg, minimal heart rate > 100 bpm, end‐diastolic
LA:Ao⩾1.0, end‐systolic LA:Ao⩾1.6, and end‐systolic LAV > 0.90 mL/kg were significantly
associated with shorter time to CD. Furthermore, among the 56 ACVIM B1 dogs, 11 (20%)
developed CHF during follow‐up. Time to CHF was significantly shorter for dogs with
end‐systolic LAV > 0.90 mL/kg (plog‐rank = 0.018), as well as for dogs with RF > 30%
(plog‐rank = 0.004).
In conclusion, these results suggest that end‐systolic LAV, LA:Ao, RF, and SPAP are
associated with CD in DMVD CKCs. This study also confirms the practical interest of
quantifying mitral regurgitation and LAV in ACVIM B1 dogs, in which both variables
are associated with time to the first CHF event despite LA:Ao values within reference
ranges.
Disclosures
Fondation Un Coeur/Vetoquinol sponsoring for a clinical research assistant position
in Alfort Cardiology Unit.
ESVC‐P‐4
Utility of clinical and electrocardiographic findings in the prediction of the severity
of pulmonic stenosis in dog
M. Bini1, T. Vezzosi2, V. Patata1, F. Marchesotti1, O. Domenech1
1Istituto Veterinario di Novara, Granozzo con Monticello (NO), Italy; 2Department
of Veterinary Sciences, University of Pisa, Pisa, Italy
Pulmonic stenosis (PS) is the most common congenital right heart disease in dogs,
and it is usually suspected by first opinion veterinarians. Echocardiography is needed
to confirm the diagnosis and define the severity of the stenosis. Pulmonary balloon
valvuloplasty (PBV) is the elective treatment for dogs with severe PS. The aim of
this study was to evaluate the utility of clinical and electrocardiographic findings
in the prediction of PS severity for the selection of dogs that could benefit from
PBV.
This was a retrospective observational study. Medical records were reviewed for dogs
with PS that had undergone echocardiography and ECG on the same day. The ECG tracings
were reviewed and data regarding heart rate, P wave amplitude, QRS complex duration,
mean electrical axis of the QRS complex (MEA) and presence of atrial or ventricular
arrhythmias were gathered. Correlation between the severity of PS and MEA deviation
was evaluated. The ROC analysis and the Youden index were used to assess the diagnostic
accuracy of clinical and ECG parameters in the prediction of severe PS.
A total of 69 dogs were included, with 28 females and 41 males. The most frequent
breeds were French Bulldog (n = 15), English Bulldog (n = 11) and Amstaff (n = 5).
Median age was 1.6 years (0.3–13 years) and median body weight was 14 kg (1.5–58 kg).
PS severity was assessed according to the Doppler‐derived peak pulmonary gradient
(PG) and was classified into mild (<50 mmHg; n = 7), moderate (51‐80 mmHg; n = 14)
and severe (>80 mmHg; n = 48). Four dogs had syncope and 8 had right‐sided heart failure,
all of these had severe PS [specificity (Sp) = 100%]. All dogs had a systolic murmur
and a murmur grade ≥4/6 was predictive of severe PS [area under curve(AUC) = 0.72;
P = 0.004; sensibility(Se) = 94%; Sp = 52%)]. Regarding ECG findings, 33 (72%) dogs
with severe PS showed a right axis deviation of the MEA. A MEA cut‐off >85° was highly
predictive of severe PS (AUC = 0.82; P < 0.0001; Se = 86%; Sp = 74%). The entity of
right MEA deviation was positively correlated with the PG (r = 0.63; P < 0.0001).
A P wave amplitude >0.35 mV was predictive of severe PS (AUC = 0.67; P = 0.029; Se
= 29%; Sp = 100%). Heart rate, QRS complex duration and presence of arrhythmias were
not predictors of severe PS.
In conclusion, syncope, right‐sided heart failure, murmur grade ≥4/6, MEA >85° and
P wave amplitude >0.35 mV in a young dog are predictive of severe PS, thus necessitating
an urgent echocardiographic evaluation because probably benefiting from PBV.
Disclosures
No disclosures to report.
ESVC‐P‐5
Assessment of global and regional right ventricular function in dogs with congenital
pulmonic stenosis using echocardiography, speckle tracking imaging, and two‐dimensional
color tissue Doppler imaging: A prospective study of 105 cases (2013‐2020)
M. P. Alvarado Masis1, P. Passavin2, V. Saponaro2, C. Poissonnier2, E. Trehiou‐Sechi2,
R. Tissier2, V. Chetboul2
1Alfort Cardiology Unit, Ecole Nationale Vétérinaire d'Alfort, Maisons‐Alfort, Maisons‐Alfort,
France; 2Ecole Nationale Vétérinaire d'Alfort, Maisons‐Alfort, France
Pulmonic stenosis (PS) is one of the most common congenital canine heart diseases.
To the best of our knowledge, no study has focused on right ventricular (RV) function
evaluated by speckle tracking echocardiography (STE) and two‐dimensional color tissue
Doppler imaging (TDI) in dogs with PS. The aims of this prospective observational
study were therefore, to investigate the global and regional systolic and diastolic
RV function using conventional echocardiography, RV free wall (RVFW) longitudinal
systolic strain (StS) as well as systolic and diastolic strain rate (SR) STE variables,
and TDI in dogs with congenital PS in comparison to a healthy control group. Intra‐RV
dyssynchrony STE parameters were also assessed, i.e., early pre‐stretch (amplitude
(%) of positive early lengthening before contraction), pre‐stretch index (early pre‐stretch/[early
pre‐stretch+systolic StS]), synchrony time index (maximal time difference between
peak StS of RVFW segments), time‐to‐peak StS (from end of T‐wave to peak StS), and
StS base:StS apex ratio.
The study population consisted of 105 cases, 75 dogs with PS and 30 control dogs.
As compared with controls, PS dogs showed significantly increased and decreased values
of RV fractional area change (RFAC) (P < 0.01) and tricuspid annular plane systolic
excursion indexed to the aortic valve diameter (P < 0.001), respectively. A markedly
reduced longitudinal RVFW StS was also found in PS dogs (median[interquartile range]
= 14%[10‐20] versus 32%[27‐34]); P < 0.0001), with greater systolic impairment at
the base, as demonstrated by a significantly lower StS base:StS apex ratio (0.87 [0.71‐1.0]
versus 1.0 [1.0‐1.0]; P < 0.0001). A post‐systolic peak StS was identified in 61/69
dogs (88%) of the PS group and in only 5/30 control dogs (17%), with an early pre‐stretch
in 42/69 PS dogs (61%) and only one control dog (3%). Dogs in the PS group also presented
a longer time‐to‐peak StS (P = 0.02) and an increased synchrony time index (P < 0.001)
in comparison to controls. Furthermore, a significantly reduced RFAC was found in
PS dogs with congestive heart failure (CHF) as compared to those without (P < 0.001).
In addition, PS dogs with RV dilation had decreased RFAC (P = 0.04) and StS values
(P < 0.01), and higher time‐to‐peak StS (P = 0.04) and pre‐stretch index (P = 0.02)
as compared with PS dogs without. Decreased systolic and early diastolic SR and segmental
RV TDI velocities were also demonstrated in PS dogs in comparison to controls.
In conclusion, PS dogs show various systolic and diastolic RV alterations, more pronounced
for basal segments and associated with intra‐RV mechanical dyssynchrony particularly
in dogs with RV dilatation.
Disclosures
No disclosures to report.
ESVC‐P‐6
Von Willebrand factor, endothelial injury and left atrial enlargement in cats with
cardiomyopathy
W. C. Cheng1, T. A. Kurosawa1, L. Wilkie1, M. Dobromylskyj2, V. Luis Fuentes1, D.
J. Connolly1
1Clinical Science and Services, Royal Veterinary College, Hatfield, UK; 2Finn Pathologists,
Harleston, UK
Left atrial (LA) thrombosis may result in aortic thromboembolism (ATE) in cats. There
is limited information regarding the role of von Willebrand factor (vWF) in this condition.
We aimed to characterize the expression of vWF, a marker of endothelial injury, in
LA samples from the following cats:
(1) Control group: cats without structural cardiac changes.
(2) Pre‐LAE group: cats with preclinical cardiomyopathy and a normal‐sized LA.
(3) Pre+LAE group: cats with preclinical cardiomyopathy and LA enlargement (LAE).
(4) CHF group: cats with CHF attributable to cardiomyopathy and LAE.
(5) ATE group: cats with ATE attributable to cardiomyopathy and LAE.
Exclusion criteria were cats with systemic diseases that might cause cardiac structural
changes. All control cats died of non‐cardiac causes and their hearts were confirmed
to be normal by histopathology. Affected cats were categorized into groups based on
necropsy and histopathology ± cardiac imaging (echocardiography or T‐FAST). Left‐over
LA samples from group 1, 4 and 5 were collected for multiplex RT‐PCR and run in duplicate
to quantify transcripts for VWF and RPS7 (reference gene). La/Ao and La minor (mm)
measurements were recorded in a proportion of the cats. Three sections of full thickness
LA myocardium from all 5 groups of cats were immunostained for vWF and integrin αIIb
(platelet marker). Data were analysed using one‐way ANOVA, Pearson’s correlation test,
and Kruskal‐Wallis test.
There were a total of 14, 5, 4, 14, and 21 cats in the Control, Pre‐LAE, Pre+LAE,
CHF, and ATE group, respectively, with a median age (range) of 2.5 (0.4‐15.3), 7.5
(4.5‐11), 6.5 (2.5‐8.1), 7 (0.6‐17.3), and 7 (1.8‐18.5) years. The majority of cats
were DSH. Male cats were overrepresented except for the Control group.
VWF transcript level was higher in the ATE (mean 0.66 [0.098], n = 13; P = 0.006)
and CHF (0.66 [0.11], n = 9; P = 0.006) cats compared to the controls (0.45 [0.18],
n = 6). No difference was detected between the ATE and CHF cats. VWF transcripts moderately
correlated with La:Ao (r = 0.511 [CI 0.058‐0.790], n = 18; P = 0.030)and La minor
(r = 0.551 [CI 0.028‐0.837], n = 14; P = 0.041).
The fluorescence of immunostained vWF was significantly increased at the endocardium
in the ATE (median 44.7 [IQR 34.9‐54.6], n = 11; P < 0.001), CHF (46.0 [36.6‐56.8],
n = 8; P < 0.001), and Pre+LAE (42.7 [27.7‐69.3], n = 4; P = 0.04) cats compared to
the controls (30.8 [28.1‐34.2], n = 11).
Endothelial injury at the level of the endocardium revealed by increased vWF expression
occurs as LA remodels in cats with cardiomyopathy.
Disclosures
No disclosures to report.
ESVC‐P‐7
Echocardiographic measurements in a large population of Italian healthy cats: The
Osservatorio Veterinario Italiano Cardiopatie data
F. Spina1, P. Ferrari2, M. Carisetti3, F. Porciello4
1Clinica Veterinaria Etiopia, Rome, Italy; 2Clinica Veterinaria Orobica, Alzano Lombardo,
Italy; 3Department of Veterinary Medicine, University of MIlan, Milan, Italy; 4Department
of Veteriinary Medicine, University of Perugia, Perugia, Italy
Cardiomyopathies are the most frequently diagnosed cardiovascular disorders in cats
and the most common of these is hypertrophic cardiomyopathy. Echocardiography is used
to investigate cats with heart murmurs, but has become a common screening test for
breeding purposes. The objective of this study was to evaluate normal echocardiographic
measurements in a population of healthy cats from Italy. The Osservatorio Italiano
Veterinario Cardiopatie (OVIC – http://www.osservatorioveterinariocardiopatie.com)
is an Italian animal screening program, mainly for breeding purposes, of canine and
feline cardiovascular diseases. Two thousand one‐hundred thirty‐eight echocardiographic
examinations of cats from 2007 to 2019, were analyzed. Cats were included if they
were at least one year old, if they had no history of systemic diseases, if pulmonary
and cardiac auscultation was normal and if echocardiographic examination showed no
congenital or acquired heart disease, or other cardiovascular abnormalities. Isolated
hypertrophic or abnormal papillary muscles and presence of systolic anterior motion
of the mitral valve were considered equivocal parameters and so met the exclusion
criteria. Pregnant or lactating cats were excluded as were cats with incomplete data.
Although sedation is acceptable, we considered data only from non‐sedated cats.
Animals were scanned from below on echocardiographic table both from right and left
recumbency according to previous published standards.
Descriptive analysis was performed. The ANOVA test was carried out to check the influence
of breed on echocardiographic variables. Only breeds represented by >30 cats were
included. We performed linear regression modeling with allometric transformation to
assess the association between bodyweight and cardiac variables. A value of P < 0.05
was considered significant.
One thousand three hundred fifty‐seven cats met the inclusion criteria. The results
confirmed the positive relation between echocardiographic measurement and body weight
while no significant correlation for gender or breed or age and any measurements were
found.
Our study provided normal reference measurements, allometric scale and body weight
prediction intervals in a population of Italian healthy cats. Body weight should be
considered when cats are evaluated for cardiomyopathy, especially if HCM is suspected.
In our acknowledgements, this is the largest study of echocardiographic measurements
in apparently healthy Italian cats.
Disclosures
No disclosures to report.
ESVC‐P‐8
Analysis of PDK4 gene deletion in a population of Doberman Pinschers from Argentina
A. Analía1, P.R. Batista2, J. Crespi3, M. Tórtora4, M. Vercellini5, M. Czernigow6,
D. O. Arias4, G. Giovambattista3
1Institute of Veterinary Genetics (IGEVET) and Cardiology Service, Faculty of Veterinary
Sciences, National University of La Plata ‐ CONICET, La Plata, Argentina; 2Cardiology
Service, Faculty of Veterinary Sciences, National University of La Plata ‐ CONICET,
La Plata, Argentina; 3Institute of Veterinary Genetics (IGEVET), Faculty of Veterinary
Sciences, National University of La Plata ‐ CONICET, La Plata, Argentina; 4Cardiology
Service, Faculty of Veterinary Sciences, National University of La Plata, La Plata,
Argentina; 5Faculty of Veterinary Sciences, National University of La Plata ‐ CONICET,
La Plata, Argentina; 6Faculty of Veterinary Sciences, National University of La Plata,
La Plata, Argentina
Dilated cardiomyopathy (DCM) in Doberman Pinschers (DP) is a polygenic disease inherited
as an autosomal dominant trait with incomplete penetrance. In American DP, DCM development
has been associated with a 16‐bp deletion in the 5′ splice site of intron 10 of the
pyruvate dehydrogenase kinase, isozyme 4 (PDK4) gene on chromosome 14. However, such
association has not been observed in European DP. The aim of this study was to estimate
the prevalence of PDK4 16bp INDEL variant and determine its association with DCM in
a DP cohort from Argentina.
A total of 134 DP (58 male and 76 female) aged 4‐15 years were assessed to evaluate
the prevalence of the 16 bp deletion allele. For the association study, dogs were
allocated into two groups: 1) DCM (n = 20, ≥ 4 years old, left ventricle diastolic
diameter ≥ 49 mm and left ventricle systolic diameter ≥ 42 mm), and 2) control (n
= 45, ≥ 7 years old, without clinical, electrical or morphological findings). The
remaining 69 DP were not included because they did not comply with the inclusion criteria.
According to the reported variant in the PDK4 gene (CFA14: g.20,829,667_20,829,682del;
genome build CanFam 3.1), primers were designed to amplify a fragment that included
the INDELs (forward primer, 5′‐GTTTTGGTTATGGCTTACCAATT‐3′ and reverse primer, 5′‐ATGGACTCTCTCTCTCTCAAATA‐3′).
Amplicons of 210‐bp for the wild type (ins) and 194‐bp for the variant (del) allele
were obtained with polymerase chain reaction (PCR). The genotype of each animal was
determined in a 1% agarose electrophoresis gel. Finally, the fragments obtained were
sequenced with ABI 3500 Genetic Analyzer (Applied Biosystems). The prevalence of the
variant allele and its association with DCM development were evaluated using a Fisher´s
Exact Test with the odds ratio function of the R epitools package. P < 0.05 was considered
significant.
Both alleles were observed in DCM and controls. However, no association was observed
between the 16‐bp deletion in PDK4 gene and DCM development (P = 0.83; OR = 1). Overall
16‐bp deletion allele frequency was 0.15 (+/−0.11‐0.20).
It is concluded, that the association between the 16 bp deletion in the PDK4 gene
and DCM reported in American DP was not confirmed in the DP cohort from Argentina.
This result is in agreement with that reported in a population of European DP. Moreover,
the prevalence of the 16‐bp deletion PDK4 variant was lower than that described in
the American and European DP cohorts.
Disclosures
No disclosures to report.
ESVC‐P‐9
Clinical characteristics for differential diagnosis and prognosis of non‐cardiogenic
pulmonary edema in dogs with concurrent congestive heart failure : 45 cases (2018‐2010)
J. Lee1, W. Kim2, S. Jeon3, H. Hwang3
1Veterinary Cardiovascular & Nephrology Center, Korea Animal Specialty Medical Institute,
Seongnam, South‐Korea; 2Columbia University, New York, USA; 3Korea Animal Specialty
Medical Institute, Seongnam, South‐Korea
Precise identification of underlying causes and key factors leading to pulmonary edema
is essential for proper treatment and prognosis. In patients with congestive heart
failure, non‐cardiogenic pulmonary edema (NCPE) can be easily misleading to a diagnosis
of cardiogenic pulmonary edema (CPE) when occurring simultaneously. However, there
have been very few reports describing the differential characteristics between NCPE
and CPE. Here, we report a retrospective study to determine the clinical characteristics
of NCPE in dogs with symptomatic myxomatous mitral valve disease (MMVD).
Emergently referred dogs with MMVD showed severe acute respiratory distress caused
by either CPE or NCPE. The detailed groups are as follows: CPE (n = 49) and NCPE (n
= 45; acute respiratory distress syndrome [n = 23], post‐anesthetic events [n = 6],
aspiration [n = 6], upper airway obstruction [n = 4], neoplasia [n = 4], acute pancreatitis
[n = 1], multiple plasma transfusion [n = 1]). We have retrospectively compared clinical
characteristics, including medical history, laboratory findings and diagnostic imaging,
and survival outcome between the CPE and the NCPE groups.
Recurrent episodes of pulmonary edema in the medical history of the NCPE group (1.4±1.6)
significantly outnumbered those of the CPE group (0.2±0.6) (P < 0.01). The differences
in SPO2 (%; 93.1 ± 4.5 vs. 97.5 ± 2.0) and hematocrit (%; 39.4 ± 6.0 vs. 43.3 ± 3.7)
were significantly less in the NCPE group (P < 0.01) than the CPE group. Furthermore,
the NCPE group showed higher levels of blood work parameters related to inflammatory
responses compared to the CPE group (P < 0.01): leukocytosis (WBCs, k/L;19.6 ± 7.4
vs. 10.3 ± 2.1) and C‐reactive protein (CRP, mg/dL; 1.9 ± 2.1 vs. 0.5 ± 0.3). In contrast,
the NCPE group exhibited significantly lower peak velocity of E wave (cm/s; 130.8 ± 36.6
vs. 157 ± 19.2) and survival outcome (%; 33.3 vs. 83.7) than the CPE group (P < 0.01).
The prevalent radiographic findings in the NCPE was unilateral asymmetrical opacities
(68.9%), although bilateral diffuse pulmonary infiltration (75.5%) was more often
observed in the CPE group (P < 0.01). Simple logistic regression to identify survival
predictors demonstrated a significant correlation with the lower SPO2 level and the
higher recurrent incidence of pulmonary edema (Cox‐Snell’s R squared; 0.512 and 0.581,
respectively) (P < 0.01). These two predictors were also found to exert a significant
effect on survival outcome in multiple logistic regression (Cox‐Snell’s R squared,
0.689; P < 0.05).
In summary, several clinical characteristics, in particular the SPO2 level and the
history of recurrent pulmonary edema, showed highly differential significance and
strong correlation with survival outcome. Our retrospective study could provide insight
into improving diagnosis and prognosis of NCPE developed in dogs with concurrent congestive
heart failure.
Disclosures
No disclosures to report.
ESVC‐P‐10
Selected hematological, biochemical and echocardiographic parameters as predictors
of survival in canine patients with mitral valve disease and heart failure
A. Pecjak1, M. Brložnik1, A. Nemec Svete2, A. Domanjko Petric3
1Veterinary faculty, University of Ljubljana, Slovenia; 2Veterinary faculty, University
of Ljubljana, Veterinary faculty, University of Ljubljana, Ljubljana, Slovenia; 3Small
Animal Clinic, Veterinary faculty, University of Ljubljana, Slovenia
Data demonstrating the association of routine blood and echocardiographic parameters
with survival in canine heart failure patients is still lacking. We aimed to investigate
the association of selected blood and echocardiographic parameters with the survival
of dogs with mitral valve disease (MVD) and heart failure.
In this retrospective study white blood cell count (WBC), absolute monocyte (MONO)
and neutrophil (NEUT) counts, and their relative numbers (MONO%, NEUT%), urea, creatinine,
potassium, chloride, left ventricular end‐diastolic diameter (LVIDd) and left ventricular
end‐systolic diameter (LVIDs), both indexed per weight1/3 and mitral E and A wave
(MvE, MvA), MvE/A ratio and left atrium to aorta ratio (LA/Ao), and tricuspid regurgitant
pressure gradient were analyzed in dogs with MVD and heart failure (ACVIM class C2
and joined class ACVIM C1+D). The latest blood and the first and latest echocardiographic
results were included. Additionally, we investigated the same parameters in hospitalized
patients. Parameters were analyzed using Cox proportional‐hazards models. Hazard ratios
(HR), 95% confidence intervals (CI), and corresponding P values were calculated. The
significance was set to 5%.
We included 165 dogs with MVD: 97 males and 68 females (96 in ACVIM C2 and 69 in ACVIM
C1+D). The mean (±standard deviation) age at the start of heart failure therapy was
10.97 ± 2.34 years, with no difference between classes. The most common breeds were
mixed breed (18.2%) and Cavalier King Charles Spaniel (17.5%). 107 dogs (64.8%) died
and 58 (35.2%) were censored. The median survival time of deceased dogs was 11.5 months
(11 days to 4.3 years). Group ACVIM C1+D had higher NEUT (P = 0.023) and NEUT% (P
< 0.001), lower potassium (P = 0.047), larger indexed LVIDd (P < 0.001), indexed LVIDs
(P = 0.004) and LA/Ao (P < 0.001), higher MvE (P < 0.001) and MvE/A (P < 0.001) and
lower MvA (P = 0.003). Hospitalized patients (59 dogs) had higher WBC (P < 0.001),
NEUT (P < 0.001), NEUT% (P = 0.003), MONO (P < 0.001), urea (P < 0.001) and creatinine
(P = 0.003) compared to non‐hospitalized dogs. The following parameters (HR; 95% CI;
P value) were negatively associated with survival: age (1.171; 1.056, 1.299; 0.003),
WBC (1.081; 1.017, 1.149; 0.013), and urea (1.047; 1.006, 1.089; 0.023). Chihuahuas
had lower risk of death for 66.7% (0.333; 0.114, 0.972; 0.044). With the exception
of LA/Ao (1.93; 1.058, 3.522; 0.032), other echocardiographic parameters showed no
association with survival.
Higher age and increasing WBC, urea, and LA/Ao are associated with decreased survival
in dogs with MVD and heart failure.
Disclosures
No disclosures to report.
ESVC‐P‐11
Longitudinal Speckle‐Tracking echocardiography of the left and right ventricular myocardium
in trained and untrained Italian blood hound dogs
C. Carnabuci1, P.E. Crisi1, M. di Tommaso1, F. Menicagli2, A. Luciani1
1Faculty of Veterinary medicine, University of Teramo Italy, Piano d'Accio, Teramo,
Italy; 2Clinica Veterinaria Giaconella, Roma, Italy
Physical activity, as in human athletes, may influence the cardiovascular system of
dogs.
Longitudinal left (LV) and right ventricular (RV) deformation assessed by speckle
tracking echocardiography (STE) in healthy dogs subjected to intensive exercise has
hitherto not been investigated.
This study aimed to investigate if LV and RV 2D echocardiographic and STE variables
differed between a group of healthy trained and untrained dogs.
Forty‐four healthy Italian blood hound dogs were recruited. Twenty‐two dogs were trained,
and 22 untrained. Standard echo 2D variables and systolic longitudinal (SL) LV and
RV strain and strain rate acquired from left apical four chamber view were measured
over three cardiac cycle, and mean and standard deviation were calculated. Statistical
tests included non‐parametric groupwise tests. P < 0,05 was considered statistically
significant.
Heart rate, right ventricular fractional area change, left ventricular ejection fraction
and shortening fraction were lower in trained compared to untrained dogs (P < 0.0006,
P < 0.01, P < 0.05, P < 0.05 respectively). Left ventricular end systolic internal
diameter normalized, right ventricular end systolic area and right atrial area, right
ventricular end diastolic and end systolic volume indexed for body weight were higher
in trained dogs compared to untrained dogs (P < 0.05, P < 0.05, P < 0.01 and P < 0.01,
P < 0.05 respectively). In trained dogs, global SL RV strain was lower compared to
global SL RV strain of untrained dogs (P < 0.01).
In conclusion, several left and right echocardiographic variables and longitudinal
systolic RV deformation by STE differed between trained and untrained dogs. These
results likely reflect functional and morphologic adaptations of the heart in response
to exercise.
Disclosures
No disclosures to report.
ESVC‐P‐12
Assessment of longitudinal left ventricle deformation by 2‐dimensional speckle tracking
echocardiography obtained from different views in cats
D. Caivano1, M. Rishniw2, F. Birettoni1, N. Nisini1, F. Porciello1
1Veterinary Medicine, University of Perugia, Perugia, Italy; 2Veterinary Information
Network, Davis, USA
Two‐dimensional speckle tracking echocardiography (STE) is a novel, angle‐independent
imaging technique useful to assess myocardial function by strain and strain rate (Sr)
analysis in human and veterinary medicine. Commonly, the left apical four‐chamber
(Lap4Ch) view is used to assess left ventricular (LV) longitudinal deformation in
dogs and cats. However, the right parasternal four‐chamber view (RP4Ch) is often more
easily obtained than the Lap4Ch view in cats. No studies exist comparing longitudinal
strain and Sr values using STE from different views in cats. Therefore, we examined
the agreement between RP4Ch and Lap4Ch for assessment of LV longitudinal strain and
Sr in cats.
We acquired 2D echocardiographic cineloops from RP4Ch and Lap4Ch views and analyzed
LV longitudinal strain and Sr in 50 cats (31 healthy cats and 19 cats with different
disease states) using XstrainTM software. Peak systolic strain and SR values of endocardial
and epicardial border were used for the analysis. All echocardiographic values were
measured three times and averaged. The two echocardiographic views were compared using
limits‐of‐agreement analyses and intra‐observer measurement variability was assessed.
We could obtain longitudinal strain and strain rate from the RP4Ch view in all cats.
Strain, but not SR, had good intra‐observer measurement variability (<10% vs ~20%).
However, only endocardial longitudinal strain and Sr values obtained with the two
views agreed (95% limits of agreement: −3.28, 2.58; −1.41, 1.36). Epicardial longitudinal
strain and Sr values did not agree sufficiently to be used interchangeably (95% limits
of agreement: ‐11.58, 9.19; ‐2.28, 1.74).
Our study suggests that RP4Ch view was feasible for assessment of the LV longitudinal
deformation analysis by STE in cats, but only endocardial longitudinal strain and
Sr values obtained from the two different views were interchangeable. Clinicians can
use RP4Ch view for endocardial longitudinal deformation analysis when Lap4Ch view
demonstrates sub‐optimal in cats.
Disclosures
No disclosures to report.
ESVC‐P‐13
Prognostic significance of left cardiac remodeling in dogs with asymptomatic myxomatous
mitral valve disease
G. Grosso1, O. Domenech2, T. Vezzosi1, R. Tognetti1
1Department of Veterinary Sciences, University of Pisa, Pisa, Italy; 2Department of
Cardiology, Istituto Veterinario Novara, Novara, Italy
In dogs with asymptomatic myxomatous mitral valve disease (MMVD), the distinction
between the ACVIM stage B1 and B2 is mainly based on the echocardiographic evaluation
of left cardiac remodeling. The recently updated ACVIM guidelines consider stage B2,
dogs with both left atrium (LA) and left ventricle (LV) enlargement. Thus, dogs only
presenting LA enlargement are classified as stage B1. The aim of this study was to
evaluate the prognosis of dogs in stage B according to different degree of left cardiac
remodeling.
This retrospective, multicenter observational study included dogs with asymptomatic
MMVD imaged between 2011 and 2019. Dogs were reclassified into stage B1 and B2 according
to the 2019 ACVIM guidelines, with LA enlargement defined as a left atrium‐to‐aorta
ratio (LA/Ao) ≥1.6 and LV enlargement by a left ventricular end‐diastolic diameter
normalized (LVIDDn) ≥1.7. Long‐term outcome was assessed by telephone interviews with
the owners. Survival was analysed using Kaplan‐Meier curves. ROC curve analysis and
the Youden index were used to define the best cut‐offs of LA/Ao and LVIDDn to predict
cardiac mortality in the stage B2.
A total of 444 dogs with asymptomatic MMVD were included, 277 in ACVIM stage B1 and
167 in stage B2. Among stage B1, 203 dogs (73%) did not present cardiac remodeling
and 74 (27%) had LA enlargement with normal LV size. In the study, 76 dogs died for
cardiac‐related causes (24 in stage B1 and 52 in stage B2). Dogs in stage B1 lived
longer (median survival time 2344 days, 95%CI 1905‐2783 days) than stage B2 (1341 days,
95%CI 984‐1698 days). In the stage B1, the median survival time of dogs with LA enlargement
[1882 days, 95%CI 1185‐2579 days] was not significantly lower than those without cardiac
remodeling [2344 days, 95%CI 1943‐2744 days; P = 0.33]. In the stage B2, a LA/Ao > 1.91
(AUC = 0.65; P = 0.0035) and a LVIDDn > 1.90 (AUC = 0.61, P = 0.035) were predictors
of cardiac mortality. The median survival time of dogs in stage B2 with both LA/Ao > 1.91
and LVIDDn > 1.90 was lower (848 days, 95%CI 406‐1286 days) than those with LA/Ao < 1.91
and LVIDDn < 1.90 (1588 days, 95%CI 1167‐2009 days; P = 0.0017).
In conclusion, the prognosis of dogs in stage B1 is not significantly influenced by
LA enlargement. In the stage B2, the entity of left cardiac remodeling has prognostic
significance and the proposed cut‐offs of LA and LV enlargement could be useful for
risk stratification of cardiac death and clinical decision making in this stage.
Disclosures
No disclosures to report.
ESVC‐P‐16
Echocardiographic analysis of dogs before and after the surgical treatment of brachycephalic
obstructive airway syndrome
M. Brložnik1, A. Nemec Svete2, V. Erjavec3, A. Domanjko Petric4
1Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia; 2Veterinary faculty,
University of Ljubljana, Veterinary faculty, University of Ljubljana, Ljubljana, Slovenia;
3Veterinary faculty, University of Ljubljana, Slovenia; 4Small Animal Clinic, Veterinary
faculty, University of Ljubljana, Slovenia
Brachycephalic Obstructive Airway Syndrome (BOAS) is characterized by numerous airways
abnormalities that can affect the heart. Surgical treatment of BOAS improves clinical
signs of respiratory distress; however, it has not yet been investigated whether surgery
affects the morphology and function of the heart. This study aims to compare echocardiographic
parameters of dogs before and six to twelve months after the surgical treatment of
BOAS.
Complete echocardiographic examination of the left and the right heart (2‐D, M‐mode,
spectral and color Doppler, tissue Doppler of right and left ventricular walls, the
global strain of the left and the right ventricle, tricuspid and mitral annular velocities,
vena cava at expiration and inspiration, right chambers linear and area dimensions)
was performed according to guidelines in 18 client‐owned dogs with BOAS (7 French
bulldogs, 6 Boston Terriers, and 5 Pugs) scheduled for rhinoplasty and folded flap
palatoplasty. Echocardiographic follow‐up was performed 6 to 12 months (median 9 months)
after surgical treatment and parameters were compared. Weight‐depended variables were
indexed (one dimensional as variable/weight1/3, and two dimensional as variable/weight2/3).
Normally distributed variables were compared with paired t‐test and not normally distributed
with Wilcoxon signed‐rank test. Statistical significance was defined as P < 0.05.
There were 12 males and 6 females included in the study. The median age of dogs before
surgery was 1.8 years (interquartile range: 0.9–3.7 years). The mean (± standard deviation)
weight of the dogs was 9.9 ± 2.4 kg before and 10.7 ± 2.6 kg after the surgery (P
= 0.014). Dogs after surgery had larger left atrium to aortic ratio (P = 0.005; mean±SD:
1.50 ± 0.12 vs 1.63 ± 0.13), left atrium in short (P = 0.012), and long axis (P = 0.012),
left atrium in long axis (LA LAX; P = 0.002), indexed LA LAX (P = 0.018) and increased
global right ventricular strain (P = 0.033; −19.3 ± 5.4% vs −23.1 ± 5.6%), and global
left ventricular four‐chamber strain (P = 0.02). Right ventricular inner diameter
at the base, absolute and indexed (P < 0.0005), and indexed right ventricular area
in systole (P = 0.038) were smaller after surgery. Vena cava collapsibility index
(P = 0.049) was higher after surgery (41.6 ± 11.3% vs. 49.2 ± 7.9%). Tricuspid inflow
E wave velocity (0.68 ± 0.13 m/s) did not differ from mitral (0.74 ± 0.16) before
(P = 0.218) and after surgery (P = 0.484); while mitral A was higher than tricuspid
before (P = 0.028), but not after surgery (P = 0.529).
Despite noticeable clinical improvement after surgery, echocardiographic changes were
mild. High tricuspid inflow velocities suggest higher diastolic pressure in the right
heart, which does not change with the surgery; however, the right ventricular function
seems to improve.
Disclosures
No disclosures to report.
ESVCN‐P‐1
Plasma amino acid and taurine concentrations in cats with obesity before and after
a period of controlled weight reduction
A. J. German1, J. Z. Yu2, G. R. T. Woods1, J. Flanagan3, V. Biourge4, A. J. Fascetti2
1Institute of Ageing and Chronic Disease, University of Liverpool, Neston, UK; 2School
of Veterinary Medicine, UC Davis, Davis, USA; 3Royal Canin Research Center, Royal
Canin, Aimargues, France; 4Royal Canin, Aimargues, France
Limited data are available regarding adequacy of essential nutrient intake during
dietary caloric restriction using a therapeutic weight management diet. Therefore,
the aim of this study was to determine changes in plasma amino acid concentrations
in cats with obesity during a period of caloric restriction.
Eleven cats were included in this non‐randomized observational cohort study. All remained
systemically well with no significant abnormalities on physical examination and clinicopathological
assessments. Each cat followed a tailored weight reduction programme, involving feeding
a high protein, high fiber therapeutic weight management diet and increased physical
activity through regular play sessions. Before and after weight reduction, blood was
taken after a fast of ≥16h, for routine clinicopathological analyses. Surplus heparinized
plasma was immediately frozen at ‐20°C for storage, and subsequently shipped on dry
ice, as a single batch, to the laboratory where they were analysed. Concentrations
of 16 amino acids and taurine was measured using high‐performance liquid chromatography
with cation exchange column separation and post column ninhydrin‐reactive colorimetric
detection (Biochrom 30). Concentrations of cysteine and methionine were not measured
due to known sensitivities with storage. The study protocol was approved by the University
Research Ethics Committee, and all owners gave informed written consent. Analysis
of covariance was used to determine the effect of weight reduction on plasma amino
acid concentrations, whilst controlling for the effect storage time.
Median (range) weight loss was 23% (12‐29%) starting weight, over a period of 254 days
(84‐546 days). Median energy intake during the weight loss period was 50 (35 to 60)
kcal/kg0.711 ideal weight per day. Storage time was associated with a significant
increase in plasma glutamate concentration, and significant decreases in plasma glutamine
and histidine concentrations (all P < 0.001). However, there were no significant changes
in plasma concentrations of any amino acid after weight reduction (all P > 0.1). Most
plasma glutamine and glutamate concentrations were above or below reference intervals,
respectively, both before and after weight loss. Occasional results were outside reference
intervals for glycine, histidine, proline, and serine both before (median 2 cats,
maximum 2 cats) and after (median 2 cats, maximum 3 cats) weight reduction. For the
rest of the amino acids, concentrations were within reference intervals at both time
points.
Given that cats remained healthy throughout the period of weight reduction and there
were no pre‐ vs. post‐weight‐reduction differences, most observed changes in plasma
amino acid concentration are probably due to the effects of prolonged storage.
Disclosures
AJG's current academic post is financially supported by Royal Canin (2002 to current).
This author has also given talks related to the topic for Royal Canin, Mars Petcare,
BSAVA, Hills, NAVC/VMX, BVA, Nestle Purina, Pfizer/Zoetis, ICC/ISFM, AAFP, FEDIAF,
and PFMA. The author's research relating to the topic has been funded by Royal Canin,
Mars Petcare, BSAVA, and Dogs Trust. GTW is an employee of the University of Liverpool
but her post is financially supported by Royal Canin. This author has also given talks
related to the topic for Royal Canin, Mars Petcare, BSAVA, Battersea Dogs Home, Guide
Dogs, and PFMA. JF and VB are both employees of Royal Canin. AJF is the Scientific
Director and JZY is the Developmental Engineer in the Amino Acid Laboratory at the
University of California Davis that provides amino acid analysis on a fee for service
basis. This did not lead to any conflict of interest or influence the collection or
interpretation of the results.
ESVCN‐P‐2
Influence of three different diets on lipid and fructosamine concentrations in a population
of healthy cats
C. F. Berman1, R. G. Lobetti2, E. Zini3, G. T. Fosgate4, J. P. Schoeman5
1Companion Animal Clinical Studies, University of Pretoria, Onderstepoort, Bryanston
Veterinary Hospital, Pretoria and Johannesburg, South Africa; 2Bryanston Veterinary
Hospital, Johannesburg, South Africa; 3Clinic for Small Animal Internal Medicine,
Department of Animal Medicine,, University of Zurich, University of Padova,Istituto
Veterinario di Novara., Italy; 4Department of Production Animal Studies, University
of Pretoria, Onderstepoort, Pretoria, South Africa; 5Companion Animal Clinical Studies,
University of Pretoria, Onderstepoort, Pretoria, South Africa
Hypercholesterolemia in cats with diabetes mellitus has been associated with lower
remission rates. Both lean and obese cats with diabetes mellitus fed a high‐protein/low
carbohydrate diet had significantly elevated serum cholesterol concentrations. However,
it is unknown whether a high‐protein/low‐carbohydrate diet causes increased cholesterol
in healthy cats.
A randomized, crossover diet trial was performed in thirty‐five healthy shelter cats.
The aim of this study was to determine the influence of either a high‐protein or a
high‐carbohydrate diet on serum concentrations of cholesterol, triglycerides and fructosamine
in healthy cats. The fat content of the high‐protein and washout diet were equal,
but nearly double that of the high‐carbohydrate diet. The washout diet had the highest
fiber content followed by the high‐protein and high‐carbohydrate diet, respectively.
Before enrolment into the study, cats were fed a commercial baseline diet. Following
baseline health assessments, cats were randomized to one of the two diets for 4 weeks.
After 4 weeks cats were fed a washout diet for 4 weeks before being transitioned to
the cross‐over diet. Each cat was transitioned onto each of the different diets over
7 days. Fasting serum cholesterol, triglycerides and fructosamine were determined
after 4 weeks of each diet. Body condition score, body weight and environmental temperatures
were evaluated serially throughout the study.
After 4 weeks, cats on the high‐carbohydrate diet had significantly lower serum cholesterol
concentrations (P < 0.001) compared to the baseline diet. While cats eating the high‐protein
and washout diets had significantly higher serum cholesterol concentrations compared
to the baseline diet at the start of the study (P < 0.001). The increase in serum
cholesterol from the high‐protein diet was reduced significantly in cats with a body
condition score >5 (P = 0.007). Similarly, cats on the high‐protein diet also had
significantly higher serum triglyceride concentrations (P < 0.001) compared to the
baseline diet but the increase was higher in cats with a body condition score ≤5.
The high‐protein (P < 0.001) diet lowered serum fructosamine concentrations significantly
compared to the baseline diet.
In conclusion, diets higher in protein, fat and fiber and lower in carbohydrates appear
beneficial for short‐term glucose control in healthy cats. Additionally, high protein/fiber
diets influence the lipid profile in healthy cats.
Disclosures
No disclosures to report.
ESVCN‐P‐3
Study of blood pressure parameters in lean and obese client‐owned dogs: Preliminary
results
V. Jergeay1, C. Gomez‐Fernandez‐Blanco2, E. Moyse2, M. Leterrier2, I. Jeusette3, M.
Diez2
1Department of Animal Resources, University of Liège, Liège, Belgium; 2University
of Liège, Liège, Belgium; 3Affinity Petcare, Spain
Obesity in dogs is a growing nutritional disease with several presumed adverse health
effects such as systemic hypertension. It has been suggested in some studies that
body condition had only a minor effect on blood pressure and that hypertension was
probably more related to age, concurrent diseases, exercise, size and breed of the
dog. The aim of this study was to compare blood pressure in healthy lean and obese
adult client‐owned dogs of similar breed.
Fifteen lean (LD) (Body Condition Score (BCS) = 5 on a 9‐point scale) and 28 obese
(OD) (BCS ≥7/9) privately‐owned adult Labradors and Golden Retrievers were recruited
for this study, and declared healthy based on clinical examination, blood biochemistry
and complete blood count. After a 10‐minute acclimatization period, blood pressure
was measured by oscillometry following ACVIM guidelines. Activity level was measured
by accelerometry during 1 week. Data were analyzed with a Kruskal‐Wallis test and
a Mann Whitney U test. Results are expressed as mean (±SD) or median (first quartile
– third quartile).
Dogs were: 23 females (17 neutered) and 20 males (14 neutered). The mean body weight
for LD and OD respectively were 30.2±4.5kg with a BCS of 5, and 40.3±7.0kg with a
mean BCS of 7.8±0.6. No significant differences between groups were found for age
(P = 0.13) and activity (P = 0.09). Only heart rates were statistically significant
(in bpm): OD 112 (105‐135); LD 98 (86‐110); P = 0.017. No difference was found for
blood pressures that were, respectively in OD and LD (in mmHg): systolic: 161 (141‐172),
142 (126‐182), P = 0.49; diastolic: 89 (72‐103), 70 (65‐120), P = 0.17; and mean arterial:
115 (96‐127), 96 (89‐138), P = 0.29.
This lack of significance can partly be explained by the small sample size, but no
correlation was found between obesity and blood pressure, like in previous studies,
where it has been more related to age and associated disorders, breed, temperament
and level of exercise.
This study failed to show differences in blood pressure parameters between lean and
obese adult client‐owned dogs of a similar breed, without any concurrent disease.
Disclosures
I. Jeusette (Affinity Petcare) provided the dry food for the next part of the study.
ESVE‐P‐1
Evaluation of kidney function in diabetic dogs: biomarker analysis
S. C. Barbosa1, M. T. Villa de Brito1
1Clinical Research Lab, Centre for Interdisciplinary Research in Animal Health (CIISA)
‐ FMV ‐ ULisboa, Lisbon, Portugal
Diabetes mellitus (DM) is the most common disease of the endocrine pancreas in dogs.
It’s a syndrome characterized by chronic hyperglycemia, glycosuria, polyphagia, polyuria/polydipsia
and weight loss. Diabetic nephropathy (DN) is a possible complication of DM that,
in humans, is the main cause of chronic kidney disease in western countries. DN includes
microalbuminuria, proteinuria, systemic hypertension and impaired kidney function.
There are only a few studies regarding canine DN and its clinical relevance is still
unclear.
The aim of this study was to evaluate the renal function of dogs diagnosed with DM,
as well as the occurrence of proteinuria, and to compare them with healthy dogs. We
also tested if there was a correlation between these biomarkers and the time of diagnosis
of DM and insulin dosage.
The study included 18 dogs diagnosed with DM and undergoing insulin therapy, and 17
healthy dogs, based on physical examination and clinical history. Dogs that presented
with diabetic ketoacidosis, acute kidney disease, urinary tract infection, active
urinary sediment, hyperadrenocorticism, or that were undergoing chronic treatment
with glucocorticoids, were excluded. Blood and urine samples were collected, the latter
by cystocentesis. Serum urea, creatinine, symmetric dimethylarginine (SDMA) concentrations
and urinary protein:creatinine ratio (UPC ratio) were determined.
There were no significant differences in weight (P = 0,65) or age (P = 0,81) between
the two groups. Even though serum urea concentrations weren’t significantly different
(P = 0,67), diabetic dogs had lower serum concentrations of creatinine and SDMA (P
= 0,01 and P = 0,02, respectively). 38,9% of the diabetic dogs had an UPC ratio higher
than 0,5. This group had an odds ratio of 10,87 (95% IC, 1,71‐127,08, P = 0,06) of
developing proteinuria when compared to healthy dogs. There was no significant correlation
between serum urea, creatinine or SDMA and UPC ratio and the time of diagnosis (P
= 0,85, P = 0,52, P = 0,10, P = 0,84, respectively). We also didn’t find an association
between any of these variables and insulin dosage (P = 0,19, P = 0,20, P = 0,91, P
= 0,23, respectively).
Even though the occurrence of clinical DN is unlikely in dogs, our results show the
possible impact of DM on the kidney in this species. The lower levels of serum creatinine
and SDMA seen in diabetic dogs when compared to healthy ones suggest that glomerular
hyperfiltration is present, which may be related with hemodynamic changes in the kidney.
Besides, these dogs showed a higher chance of developing proteinuria, which reinforces
the importance of UPC ratio assessment when monitoring these patients.
Disclosures: This study was supported financially by the Centre for Interdisciplinary
Research in Animal Health (CIISA), which is hosted by the Faculty of Veterinary Medicine
of the University of Lisbon. MTVB is a member of the CIISA’s Clinical Research Lab,
and an employee of the Faculty of Veterinary Medicine, and receives funding support
for other unrelated research projects from CIISA. All testing was conducted at Laboratório
de Análises Clínicas Prof. Dr. Braço Forte Júnior, which is also hosted by the Faculty
of Veterinary Medicine of the University of Lisbon.
ESVE‐P‐2
Lack of training on proper use of insulin syringes leads pet‐owners to significant
deviations from target dose
S. Borin‐Crivellenti1, C. Gilor2, L. Z. Crivellenti3, C. M. F. Bagliotti4, M. B. Olivio4,
E. Lemos4, J. A. C. E. Silva5, P. B. Costa6, F. N. Gouvêa6, L. O. Branco6, A. E. Santana5
1Small Animal Internal Medicine, Graduate Program in Veterinary Science, Universidade
Federal de Uberlândia, Uberlândia, Brazil; 2Department of Small Animal Clinical Sciences,
College of Veterinary Medicine, University of Florida, Gainesville, USA; 3Small Animal
Internal Medicine, Animal Science Graduate Program, Franca University (UNIFRAN), Franca,
Brazil; 4College of Veterinary Medicine, Franca University (UNIFRAN), Franca, Brazil;
5Department of Veterinary Clinic and Surgery, Univ Estadual Paulista, Jaboticabal,
Brazil; 6Graduate Program in Veterinary Science, Universidade Federal de Uberlândia,
Uberlândia, Brazil
The success of insulin therapy greatly depends on pet owners’ skills in handling the
device chosen for insulin administration. This study aimed to assess whether previous
training might influence the ability of pet owners to properly handle U‐100 insulin
syringes.
After Research Ethics Committee approval, fifty pet owners were asked to obtain 1
and 10 IU of insulin with no training from the researchers. Then, after have received
instructions on how to properly handle insulin syringes by the researches, they were
asked to repeat the initial procedure 4 times. Each dose was weighed on an analytical
scale, and accuracy and precision were calculated. The proportions of clinically‐important‐deviation
(CID; ≥ ± 20% off target) outcomes were compared between “before” and “after” training.
The averages of the first acquisitions of 1 and 10 IU of insulin were x15.1 and x3.75
times higher than targets (P < 0.0001; P < 0.0001), respectively. After have received
training by a veterinary professional, pet owners showed significant improvement in
their ability to acquire both 1 and 10 IU of insulin (x1.07 [P < 0.0001] and x0.92
[P = 0.0016] times off target). There was a significant reduction in the frequency
of CID outcomes after training in 1 IU (98% before vs. 84% after, P = 0.03) and in
10 UI (76% before vs. 12% after, P < 0.0001).
These data suggest a great risk of inaccuracy in insulin administration by pet owners
when not appropriately trained, especially when administrating small doses of insulin.
Disclosures
The authors would like to thank Coordenação de Aperfeiçoamento de Pessoal de Nível
Superior ‐ Brasil (CAPES ‐ Finance Code 001) and Conselho Nacional de Desenvolvimento
Científico e Tecnológico ‐ Brasil (CNPq) for scientific and financial support.
ESVE‐P‐3
Glycemic control and owner preference in insulin delivery in diabetic dogs
F. del Baldo1, L. Colajanni2, S. Corradini3, P. Palagiano4, A. di Cunzolo5, L. Perissinotto2,
L. Horspool6, F. Fracassi2
1Department of Veterinary Medical Science, University of Bologna, Ozzano dell'Emilia
(BO), Italy; 2University of Bologna, Ozzano dell'Emilia (BO), Italy; 3Clinica veterinaria
dell'Orologio (BO), Clinica Veterinaria dell'Orologio, Bologna, Italy; 4Clinica Veterinaria
Meda, Meda (mb), Italy; 5Clinica Veterinaria Vetlan, Battipaglia, Italy; 6MSD Animal
Health, Boxmeer, The Netherlands
In human medicine, numerous studies have shown that insulin injection pen devices
have several advantages over insulin syringes for subcutaneous insulin injection,
including improved patient satisfaction and adherence, greater ease of use and superior
dosing accuracy. A reusable insulin pen (VetPen™, MSD Animal Health) with insulin
cartridges (Caninsulin®, MSD Animal Health) has been designed specifically for use
in diabetic dogs and cats. This study aimed to assess owner preference and compare
glycemic control following two different methods of subcutaneous injection (insulin
pen and U40 insulin syringes) of porcine insulin zinc suspension (Caninsulin®) in
a randomized, 2‐period crossover study in client‐owned dogs with naturally occurring
diabetes mellitus (DM). Eighteen dogs with DM on insulin treatment and on the same
prescription diet were enrolled in the study. Dogs were randomly assigned to receive
insulin by syringe (n = 11) or pen (n = 7) for 2 months, followed by 2 months of the
other injection method. The owner’s preference for the delivery method was assessed
using a questionnaire. A total score was assigned for glycemic control: good (8‐12),
moderate (4‐7), poor (1‐3), based on scores using a 12‐point scale (including clinical
signs, blood glucose curve parameters and serum fructosamine) while serum fructosamine
(SF) and glycated hemoglobin (HbA1c%) concentrations were analyzed. Preference of
50% of the owners for the pen and 50% for the syringe was not affected by the order
that each device was used (P = 0.620). Median clinical score was 8, 8, and 8 at inclusion,
after 2 months of pen and after 2 months of syringes, respectively (P = 0.445). Median
SF (μmol/L) was 377.5, 457.9, and 388.6 at inclusion, after 2 months of pen and after
2 months of syringes, respectively (P = 0.327). Median HbA1c(%) was 5.75, 6.2, and
5.65 at inclusion, after 2 months of pen and after 2 months of syringes, respectively
(P = 0.290). While an equal number of owners expressed a preference for each device,
a larger sample size would be required to show a difference. It was not possible to
demonstrate differences in glycemic control between the two devices. In humans, adherence
to insulin injections is strongly influenced by the selection of the injection device.
Further studies are needed to help veterinarians match the owners of diabetic pets
with the injection device best suited to their needs and capabilities.
Disclosures
Federico Fracassi Financial support: Dechra, MSD Speaking & consultancies: Boehringer
Ingelheim, Dechra, MSD, Royal Canin, Hill’s, Nestlé Purina, La Vallonea. Linda Horspool
is an employee of MSD Animal Health.
ESVE‐P‐4
Use of the continuous glucose monitoring system 'Freestyle Libre' in diabetic cats
R. Mischke1, V. Deiting1
1Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover,
Germany
Continuous glucose monitoring systems facilitate monitoring of diabetic patients.
Aims of this study were to assess the flash glucose monitoring system “Freestyle Libre”
regarding its measurement accuracy and tolerability in cats.
Results from 66 sensors applied to 34 cats (33 diabetic, 1 hypoglycemic) were included.
The behavior during the application, wearing and removing of the sensor and the skin
site of application were assessed. Blood samples were regularly collected for comparative
measurements using the hexokinase method.
Minimal signs of discomfort were noted, although the sensor was additionally fixed
using individual skin stitches. 46 sensors, which stopped working in situ, had a median
functional life of 8.3 (1.6–14) days. Only nine reached a functional life of 14 days
as specified by the manufacturer for humans. Skin reactions on the glued surface occurred
after removal of 23/66 sensors (mild erythema: n = 21; superficial dermatitis: n =
2) and were not detectable in the remaining 37/66 cases. Due to the upper limit of
the measurement range of 27.8 mmol/l (500 mg/dl), the reading device displayed “hi”
in 21 cats at least at one individual time point. In 17 of these cats this was repeatedly
the case or for longer time periods and required additional measurements with the
reference method. There was a high correlation with the results of the reference method
(rs = 0.90, n = 359), which was however lower in the hypoglycemic and normoglycaemic
range of values.
In conclusion, the device proved to be practicable, less stressful for the animals
and generated acceptable results. Although the upper limit of the measurement range
is a limiting factor, the device promises to significantly facilitate the management
of diabetic cats.
Disclosures
No disclosures to report.
ESVE‐P‐5
Reliability assessment of a novel feline glucosuria home screening test
A. Diquélou1, E. Khénifar2, A. Gagnon3, C. Gara‐Boivin3
1Small Animal, Ecole Nationale Vétérinaire de Toulouse, Toulouse cedex 3, France;
2Vet Consulting, Strasbourg, France; 3Faculté de médecine vétérinaire, Saint‐Hyacinthe,
Canada
Diabetes mellitus (DM), frequent in feline endocrinology, may be laborious to diagnose
due to its insidious clinical signs and stress‐induced hyperglycemia observed in non‐DM
cats. It needs tedious survey (regular in‐clinics or at home blood glucose curves)
to detect uncontrolled DM or spontaneous remission. As a key clinical feature of DM
is the presence of glycosuria, a non‐invasive, at‐home, easy‐to‐use test to detect
glucosuria would be of interest to suspect or to monitor DM. The aim of this study
was to evaluate the reliability of a novel at‐home test using granules, turning blue
with glucose, to be added on top of the cats litter to detect glucosuria.
To assess the feasibility of the test at home, 16 cats (10 healthy and 6 diabetic)
were enrolled. 20g of granules were poured on the cat litter. Their color, when trapped
in the urinary clumps, was noted by the owner according to a visual color scale (0
to 3+), twice a day for 14 days.
Reliability was assessed in a field study in 132 cats at risk of glucosuria (aged
> 12 years, overweighed, or receiving corticosteroids, n = 113) or diabetic (n = 19)
recruited in private practices. Urine was obtained by cystocentesis and standard urinalysis
were performed. 2 drops were poured parallelly on 4 granules and their color evaluated
3 minutes later, using the color scale. 0,3mL of each urine sample were stored at
‐20°C to determine glucosuria by spectrophotometry (ADVIA® 1800). A cat was considered
glucosuric if glucosuria was ≥25mg/dL ;a test was considered positive if the mean
score of the 4 granules was ≥1+. The test sensitivity (Se), specificity (Sp), and
positive and negative predictive values (PPV, NPV) were determined using the spectrophotometry
as gold standard.
At home, the granules were easy‐to‐use for owners and well‐tolerated by cats. 100%
of the granules remained white for healthy cats (n = 260/260). In diabetic cats, 91.2%
were ranked ≤1+ in well‐controlled diabetic cats (n = 52/57) and 67.3% were ranked
≥2+ (n = 37/55) in cats with severe hyperglycemic episodes.
Concerning the field study, color of the granules were in accordance with the results
of the dipstick in 132/132 cats (26 of which glucosuric) and strongly correlated with
glucosuria (r = 0.823, P < 0.0001), resulting in Se = 96.15%, Sp = 99.06%, PPV = 96.15%,
NPV = 99.06%.
This study suggest that these granules would be useful in order to easily diagnose
glucosuria at home and may be of interest in detection and management of feline diabetes
mellitus.
Disclosures
The study was financially supported by Blücare Lab Inc. One of the author (A. Diquélou)
has a research contract for this study only, and the others (E. Khenifar, A. Gagnon
and C. Gara‐Boivin) have contracts with this lab for this study and other ones.
ESVE‐P‐6
Bacteriuria in dogs with spontaneous hyperadrenocorticism: A retrospective study of
89 cases (2009‐2019)
F. Da Riz1, C. Maurey1, C. Colliot1, M. Kurtz1, M. Canonne‐Guibert1, G. Benchekroun1
1Service de médecine interne, Ecole Nationale Vétérinaire d'Alfort, Maisons‐Alfort,
France
Hyperadrenocorticism (HAC) has been previously reported as a predisposing factor for
urinary tract infection (UTI) or subclinical bacteriuria in dogs. However, recent
studies on characteristics of bacterial isolates in HAC and on evolution of bacteriuria
during HAC treatment are lacking.
The aims of this retrospective, observational study were to describe the frequency
of bacteriuria in a cohort of dogs newly diagnosed with spontaneous HAC, investigate
associations with clinicopathological variables, and detail the follow‐up of dogs
with bacteriuria. Dogs recruited had a definitive diagnosis of spontaneous HAC and
a bacterial culture performed at the time of diagnosis (+/‐ one month) on urine collected
by cystocentesis. Dogs were excluded if they were receiving antimicrobials or immunosuppressants
during the last month, and if they suffered from another significant predisposing
disease for UTI. Clinicopathological variables were compared between dogs with and
without bacteriuria using Fischer’s and Mann‐Whitney tests with P < 0.05 considered
as significant.
Eighty‐nine dogs were included, among which 24 (27%) had a Positive Urine Culture
(PUC), representing 26 bacterial isolates. Four dogs (17%) with PUC had clinical signs
of UTI. There was no significant association between age or gender (including neutering
status) and bacteriuria. A Positive Leucocyte Esterase Test (PLET) on the dipstick
(12/24, 50%), pyuria (11/23, 48%) and bacteriuria (14/23, 61%) on sediment examination
were significantly associated with PUC (P < 0.001), whereas specific gravity, pH and
proteinuria did not differ significantly between groups. Six dogs with PUC (25%) had
no abnormality on both dipstick and sediment examination. Escherichia coli was the
most frequent micro‐organism isolated (15/26, 58%), followed by Enterococcus faecalis
(4/26, 15%). Antimicrobial resistance was common, with 14/25 (56%) isolates showing
multi‐drug resistance (≥3 antimicrobial categories tested), and 4/25 (19%) showing
extreme drug resistance (all but ≤2 antimicrobial categories tested). All 24 dogs
with PUC were treated with targeted antimicrobial therapy. Sixteen dogs (67%) had
a follow‐up urine culture (median time 35 days, range [14‐98]), with 7/16 (43%) showing
persistence of bacteriuria, and 9/16 dogs cured, among which 3 showed reinfection
later on (72 days, [61‐202]).
The frequency of PUC in this population was 27%. PLET and active sediment (pyuria/bacteriuria)
had good positive predictive value (respectively 80%, 79% and 93%) to detect PUC despite
low sensitivity. There is no definitive consensus regarding treatment of asymptomatic
bacteriuria in dogs with HAC, however the high frequency of antimicrobial resistance
highlights the need for antibiotic susceptibility testing prior to medical treatment
if intended.
Disclosures
FD's residency position is financially supported by Royal Canin.
ESVE‐P‐7
The diagnostic performance of the heat‐stable alkaline phosphatase in dogs with suspected
hyperadrenocorticism
A. Carranza1, F.K. Zeugswetter1
1Clinical Department for Small Animals and Horses, University of Veterinary Medicine
Vienna, Vienna, Austria
Increased total alkaline phosphatase (tALP) activity is a common biochemical finding
in dogs with hyperadrenocorticism (HAC). From the three isoenzymes detectable in serum,
the corticosteroid‐induced ALP assessed by the thermostability method (heat‐stable
ALP) has been used as a source of additional diagnostic information for HAC, although
clear cutoffs and recent studies that corroborate its diagnostic value are lacking.
The aim of this study was to evaluate the diagnostic performance of the heat‐stable
ALP (HS‐ALP) as an absolute value and as a percentage of tALP (%HS‐ALP), and to compare
it to that of tALP alone in dogs with suspected HAC.
The electronic database of the central laboratory in our institution was retrospectively
searched for dogs with suspected HAC without acute non‐adrenal illness that underwent
a low dose dexamethasone screening test (LDDST) between April 2001 and January 2020.
Dogs were divided into two groups: HAC group (confirmed by at least one positive diagnostic
test and response to treatment/histopathology) and non‐HAC group. As the diagnostic
performance of the HS‐ALP was unexpectedly low in these likely hypercortisolemic patients,
the non‐HAC group was complemented with patients suspicious of HAC with HS‐ALP records
and normal urine cortisol/creatinine ratio. tALP was assessed by the Cobas ALP2‐assay
on a Roche/Hitachi Cobas c502. Dogs were excluded when both tALP and HS‐ALP records
were missing.
The final study population consisted of 103 dogs (57%) with HAC and 78 (43%) without
HAC. There was no difference in age (P = 0.53), weight (P = 0.15) and gender (P =
0.95) between the groups. Classical clinical signs except excessive panting (P = 0.18)
were significantly more common in dogs with HAC. Median values of tALP and HS‐ALP,
but not those of %HS‐ALP (70% [1‐103] in the HAC group vs. 61.5% [0‐106] in the non‐HAC
group, P = 0.17) were significantly higher in the HAC group (P < 0.001). The areas
under the ROC‐curves were 0.72 (0.63‐0.8), 0.69 (0.6‐0.78) and 0.56 (0.46‐0.66), respectively.
The cutoff values associated with the highest sensitivity and specificity (differential
positive rates) were 185 U/L for tALP (sensitivity 80%/ specificity 51%; pos. likelihood
ratio 1.63) and 70 U/L for HS‐ALP (sensitivity 77%/ specificity 51%; pos. likelihood
ratio 1.56).
The results of this study do not support the assessment of HS‐ALP or %HS‐ALP in dogs
with suspected HAC, as these parameters do not seem to provide additional diagnostic
information compared to the measurement of tALP alone.
Disclosures
No disclosures to report.
ESVE‐P‐8
Prevalence of feline hyperthyroidism in a population of 27,893 cats in Spain
R. Santiago1, L. Feo1, A.B. Priego2, J. Rodon3, J. Puig1
1Internal Medicine, Ars Veterinaria, Barcelona, Spain; 2General Medicine, Ars Veterinaria,
Barcelona, Spain; 3Idexx Laboratories, Barcelona, Spain
Feline hyperthyroidism is the most common endocrinopathy in cats. Several epidemiological
studies suggest that hyperthyroidism is a common disease in countries such as UK (11.9%),
Germany (11.4%), Portugal (9%), Poland (20.4%) and Ireland (21%). However, in Spain
it has been historically considered a rare disease. A retrospective study in 2005
found a prevalence of 1.53% and 10% in a second prospective study in 2015 in 207 geriatric
cats. The aims of this study were to assess the overall and regional prevalence of
feline hyperthyroidism in Spain, to determine the age of hyperthyroid and non‐hyperthyroid
cats and to evaluate the percentage of animals with more than one measurement of total
thyroxine (tT4) and the time between these. The study was performed retrospectively,
including serum blood samples submitted to a reference laboratory during a 3‐year
period (January 2016‐December 2018). Prevalence in this population referred to the
total number of hyperthyroid cats divided by the total number of individual cats tested.
Serum tT4 concentrations were determined in all cats by use of a chemiluminescent
competitive immunoassay (Immulite 2000 feline tT4). A cat was considered hyperthyroid
when the tT4 concentration was greater than 4.7 μg/dL (reference range 0.8‐4.7 μg/dL).
A total of 27,893 client‐owned cats from different regions of Spain were included
in the study. The overall prevalence of feline hyperthyroidism was 6.35%. The prevalence
was variable according to the area, with a lower prevalence in Castilla Leon (3.17%)
and a higher prevalence in Balearic Islands (9%). Age data was available from 6,470
cats. The mean age of the hyperthyroid cats was 14 years (range 2–25) and 11.7 years
(range 1‐27) in non‐hyperthyroidism group. Total thyroxine measurement was repeated
in 8.5% of the cats. Average of repeated measurements in the hyperthyroid group was
4 months compared to 8.6 months in the non‐hyperthyroid cats. The number of cats in
which tT4 was measured increased from 2016 to 2018 (from 7652 to 10345 cats tested
per year) which might suggest a more thorough follow‐up or greater effort in challenging
cases. The overall prevalence of feline hyperthyroidism was 6.35% in a population
of 27,893 cats in Spain, but these results were variable according to the area. To
the authors’ knowledge this has been the largest prevalence study performed in Spain
about feline hyperthyroidism.
Disclosures: Raquel Santiago residence program has been sponsored by Idexx laboratories.
ESVE‐P‐9
Performances of recombinant human thyrotropin stimulation test in dogs with suspected
hypothyroidism: Retrospective evaluation in 130 cases
A. Corsini1, E. Faroni2, F. Lunetta2, F. Fracassi2
1Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia
(BO), Italy; 2University of Bologna, Ozzano dell'Emilia (BO), Italy
Recombinant human thyrotropin (rhTSH) stimulation test (TSHst) is considered a gold
standard for diagnosing hypothyroidism in dogs. TSHst is mostly performed using 75
μg/dog of rhTSH, but one study reported that a dose of 150 μg/dog is more appropriate
for animals with non‐thyroidal illness or receiving medications. rhTSH is expensive
and using the higher dose would increase the costs. In our institution, TSHst is routinely
performed using 75 μg/dog.
The aim of this study was to evaluate the performances of a TSHst, using a dose of
75 μg/dog, in dogs with the suspicion of hypothyroidism.
Medical records of dogs presented for suspected hypothyroidism from January 2006 to
January 2020 were evaluated. Animals were included if a TSHst with a dose of 75 μg/dog
was performed and follow‐up, obtained from medical records or telephone contact, was
available. Serum total thyroxine (tT4) concentration was determined by a chemiluminescent
immunoassay (Immulite®) validated for use in dogs. Dogs with a post‐stimulation tT4
greater than or equal to 2.2 μg/dL were considered euthyroid. Dogs with a post‐stimulation
tT4 below 2.2 μg/dL were classified as hypothyroid or euthyroid based on clinical
and clinicopathological signs, serum cTSH concentration, follow‐up and, if applicable,
response to treatment with levothyroxine. The classification was done by a board‐certified
internist with experience in the field of veterinary endocrinology that evaluated
the clinical records of every case. A receiver operating characteristic (ROC) curve
was used to define the best cut‐offs to identify or exclude hypothyroidism.
One hundred thirty dogs were identified. Fifteen dogs were excluded because of some
missing data and/or follow‐up was not available; therefore, in these dogs, hypothyroidism
could not be confirmed or excluded. Forty dogs were classified as hypothyroid and
75 dogs as euthyroid. Post‐stimulation tT4 cutoffs of 1.3 μg/dL and 1.7 μg/dL showed
a sensitivity of 92.5% and 100%, and a specificity of 97.3% and 92.0%, respectively.
Post‐stimulation tT4 above 1.7 μg/dL had a negative predictive value of 100%. Post‐stimulation
tT4 below 1.3 μg/dL showed a positive predictive value of 94.9%. TSHst area under
the ROC curve was 0.987.
The main limitation of this study was the lack of a highly objective method (e.g.
scintigraphy or histopathology) to classify the 2 groups of dogs. Thus, some dogs
could have been misclassified.
This study suggests that TSHst using 75 μg/dog of rhTSH is accurate in distinguishing
hypothyroidism from NTI in a population of dogs in which hypothyroidism is suspected.
Disclosures
Federico Fracassi Financial support: Dechra, MSD , Monge, Candioli Speaking & consultancies:
Boehringer Ingelheim, Dechra, MSD, Royal Canin, Hill’s, Nestlé Purina, Zooetis, La
Vallonea.
ESVE‐P‐10
Use of desoxycorticosterone pivalate by veterinary surgeons: A Western European survey
R. C. Rebocho1, M. Domínguez‐Ruíz2, C. Arenas3, M. Pérez‐Alenza4, A. Corsini5, F.
Fracassi5, M. Bennaim6, R. A. Oliveira Leal7
1Hosp. Escolar Vet. ‐ Fac. Med. Vet. U. Lisboa, Lisboa, Portugal; 2Hosp. Clinico Vet.,
University Alfonso X el Sabio, Madrid, Spain; 3Anicura Hosp. Vet. Valencia Sur, Valencia,
Spain; 4Hosp. Clinico Vet., Complutense University, Madrid, Spain; 5Department of
Veterinary Medical Science, University of Bologna, Bologna, Italy; 6Clinique Vétérinaire
Aquivet, Bordeaux, France; 7Centro de Investigação Interdisciplinar em Sanidade Animal,
Fac Med Vet U.Lisboa, Lisbon, Portugal
A desoxycorticosterone pivalate (DOCP) product was approved by the European Medicines
Agency in 2015. Lower‐than‐label doses and extended treatment intervals have been
reported by several authors. The frequency of use of DOCP as first‐line mineralocorticoid
supplementation, initial doses and treatment intervals have not been evaluated among
Western European veterinary surgeons (WEVS). This study aimed to characterize the
use of DOCP by WEVS in dogs diagnosed with Addison’s disease.
An online survey translated into four different languages (Portuguese, Spanish, French
and Italian) was developed using an electronic platform. Respondents were recruited
through social network veterinary groups and mailing lists. Questions focused on initial
treatment regimen, DOCP starting dosage, clinical and electrolytic monitoring schedule
in dogs diagnosed with Addison’s disease. Responses from participants who had diagnosed
canine Addison’s disease over the previous 12 months were included.
Overall, 167 responses from six European countries were included (Portugal [n = 65],
Spain [n = 55], Italy [n = 34], France [n = 8], Belgium [n = 4] and Luxembourg [n
= 1]). Among respondents, 83% had already used DOCP and 78% indicated they preferred
its use over fludrocortisone acetate as first‐line treatment for mineralocorticoid
supplementation. Among 138 respondents who had used DOCP, 61% indicated using 2.2mg/kg
as initial dosage while 15% stated using lower dosages. The remaining 24% did not
detail it. Following initiation of DOCP treatment, 89% of respondents indicated monitoring
electrolytes twice a month (67% at day 10 and day 25 and 22% at day 10 and day 28‐30)
and 11% once a month (6% at day 10, 3% at day 25 and 2% at day 28‐30) until stabilization.
Out of 89 WEVS that specified a preferable therapeutic adjustment, 51% indicated changing
administration interval rather than dosage while 49% stated changing dosage rather
than frequency. Following the initial administration, 9% of respondents indicated
administering subsequent DOCP injections only in case of clinical relapse. In dogs
with stable electrolytes concentrations, 34% of respondents reported reassessing dogs
monthly, 44% quarterly, 17% twice yearly and 5% yearly.
In Western Europe, DOCP is the preferred treatment for mineralocorticoid supplementation.
The large majority of WEVS follow the manufacturer’s recommendations for initial dosage
and short‐term monitoring schedule. Subsequent preferred therapeutic adjustments regarding
change in dosage or dosing intervals vary among WEVS, most likely reflecting the absence
of strict guidelines. Of particular concern, a significant proportion of WEVS only
administer DOCP in case of clinical relapse following the initial administration,
which likely increases the risk of addisonian crisis.
Disclosures
Dechra Veterinary Products (Iberia) Ltd did aid in the promotion of the questionnaire.
Study funded by: Project UIDP/CVT/00276/2020 (funded by FCT).
ESVE‐P‐11
Evaluation of basal cortisol testing in dogs with signs consistent with hypoadrenocorticism
A. Fernandez Gallego1, A. Gow2, A. Boag2
1The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Midlothian,
UK; 2Small Animal Internal Medicine, The Royal (Dick) School of Veterinary Studies,
University of Edinburgh, Midlothian, UK
Basal cortisol concentration <55 mmol/L is well described as a screening test for
hypoadrenocorticism and commonly performed in suspected cases. Canine hypoadrenocorticism
can manifest with a variety of vague and nonspecific clinicopathological features,
mimicking conditions such as renal, gastrointestinal or neurological disease.
The aim of this study was to evaluate basal cortisol testing in dogs with clinical
signs and clinicopathological abnormalities consistent with hypoadrenocorticism presenting
to a referral institution.
Medical records for all dogs having had a basal cortisol performed between May 2013
and November 2018 were reviewed for signalment, basal cortisol or ACTH stimulation
results, and final diagnosis. Dogs were excluded if testing was performed as a screening
for hyperadrenocorticism.
A total of 1182 cases were included. Six hundred and forty‐four dogs were male (54.5%)
and 538 were female (45.5%). Labrador Retriever was the most common breed (15.1%).
Most common clinical signs on presentation were gastrointestinal signs, such as vomiting
(37.2%), diarrhea (32.2%), lethargy (25.0%), weight loss (11.8%) and hyporexia (9.2%).
Other frequent presenting complaints included collapse (6.8%), regurgitation (6.1%),
polydipsia (4.4%), polyuria (4.1%) and abdominal pain (4.1%).
Basal cortisol ranged between <13.8 to 988 mmol/L (median 90 mmol/L). A result <55 mmol/L
was obtained in 327 cases (27.7%). Basal cortisol was retested in 136 patients and
82/136 were <55 mmol/L; ACTH stimulated cortisol was tested in 225 dogs. Hypoadrenocorticism
was the final diagnosis in 17 dogs (1.4%). Multivariate logistic regression analysis
was performed on the 327 dogs with an initial basal cortisol <55 mmol/L to explore
routine blood variables and the most common presenting signs associated with hypoadrenocorticism.
The following changes were associated with hypoadrenocorticism within this group:
increased potassium (P = 0.003), decreased cholesterol (P < 0.001), increased globulin
(P = 0.003) and increased urea (P = 0.029). Overall, the most common diagnosis was
chronic primary inflammatory enteropathy (18.2%), followed by pancreatitis (4.5%)
and kidney disease (3.5%). A final definitive diagnosis was not obtained in 16.5%
of patients.
In this study, basal cortisol screening for hypoadrenocorticism was frequently assessed
in a population of dogs due to its wide variety of clinicopathological abnormalities
and it was the final diagnosis in only 17 of 1182 dogs (1.4%) tested for clinical
suspicion presenting to a referral institution. No presenting clinical signs were
specifically significantly associated with hypoadrenocorticism.
Disclosures
This work did not receive any funding Alisdair Boag is employed by there University
of Edinburgh and has received funding for unrelated work from the Wellcome Trust,
Society of Comparitive Endocrinology and the Society for Endocrinology and has no
conflicts of interest.
ESVIM‐P‐1
Respiratory and digestive abnormalities in a population of dogs with chronic idiopathic
lymphoplasmacytic rhinitis
P. Gianella1, F. Cagnasso2, S. Roncone1, U. Ala1, G. Cagnotti1, E. Bottero3, C. Bellino1
1Veterinary Science, University of Turin, Grugliasco, Italy; 2Veterinary Sciences,
University of Turin, Grugliasco, Italy; 3Poliambulatorio Veterinario Argentina, Arma
di Taggia, Italy
Chronic idiopathic lymphoplasmacytic rhinitis (CILPR) is a common inflammatory disorder
of the nasal cavity in dogs due to unknown etiology. The definitive diagnosis is made
by exclusion of other causes of nasal disease and specific therapeutic protocols are
lacking. In human medicine, a relationship between CILPR and gastrointestinal symptoms
has been postulated, and a remission of respiratory signs after clinical trials with
oral proton‐pump inhibitors, prokinetics and/or diet has been observed. The aims of
the present study were to describe history, clinical presentation, endoscopic and
histopathologic concurrent respiratory and digestive abnormalities; and to evaluate
the eventual improvement of respiratory signs after treatments for gastrointestinal
signs. The following information from 25 dogs with CILPR was recorded and studied:
respiratory/digestive signs, airway/digestive endoscopic abnormalities, histologic
evaluation of respiratory and gastrointestinal tract biopsy specimens, clinical response
to different treatment strategies. Overall, a high proportion of dogs (88%) showed
endoscopic gastrointestinal lesions, while thirteen dogs (52%) had concurrent gastrointestinal
signs. Most esophageal and duodenal endoscopic abnormalities were classified as moderate/severe.
Most gastric endoscopic abnormalities were classified as mild. Respiratory and gastrointestinal
histologic evaluation identified mostly chronic inflammation. All dogs that received
only treatments for gastrointestinal signs (30.4%) showed remission or marked improvement
of respiratory signs at two‐month follow up. A significant association between age
and respiratory symptoms was found. Nasal clinical signs of some dogs treated exclusively
with gastrointestinal approach notably improved or disappeared. Further studies are
need to explore the possibility of a cause‐effect relationship between the two processes.
Disclosures
No disclosures to report.
ESVIM‐P‐3
Influence of concurrent lower respiratory tract disease on point‐of‐care lung ultrasound
in small‐breed dogs with mitral valve disease
M. C. Lam1, C. H. Lin1, P. Y. Lo1, H. D. Wu2
1National Taiwan University Veterinary Hospital, National Taiwan University, Taipei,
Taiwan; 2Section of Respiratory Therapy, Department of Integrated Diagnostics&Therapeutics,
National Taiwan University, Taipei, Taiwan
Small‐breed dogs commonly suffer with concurrent heart and respiratory disease. In
previous studies, various respiratory etiologies can produce false‐positive results
with point‐of‐care lung ultrasound (POC‐LUS) for cardiogenic pulmonary edema (CPE).
Therefore, we hypothesized that small‐breed dogs with lower respiratory tract disease
(LRTD) have increased numbers of B‐lines and are prone to misdiagnosis.
Eighty‐four small‐breed dogs with preclinical stage B mitral valve disease (MVD) were
included. POC‐LUS was obtained by a single clinician using the Vet BLUE protocol.
The number of B‐lines was recorded at each scan site. The presence/absence of LRTD
was assessed by clinicians blinded to the POC‐LUS results.
LRTD was present in 72.6% of MVD dogs. When a previously used criterion for CPE diagnosis
(≥2 sites with >3 B‐lines/site) was applied, false‐positive results were observed
in 14.3% of dogs with preclinical MVD. Total B‐line score was significantly higher
in dogs with LRTD compared with dogs without LRTD (4 vs. 0, P = 0.0009); however,
the proportion of false‐positive results was not statistically different between dogs
with and without LRTD (18.0% vs. 4.3%, P = 0.17). Multivariable logistic regression
showed that with presence of abnormalities other than B‐line on POC‐LUS (eg, thickened
pleura or consolidation) could predict false‐positive results (OR = 14.6, P = 0.006)
after adjusting for the effects of LRTD and echocardiographic hemodynamic parameters.
In conclusion, small‐breed dogs with concurrent MVD and LRTD could have increased
B‐lines before CPE development. Adhering to previously reported criteria for CPE diagnosis
and carefully evaluating abnormalities other than B‐line on LUS may help to prevent
misdiagnosis in small‐breed dogs.
Disclosures
This study was supported by Ministry of Science and Technology, Taiwan (MOST 107‐2311‐B‐002‐011
‐).
ESVIM‐P‐4
Signalment, clinical presentation and diagnostic imaging findings in 14 dogs and 3
cats with lobar emphysema
H. Warwick1, J. Mortier2, D. Batchelor2, J. Guillem2
1Internal Medicine, Northwest Veterinary Specialists, Runcorn, UK; 2Small Animal Department,
University of Liverpool, Small Animal Teaching Hospital, Neston, UK
Lobar emphysema is an uncommon condition described in infant humans and dogs and cats.
It is caused by bronchial collapse during expiration, leading to air trapping and
subsequent hyperinflation of the affected lung lobe. The mass effect associated with
the hyperinflated lobe can lead to severe clinical signs.
Congenital forms of the disease are most frequently associated with bronchial cartilage
defects in both human and veterinary medicine. However, acquired forms caused by neoplasia
or anomalous pulmonary vessels have been reported.
The purpose of this study was to review the clinical presentation and imaging findings
in a series of dogs and cats diagnosed with lobar emphysema.
Seventeen cases of lobar emphysema (14 dogs, 3 cats) were retrospectively recruited
from referral veterinary hospitals. Diagnosis was based on diagnostic imaging, surgery
and histopathology when available. Signalment, presenting signs, clinicopathological
findings and surgical reports were also reviewed. All images were reviewed by a board‐certified
radiologist.
Small breed dogs were overrepresented (median – 4.7kg) and there was a bimodal age
distribution amongst the group of dogs (median ‐ 15 months, local peaks – 1 year and
12 years). The most common presenting signs included dyspnea, coughing, dysphagia
and vomiting. Clinicopathological findings were non‐specific.
The most common imaging findings included decreased opacity/attenuation and bronchial
collapse of the affected lung lobe, atelectasis of the adjacent lung lobes and mass
effect. Computed tomography was superior in identifying the affected lung lobe. The
right middle lung lobe was most frequently affected (13 of 17) followed by the right
cranial lobe (4 of 17). Multiple lobes were involved in several patients (4 dogs,
1 cat). Acquired forms of lobar emphysema were identified in 3 cases including two
cases of pulmonary carcinoma (1 cat, 1 dog) and one case of diaphragmatic hernia (1
cat).
Ten patients underwent surgery (9 lung lobectomy, 1 diaphragmatic hernia repair) with
8 surviving to discharge. Histopathology confirmed congenital lobar emphysema in 8
cases following lung lobectomy whilst pulmonary carcinoma was diagnosed in one case.
This case series suggests that computed tomography provides superior information for
the diagnosis of lobar emphysema. In keeping with previous reports, the right middle
lung lobe is most frequently affected in veterinary patients. In older patients presenting
with lobar emphysema, acquired causes of bronchial compression should be suspected.
Disclosures
No disclosures to report.
ESVIM‐P‐5
Suitability of commercial human rheumatoid factor rapid tests for detection of rheumatoid
factors in dog serum
C. N. Weber, J. Zeitz, E. Mueller
Laboklin GmbH, Bad Kissingen, Germany
The diagnosis of rheumatoid arthritis can be supported by detection of serum rheumatoid
factors (RF), autoantibodies directed against IgG immunoglobulins. Rapid tests are
commercially available, time‐saving, and would be useful in veterinary practice. However,
it is unclear if RF tests developed for human RF detection are suitable to detect
canine RF.
In total, 7 and 3 commercially available rapid tests based on Waaler Rose hemagglutination
and latex agglutination principles, respectively, were examined (further information
available on request). We used surplus material from samples obtained for diagnostic
purposes, in total 12 dog sera tested positive (n = 6) or negative (n = 6) with the
routine method used in the author´s lab (Waaler Rose principle, sensitivity 86%, specificity
97.9%). According to the manufacturer´s recommendations, sera were mixed with reagent,
and slides were examined macroscopically for presence of agglutination after 2‐3 min
of undisturbed incubation or incubation on a rotator. When agglutination occurred,
sera were diluted 1:10 to exclude false positives which may be caused by heterophilic
antibodies.
We verified that a human serum tested positive with the routine method was positive
with all rapid tests. Noticeable, this serum was clearly positive applying latex agglutination
tests which use particles coated with species‐specific IgG to detect agglutination.
In contrast, in tests using Waaler Rose principle, the human serum showed clear agglutination
only after a prolonged incubation time of 5‐8 min. In dog sera, however, none of the
rapid tests detected RF. Because canine RF has low affinity for human IgG, this result
was foreseeable when using rapid latex agglutination tests which all use human IgG
coated latex particles. In contrast, it could have been expected that rapid tests
based on non species‐specific Waaler Rose principle based on sheep erythrocytes sensitized
with rabbit IgG may be suitable for canine RF detection. However, also the use of
the latter tests was not successful.
The investigated rapid tests are not suitable for the detection of RF in dog sera,
thus specialized laboratory testing for canine RF is recommended.
Disclosures
Some of the evaluated tests were provided for free from the companies. Our lab offers
testing for rheumatoid factors, but uses none of the tests mentioned in the abstract.
ESVIM‐P‐7
Multiple abdominal granuloma caused by Scedosporium spp in a dog
A. Salas García1, I. Ferrandis Rodríguez2, G. Carbonell Rosselló3, C. Arenas Bermejo4
1Small Animal Internal Medicine, Pride Veterinary Centre, Derby, UK; 2Diagnostic Imaging,
Aúna Especialidades Veterinarias, Valencia, Spain; 3Surgery, Aúna Especialidades Veterinarias,
Valencia, Spain; 4Internal Medicine, Anicura Hospital Veterinario Valencia Sur, Valencia,
Spain
Infections caused by Scedosporium spp. are occasionally described in dogs causing
rhinitis, keratitis, osteomyelitis, discospondylitis, and rarely disseminated infections.
Granulomatous lesions have been reported in urinary bladder and ureter, and nasal
cavity. This case describes multiple abdominal pyogranulomatous lesion secondary to
Scedosporium spp. infection.
A 2‐year‐old female spayed mixed‐breed dog presented with a 3‐week history of vomiting,
lethargy and weight loss. Previous history included abdominal evisceration secondary
to postsurgical dehiscence 5 days after being spayed, 12 months prior to presentation.
Physical examination revealed an abdominal mass, discomfort on palpation and hyperthermia
(39,2°C). Systolic blood pressure was 80 mmHg. Hematology showed a non‐regenerative
normocytic normochromic anemia (PCV 30.7; range, 37.3 – 61.7 percent), moderate neutrophilia
22.64(range, 2.95 – 11.64 × 109/L), hypoalbuminemia 21(range, 23‐40 g/L), hyperglobulinemia
60(range 25 – 45 g/L) and increased ALP 534 (range, 23‐212 U/L). Coagulation profile,
urinalysis and culture and thoracic radiographs were unremarkable. Abdominal ultrasound
showed an ill‐defined mass with irregular margins involving the stomach, spleen, liver
and pancreas. The liver parenchyma was heterogeneous, there was portal hypertension
and ascites. Computed tomography showed a soft tissue peritoneal mass involving the
previously mentioned organs compressing the portal vein with multiple acquired portosystemic
shunts and generalized abdominal lymphadenomegaly. Fine‐needle aspirations from the
liver and spleen and peritoneocentesis were consistent with pyogranulomatous inflammation
and pure transudate, respectively. Exploratory laparotomy was performed; complete
resection of the mass was not possible. Splenectomy and omental biopsies were taken.
Histological examination revealed pyogranulomatous splenitis, peritonitis and omentitis
with intralesional fungal organisms. Tissue culture grew Scedosporium spp. and Staphylococcus
epidermidis.
The patient was treated with itraconazole (5 mg/kg PO q24h), marbofloxacin (2mg/kg
PO q24h) and S‐adenosylmethionine (10 mg/kg PO q24h). The dog made a full recovery
after surgery with transient improvement of clinical signs. However, was euthanized
2 months after diagnosis due to clinical deterioration.
Scedosporium spp is an opportunistic pathogen and infections are reported in dogs,
cats and humans with a very poor outcome. Most of the dogs reported in the literature
were immunocompromised. The dog we report here was not immunosuppressed. There are
few reports of granulomatous lesions caused by Scedosporium spp. in dogs and one involving
liver and abdominal cavity caused by Pseudallescheria boydii, actually classified
as a distinct specie in the Pseudallescheria/Scedosporium complex. This is the first
multiple abdominal granuloma caused by Scedosporium spp reported in dogs. We hypothesize
that this multiple organ involvement was secondary to the previous postsurgical abdominal
evisceration.
Disclosures
No disclosures to report.
ESVIM‐P‐9
Indications and outcomes of feeding tubes in cats : 56 cases (2015‐2018)
A. Brunet1, T. Bouzouraa2, J.L. Cadoré1, M. Hugonnard1
1Département des animaux de compagnie de loisir et de sport, Université de Lyon, VetAgro
Sup, Campus vétérinaire de Lyon, Marcy l'Etoile, France; 2Internal Medicine, Clinique
Vétérinaire Armonia, Villefontaine, France
Appetite disturbance is very common in cats. Prolonged anorexia can be a life‐threatening
condition in this species, which can develop hepatic lipidosis.
This study aimed to report the clinicopathological findings and outcome of anorectic
cats with enteral feeding tube placement during hospitalization in a tertiary care
referral center.
Medical records of 56 cases (representing 53 cats) managed with a feeding tube between
January 2015 and July 2018 were retrospectively reviewed. Thirty‐four cases were spayed
females and 22 were castrated males. Mean age was 9 years (range: 1‐18). The reason
for tube placement was complete anorexia (39 cases, 70%) or partial anorexia (17 cases,
30%). Mean duration of anorexia before tube placement was 10 days (range: 2–61 days).
Mirtazapine was unsuccessfully attempted before feeding tube placement in 21/56 (38%)
cases. The most common clinical signs associated with anorexia were lethargy (86%,
48/56), vomiting (57%, 32/56) and icterus (30%, 17/56). Main biological abnormalities
encountered before tube placement were increased ALT in 33/50 (66%), hyperbilirubinemia
in 20/31 (66%) and hypokalemia in 24/48 (50%) cases. Most commonly associated medical
conditions were digestive: hepatic (12/56), pancreatic (8/56), gastrointestinal (9/56)
or mixed (3/56). Forty‐six (82%) cases had a naso‐esophageal feeding tube and 10 (18%)
an esophagostomy feeding tube. Eight of 10 cases (80%) with esophagostomy feeding
tubes were previously managed with naso‐esophageal tubes without spontaneous refeeding
during the first seven days of enteral nutrition. Those 8 cases had neutrophilic cholangitis
(3/8), hepatic lipidosis (2/8), infectious rhinitis (2/8) and digestive neoplasia
(1/8). The two remaining cases had a neutrophilic cholangitis and a triaditis, respectively.
Complications were reported in 2/56 (3.5%) cases (dislodgement of the esophagostomy
tube in one case, aspiration pneumonia due to malposition of the tube in one case).
The type of tube chosen did not seem to be associated with any clinicopathological
and diagnostic finding or the duration of anorexia. Forty‐seven (84%) cases were discharged
from hospital while 9 (16%) cases died or were euthanized during hospitalization.
Spontaneous refeeding occurred in 29/47 cases during hospitalization. The mean time
between feeding tube placement and removal for naso‐esophageal and esophagostomy tubes
were 5 (range: 1‐17) and 33 days (range: 5‐61), respectively.
This retrospective study shows that medical conditions associated with feeding tube
placement varied widely, though hepatic diseases were frequent. Most cats were discharged
and recovered. A larger prospective case‐controlled study is needed to identify putative
historical and clinicopathological prognostic factors.
Disclosures
Audrey Brunet received travel grants from Royal Canin S.A. and from Biomerieux S.A.
ESVIM‐P‐10
Central venous catheter associated thrombosis in dogs
R. Mischke1, M. Pereira1, M. Hewicker‐Trautwein2, M. von Depka Prondzinski3
1Small Animal Clinic, University of Veterinary Medicine Hannover, Foundation, Hannover,
Germany; 2Department of Pathology, University of Veterinary Medicine Hannover, Foundation,
Hannover, Germany; 3Werlhof Institute Medical Care Center, Hannover, Germany
Thrombosis in the jugular vein related to central venous catheters (CVC) is a complication
empirically observed in canine patients treated in intensive care units. This study
aimed to determine the incidence of catheter‐induced thrombosis in canine intensive
care patients and, thereby, the efficacy of a routine prophylactic heparin treatment.
In addition, it should be assessed whether initial changes of different hemostasis
parameters can be used to predict an increased risk for thrombosis formation.
Canine in‐patients of a small animal clinic receiving a central venous catheter in
the jugular vein for medical reasons from March 2017 to December 2019 were included
in the study. All animals received standard anticoagulant treatment with low dose
unfractionated heparin (UFH), i.e. 150 IU [75 IU in surgical patients]/kg BW TID subcutaneously.
Before the catheter was inserted (day 0) and on days 1, 3, 5, etc. the respective
vein was assessed by color Doppler sonography and blood samples were collected. Hemostasis
tests performed included routine coagulation tests, rotational thromboelastometry,
thrombin generation assay (TGA), D‐dimer, antithrombin and the heparin activity using
a chromogenic anti‐factor Xa test. After removal of the CVC, catheter tips were examined
electron microscopically.; 32 dogs entered the study including 12 dogs receiving the
reduced heparin dose. Based on ultrasonographic findings of the external jugular vein,
8 dogs (all of them receiving 150 IU UFH/kg BW TID) showed thrombus formation (in
none of the cases completely occluding the vein) and 6 dogs fibrin precipitates within
or attached to the CVC. These findings did not correlate well with the electron microscopic
assessment of the catheter tips (unfortunately these studies are not complete at this
time). Heparin plasma activities showed a wide variation with median values (minimum–maximum)
of 0.36 (0.00–0.72) IU/ml and 0.11 (0.02–0.32) IU/ml in dogs treated with 150 and
75 IU UFH/kg BW TID, respectively, with no significant difference between dogs with
and without sonographically detectable thrombi. Fibrinogen concentrations were higher
in dogs with thrombi, whereas the residual hemostasis parameters including low antithrombin
activities (65.5, 42.8–104 %) were not significantly different between these patient
groups.
Results demonstrate that catheter associated thrombotic changes detected by ultrasonography
do not correlate with results of electron microscopy of the catheter tip. The used
anticoagulatory treatment is not completely effective to prevent catheter‐induced
thromboses in dogs, whose development may be supported by the wide variation of UFH
plasma activities and low antithrombin activities in intensive care patients.
Disclosures
No disclosures to report.
ESVIM‐P‐11
Importance of bone marrow examination in reaching the final diagnosis in a referral
population of dogs with non‐regenerative anemia: 23 cases (2015‐2020)
A. Salas García1, A. Hrovat Vernik1
1Small Animal Internal Medicine, Pride Veterinary Centre, Derby, UK
There is very little information or criteria available in the veterinary literature,
allowing clinicians to plan diagnostic work up, including bone marrow sampling, in
dogs with severe non‐regenerative anemia.
The aim of this study was to determine the importance of bone marrow examination in
reaching the final diagnosis in dogs with non‐regenerative anemia.
Medical records from a referral hospital were searched retrospectively from 2015 to
2020 for all dogs presenting with a more than 5 days history of documented non‐regenerative
anemia defined as PCV < 20% and reticulocyte count < 60.000/mcL. To be included, a
complete history, physical examination findings, routine and specialized laboratory
testing, diagnostic imaging and sampling of documented abnormalities necessary to
reach the final diagnosis, had to be available as well.
A total of 23 client owned dogs fulfilled the inclusion criteria. Median age of dogs
was 6.5 (range, 9 months to 13 years). There were 4 sexually intact and 7 spayed females,
3 intact and 9 neutered males. Median PCV and reticulocyte count on presentation were
16.7 (range, 6.1 – 20 percent) and 16.9 (range, 3.1 – 58.8 x 109/L), respectively.
Lethargy, anorexia, pale mucous membranes and hemic heart murmur were most common
physical examination findings. Chronic kidney disease as a suspected cause of non‐regenerative
anemia was documented in 3/23 dogs, precursor‐targeted‐immune‐mediated hemolytic anemia
(PT‐IMHA) in 7/23, and one each of stage 5b hepatosplenic lymphoma, metastatic insulinoma
with secondary iron deficiency anemia, submandibular round cell neoplasia with suspected
myeloid leukemia and one dog with severe gastrointestinal bleeding. Bone marrow sampling
was performed in 14/23 dogs and was imperative for obtaining the final diagnosis in
9/14 dogs of which four were diagnosed with primary or metastatic bone marrow neoplastic
disease and five with myelofibrosis; 6/9 of these dogs presented with either pancytopenia
or bicytopenia. Coombs test was performed in 6/9 of these dogs and was negative in
four.
In remaining 5/14 dogs, BM examination revealed PT‐IMHA; all five dogs had positive
Coombs test results. Myelofibrosis was diagnosed in total of 8/14 dogs in this cohort
and was associated with PT‐IMHA and bone marrow neoplasia (primary or secondary) in
3 and 2/8 dogs, respectively.
Results of this study revealed that BM examination is valuable in obtaining the final
diagnosis in most dogs with non‐regenerative anemia, but might be particularly vital
in dogs with negative Coombs test results and depression of two or more blood cell
lines.
Disclosures
No disclosures to report.
ESVIM‐P‐12
Thrombocytosis in iron deficient dogs and cats
T. A. M. Corvers1, C. Dye1
1Internal medicine, Pride Veterinary Centre, Derby, UK
Iron deficiency is a well‐known cause of anemia in dogs and cats, and is often found
as a consequence of chronic gastrointestinal bleeding. In humans, iron deficiency
anemia is associated with reactive thrombocytosis and, in patients with inflammatory
bowel disease (IBD), an elevated platelet count can be used as a marker of active
disease. There is also accumulating evidence to support concurrent platelet activation
and an increased thromboembolic risk. The aim of this study was to investigate whether
there is an association between iron parameters and platelet count in dogs and cats.
A search of clinical records from 2010‐2020 was done to identify patients in whom
a serum iron panel had been submitted. Serum iron, % saturation, total iron binding
capacity (TIBC), concurrent hematocrit and platelet counts were documented and assessed
for correlation. Automated hematologic parameters were verified by microscopic smear
evaluation in all cases.
A total of 111 patients (94 dogs and 17 cats) with serum iron panel results and concurrent
platelet counts were identified, all of whom had confirmed anemia, microcytosis or
chronic blood loss. In 67 patients (54 dogs and 13 cats) iron deficiency (iron < 20
μmol/l) was documented, of these, 12 patients (10 dogs and 2 cats) had thrombocytosis
(platelet > 500 *10̂9/L). No significant correlation was established between serum
iron parameters and platelet count, nor between the magnitude of iron deficiency and
degree of anemia in either dogs or cats.
This study did not identify any association between platelet count and serum iron
parameters in dogs or cats. These preliminary results suggest that iron deficiency
may not immediately stimulate megakaryopoiesis in dogs and cats to the same degree
as in humans. Accordingly, until further information is available, thrombocytosis
should not be used by practitioners as a surrogate marker to raise the suspicion of
iron deficiency.
Disclosures
No disclosures to report.
ESVIM‐P‐14
Clinical and laboratory findings and their association with AA‐amyloidosis in shelter
cats: A retrospective study
C. Palizzotto1, M. Drigo2, F. Ferri3, F. Porporato3, S. Ferro4, C. Callegari3, V.
Fiore5, D. Enache3, F. Rossi6, C. Guglielmetti7, M. Mazza7, E. Zini8
1Internal Medicina, Istituto Veterinario di Novara, Granozzo con Monticello (NO),
Italy; 2Department of Animal Medicine, Production and Health (MAPS), Università degli
Studi di Padova, Padova, Italy; 3Internal Medicine, Istituto Veterinario di Novara,
Granozzo con Monticello (NO), Italy; 4Dipartimento di Biomedicina Comparata e Alimentazione,
Università degli Studi di Padova, Padova, Italy; 5La Cincia, Val della Torre (TO),
Italy; 6Internal medicine, Istituto Veterinario di Novara, Granozzo con Monticello
(NO), Italy; 7Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle
d'Aosta, Torino, Italy; 8Clinic for Small Animal Internal Medicine, Vetsuisse Faculty,
University of Zurich, Zürich, Switzerland
Amyloidosis is a group of diseases characterized by tissue deposition of amyloid fibrils.
In animals AA‐amyloidosis is the most common form and chronic inflammation is deemed
crucial to promote fibril deposition. In cats, AA‐amyloidosis has been mainly described
in the familial form in Abyssinian and Siamese breeds, and rarely in domestic shorthairs.
Recently, a high prevalence of AA‐amyloidosis has been reported in shelter cats but
the underlying reason is unknown. The aim of this study is to explore the association
between clinical and laboratory findings and AA‐amyloidosis in cats of a shelter with
high disease prevalence.
Cats from one shelter were included if necropsies were performed within 6 hours from
death. Kidney, spleen and liver samples were collected and a diagnosis of AA‐amyloidosis
was given if any of the 3 organs had amyloid fibrils. An association between clinical
and laboratory findings and AA‐amyloidosis was investigated using available data at
onset of clinical illness and before death. Variables retrieved from medical records
were duration of stay in the shelter and of illness, white blood cells count (WBC),
hematocrit, erythrocyte mean corpuscular volume (MCV), serum creatinine, bilirubin,
albumin and globulin concentrations, urine protein‐to‐creatinine ratio (UPC). Additionally,
an illness severity score derived from abnormal laboratory findings was assigned to
cats. Comparisons were performed between cats with and without AA‐amyloidosis.
Twenty domestic shorthair cats were included: 12 with AA‐amyloidosis and 8 with other
diseases (3 chronic kidney disease, 2 lymphoma, 2 infectious diseases, 1 discospondylitis).
At onset of clinical illness, cats with AA‐amyloidosis vs. those without AA‐amyloidosis
had significantly lower albumin [median 2.3 g/dL (interquartile range 2.1‐2.4) vs.
2.6 g/dL (2.5‐2.9), P = 0.031] and higher illness severity score [0.60 (0.50‐0.69)
vs. 0.40 (0.38‐0.50), P = 0.025]. Before death, cats with AA‐amyloidosis vs. those
without AA‐amyloidosis had significantly higher WBC [18400/μL (15900‐23000) vs. 9550/μL
(4800‐12100), P = 0.005] and lower albumin [2.3 g/dL (2.1‐2.4) vs. 2.9 g/dL (2.4‐3.0),
P = 0.039]. Differences between the 2 groups were not observed for duration of stay
and of illness, hematocrit, MCV, creatinine, bilirubin, globulin and UPC, at either
time point. Age and gender did not differ.
In conclusion, AA‐amyloidosis in shelter cats is associated to lower serum albumin
concentrations throughout clinical illness. Hypoalbuminemia does not seem caused by
proteinuria. The higher illness score at onset of clinical signs might suggest that
disease severity has a permissive role in the pathogenesis of AA‐amyloidosis in shelter
cats. Further studies are needed to confirm these preliminary findings.
Disclosures
No disclosures to report.
ESVIM‐P‐15
Alendronate treatment in cats with idiopathic hypercalcemia: A retrospective control
study of 20 cases
M. Kurtz1, L. Desquilbet2, J. Maire3, F. Da Riz4, M. Canonne4, G. Benchekroun4, C.
Maurey4
1Internal Medicine, Alfort Veterinary School, Maisons‐Alfort, France; 2Clinical epidemiology
and biostatistics, Alfort Veterinary School, Maisons‐Alfort, France; 3Alfort Veterinary
School, Maisons‐Alfort, France; 4Internal medicine, Alfort Veterinary School, Maisons‐Alfort,
France
Alendronate has been advocated for long‐term management of idiopathic hypercalcemia
of cats (IHC). To date, only three case reports and one prospective uncontrolled study
have documented the usefulness of alendronate in IHC.
The aims of this study were to investigate whether treatment with alendronate is associated
with a decrease of ionized calcium (iCa) in comparison with other (or no) treatment.
Cats with IHC were recruited. IHC was defined by persistently elevated iCa and exclusion
of other causes of hypercalcemia based on paraclinical including PTH dosage. Patients
were divided into group 1 (cats treated with alendronate) and 2 (cats not treated).
T0 was defined as last control before treatment initiation, and iCaT0 as iCa at T0.
Two endpoints were investigated: occurrence of normocalcemia (iCa < 1.40 : iCa<1.40)
and occurrence of a 15%‐decrease in iCa in comparison to iCaT0 (iCa < iCaT0 – 15%
iCaT0 : iCa‐15%). Kaplan‐Meier method with logrank testing was used to compare time
to endpoints between groups. Variables were presented as medians [25th quartile ;
75th quartile] and compared with Mann‐Whitney test. Differences were considered significant
when P < 0.05.
Twenty cats were included. The two groups were comparable regarding epidemiologic
and biological data. Three cats in group 2 received other treatments: prednisolone
(2) or furosemide (1). In 6/11 cats (55%), alendronate dose had to be increased from
10 to 15 (1) or 20 mg (5) weekly. Median iCa variation from iCaT0 at 6 months of follow
up (+/‐ 60 days) was ‐18% [‐21 ; 3] in group 1 and ‐1% [‐6 ; 3] in group 2 (P = 0.35).
Median percentage of days spent with normocalcemia over total duration of follow‐up
was 66% [6 ; 18] in group 1 and 17% [17 ; 40] in group 2 (P = 0.106). Median time
to iCa‐15% was significantly longer in group 1 (119 days) than in group 2 (median
not reached; P = 0.02). Median times to iCa<1.40 were not significantly different
between group 1 (80 days) and group 2 (150 days; P = 0.81). Severe hypophosphatemia
was observed in one treated cat ; alendronate was stopped. No other sign of toxicity
was observed.
These results suggest that treatment with alendronate in IHC seems to be associated
with a shorter time to a 15%‐decrease of iCa from baseline, as compared with other
(or no) treatment. Alendronate might be more indicated than other or no treatments
for IHC.
Disclosures
No disclosures to report.
ESVNU‐P‐1
A prospective evaluation of contrast‐induced nephropathy (CIN) in dogs
P. Gianella1, S. Roncone1, A. Valazza2, U. Ala1, A. Borrelli2, F. Cagnasso2, G. Cagnotti1,
B. Miniscalco2, C. Bellino1
1Veterinary Science, University of Turin, Grugliasco, Italy; 2Veterinary Sciences,
University of Turin, Grugliasco, Italy
Administration of intravenous iodinated contrast (IVIC) in humans has been causally
associated with the development of acute kidney injury, known as contrast‐induced
nephropathy (CIN). Serum creatinine has been shown to increase 3‐5 days after IVIC
and kidney injury could range from subclinical forms to severe kidney failure. Scattered
information exists in dogs in vitro as well as in laboratory studies. In a recent
retrospective study, an increase in serum creatinine after IVIC was observed in dogs,
however, a causal association was not demonstrated. A population of dogs undergoing
computed tomography examination was prospectively evaluated for evidence of CIN after
IVIC administration. Biochemical parameters (serum creatinine, blood urea nitrogen,
total protein, albumin, chloride, phosphorus, potassium, calcium, sodium and symmetric
dimethylarginine) and urinalysis (specific gravity, dipstick, sediment, protein/creatinine
ratio, alkaline phosphatase/creatinine ratio, γ‐glutamyl transferase/creatinine ratio)
were evaluated at the time of IVIC administration (T0) and after 3‐7 days (T1). Twenty‐three
dogs of different age, breed and sex were enrolled. Three dogs showed increased symmetric
dimethylarginine and hyperphosphatemia at T1, whereas 6 dogs showed isosthenuria,
cilindruria and proteinuria. An increased in serum creatinine >25% and γ‐glutamyl
transferase/creatinine ratio >50% from baseline was found in 2 and 4 dogs, respectively.
None of these dogs had a pre‐existing kidney disease. A significant difference between
T0 and T1 for serum albumin, total protein, chloride, calcium and phosphorus was found.
Although no clinically relevant kidney injury was found, CIN developed in some dogs
after IVIC administration. Further studies are need to confirm these preliminary results.
Disclosures
No disclosures to report.
ESVNU‐P‐2
Examination of serum hepcidin concentration in dogs with kidney disease
Z. S. Vizi1, K. Lányi2, R.A. Márton3, F. Falus4, K. Szabó4, F. Manczur4, Á. Sterczer4
1Internal Medicine Department, University of Veterinary Medicine Budapest, Budapest,
Hungary; 2Department of Food Hygine, University of Veterinary Medicine Budapest, Budapest,
Hungary; 3Graduating student, University of Veterinary Medicine Budapest, Budapest,
Hungary; 4Department of Internal Medicine, University of Veterinary Medicine Budapest,
Budapest, Hungary
Hepcidin is the key regulator hormone of the iron homeostasis. According to human
studies, the serum hepcidin concentration in patients with kidney disease is frequently
elevated, and the consequently evolved iron sequestration contributes the non‐regenerative
anemia and even may lead to erythropoetin resistance.
Our study aimed to measure serum hepcidin concentration in dogs with kidney disease;
the hypothesis was that serum hepcidin in these sick dogs is elevated compared to
healthy ones.
The study population included 21 dogs (7 with acute kidney injury [AKI] and 14 with
chronic kidney disease [CKD]) from patients presented in the Small Animal Hospital
Nephrology Service or Intensive Care Unit of the University of Veterinary Medicine
‐ Budapest. Routine hematology, biochemistry (including C‐reactive protein, iron,
total iron‐binding capacity) and urinalysis were performed by all patients. Left‐over
serum samples were used to measure hepcidin with liquid‐chromatography tandem mass
spectrometry method (LC/MS‐MS). Results from our previous study evaluating serum hepcidin
in 86 healthy dogs were used as control.
All dogs with AKI (7/7) and 50% of the dogs with CKD (7/14) had hepcidin concentration
above the reference range, with mean hepcidin of 63,45 ng/mL (40,1‐110,1) in AKI group
and 38,45 ng/mL (17,7‐66,9) in CKD group compared to the healthy population 16,6 ng/mL
(2,3‐41,1). The difference was significant in all dogs vs healthy (P < 0,001), in
AKI vs healthy (P = 0,015), AKI vs CKD (P = 0,031), but not between the CKD and healthy
groups (P = 0,067).
Serum hepcidin significantly correlated with C‐reactive protein levels in the kidney
disease population (P = 0,037, rho = 0,6142), but not with hematocrit, serum iron
and iron‐binding capacity.
This study showed that correspondingly to human studies, elevated serum hepcidin concentrations
were frequently detected in dogs with kidney disease.
This research was funded by National Distinction Program No NKB KEDH106320 and European
Social Fund (grant agreement no. EFOP‐3.6.3‐VEKOP‐16‐2017‐00005).
Disclosures
This research was funded by National Distinction Program No NKB KEDH106320 and European
Social Fund (grant agreement no. EFOP‐3.6.3‐VEKOP‐16‐2017‐00005).
ESVNU‐P‐3
3D bladder ultrasound for estimation of urine volume in dogs vs. traditional 2D ultrasound
methods
A. R. Kendall1, E. Keenihan1, Z. T. Kern1, C. Lindaberry1, A. Birkenheuer1, G. E.
Moore1, S. L. Vaden1
1NCSU College of Veterinary Medicine, Raleigh, USA
Urinary bladder volume (UBV) and residual volume can provide important clinical information
for hospitalized dogs and dogs with micturition disorders. UBV can be measured directly
via urethral catheterization or indirectly via 2D ultrasound formulations. However,
these techniques impose risk such as those associated with sedation, moderate restraint
needed, catheter‐associated urinary tract infections and/or need for appropriate operator
skill and equipment. 3D ultrasound for point‐of‐care volumetric assessments of the
urinary bladder is the method of choice for monitoring UBV in people but is not routinely
performed in dogs.
The aim of this study was to validate the application of 3D ultrasound at small, medium,
and large urinary volumes in dogs, compare measurements of 3D bladder estimation obtained
by a novice to traditional 2D measurements by a board‐certified veterinary radiologist,
and compare time required for examination by 3D ultrasound to traditional 2D, B‐mode
ultrasound calculations.
In this prospective, experimental study, 10 laboratory‐bred Beagle dogs were utilized
for estimation of UBV. Bladders were infused with a calculated amount of sterile saline
to represent small, medium, and large volumes. Each UBV was estimated and calculated
by a boarded radiologist using 2D ultrasound followed by a 3D ultrasound device by
a novice. Measured UBVs were compared to the instilled UBV for each method, and the
two methods were compared to each other. Time from start to end of examination was
recorded for both methods.
Use of 2D ultrasound overestimated infused UBV with a mean [SD] difference of 4.2
ml +/− 13.1 ml. The 3D ultrasound underestimated infused UBV with a mean difference
[SD] of −9.8 ml +/− 9.8 ml. 3D ultrasound took less time to measure UBV with a mean
of 80 seconds per measurement compared to 165 seconds per measurement for 2D.
The tested 3D ultrasound device is a safe, efficient, and clinically effective tool
for measuring UBV in dogs. The device decreases need for operator skill or board certification,
reduces time for bladder estimation and provides a quick estimate of bladder volume
in real time.
Disclosures
No disclosures to report.
ESVNU‐P‐4
Use of 3D ultrasound for investigation of urinary retention in hospitalized dogs
A. R. Kendall1, E. Vasquez1, S. L. Vaden1, S. Musulin1
1NCSU College of Veterinary Medicine, Raleigh, USA
Urine residual volume (URV) is the volume of urine remaining in the bladder immediately
after the completion of micturition and is a clinically important measurement for
assessing bladder function. URV >1 ml/kg can lead to serious clinical consequences
such as detrusor atony and urinary tract infections. Multiple factors, such as anesthesia
and surgery have been implicated to cause postoperative urinary retention (POUR) in
people, which has led to routine bladder monitoring. Clinical application of a 3D
ultrasound device has been used for point‐of‐care volumetric assessments and is routinely
used for fast, ‘bedside’ estimation of urinary bladder volumes.
The aim of this study is to investigate the degree of urinary retention in hospitalized
dogs using a 3D ultrasound device, and to describe various factors that could be contributing
to urinary retention.
In this prospective, observational study, a total of 25 hospitalized dogs were enrolled.
All dogs were hospitalized for more than 24 hours, weighed more than 5 kg, and had
no concurrent urinary or neurologic disease that would affect their ability to ambulate
or voluntarily urinate. Pre‐ and post‐void bladder volumes were measured within 12
hours of presentation, and subsequent measurements were obtained during the length
of their hospitalization at the same time daily. Use of a 3D ultrasound device was
used to measure pre‐ and post‐ void urinary volumes.
URV was increased and urine retention was observed in all hospitalized dogs. Urine
retention was observed in all dogs regardless of the length of hospitalization and
the majority of dogs experienced the greatest degree of urinary retention on the second
day. Of the 25 dogs enrolled, 18 dogs had an anesthetic event during their hospitalization.
Of the 18 dogs who underwent anesthesia, 16/18 (88%) had a degree of urinary retention
above the normal reference range (0.4ml/kg) with an average URV of 4.34 ml/kg.
Urinary residual volume is an important clinical measurement and can be used as a
direct parameter for monitoring bladder function and urine retention in dogs. Use
of a safe and efficient ‘cage‐side’ 3D ultrasound device to measure daily urinary
bladder volume in hospitalized dogs could help in early identification of patients
that are retaining urine, and ultimately prevent the effects of urinary retention.
All dogs that undergo an anesthetic event during their hospitalization should be monitored
for complete urine voiding and increased residual volume.
Disclosures
No disclosures to report.
ESVNU‐P‐5
Elevated blood creatinine: A biomarker of renal function—associates with multiple
metabolic perturbations in dogs
C. S. Ottka1, K. Vapalahti1, A. M. Määttä2, N. E. A. Huuskonen2, S. K. Sarpanen3,
L. A. Jalkanen4, H. Lohi1
1PetBIOMICS Ltd., Helsinki, Finland; 2Movet Ltd., Kuopio, Finland; 3Kuopio Animal
Health Center Ltd., Kuopio, Finland; 4Veterinary Clinic Punaturkki Ltd, Kuopio, Finland
Chronic kidney disease (CKD) is a common, progressive disease in dogs. While the kidneys
have multiple important metabolic functions, the occurrence of metabolic disturbances
in canine CKD has not been extensively studied. Here we utilize a canine NMR metabolomics
platform to identify metabolic changes in blood samples exhibiting elevated blood
creatinine, a hallmark of CKD.
Clinical samples analyzed by the 1H NMR‐based metabolomics platform were used as the
base population. Twenty‐three samples with creatinine over 125 μmol/l were included
in the case group and 873 samples with creatinine within the analysis reference interval
were included in the control group.
Biomarker association with elevated creatinine concentration was evaluated utilizing
three different statistical approaches: Wilcoxon rank‐sum test and logistic regression
analysis (P‐values FDR‐corrected), and classification using random forest. A created
heatmap visualized these changes. Means of the groups and their 95% CI were compared
to reference intervals and histograms were plotted to further visualize the observed
changes.
Each of the used statistical methods identified similar biomarkers associated with
elevated creatinine concentration. The levels of 9 biomarkers; citrate, tyrosine,
branched‐chain amino acids, valine, leucine, albumin, acetate, linoleic acid % and
the ratio of phenylalanine to tyrosine were significantly different between cases
and controls in the Wilcoxon rank‐sum test (P < 0.05). The same biomarkers, excluding
acetate and including docosapentaenoic acid %, were associated with elevated creatinine
concentration in logistic regression analysis (P < 0.05). The ten biomarkers with
the highest variable importance in the random forest model were the same that reached
significance in the Wilcoxon rank‐sum test, as well as the amino acid alanine.
This study identified multiple metabolic changes associated with elevated blood creatinine,
including prospective diagnostic markers and therapeutic targets. The NMR metabolomics
platform is a promising tool for improving diagnostics and management of canine CKD.
Further research is needed to verify the association of these changes to the patient’s
clinical state.
Disclosures
The study was funded by PetBIOMICS Ltd. CO is an employee, KV a previous employee,
and HL is an owner and the Chairman of the Board of PetBIOMICS Ltd. AMM is the CEO,
and NH a member of board of Movet Ltd. SS is an owner and CEO of Kuopio Animal Health
Center Ltd. LJ is an owner and chairman of board of Punaturkki Ltd.
ESVNU‐P‐6
Effect of hypoxia on mineralocorticoid expression and activation in primary cultures
of feline renal cortical fibroblasts and proximal tubular epithelial cells
S. E. Spencer1, C. Wheeler‐Jones2, J. Elliott2
1Royal Veterinary College, London, UK; 2Comparative Biological Sciences, Royal Veterinary
College, London, UK
Chronic kidney disease (CKD) is the most common cause of mortality in ageing cats.
Feline CKD is pathologically characterized by tubulointerstitial fibrosis and inflammation.
Renal ischemia/hypoxia is proposed as an initiating and/or progression factor in feline
CKD; hypoxia induces pro‐fibrotic gene expression in feline renal cortical fibroblasts
(FCFs) and changes consistent with epithelial‐to‐mesenchymal transition in feline
proximal tubular epithelial cells (FPTECs) in vitro. Aldosterone is emerging as a
contributor to renal fibrosis and inflammation and mineralocorticoid receptor (MR)
blockade is beneficial in rodent models of renal ischemia/reperfusion injury. Data
from in vitro studies investigating the effect of hypoxia on MR activation are limited
and conflicting and appear to be cell specific. The aim of this study was to assess
the effect of hypoxia on MR expression and activation (indicated by serum glucocorticoid‐regulated
kinase‐1 [sgk1] expression) in FCFs and FPTECs.
Primary cultures of FCFs and FPTECs were isolated post‐mortem from cats with (FCFs,
n = 3) and without (FPTECs, n = 3) CKD. Cells were exposed to 24‐ or 72‐hours hypoxia
(1% oxygen) or normoxia (18% oxygen). One to three repeats were performed per isolate
for each treatment and timepoint. MR and sgk1 mRNA expression (relative to reference
gene [RPS7] expression) was assessed by reverse transcription‐qPCR. Paired t‐tests
were used to compare gene expression between normoxic and hypoxic conditions.; 24‐hours
hypoxia had no effect on MR and sgk1 expression compared to control conditions in
either cell type. MR expression tended to decrease following 72‐hours hypoxia in FCFs
(mean [±standard deviation] fold change in gene expression 0.68 ±0.079, P = 0.0573)
and decreased in FPTECs (0.49 ±0.097, P = 0.0352), whereas sgk‐1 expression was decreased
at this timepoint in FCFs (0.50 ±0.023, P = 0.0019) but not FPTECs (0.72 ±0.094, P
= 0.0907). Importantly, responses in gene expression appeared to vary between isolates
(i.e. individual cats) after 24‐hours hypoxia whereas a consistent decrease was evident
following 72‐hours hypoxia.
These preliminary findings suggest that MR expression and activation decreases following
prolonged hypoxia in FCFs and FPTECs. The effect of this downregulation on protein
expression and response to renal injury requires further investigation.
Disclosures
This work was supported by the Biotechnology and Biological Sciences Research Council
[grant number BB/M009513/1]. SS is in receipt of a CASE studentship co‐funded by the
BBSRC and CEVA Animal Health. JE is a member of the International Renal Interest Society,
which is sponsored by Elanco Animal Health Ltd. JE has acted as a paid consultant
for CEVA Animal Health, Boehringer Ingelheim Ltd., Kindred Bio Inc., Orion Ltd., Royal
Canin Ltd., Idexx Laboratories Ltd. and Waltham Ltd. JE is in receipt of grant funding
from Royal Canin Ltd., Elanco Animal Health Ltd. and Idexx Laboratories Ltd. None
of the authors has any other financial or personal relationships that could inappropriately
influence or bias the content of the paper.
ESVNU‐P‐7
Palatability and tolerance evaluations of a new formulation of a supplement dedicated
to maintain the balance of renal function in dogs and cats (Pronefra)
C. S. Nicolas1, C. Bouchez2, P. Schreiber2, P. Monginoux2
1GMBO, Virbac, Carros, France; 2Virbac, Carros, France
Pronefra oral suspension (Virbac) is a supplement dedicated to maintain the balance
of renal function of dogs and cats. It contains phosphate binders, chitosan to bind
uremic toxins and a marine oligopeptide to help maintain a balanced blood pressure.
A new formulation of Pronefra with these main ingredients in olive and corprah oils,
has been developed. The palatability and tolerance of this formulation were tested
on healthy cats and dogs.
Palatability: In dogs, the supplement was added once with food of 38 dogs and the
number of dogs taking the product and food was evaluated. For cats, the suspension
was mixed with food of 83 cats daily for 7 days and the mean ration consumed with
the supplement was compared to the usual ration (without the suspension).
Tolerance: The tolerance was evaluated for 28 days in healthy dogs and cats receiving
either 1 time the recommended dose (0.25 and 0.2 ml/kg, BID – 8 cats and 8 dogs, respectively)
or 5 times the recommended dose (8 cats and 8 dogs). Four cats, receiving no supplement,
were used as control. The animals’ general health, food consumption and stools consistency
were assessed daily. A complete clinical examination and body weight measurement were
performed once a week. Blood samples were taken before the start and at the end of
the study for standard hematology and blood biochemistry (plus SDMA).
Palatability results: all dogs (100%) took the product, 84% consumed more than 95%
of the product and 92% of dogs totally consumed their kibbles. For cats, the food
with product was accepted by 94% of cats with no impact on the mean food consumption
on Day 7. The owners gave a mean acceptability score of 7.7/10 (median of 8/10) and
72% judged the acceptability was good enough to give it for 30 days.
Tolerance results: No product‐related clinical signs were observed. The supplement
did not affect body weight, food consumption or blood parameters.
Therefore, Pronefra oral suspension is considered as very palatable and well tolerated
by cats and dogs.
Disclosures
All authors are Virbac employees.
ESVNU‐P‐8
Use of 3D bladder ultrasound for characterization of urinary incontinence in male
dogs
A. R. Kendall1, S. L. Vaden1
1NCSU College of Veterinary Medicine, Raleigh, USA
Urethral sphincter mechanism incompetence (USMI) occurs in up to one in five female
dogs in the United States. Urinary incontinence in male dogs is less characterized
and is difficult to distinguish between urethral abnormalities, such as USMI, from
those that have urinary retention with overflow incontinence. Post‐void urine residual
volume (URV) may be a useful tool in differentiating these disorders. Urethral catheterization
and imaging studies can be used to determine URV; however catheterization increases
risk of urinary tract infections and 2D imaging studies require advanced equipment
and expertise. Use of 3D ultrasound has been utilized in both humans and dogs as a
rapid, non‐invasive estimation of urinary bladder volume and URV. The aim of this
study is to evaluate post‐void URV, using a 3D ultrasound device, in male dogs presenting
for urinary incontinence to determine if these dogs can be further characterized as
having urethral disorders vs overflow incontinence.
In this prospective, observational study, 13 male dogs presenting for urinary incontinence
were enrolled. All dogs weighed > 5 kg, and had no apparent urinary or neurologic
disease that would affect their ability to ambulate or voluntarily urinate. Use of
a 3D ultrasound device was used to measure pre‐ and post‐void URV. An unpaired t‐test
was used for comparison of the 2 groups; a P‐value of <0.05 was considered significant.
Five of 13 dogs presenting for urinary incontinence had evidence of urinary retention
with a mean (SD) URV of 6.61 ml/kg (8.12 ml/kg). Four of the 5 dogs with urinary retention,
had a final diagnosis of detrusor atony and a mean URV (SD) of 8.05 ml/kg (8.53 ml/kg).
The remaining 8 dogs had no evidence of urinary retention with a mean URV (SD) of
0.32 ml/kg (0.35 ml/kg). Five of 8 dogs were diagnosed with USMI and the remaining
3 were diagnosed with ectopic ureters (EU). Dogs with evidence of overflow incontinence
had a significantly higher URV than those with USMI or EU (P = 0.04).
Urinary incontinence in male dogs can be further subdivided into dogs with overflow
incontinence from urinary retention and those without urinary retention from USMI
or EU. Use of a safe and efficient 3D ultrasound device to measure post‐void URV is
a useful diagnostic tool at time of initial evaluation. A URV of >1 ml/kg can be utilized
to begin treatment for detrusor atony prior to considering USMI as a cause of urinary
incontinence in a male dog.
Disclosures
No disclosures to report.
ESVNU‐P‐9
Comparison between non‐injected computed tomography and ultrasonography for detection
of ureteral stones in the cat: a prospective study
I. M. Testault1, L. Gatel2, M. Vanel3
1Atlantia Hospital Center, Nantes, France; 2Imaging, Azurvet, Nice, France; 3Imaging,
Atlantia Hospital Center, Nantes, France
Computed tomographic scan (CT) is now considered as the gold standard in human medicine
for renal colic. This prospective study aims to compare ultrasound (US) and CT for
detection of ureteral stones in cats.
Fifty‐one cats with a ureteral obstruction were included. An ultrasound followed by
a non‐injected CT were performed. The number of stones and their location (proximal,
middle and distal) were recorded in both modalities and their numbers were compared
with a Student test. Pelvic distension was measured on US only. Based on the US results,
3 groups were created: without stone, stone not detected, stone detected. Pyelic dilatation
between the three groups was compared with a Wilcoxon test.
There are significantly more stones detected with the CT compared to US (126 versus
90; P < 0.05). More stones were detected in the proximal and distal regions (P < 0.05)
with CT. Pyelic dilatation is significantly different between the 3 groups (1.2 mm
[SD 1.5 mm], 3.4 mm [SD 2.2 mm] and 8.3 mm [SD 5.9 mm] in the “no stone”, “stone not
detected” and “stone detected” groups respectively).
CT seems to be more informative than ultrasound for detection of ureteral stones in
cats, as in human medicine. Proximal and distal stones seem to be the most difficult
to diagnose with US. Distension of the pelvis is more pronounced when a ureteral stone
is detected. However, a ureteral stone should not be ruled out if there is no or a
small distension of the pelvis.
Disclosures
No disclosures to report.
ESVNU‐P‐10
Palatability and tolerance of an oral suspension developed to maintain a healthy urinary
tract in cats
C. S. Nicolas1, P. Schreiber2, N. Jouty2, P. Monginoux2
1GMBO, Virbac, Carros, France; 2Virbac, Carros, France
Feline lower urinary tract disorders are common in cats and relapses are frequent.
To help maintain a healthy urinary tract in cats, an oral suspension containing glycosaminoglycans
as well as hibiscus and green tea concentrates was developed.
The objectives of the studies presented here were to test the palatability and tolerance
of this suspension in healthy cats.
Palatability: to test the palatability of the suspension, 1 ml was poured over the
food of 89 client‐owned cats for 7 days, twice a day (as recommended) and the daily
consumption of the food was compared to the usual consumption with no supplement (assessed
for 2 days prior to the study start).
Tolerance: the tolerance of the product was tested for 28 days on cats receiving either
1 time the recommended dose (1 mL, twice a day, n = 8) or 5 times the recommended
dose (5 ml, twice a day, n = 8). A group of 4 cats, receiving no product was used
as a control. Cats were observed daily during the 14‐day acclimation phase (no product
administration) and 28‐day administration phase. A complete clinical examination was
performed once a week. Food consumption and stool consistency were assessed daily.
Blood samples were taken on Day ‐5 (during the acclimation phase) and on Day 28 for
standard hematology and blood biochemistry.
Palatability results: 82/89 cats (92%) accepted to eat the food with the product and
the mean food consumption did not change by day 7 for these cats. The mean acceptability
score given by the 89 owners was 7.2/10 (median of 8/10) and 73% of owners judged
the palatability was good enough to give the product over 30 days. Seventy‐four percent
(74%) of owners judged there was either no impact or a positive impact of the suspension
on the cat’s eating behavior.
Tolerance results: no product‐related clinical signs were observed and all cats remained
healthy throughout the study. The supplement did not affect body weight, food consumption
or blood parameters.
In conclusion, this product developed to help maintain a healthy urinary tract in
cats is therefore considered as very palatable and well tolerated by cats.
Disclosures
All authors are Virbac employees.
ESVNU‐P‐11
Usefulness of Serum Amyloid A in diagnosing pyelonephritis in cats
M. Kurtz1, C. Maurey2, F. Da Riz2, M. Canonne2, P.B.M. Pey3, G. Benchekroun2
1Internal Medicine, Alfort Veterinary School, Maisons‐Alfort, France; 2Internal medicine,
Alfort Veterinary School, Maisons‐Alfort, France; 3Medical Imaging, Universita di
Bologna, Bologna, Italy
Veterinary literature is scarce about pyelonephritis in cats, despite its probable
underestimated prevalence. More specifically, diagnostic features are not well defined.
They rely on the association of both evocative clinical and paraclinical modifications
(e.g. fever, painful abdominal palpation, azotemia, bacteriuria), as well as ultrasonographic
abnormalities (e.g. renal pelvic dilation). However, these signs are often non‐specific.
Definitive diagnosis is based on pyelocentesis or biopsy for bacterial culture, which
remains technically challenging. Accurate diagnosis is crucial, considering both therapeutic
and prognostic implications.
The aim of this retrospective study was to evaluate the utility of measuring serum
amyloid A (SAA), a major positive acute phase response protein, as a marker of pyelonephritis
in cats.
Medical records were reviewed and animals were classified in 2 groups. Group 1 included
cats with confirmed (1a) or presumed (1b) pyelonephritis (1a: cats with positive bacterial
culture on urine collected via pyelocentesis. 1b: cats fulfilling 3 out of 4 criteria
among azotemia, hyperthermia, bacteriuria and pelvic dilation on ultrasound). Group
2 included cats with chronic kidney disease (CKD) in which pyelonephritis was either
excluded (2a: negative urine culture via pyelocentesis) or considered unlikely (2b).
Cats with incomplete medical data were excluded, as well as Abyssinian cats. Statistical
analysis was performed using Mann‐Whitney test, and differences were considered significant
when P < 0.05. Variables are presented as medians [25th percentile; 75th percentile].
Forty cats (46 observations) were included in the study. Median age at presentation
was 9 years old [6.3 ; 11.8]. Median SAA concentrations (reference interval: 0 – 12
mg/L) in group 1 (n = 13) and 2 (n = 33) were 127 mg/L [51.3 ; 216.8] and 5.6 mg/L
[2.6 ; 9.7], respectively. Median SAA in group 1 was significantly higher than in
group 2 (P = 0.0005). Group 2 included seven cats with ureteral obstruction, six with
subclinical bacteriuria, and the remainder were presented for worsening of clinical
condition or for regular recheck (CKD or subcutaneous ureteral bypass). Seven cats
in group 2 had increased SAA. Among them, median SAA was 59.4 mg/L [25.2 ; 70]. In
two of them, a patent extrarenal disease was identified. Two cats in group 1b showed
SAA concentration within reference range.
These results suggest that cats with pyelonephritis are very likely to have higher
SAA concentrations as compared with cats with CKD. SAA might be a valuable diagnostic
tool for feline pyelonephritis.
Disclosures
No disclosures to report.
ESVNU‐P‐14
Urine protein to creatinine ratio (UPC) in puppies and young dogs
S. Kovarikova, N. Zivotska, J. Blahova
Department of Animal Protection and Welfare and Public Veterinary Medicine, University
of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic
Some of hematological variables and biochemical analytes have specific reference intervals
for puppies. Nevertheless, the literature concerning urine parameters in puppies is
scarce. The purpose of this study was to determine the urine protein to creatinine
ratio (UPC) in puppies and young dogs aged 2‐12 months, compare the results with results
of adult dogs and evaluate them according to the general reference interval for dogs.
In total, 176 voided urine samples of clinically healthy puppies, young dogs and adult
dogs were enrolled. Five groups according to the age were created: puppies aged 2‐3
months (n = 25), puppies aged 3‐4 months (n = 22), puppies aged 4‐6 months (n = 36),
young dogs aged 6‐12 months (n = 26), and adult dogs older than 1 year (67). To calculate
the UPC, urine protein concentration was measured by use of benzethonium chloride;
creatinine concentration was measured with Jaffe method; both in an automated analyzer
(Abbott Architect c4000, Abbott Diagnostics). The UPC was classified in accordance
with IRIS guidelines. Therefore, dogs with a UPC<0.2 were classified as nonproteinuric,
dogs with a UPC ratio from 0.2 to 0.5 had borderline proteinuria, and dogs with a
UPC ratio >0.5 had proteinuria.
In puppies aged 2‐3 months, the mean UPC (± standard deviation) was 0.77±0.42 (range
0.24‐2.25); in puppies aged 3‐4 months, it was 0.57±0.45 (range 0.18‐2.31), in puppies
aged 4‐6 months it was 0.23±0.14 (range 0.05‐0.57), in young dogs aged 6‐12 months
it was 0.10±0.06 (range 0.02‐0.23), and in adult dogs it was 0.11±0.13 (range 0.02‐0.78).
Mean UPC was significantly higher in puppies aged 2‐3 months, 3‐4 months, and 4‐6
months when compared to adult dogs (p<0.001). No difference in UPC was found between
young dogs aged 6‐12 months and adult dogs.
In puppies and young dogs, the proportion of proteinuric samples decreased with age,
whereas the proportion of non‐proteinuric samples increased with age. The percentage
of proteinuric, borderline proteinuric and non‐proteinuric samples was 72%, 28%, and
0% in puppies aged 2‐3 months; 50%, 45.5%, and 4.5% in puppies aged 3‐4 months; 8.3%,
38.9%, and 52.8% in puppies aged 4‐6 months; 0%, 11.5%, and 88.5% in young dogs.
Our study shows that UPC is affected by age and puppies younger than 6 months should
have specific reference range.
Disclosures
No disclosures to report.
ESVNU‐P‐15
Comparison of two quantitative methods for urine protein measurement used for calculation
of urine protein to creatinine ratio (UPC)
S. Kovarikova1, J. Blahova1, K. Rehakova2
1Department of Animal Protection and Welfare and Public Veterinary Medicine, University
of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic; 2Clinic Laboratory
for Small Animals, University of Veterinary and Pharmaceutical Sciences Brno, Brno,
Czech Republic
Urine protein to creatinine ratio (UPC) is considered as a gold standard for quantification
of proteinuria in dogs and cats. For this ratio, urine creatinine concentration is
mostly measured via the Jaffe method with picric acid. Nevertheless, various methods
are reported for assessment of urine protein concentration. The aim of this study
was to compare two commonly used quantitative methods for urine protein measurement.
Voided urine samples obtained from 67 dogs were used for this study. In all samples,
creatinine concentration was determined by Jaffe method with automated biochemical
analyzer Konelab 20i (Thermo Fisher Scientific). In paired samples, protein concentration
was measured via turbidimetric method with benzethonium chloride (automated biochemical
analyzer Abbott Architect c4000, Abbott Diagnostics) and using photometric method
with pyrogallol red (automated biochemical analyzer Konelab 20i). Both methods were
calibrated using Total protein Urine/Liquor calibrator with concentration 1300 mg/l.
Urine protein to creatinine concentration was calculated for both methods. The UPC
was classified in accordance with International Renal Interest Society (IRIS) guidelines.
Therefore, samples with UPC < 0.2 were classified as nonproteinuric, samples with
a UPC ratio from 0.2 to 0.5 as borderline proteinuria, and samples with a UPC ratio
> 0.5 as with proteinuria. To compare results, Wilcoxon signed‐rank test was used.
Median UPC calculated from results obtained by method with benzethonium chloride was
0.18 (range 0.02‐1.19). In case of pyrogallol red method, median UPC was 0.09 (range
0.04‐0.78). Method with benzethonium chloride gave us significantly higher results
(p<0.001). According to the IRIS guidelines, in samples evaluated by method with benzethonium
chloride 11 cases were classified as proteinuric, 19 had borderline proteinuria, and
37 were nonproteinuric. In samples assessed by pyrogallol red method, only one case
was classified as proteinuric, 9 samples had borderline proteinuria, and 57 samples
were nonproteinuric.
This study shows that urine protein measurement using different quantitative methods
leads to significantly different results of UPC and it may have clinical consequences
when general limits recommended by IRIS are adopted.
Disclosures
No disclosures to report.
ESVNU‐P‐16
Erythrocyte and platelet changes in dogs managed with hemodialysis
F. Perondi1, V. Marchetti1, G. Lubas1, E. Gori1, A. Pierini1, M. Mogioni1, I. Lippi1
1Department of veterinary science, University of Pisa, San Piero a Grado, Italy
In human medicine, different changes in some hematological parameters such as packed
cell volume (PCV), hemoglobin concentration (HGB), red blood cell (RBC) (hemolysis,
broken cells, lower hematocrit), platelet activation and thrombocytopenia have been
reported in patients managed with hemodialysis (HD). These alterations could be due
both to the severe uremia and to HD treatment (blood cell physical and chemical stress).
The aim of the study was to evaluate erythrocyte and platelet changes in uremic dogs
managed with HD. Seven dogs with Acute Kidney Injury, AKI or Acute on Chronic Kidney
Disease, AKI/CKD were enrolled: three dogs were in stage IV and four in stage V, and
managed with 25 HD sessions overall. Each dog at every pre and post HD treatment was
evaluated with a complete blood count. The data collected were assayed with D’Agostino
test for normality. In order to compare the values of RBC, HCT, HGB, red cells distribution
width (RDW) mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) platelet
count (PLT), plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution
width (PDW) between pre‐ and post‐HD Wilcoxon matched pairs test or paired t‐test
were used. Chi squared test was used to evaluate the difference on platelet estimation
between pre‐ and post‐HD treatment. Four males and 3 females of different breed, age
and body weight were included. There were no statistically significant differences
between pre and post HD treatment about RBC, HCT, HGB and RDW. On the contrary, MCV
pre‐HD 61.9 fL (range 58.6‐63.6) and post‐HD 64.2 fL (range 59.3‐65.4) and MCH values
pre‐HD 22.7 pg (range 21.7‐23.2) and post‐HD 23.3 pg (21.7‐23.4) were significantly
increased post‐HD (P < 0.0001 and P = 0.002, respectively). The PLT pre‐HD 181 K/mL
(range 98‐407.5) and post‐HD 110 K/mL (range 58‐422) and PCT pre‐HD 0,19% (range 0.13‐0.35)
and post‐HD 0,15% (range 0.07‐0.27) were significantly decreased post‐HD (P < 0.0001).
Chi squared test was not significant difference in platelet estimation between pre‐
and post‐HD. Canine HD seems to induce changes in few RBC and PLT parameters. The
increase of MCV and MCH were striking post‐HD probably linked to the persistency of
RBC in the fluid tonicity used in HD. The reduction of PLT count and the overall mass
post‐HD was significant probably due to the activation of coagulation process. These
information could be useful to the clinician in order to adjust the fluid tonicity
and the anticoagulant protocol used in HD dogs.
Disclosures
No disclosures to report.
ESVNU‐P‐17
Retrospective study of cystinic lithiasis in dogs in France
T. Méric1, A. Sulter2, A. Bogey‐Lambert2, A. Blavier3, C. Nelaton3, M. Canonne Guibert4,
M. Manassero5, G. Benchekroun4, C. Maurey4
1Internal medicine, National Veterinary School of Alfort, Maisons‐Alfort, France;
2Vet'Analys, Hyères, France; 3Royal Canin, Aimargues, France; 4Internal Medicine,
National Veterinary School of Alfort, Maisons‐Alfort, France; 5Surgery, National Veterinary
School of Alfort, Maisons‐Alfort, France
Cystine lithiasis are likely to form in case of cystinuria, which is secondary to
a lack of reabsorption by the proximal convoluted tubule. North American studies show
low prevalence among lithiasis in dogs (0.3‐0.8%), unlike European publications (3.0
to 5.6%). This disease is still poorly described.
The aims of this retrospective, observational study were 1/ to describe the lithiasis
characteristics and breed predispositions of dogs with cystine urolithiasis recruited
from a French veterinary analysis laboratory over two years and 2/ to report epidemiological,
clinical, paraclinical and prognostic aspects of dogs diagnosed with cystine urolithiasis
at our hospital. Dogs were included if stone analysis by infrared spectroscopy confirmed
cystine composition (100%). Results are presented as percentage or odd ratio (OR)
subjected to a 95% confidence interval, or as median subjected to interquartile range
(IQR).
In the first population, 104 dogs were included. Cystine lithiasis represented 8.9%
[7.7‐10,1] of all analyzed stones (n = 2054). Stones were in the urethra in 68% [61‐75]
and in the bladder in 77% [71‐83] of cases. Median number of stones was 7 (IQR: 12)
and median size was 5mm (IQR: 6.25). 99.4% [98.4‐100] of dogs were males and 90% [85‐94]
were entire. In dogs with lithiasis, English Bulldogs (OR: 55.6 [27.41‐112.8]), American
Staffordshire Terriers (OR: 38.22 [20.33‐71.84]), French Bulldogs (OR: 14.84 [8.26‐26.67]),
Staffordshire Bull Terriers (OR: 13.46 [6.48‐27.94]), Dachshunds (OR: 3.43 [1.72‐6.82])
and Chihuahuas (OR: 2.41 [1.43‐4.05]) were predisposed to have cystine lithiasis.
22% [16‐28%] of dogs had recurrent stones.
At our hospital, 25 dogs were included over twenty years. Overall diagnostic frequency
was 0.021% [0.013‐0.029]. All dogs were entire males. Sub‐obstruction of urethra was
present in 71% [53‐89] of cases. Uroliths were radio‐opaque in 74% [54‐93]. Cystine
crystals were observed on sediment examination in 35% [15‐54] of cases. In 88% [74‐100]
of cases, a low purine food was prescribed; otherwise homemade diet or wet industrial
diet was advised. Tiopronine, D‐penicillamine, antibiotics and potassium citrate were
respectively used in 60% [41‐79], 28% [10‐46], 24% [15‐34] and 16% [2‐ 37] of cases.
D‐penicillamine and potassium citrate were respectively interrupted in 1 out of 4
and 2 out of 8 cases for which follow‐up was available. 40% [21‐59] of dogs recurred
once or more, up to 5 times for 1 case. Recurrence and treatment interruption were
not associated. This study highlights the significant part of cystine among stones
in French dogs and the unreported radio‐opacity of the stones.
Disclosures
Blavier A and Nelaton C work for Royal Canin. Bogey‐Lambert A and Sulter A work for
Vet'Analys which is in partnership with Royal Canin.
ESVNU‐P‐18
Urinalysis alterations in dogs affected with urinary tract infection: A retrospective
case/control study
J. Zambarbieri, M. Busnelli, P. Scarpa
Department of Veterinary Medicine, University of Milan, Lodi, Italy
Urine culture and antimicrobial susceptibility test are the gold standard in order
to select a correct treatment in urinary tract infections (UTI). However, a complete
urinalysis is the first line investigation in dogs with urinary symptoms and results
can help the clinician in the diagnostic workup.
The aim of this study was to compare signalment and urinary parameters obtained from
dogs with positive urine culture (“UTI‐group”) to those with sterile culture (“nUTI‐group”)
in a population in which UTI was considered among the differential diagnosis.
Two‐hundred‐eighty‐two culture and urinalysis results, from urine sampled by cystocentesis
in 214 dogs, between 2013 and 2019, were included in this retrospective study. Statistical
analysis was performed by chi‐square, Wilcoxon or Kruskal‐Wallis test using JMP 14
(SAS Inc., Cary, USA).
One‐hundred‐nine urine samples from 85 dogs were positive and 173 samples from 129
dogs were negative to culture.
Single isolates were 92.7% and Escherichia coli was the main pathogen (50.5%).
Dogs in UTI‐group were significantly (P < 0.01) older (9.8±4.2 years) compared to
nUTI‐group (7.6±4.6). No significant difference regarding breed and sex were found.
Urine appearance was predominantly yellow in both groups, but pale yellow (11% vs
5%) was overrepresented in UTI‐group. Turbid aspect was predominant in UTI‐group (32%
vs 9%), but 35% of UTI‐group samples was clear.
UTI‐group had lower (P = 0.03) urine specific gravity (USG); pH was similar between
groups.
Positivity to blood and hemoglobin was higher in UTI‐group (P < 0.01) but negative
results (44% and 60% respectively) were present in UTI‐group and positive (28% and
17% respectively) in nUTI‐group.
Nitur test was positive in 13% of UTI‐group and 0% in nUTI‐group.
Urinary red blood cells were not significantly different between groups. White blood
cells (>5/hpf) were present in 72% of UTI‐group and in 15% of nUTI‐group showing a
significant difference (P < 0.05).
Bacteria were detected in 75% of urinary sediments of UTI‐group and apparently evident
in 5% of nUTI‐group. In the 27 dogs of UTI‐group in which bacteria were not evident,
USG ranged from 1002 to 1048 and resulted below 1014 in 11 cases.
Proteinuria staged according to IRIS guidelines was significantly different (P < 0.01)
between groups: proteinuric and borderline proteinuric were respectively 44% and 28%
in UTI‐group, while in nUTI‐group were 30% and 14%.
Although the set of found alterations can lead to a suspicion of infection, urinalysis
is not diagnostic of UTI; based on these results, the diagnosis could be missed in
at least 25% of patients.
Disclosures
No disclosures to report.
ESVNU‐P‐19
Cystoscopic‐assisted urinary bladder lavage in male cats with recurrent urethral obstructions:
Treatment and outcome in 9 cases
A. Cocci1, S. Monti2, V. Greci3
1Clinica Veterinaria San Siro, Milano, Italy; 2Clinica Veterinaria Valdostana, Saint
Christophe ‐ AO, Italy; 3Ospedale Veterinario Gregorio VII, Roma, Italy
Urethral obstruction (UO) is a common and potentially life threatening complication
in male cats with feline lower urinary tract disease (FLUTD). Consensus regarding
the most effective medical treatment to prevent recurrence of UO is lacking. Recurrence
of UO can lead to repeated hospitalization, increase risks of urethral injury secondary
to catheterization or need for surgical intervention (perineal urethrostomy, PU).
The aim of this work is to report the use of cystoscopic‐assisted urinary bladder
lavage and the outcome in 9 male cats with recurrent UO.
Exclusion criteria were age less than 12 months, less than 2 episodes of UO, presence
of any underlying disease different from FLUTD or existing PU.
All nine cats were DSH castrated males with a mean age of 5.3 years (2‐12 years).
All nine cats showed recurrent pollakiuria and stranguria and 3/9 cats macroscopic
hematuria. Mean duration of clinical signs was 15.6 months (1‐48 months).
All cats were anesthetized and the urinary bladder was distended with warm saline
infused through a preoperatively placed rigid polypropylene open‐ended, 3.5 F, tomcat
catheter. A mini‐laparotomy incision on the midline, about half of the way between
the pubis and the umbilicus, was performed to expose and secure the cranial region
of the bladder to the abdominal wall.
A 2.4 mm rigid cystoscope was placed, within its 3.5 mm cannula, through a small incision
made into the ventral wall of the urinary bladder.
Amorphous debris, mucous plugs, sand, blood cloths and small size uroliths (<2mm)
were flushed from the urinary bladder under high pressure saline solution infused
through the catheter and removed with suction attached to the ingress/egress portal
of the cannula. The scope was often withdrawn from its cannula to remove material
trapped within the lumen.
All cats were discharged uneventfully with medical and dietary therapy depending on
clinical condition, stress factors and urinalysis.
Mean follow‐up was 9.6 months (3‐24 months). One cat had recurrence of UO and perineal
urethrostomy was performed.
In this case series 8/9 cats (88.8%) showed long term remission of FLUTD, without
recurrence of UO. Cystoscopic‐assisted urinary bladder lavage might represent a more
effective technique than decompressive cystocentesis or urethral catheterization in
treating UO in male cats. Increased endoscopic visualization and high pressure saline
flow allow more accurate removal of mucous plugs, cloths and small uroliths reducing
the risks for repeated catheterizations or need for PU.
Disclosures
No disclosures to report.
ESVNU‐P‐20
Increase in canine cystine urolithiasis in Norway
H. S. Lund1, S. I. Thoresen2
1Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences,
Oslo, Norway; 2Department of Preclinical Sciences and Pathology, Norwegian University
of Life Sciences, Oslo, Norway
Cystine is a dibasic amino acid, a dimer consisting of two molecules of the non‐essential
amino acid cysteine. Cystinuria occurs when there is insufficient reabsorption of
dibasic amino acids (cystine, ornithine, lysine and arginine) in the renal proximal
tubules. Compared to the other dibasic amino acids, cystine has low solubility in
acidic urine and may form cystine crystals and uroliths. Mutations in two genes (SLC3A1
and SLC7A9) involved in the reabsorption of these amino acids in the proximal tubules
have been identified in various breeds in addition to an androgen‐dependent type of
cystinuria which seems less breed dependent.
Due to a suspected increase in dogs with cystinuria in Norway, the aim of the present
study was to investigate possible changes in the proportion of cystine uroliths among
all analyses of canine uroliths performed from January 2010 until May 2019 in a reference
laboratory.
A gradual increase in cystine uroliths was noted, constituting 12 % (10/81) of the
total number of uroliths analyzed in 2010, 11 % (7/66) in 2011, 9 % (7/80) in 2012,
7 % (6/87) in 2013, 12 % (10/84) in 2014, 12 % (10/84) in 2015, 17 % (12/69) in 2016,
18 % (10/55) in 2017, 30 % (17/56) in 2018 and 33 % (8/22) in the 5 months included
of 2019.
Of the total of 97 dogs with cystine uroliths, 91 (94 %) were intact males, 3 (3 %)
intact females, 2 (2 %) castrated males and 1 (1 %) castrated female.
In addition, information concerning diet prior to diagnosis of cystine uroliths and
amino acid profile results was recorded for a subset of these dogs. Of 19 dogs, 12
(63 %) were eating a high protein diet or meat‐based diet, 1 dog was already on a
specialized diet due to previous episodes of cystine uroliths and for the remaining
6 dogs type of diet was unknown. Two dogs had urinalysis results consistent with a
more generalized defect in the renal proximal tubules such as Fanconi syndrome.
In the present study, an increase in cystine uroliths was confirmed and high protein
diets may be a predisposing factor. Due to a large population of intact dogs in Norway,
androgen‐dependent cystinuria may be relatively frequent. In addition, the increase
in cystine uroliths correlates with a substantial increase in dogs with acquired Fanconi
syndrome in Norway and, therefore, concordant disease mechanisms between different
proximal tubulopathies may be considered.
Disclosures
No disclosures to report.
ESVNU‐P‐21
Outbreak of acquired Fanconi syndrome in dogs in Norway
H. S. Lund1, K. P. Anfinsen1, A. H. Haaland1
1Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences,
Oslo, Norway
Fanconi syndrome (FS) is defined as a generalized inherited or acquired proximal renal
tubulopathy, characterized by inadequate reabsorption of substances such as glucose,
amino acids, bicarbonate, potassium, calcium, sodium, chloride, phosphate, magnesium,
ketones and lactate. Metabolic acidosis and progressive renal failure may develop.
Acquired Fanconi syndrome (aFS) has been reported in association with several different
causes including various infections, diseases, drugs and intoxications. In addition,
aFS has been associated with ingestion of pet jerky treats of Chinese origin. Dogs
diagnosed with aFS have been reported in North America, Australia, Asia and Europe.
In the late autumn 2017, an increase in cases diagnosed with aFS was noted in Norway
and confirmed by analysis of patient records from 2010‐2017. Therefore, a national
register for aFS in dogs was established.
The aim of the present retrospective study was to describe signalment and clinicopathological
findings for 59 dogs with normoglycemic glucosuria registered between October 2015
and February 2019.
The study sample consisted of 23 (39 %) females and 36 (61 %) males between 1 and
13 years of age. Mean and median age was 6.6 and 7 years, respectively.
There were 8 mixed‐breed dogs, 1 unknown breed and 50 pure‐breed dogs of 28 different
breeds. Sixteen dogs (27 %) were toy breed dogs (0‐5 kg), 22 (37 %) small breed dogs
(5‐10 kg), 9 (16 %) medium breed dogs (10‐25 kg) and 11 (19 %) large breed dogs (25‐45
kg). More than 80 % of the dogs had PU/PD and more than 60 % were lethargic and showed
signs of inappetence. Vomiting was reported in 38 % of the dogs.
Urine specific gravity ranged from 1.000‐1.060 (mean 1.018 and median 1.015). Aminoaciduria
was examined and confirmed in 49/59 dogs. Proteinuria was detected by dipstick in
76 %, hypokalemia was detected in 37 % and hypophosphatemia in 21 % of the dogs. Twenty‐nine
percent had serum creatinine levels above the reference interval. Blood gas analysis
was performed in 35/59 dogs, of which 43 % had acidosis and 33 % had bicarbonate concentrations
below the reference interval.
The majority of the dogs (90 %) had ingested jerky treats. No other potential causes
for aFS were detected.
Acquired Fanconi syndrome has previously not been described in Norwegian dogs. While
clinicopathological findings are in line with existing literature, the present study
included a larger proportion of medium and large breed dogs than previously reported.
Disclosures
No disclosures to report.
ESVONC‐P‐1
Acid Suppressants Alter Neoplastic Mast Cell Structure and Cytokine Expression
E. N. Gould1, J. A. Vose2, H. Wilson‐Robles3, T. Miller3, J. A. Szule3, A. Buono1,
J. M. Steiner1, E. M. Lennon4, M. K. Tolbert1
1Gastrointestinal Laboratory, Texas A&M University College of Veterinary Medicine,
College Station, USA; 2University of Tennessee College of Veterinary Medicine, Knoxville,
USA; 3Texas A&M University College of Veterinary Medicine, College Station, USA; 4University
of Pennsylvania School of Veterinary Medicine, Philadelphia, USA
Mast cell tumors (MCTs) are the most common cutaneous neoplasm in dogs, and are associated
with life‐threatening adverse effects, including degranulation and release of pro‐inflammatory
mediators. Gastric acid suppressants, such as histamine‐2 receptor antagonists (H2Ras;
e.g., famotidine) and proton pump inhibitors (PPIs; e.g., esomeprazole), are routinely
prescribed to dogs with MCTs. However, there is a lack of evidence to support a choice
of one acid suppressant over another and no consensus on when or if acid suppressants
are beneficial for these patients. In preliminary studies, we have demonstrated that
in vitro murine mast cells (MC) undergo structural changes and cell death following
acid suppressant therapy. Moreover, esomeprazole consistently induced more pronounced
effects, suggesting that selection of acid suppressant might be important. The effect
of acid suppressants on in vitro or in vivo canine MCTs or cytokines is unknown, posing
a knowledge gap regarding the most efficacious therapy for impairing MC function.
Our objectives were to evaluate the effect of clinically relevant concentrations of
famotidine and esomeprazole on validated in vitro human (LAD2) and canine (C2) neoplastic
MC structure and cytokine expression.
The LAD2 line, which best models degranulation and cytokine release of neoplastic
MCs, was evaluated along with the canine C2 line. Light and transmission electron
microscopy along with electrochemiluminescence multiplex assays were used to assess
MC structure and cytokines (ILs‐3, 4, 6, 10, and 12, CXCL8, TNF‐α, and IFN‐γ) following
vehicle‐control, H2RA, or PPI treatment
Concentration and time‐dependent structural changes were observed in MCs following
drug treatment, with more pronounced effects seen with esomeprazole. Granule morphology
was dramatically altered, with some cells demonstrating loss of most granules and
increased cytoplasmic vacuolization. A significant decrease in CXCL8 was seen only
with esomeprazole (P < 0.01; ANOVA with Holm‐Sidak).
Acid suppressants altered in vitro MC structure, but only esomeprazole reduced pro‐inflammatory
cytokine production. This work indicates that acid suppressants may directly impact
neoplastic mast cells, and that selection of the optimal class of acid suppressant
for use in dogs with MCTs, especially those with non‐resectable tumors, requires further
study in vivo.
Disclosures
No disclosures to report.
ESVONC‐P‐2
Do feline solid and cystic pancreas tumors influence different pancreatic lipases?
K. Törner1, M. Staudacher2, K. Steiger3, J. M. Grassinger1, C. Weber1, E. Müller1,
H. Aupperle‐Lellbach1
1LABOKLIN GmbH & Co. KG, Bad Kissingen, Germany; 2Tierärztliche Klinik Dr. Staudacher,
Aachen, Germany; 3Technische Universität München, Munich, Germany
In feline pancreatic tumors, solid and cystic growth has been described in detail.
Additional inflammation was frequently seen in feline pancreatic neoplasms. The aim
of the study was the evaluation of feline pancreatic lipase immunoreactivity (fPLI)
and 1,2‐o‐dilauryl‐rac‐glycero‐3‐glutaric acid‐(6’‐methylresorufin)ester (DGGR) lipase
in cats with solid and cystic pancreatic tumors. Corresponding tissue and serum from
21 cats with primary pancreatic tumors, routinely submitted between 2014 and 2019,
were examined. The animals were 5–20 years old (median 11) and predominantly Domestic
Shorthair (n = 14). FPLI [<3.5 μg/l] (n = 21) and DGGR lipase [<26 U/l] (n = 13) were
measured in serum. Pancreatic tumors were macroscopically either cystic (n = 7) or
solid (n = 14) and up to 16.0 x 7.0 x 7.0 cm in size. Histologically, all solid neoplasms
were malignant, whereas cystic tumors were benign (n = 4) or malignant (n = 3). Mild
(4 cystic, 7 solid), moderate (3 cystic, 4 solid) or severe (2 solid) lymphoplasmacellular
(n = 7) or mixed (n = 13) pancreatitis was present. One cat showed no pancreatitis.
FPLI values were mostly elevated (cystic 7/7, solid 11/14; 1.7–40.0 μg/l, median 14.3
μg/l), regardless of dignity, degree or character of additional pancreatitis. DGGR
lipase (9.3–287.4 U/l, median 39.8 U/l) was increased in 9/13 cats. None showed solitary
increased DGGR lipase. In conclusion, feline solid/cystic pancreatic tumors can cause
elevation of fPLI and DGGR concentrations. For differentiation from pancreatitis,
pathohistological examination is required. Increased blood values were probably due
to epithelial cell transformation, because no correlation to character or degree of
the pancreatitis was obvious.
Disclosures
No disclosures to report.
ESVONC‐P‐3
Tumors of the retrobulbar space in cats: 31 cases
K. Purzycka1, N. Cotterill2, U. Dietrich3, R. Drees4
1Oncology, Anderson Moores Veterinary Specialists, Winchester, UK; 2Queen Mother Hospital
for Animals, Royal Veterinary College, London, UK; 3Ophtalmology, Queen Mother Hospital
for Animals, Royal Veterinary College, London, UK; 4Radiology, Queen Mother Hospital
for Animals, Royal Veterinary College, London, UK
The objective of this retrospective case series is to describe the clinicopathological
features of feline neoplasia involving the retrobulbar space.
Medical records of 31 cats diagnosed between 2007 and 2019 with neoplasia involving
the retrobulbar space were reviewed. Signalment, reason for referral, physical and
ophthalmological examination, imaging and pathological findings were recorded. The
most common breed was a domestic short hair (21). Median age was 11 years (range:
2‐18).
Twenty‐one cats were referred for ocular‐related problems; 10 cats presented for non‐ocular
clinical signs only, most frequently respiratory signs (nasal discharge, sneezing
and dyspnea), facial swelling/mass or anorexia.
The most common ocular findings included exophthalmos (16), serous ocular discharge
(13), decreased retropulsion (13), third eyelid prolapse (12), periorbital swelling
(6), anterior and/or posterior uveitis with associated decrease in vision (2). Cats
with exophthalmos exhibited exposure keratitis and corneal ulcerations (6) with one
cat presenting with a corneal perforation.
All cats underwent advanced imaging of the head including 3 MRI and 28 CT exams. In
4/31 cats, primary retrobulbar tumors were documented and in the remaining cases tumors
with secondary retrobulbar extension were identified.
The diagnosis was achieved via cytology, histopathology or both in 11, 14 and 6 cases,
respectively. Tumor types included lymphoma (19), carcinoma (7), sarcoma (3), extramedullary
plasma cell tumor (1) and undifferentiated neoplasia (1).
In this study, secondary neoplastic local involvement of the retrobulbar space was
most common, with intranasal neoplasia being the most common cause. Lymphoma was identified
as the most frequent neoplasia involving the retrobulbar space in cats.
Disclosures
No disclosures to report.
ESVONC‐P‐4
Are severe adverse events commonly observed in dogs during cancer chemotherapy? A
retrospective study on 155 dogs
T. Chavalle1, G. Chamel1, P. Berny1, P. Denoeux1, M. Lajoinie1, D. Sayag2, F. Ponce1
1VetAgro Sup, Marcy l'Etoile, France; 2Centre Hospitalier Vétérinaire Advetia, Vélizy‐Villacoublay,
France
Severe adverse events (AE) might be induced by maximum tolerated dose chemotherapy
and often require protocol modification, or even chemotherapy arrest which has an
impact on the prognosis of cancer bearing pets and on owners' acceptance. The aim
of this retrospective study was to assess the rate and risk factors of severe AE secondary
to chemotherapy in dogs. Medical records from dogs receiving chemotherapy between
January 2013 and December 2018 were retrospectively reviewed. A causality link between
chemotherapy and clinical and/or biological signs was established, mainly based on
the chronology and compatibility with known AE. The severe AE were graded according
to VCOG‐CTCAE grading system. Multiple correspondence analysis and Fisher’s exact
Chi‐2 tests were performed. 155 dogs were included in the study. AE were reported
at least once in 123/155 dogs (79,4%) and severe AE were observed in 70/155 dogs (45,2%).
Among these dogs, 43/70 (58,9%) had gastro‐intestinal and 30/70 (42,9%) had myelotoxic
events. Severe AE led to delay and/or dose reduction in 46/70 dogs (65,7%), to molecule
modification in 21/70 dogs (30%), to chemotherapy arrest in 12/70 dogs (17,1%) and
to euthanasia or death in 9/70 dogs (12,9%). Multiple Correspondence Analysis showed
relationship between the presence of severe AE, hematopoietic tumors, and L‐COP chemotherapy
for instance, but also an influence of the body condition score. Conversely, no association
between AE and in charge clinician, age, gender or body weight was observed. These
associations were further investigated. Significant relationship between occurrence
of severe AE and tumor type (P < 0.005) or multi‐agents chemotherapy protocol (P < 0.005)
were observed. Contrary to previous studies, severe AE following chemotherapy and
leading to modification of the chemotherapy regimen was relatively common in dogs.
Disclosures
No disclosures to report.
ESVONC‐P‐5
Retrospective comparative analysis of some clinical and clinico‐pathological features
of canine lymphoma from Italy and Thailand
A. Pierini1, P. Simcic1, S. Ciampalini1, T. Sirinarumitr2, V. Marchetti1, A. Gavazza3,
G. Lubas1
1Department of Veterinary Sciences, University of Pisa, San Piero a Grado, Pisa, Italy;
2Department of Pathology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok,
Thailand; 3School of Biosciences and Veterinary Medicine, University of Camerino,
Matelica, Macerata, Italy
Non‐Hodgkin’s lymphoma is one of the most common hematopoietic tumor in dogs and represents
7‐24% of all canine tumors. Middle‐aged dogs and some purebreds (i.e. Boxer, Bull
mastiff, etc.) are more affected. Few studies regarding the distributions of lymphoma
subtypes in different countries have been published.
The aim of this retrospective study was to compare some clinical data and the cyto‐morphological
aspects of canine lymphoma cases collected in two different countries, Italy (Pisa)
and Thailand (Bangkok).
This study included 192 dogs with lymphoma (cytologically and/or histologically diagnosed)
collected at the Veterinary Teaching Hospital of Pisa (VTHP) between January 2010
and May 2017, and 436 dogs collected at the VTH of Bangkok (VTHB) between January
2015 and November 2017. The data analysed included breed, size (small, medium, and
large), sex, age, and lymphoma classification (anatomo‐clinical, tumor grade, immunophenotype).
Differences for age have been evaluated by the Mann‐Whitney test, while other parameters
have been investigated with the Chi‐squared or Fisher’s exact tests (P‐value of <0.05
was statistically significant). Breeds affected by lymphoma were compared with the
whole canine population presented at the same period in the two facilities.
Dobermann and Rottweiler for VTHP and Golden Retriever for VTHB were significantly
overrepresented. VTHB‐dogs were considerably older (median 9 vs. 8 years) and were
mostly small sized breeds compared to the population at VTHP. More than 90% of lymphomas
were classified as high‐grade in both groups. Multicentric lymphoma (83%) was significantly
more frequent in the VTHP. Extra‐nodal (34%) and cutaneous lymphomas (26%) were significantly
more frequent in the VTHB. B‐cell lymphomas (71%) were significantly more frequent
in VTHP and T‐cell lymphomas (34%) in VTHB.
Striking differences were found in the signalment data and the higher frequency of
cutaneous lymphomas in VTHB dogs should be pointed out. Moreover, such findings probably
influenced the immunophenotype results, since almost all cutaneous forms were T‐cell
lymphomas. Different breed and size distribution, lifestyle and environmental factors
could influence the two study populations, as shown by our results.
Disclosures
No disclosures to report.
ESVONC‐P‐6
Toceranib phsophate in the management of insulinoma in dogs
N. del Castillo1, C.R. de la Riva2, N. Rayón3, S. Márquez1, R. Ruano4, C. Aceña5,
E. Rollón6, V. Domingo7
1CV Surbatan, Madrid, El Salvador; 2HCV UAX. Oncopets, Spain; 3Spain; 4HV Mediterráneo,
Spain; 5HV UZ, Spain; 6CV Canymar, Spain; 7Atypia, Spain
Pancreatic tumors are uncommon in dogs, being those that arise from the islets of
Langerhans (insulinoma: β cell insulin secreting tumors or β cell carcinomas) the
most representative. Insulinomas commonly metastasize to regional lymph nodes and
liver (50% at presentation). Clinical signs are mainly due to hypoglycemia secondary
to the increase of insulin secretion. Classical treatment is based on surgery and
control of clinical signs due that, so far, no specific medical treatment has shown
clear efficacy. Toceranib phosphate is a tyrosine kinase inhibitor (TKI) that may
inhibit angiogenesis and others kinase receptors involved in the development of the
neoplasm and whose use in the management of neuroendocrine neoplasms has been consolidated
in the last years. Dogs with insulinoma, treated with surgery and toceranib or toceranib
as monotherapy, were included in this retrospective study. Diagnostic was performed
by glucose and insulin serum levels, cytology and/or biopsy. Clinical stage was based
on imaging techniques (mainly CT). All dogs received 2.5 mg/kg of toceranib in Monday‐Wednesday‐Friday
schedule. Response to therapy was based on glycemic control and imaging monitoring.
Descriptive data analysis and Kaplan‐ Meier survival function was calculated with
IBM SPSS V22 software. Twenty dogs were included, 8 males (40%) and 12 females (60%).
West Highland Withe Terrier was the most represented breed (6/20; 30%). Median age
was 10,05 years (+/‐ 1,99). Ten (10/20; 50%) were treated with surgery and adjuvant
toceranib and 10 (10/20; 50%) with toceranib as monotherapy. Median survival time
was 577 days for the group managed with surgery and toceranib, and 984,80 days for
the group which received toceranib as monotherapy, however no significative differences
were observed between both groups (P = 0.85). The objective of this study was to evaluate
retrospectively the efficacy of toceranib in the management of canine insulinoma,
with or without surgery. Survival time was superior to previously report for both
groups (381 days for surgery and 74 days for medical therapy; Tobin et al. 1999).
In our study no differences in survival time were found in dogs that underwent surgery.
However, the role of the surgery in canine Insulinomas should be clarified in prospective
studies with a larger number of cases.
Disclosures
No disclosures to report.
ESVONC‐P‐8
Comparison between oral chlorambucil and dose‐intense chemotherapy for the treatment
of feline transmural low‐grade alimentary T‐cell lymphoma
C. Agnoli1, R. Finotello2, V. Turchi3, M. Tumbarello1, F. Dondi1, L. Marconato1
1Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia
(BO), Italy; 2Department of Small Animal Clinical Science, University of Liverpool,
Liverpool, UK; 3Department od Veterinary Medical Sciences, University of Bologna,
Ozzano dell'Emilia (BO), Italy
While several studies have been published on feline alimentary low‐grade T‐cell lymphoma
of the mucosa, limited data are available for its transmural counterpart (tLGAL).
This retrospective study aimed at comparing clinical benefit (CB), response rate (RR)
at 3 and 6 months, time to progression (TTP) and survival time (ST) of cats with tLGAL
receiving chlorambucil‐prednisolone (Chl‐P) or dose‐intense chemotherapy. tLGAL was
defined as a neoplastic infiltrate composed of small T‐cells extending markedly into
the submucosa and muscolaris propria.
Cats with newly‐diagnosed, histologically and immunohistochemically‐confirmed tLGAL
that underwent complete staging work‐up, had abdominal ultrasound performed at admission,
received treatment, and had an adequate follow‐up were included. Cats were classified
into 2 groups: Chl‐P and dose‐intense chemotherapy. To determine treatment efficacy,
the following variables were compared between groups: previous administration of corticosteroids,
hematology, serum albumin, LDH, cobalamin, FIV/FELV status, presence of epitheliotropism,
serosa infiltration, extra‐intestinal involvement. RR was evaluated according to RECIST
criteria; adverse treatment events (AEs) were recorded. Data were compared with non‐parametric
statistics or crosstabs (Fisher exact test). P < 0.05 was considered significant.
Fifteen cats were included. At admission vomit and/or diarrhea (median 60 days; range
2‐700) were frequent. Three cats underwent enterectomy due to sub‐occlusion. In 8
cats, LGAL extended to the serosa. Nine (60%) cats received Chl‐P and 6 (40%) received
dose‐intense chemotherapy (5 CHOP, 1 lomustine). Enterectomy (P = 0.047) and previous
steroid treatment (P = 0.047) were more common in the dose‐intense chemotherapy group;
otherwise, groups were well‐balanced for all other variables. Overall, 12 (80%) cats
obtained CB within a median of 22 days (range, 7‐60) documented by the resolution
or improvement of symptoms. Fourteen cats that were alive at 3 months were re‐scanned:
there were 2 complete and 9 partial remissions (RR 73%). At 6 months, 13 cats that
were still alive were re‐scanned: there were 6 complete and 5 partial remissions.
Median TTP was 395 days (range, 58‐997). At the end of the study, 8 (53%) cats were
alive, 7 (47%) had died of lymphoma; median ST was 374 days (range, 58‐1700). TTP
was significantly longer for cats receiving Chl‐P than dose‐intense chemotherapy (867
vs 200 days, respectively) (P = 0.028), whereas there was no significant difference
between groups in CB, RR, ST and AEs.
Results of this study suggest that Chl‐P and CHOP‐based may be equally effective in
tLGAL. Further prospective studies are warranted to confirm these findings given our
small sample size and the retrospective nature of the data.
Disclosures
No disclosures to report.
ESVONC‐P‐9
The effect of age and body weight on the incidence of neutropenia in dogs receiving
chemotherapy
N. Ignatenko1, A. Rieger2, K. Troedson1, C. Fejos1, J. Hirschberger3
1Oncology and radiology, Ludwig Maximilians University, Muenchen, Germany; 2MTK, Ludwig
Maximilians University, Muenchen, Germany; 3Oncology and radiology, MTK, Ludwig Maximilians
University, Muenchen, Germany
Old age and low body weight of cancer patients may cause veterinarians to reduce the
dose of chemotherapy. However, reducing the dose of chemotherapy leads to a decrease
in its effectiveness. In the literature, data on the effects of age and body weight
on neutropenia as side effect of chemotherapy in dogs are controversial. The aim of
our retrospective study was to determine whether old age (≥10 years) or low body weight
(<11 kg) cause a more frequent occurrence of neutropenia. Statistical analysis was
carried out using Pearson’s Chi‐squared test.
The medical database from 04.2003 to 08.2018 was analyzed for dogs receiving chemotherapy.
Overall, 971 chemotherapy sessions were analyzed in 295 dogs. In dogs ≥10 years, 415
chemotherapy administrations resulted in 122 (29.4%) episodes of neutropenia. In patients
<10 years, 556 chemotherapy administrations resulted in 204 (36.7%) episodes of neutropenia,
a significant difference (P = 0.021). Younger dogs had more often neutropenia before
chemotherapy compared to those ≥10 years old.
The weight of dogs receiving chemotherapy ranged from 1.8 kg to 55.6 kg. In patients
<11 kg, 198 chemotherapy sessions and in patients ≥11 kg 773 chemotherapy sessions
were analyzed. The doxorubicin administrations were excluded since the dose calculation
of 1 mg/kg in patients <11 kg was used. 164 chemotherapy administrations in dogs <11
kg resulted in 66 (40.2%) episodes of neutropenia. In patients ≥ 11 kg, 600 chemotherapy
administrations resulted in 190 (31.7%) episodes of neutropenia. The difference was
statistically significant (P = 0.049).
This study suggests, that high age (≥10 years) not increases the risk of chemotherapy
induced neutropenia, but in contrast young dogs (<10 years) have a significantly increased
risk of neutropenia. As expected, small dogs with a low body weight (<11 kg) have
a significantly increased risk of neutropenia caused by other chemotherapeutics than
doxorubicine.
Disclosures
No disclosures to report.
ESVONC‐P‐10
Collection, Culture, and Characterization of Canine Urothelial Carcinoma Organoids:
Reverse Translational Clinical Research in the Veterinary Patient
C. Iennarella‐Servantez1, V. Gabriel1, T. Atherly1, S. Minkler1, S. Thenuwara1, S.
Mao1, M. Colosimo1, L. Kurr1, D. Borcherding1, A. Bourgois‐Mochel1, A. E. Jergens1,
K. Allenspach1, J. P. Mochel1
1Iowa State University, Ames, USA
Urothelial carcinoma (UC) is the most common type of bladder cancer in both dogs and
humans. UC is incurable with minimal treatment success due to tumor heterogeneity
and frequency of distant metastases at the time of diagnosis. Dogs function as physiologically
relevant models for UC in humans due to similarities in genetic predispositions, environmental
risk factors, clinical presentation, responsiveness to common chemotherapeutics, and
tumor molecular and behavioral phenotypes. Recent optimization of adult stem cell‐derived
organoid cultures in various species has shown an increasing value to reverse translational
clinical research and personalized medicine.
This preliminary study aimed to culture and characterize UC organoids from urine collected
from a canine clinical patient and characterize UC organoids based on shared histology
and molecular markers of UC. Further, we aimed at developing assays for drug screening
of chemotherapy to be used for precision‐medicine purposes both in veterinary and
human patients suffering from UC.
Free‐catch urine was collected from one dog at time of UC diagnosis. Sample was centrifuged
and supernatant was removed. Pellet was washed with phosphate‐buffered saline (PBS),
then incubated in complete chelating solution (CCS) with EDTA and plated in Matrigel
for establishment of organoid culture within one week. Sub‐samples of differentiated
UC organoids were taken for 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide
(MTT) assay for metabolic activity assessment after incubation with chemotherapeutic
agents. Remaining UC organoids were characterized with H&E, RNA in‐situ hybridization
(RNA‐ISH), and immunohistochemistry (IHC) staining techniques.
Differentiated organoids showed structural similarity to UC tumor epithelium on H&E
staining. RNA‐ISH showed high expression of Keratin‐7 (KT‐7, a marker specific for
urothelial epithelium) in UC organoids. Ki‐67 (epithelial proliferation marker), vimentin
(marker upregulated in metastatic UC) and CD44 (presumptive urothelial stem cell marker)
were overexpressed in canine UC organoids, consistent with in vivo canine UC tissue
and human muscle invasive bladder cancer tissue and organoids. Results from MTT assay
on maintained, differentiated canine UC cultures demonstrated reduced metabolic activity
of UC organoids after incubation with cisplatin for 24‐48 hours.
These preliminary results indicate that urine‐derived canine UC organoids share histological
and molecular similarities to UC tissue in vivo. In addition, we show proof‐of‐concept
for a precision‐medicine test using cisplatin on canine UC organoids. Collectively,
these results show the potential value of the organoid technology for characterization
of UC phenotype and treatment responsiveness as an emerging tool for personalized
medicine applications in veterinary and human medicine.
Disclosures
No disclosures to report.
ISCAID‐P‐1
Chronic diarrhea as a main clinical sign of canine leishmaniosis: 22 cases
M. C. López1, C. Bertolani2, A. Sainz3, M.D. Tabar4, X. Roura1
1Hospital Clínic Veterinari, Univesitat Autònoma de Barcelona, Barcelona, Spain; 2Hospital
Veterinari Canis, Palma de Mallorca, Spain; 3Department of Animal Medicine and Surgery,
College of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain; 4Hospital
Veterinario San Vicente‐Vetsum, San Vicente del Raspeig, Spain
Chronic diarrhea, originating from either small or large intestine, is a clinical
sign associated with canine leishmaniosis, varying from 3–8% to as high as 30% of
prevalence. However, in the majority of the cases, its occurrence has been mostly
associated with chronic kidney or liver disease. Furthermore, Leishmania organisms
can also cause inflammation of the digestive tract in an isolated manner causing only
chronic diarrhea, although it has been poorly documented in dogs.
The aim of this retrospective observational study was to describe dogs with mainly
gastrointestinal clinical signs associated with a diagnosis of leishmaniosis by serology
and/or identification of the agent by microscopy or PCR at four referral hospitals
from endemic areas between 2006 and 2019. All selected cases had a complete medical
record including CBC, biochemistry, urinalyses, and diagnostic tests for leishmaniosis.
Exclusion criteria were evidence of renal or hepatic disease and previous gastrointestinal
disease diagnosed.
Twenty‐two dogs (4FN, 1MN, 5FE, 12ME; median age 4y) were included. Small bowel diarrhea
was present in 6/22 (27%), large bowel diarrhea in 9/22 (41%), mixed diarrhea in 7/22
(32%). Vomiting, weight loss and, hyporexia were found in 4/22 (18%), 10/22 (45%)
and 3/22 (14%), respectively. Ten dogs (45%) showed anemia that was more frequently
non‐regenerative 9/10 (90%). Hypoalbuminemia and hyperglobulinemia were a common finding
(45%) (median serum albumin 2,1 g/dL) and (63%) (median serum globulin 5,4 g/dL) respectively.
Abdominal ultrasound was performed in 18/22 dogs, which revealed thickening of the
gastrointestinal wall in stomach 1/18 (6%), duodenum 5/18 (28%), and colon 4/18 (22%),
and mesenteric lymphadenopathy in 3/18 (17%). Gastrointestinal biopsies by endoscopy
were performed in 8/22 dogs, in all of them Leishmania amastigotes were found. Whether
the owner declined biopsies, leishmaniosis was diagnosed by IFAT in 7/14 (50%), IFAT
and PCR in 3/14 (21%), ELISA in 2/14 (14%), ELISA and PCR in 1/14 (7%), lymph node
cytology in 1/14 (7%), and blood PCR in 1/14 (7%). All dogs, except one that was euthanized
after diagnosis, had a complete resolution of diarrhea between 15 days and 3 months
after the treatment with meglumine antimoniate (75‐100mg/kg SID during 1 month) plus
allopurinol (10 mg/kg BID during at least 6 months).
This study suggests that leishmaniosis should be included in the differential diagnosis
of dogs, living in or with a history of travel to endemic areas, with mainly gastrointestinal
signs, especially small, large or mixed chronic bowel diarrhea.
Disclosures
No disclosures to report.
ISCAID‐P‐2
Prevalence of Babesia spp. in dogs diagnosed by polymerase chain reaction in Northeaster
of Spain
R. Santiago1, L. Feo1, M. Carrasco2, J. Rodon3, J. Puig1
1Internal Medicine, Ars Veterinaria, Barcelona, Spain; 2Ars Veterinaria, Barcelona,
Spain; 3Idexx Laboratories, Barcelona, Spain
Babesiosis is a protozoal tick‐borne disease with a worldwide distribution. Multiple
Babesia spp. have shown to infect dogs (B. canis, B. vogeli, B. gibsoni, B. conradae,
B. rossi and B.vulpes) and the geographic distribution is largely dependent on the
habitat of tick species. In Spain, most of studies have been performed in the Northwest
region, with little available data in the Mediterranean area. The objective of the
present study was to evaluate the prevalence of Babesia spp. by real‐time polymerase
chain reaction (PCR) in Northeastern Spain (Catalonia). This study was performed retrospectively,
including EDTA blood samples submitted to a reference laboratory during a 5‐year period
(2014 to 2019). Samples were processed by real‐time PCR for the detection of Babesia
spp. (B. canis, B. vogeli, B. gibsoni, B. conradae and B. rossi). Total nucleic acid
was extracted by applying the QIAamp DNA Blood BioRobot MDx kit (QIAGEN, Germany).
In case of a positive test result, differentiation of species was achieved by specific
individual real‐time PCR. B. vulpes was considered positive in case of a positive
Babesia spp. test result but negative specific individual test. Prevalence in this
population referred to the total number of positive Babesia spp. dogs divided by the
total number of individual dogs tested. A total of 481 samples were included, the
overall prevalence was5.1% (68% to B. Vogeli, 28% to B. canis, and one case (4%) of
B.vulpes). Coinfections were not detected with other Babesia species. Prevalence studies
in Europe have described the presence of B. canis mostly in cold and humid climates
(Northwest of Spain). Generally, B. canis is transmitted by D. reticulatus which is
frequently associated with these environments. However, B. canis has been also detected
in I. hexagonus and R. sanguineus, that are easily found in the Mediterranean area.
This fact may be the explanation of the current unexpected high prevalence of B. canis
in our study. In conclusion, prevalence of Babesia spp. in Catalonia area was estimated
5.1%, including B. canis and B. vogeli and a single case of B. vulpes. It is important
to consider babesiosis in the differential diagnosis in dogs with suggestive clinical
sings in Northeaster of Spain.
Disclosures
Raquel Santiago residency program has been sponsored by Idexx Laboratories
ISCAID‐P‐3
A study of 78 new Angiostrongylus cantonensis infections in Australian dogs
J. Yu1, M. K. Wun2, J. Slapeta1, D. Spielman1, R. Lee3, R. Malik4
1Sydney School of Veterinary Science, The University of Sydney, Sydney, Australia;
2Veterinary Specialist Services, Brisbane, Australia; 3Centre for Infectious Diseases
and Microbiology Laboratory Services, ICPMR, Westmead Hospital, Westmead, Australia;
4Centre for Veterinary Education, The University of Sydney, Sydney, Australia
Canine neuroangiostrongliasis is caused by migration of Angiostrongylus cantonensis
(rat lungworm) larvae through the central nervous system. It is an emerging infectious
disease in New South Wales, Australia and endemic in coastal east Queensland. The
aim of this study is to further define the epidemiology and clinical features of canine
neuroangiostrongliasis in a large cohort of dogs (the largest cohort studied to date)
and to determine which tests was more likely to confirm a presumptive diagnosis in
dogs with eosinophilic pleocytosis in cerebrospinal fluid (CSF).
A total of 78 dogs were presumptively diagnosed with neuroangiostrongliasis (2010
to 2019). 58% of dogs were less than 6 months old. The gender breakdown was 51 males
(18 neutered; 33 entire) and 26 females (13 spayed; 13 entire), with gender unrecorded
for two patients. The striking preponderance of male dogs presumably reflects males
being more exploratory and thus more likely to consume molluscs. There has been a
progressive increase in the number of cases diagnosed each year over the study period,
with 17 cases in 2019. Most cases were diagnosed in autumn or winter. The disease
was rarely seen in summer.
CSF records were available from 71 dogs: cell counts ranged from 2 to 146,150 cells/μL
(median 4,470). The percentage of eosinophils varied from 15% to 98% (median 83.5%).
CSF was obtained from the cisterna magna in 65 dogs, from the lumbar cistern alone
in six dogs and from both sites in 3 dogs. Nucleated cell counts in lumbar CSF was
substantially higher than in the corresponding cisternal CSF, suggesting inflammation
was more severe caudally. 54 leftover CSF samples were available for both ELISA testing
(for antibodies) and qPCR (for larval DNA), 43 dogs (80%) were both ELISA and qPCR
positive, 4 (7%) were ELISA positive but qPCR negative, while 7 (13%) were qPCR positive
but ELISA negative. Of the qPCR positive cases, CT values ranged from 24 to 38.
Although the presentation of neuroangiostrongliasis is usually syndromic with hyperaesthesia
and caudal spinal involvement, some cases are atypical with encephalitic signs including
blindness. Preventative therapy consisting of monthly moxidectin should be considered
to prevent dogs acquiring this infection. We are currently determining if qPCR can
diagnose this disease using blood or urine as diagnostic specimens.
The Angio Detect™ rapid point‐of‐care immunochromatography test for A. vasorum was
run on six canine CSF specimens from dogs with presumptive rat lungworm disease. All
samples tested negative.
Disclosures
No disclosures to report.
ISCAID‐P‐4
Pharmacokinetic profile of oral dosing of mefloquine to cats, as a potential treatment
for FIP
J. Yu, J. Norris, B. Kimble, M. Govendir
Sydney School of Veterinary Science, The University of Sydney, Sydney, Australia
Feline infectious peritonitis (FIP) is a fatal disease in cats induced by coronavirus.
Treatment options are limited. In searching for antiviral agents against feline coronavirus,
mefloquine, a human anti‐malarial drug has been demonstrated to reduce the viral load
of FIPV in vitro. The aim of this study was to investigate the pharmacokinetic profile
of mefloquine when administered orally, twice weekly for two weeks. The second objective
was to identify the changes in hematological and biochemical analytes and physiological
responses during the dosing period.
On ethics approval, mefloquine was administered orally (62.5 mg per cat) to seven
clinically normal, mature cats (3 males: 4 females) on day 0, 4, 7 and 10, ideally
administered with food. Serial blood samples were collected at 0, 1, 2, 4, 8, 12,
24, 48, 96, 168, 240 and 336 hour after the first dose. Blood samples at 96, 168 and
240 hour were taken prior to dosing. Hematology and biochemistry were performed at
0, 168 and 336 hours. Plasma samples were quantified for mefloquine concentrations
by high performance liquid chromatography (HPLC).
Pharmacokinetic (PK) analysis of mefloquine plasma concentrations was undertaken using
a non‐compartmental analysis for 4 cats over the first 96 hours. A single oral dose
of mefloquine resulted in a Cmax of 2.71 ug/mL at 15 hour (Tmax) while the plasma
concentration reached 4.06 ug/mL at 240 hour after second dose of mefloquine was given
with food. The elimination half‐life of mefloquine over the first 96 hours is 224
hour (s.d. 51.6). Two cats vomited and were excluded from PK analysis over 96 hours.
Another cat’s PK profile was excluded as mefloquine concentrations were much lower
than the others and skewed the data.
Hematology results were unremarkable in all cats at all time. Biochemical analytes
were also unremarkable other than a significant increase in serum symmetric dimethylarginine
(SDMA) concentrations at 168 and 336 hour, compared to t = 0 hour in all cats using
a repeated measures one‐way ANOVA (P < 0.002) and Tukey’s multiple comparisons test
(P < 0.05). All cats seemed clinically well and had normal appetites at the end of
mefloquine dosing.
Disclosures
A grant of AUD $26 173 was received from the Winn Feline Foundation and AU$26 035
has been paid primarily to Invetus, a research organisation. Invetus housed, medicated
and collected blood from the cats. Invetus also arranged for some biochemical tests,
which was also incorporated into their fee.
ISCAID‐P‐5
Serological and molecular study of Borrelia infection in dogs from different areas
in Spain
M. Baxarias1, P. Martínez‐Orellana1, G. Medina1, A. Aldea1, A. Álvarez‐Fernández1,
V. Priolo1, R.K. Straubinger2, G. Baneth3, L. Solano‐Gallego1
1Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat
Autònoma de Barcelona, Bellaterra, Spain; 2Department of Infectious Diseases and Zoonoses,
Bacteriology and Mycology, Ludwig‐Maximilians‐University Munich, Munich, Germany;
3Koret School of Veterinary Medicine, The Hebrew University, Rehovot, Israel
Several Borrelia spp. are transmitted by ticks and cause relapsing fever in humans
and domestic animals. The disease in humans manifests with recurrent episodes of fever
while fever, lethargy, anorexia, anemia and thrombocytopenia are encountered in dogs
infected by relapsing fever spirochetes. Two species of relapsing fever Borrelia causing
disease in dogs have been described in the Mediterranean basin: Borrelia hispanica
infection has been sporadically documented in southern Spain and Borrelia persica
infection in Israel and Iran. Although these species have been reported, little information
is available about the real magnitude of this infection in Mediterranean basin.
The aim of this study was to investigate the prevalence of relapsing fever Borrelia
infection in blood samples from dogs living in Spain. For this reason, quantitative
detection of reactive antibodies against B. persica antigen was performed by ELISA.
Moreover, the presence of Borrelia DNA in blood samples was also carried out by real
time PCR. Residual samples from 289 dogs from different areas of Spain were investigated:
Mallorca (n = 95), Cádiz (n = 99), Córdoba (n = 42) and Asturias (n = 53).
The seroprevalence of Borrelia spp. in Spain was 41.9%. The results of the serological
study differed depending on the geographical location (P < 0.001). The highest percentage
of seropositivity was in the Island of Mallorca (61.1%) followed by the southern locations,
Cádiz (41.4%) and Córdoba (28.6%), while Asturias, the most northern location, presented
the lowest result (18.9%). Furthermore, seropositivity to B. persica antigen was also
associated with young dogs (under the age of 1 year; P < 0.001), hunting dogs (P = 0.003),
presence of ectoparasites (P = 0.001) and presence of clinical signs (P = 0.024).
The borreliae‐specific PCRs performed were all negative.
This study shows the geographical differences in seroreactivity with B. persica antigen
in Spain, with higher prevalence in southern locations when compared with northern
locations. Moreover, dogs exposed to ectoparasites, living in rural areas and presenting
clinical signs were more prone to have Borrelia spp. exposure. The highest seroprevalence
found for B. persica antigen might indicate a high exposure of a similar relapsing
fever Borrelia spp. or other Lyme borreliosis causing species in dogs in Spain.
Disclosures
No disclosures to report.
ISCAID‐P‐6
A new in‐clinic titer test detects antibodies to canine distemper, adenovirus type‐2,
and parvovirus in 10 minutes with high accuracy
J. Lizer1, J. Workman2, J. Gillies2, K. Shuler2
1Zoetis, Kalamazoo, USA; 2VMRD, Zoetis, Kalamazoo, USA
VETSCAN Rapid Canine Titer is a novel lateral flow assay (LFA) for simultaneous detection
of antibodies to canine distemper virus (CDV), canine adenovirus type‐2 (CAV‐2) and
canine parvovirus (CPV) from vaccination or exposure. A positive result should correlate
to protective antibody titers measured by serum neutralization (SN) (≥1:24 for CDV
or ≥1:16 for CAV‐2) or hemagglutination inhibition (HI) (≥1:80 for CPV) assay. A negative
result should indicate antibody titers below the protective titer cut‐off. This study
aims to evaluate the diagnostic performance of the LFA compared to SN or HI titers
determined by a reference laboratory. Sensitivity was estimated by testing sera from
≥20‐weeks‐old, healthy client‐owned dogs (n = 662) vaccinated ≥1 month to ≤3 years
prior for CDV, CAV‐2, and CPV. Specificity was estimated by testing sera from client‐owned
dogs with titers below the cut‐off (n = 39‐114) and specific pathogen free (SPF) dogs
(n = 150). Using SN or HI titers as the reference, LFA showed good performance (CDV:
sensitivity 90.9%, specificity 87.1%, accuracy 89.7%; CAV‐2: sensitivity 99.0%, specificity
83.1%, accuracy 95.3%; CPV: sensitivity 100.0%, specificity 84.8%, accuracy 96.3%).
Using only SPF canine sera, the specificity was 94.0 – 98.0% for all analytes. Positive
predictive values for CDV, CAV‐2 and CPV were 93.6%, 95.1% and 95.3%, respectively,
and negative predictive values were 82.1%, 96.3% and 100.0%, respectively. LFA agreement
by Kappa statistic with reference method for CDV, CAV‐2 and CPV were 0.768, 0.862
and 0.894, respectively. These data conclude that VETSCAN Rapid Canine Titer may be
beneficial in helping veterinarians make informed pet‐side vaccination decisions based
on antibody titers.
Disclosures
This work was funded by Zoetis, Inc. All the authors are employed by Zoetis, and VETSCAN
Rapid Canine Titer is a product of the company with a business and/or financial interest.
ISCAID‐P‐7
Detection of pathogens implicated in feline upper respiratory infections in cats without
respiratory signs hospitalized in a veterinary teaching hospital
A. Brunet1, M. Baldasso2, M. Cervone1, L. Chabanne1, J. L. Cadoré1, J. Yugueros Marcos2,
P. Gracieux2, E. Krafft1
1Département des animaux de compagnie de loisir et de sport, Université de Lyon, VetAgro
Sup, Campus vétérinaire de Lyon, Marcy l'Etoile, France; 2Centre Diagnostic Moléculaire
Christophe Mérieux, BioMérieux S.A., Grenoble, France
Most agents implicated in feline upper respiratory infections (FURI) are highly transmissible
and can be harbored by healthy and convalescent carriers. Feline calicivirus (FCV)
can also persist in the environment for prolonged periods. Nosocomial infection through
indirect contact with healthy cat carriers or transmission via hospital members and
facilities are therefore often feared, especially considering that some hospitalized
cats can be immunocompromised and that cats seen for elective surgical procedure are
sometimes not vaccinated. This risk might also be increased in teaching hospitals
due to high densities of animals and humans and potential suboptimal adherence to
biosecurity protocols. However, to our knowledge, the carriage of pathogens implicated
in FURI has not been evaluated in cats hospitalized in a teaching hospital.
This study aimed to evaluate the detection rate of pathogens implicated in FURI: feline
calicivirus (FCV), feline herpesvirus type 1 (FHV1), influenza virus type A (FluA),
Chlamydophila felis (Cf), Bordetella bronchiseptica (Bb), and Mycoplasma felis (Mf)
in cats without signs of upper respiratory tract disease hospitalized at a veterinary
teaching hospital.
Conjunctival and oropharyngeal swabs were prospectively sampled from 101 cats admitted
between January and October 2019, without upper respiratory tract disease. Samples
were evaluated for FURI agents’ detection using multiplex PCR. All positive results
were verified by simplex PCR. Descriptive statistics were used.
Detection rate by multiplex testing was 24,7% for Mf, 12,9% for FCV, 4% for FHV1,
2% for Bb, 0,99% for Cf and 0% for FluA. Detection was confirmed in most cases by
simplex PCR, leading to a detection rate of 20,8% (Mf), 8,9% (FCV) and 0,99% (FHV1,
Bb and Cf). 41 cats tested positive for at least one upper respiratory agent by multiplex
testing, with respectively 54, 43 and 2% of them tested positive for 1, 2 or 3 agents.
Nucleid acid from various FURI pathogens was isolated in almost of half of the cases,
even though the detection rate for FCV and FHV1 was lower than previously reported
in multicat household. Whether this detection is associated with persistent carriage
and further disease development and whether cats were contaminated prior or during
their hospital stay remains to be elucidated. Results of the present study highlight
teaching hospital visit as a risk factor for FURI pathogens transmission.
Disclosures
Disclosures to report.
This research was funded by bioMérieux S.A. (France) and its affiliate BioFire Diagnostics
LLC (USA), a private company which, among others, develops molecular testing tools.
Three of the authors (M. Baldasso, J. Yugueros Marcos and P. Gracieux) are current
employees of bioMerieux S.A. and the PCR experiments were run at bioMerieux S.A.,
Centre Christophe Mérieux. Travel grants for the ECVIM 2020 congress will be granted
to A. Brunet and E. Krafft by bioMerieux S.A. Audrey Brunet also received travel grants
from Royal Canin S.A.
ISCAID‐P‐8
Negative or low levels of antibodies in dogs with overt clinical disease associated
with leishmaniasis; 12 cases
P. Silvestrini1, J. Castro2, M. D. Tabar3, C. Bertolani4, C. Blasi5, X. Roura5
1Small Animal Studies, Institute of Veterinary Science, Neston, UK; 2Small Animal
Internal Medicine, Facultad de Veterinaria. Universidad CEU Cardenal Herrera, Valencia,
Spain; 3Small Animal Internal Medicine, Hospital Veterinario San Vicente del Raspeig,
Alicante, Spain; 4Small Animal Internal Medicine, Hospital Veterinari Canis, Palma
de Mallorca, Spain; 5Small Animal Internal Medicine, Universitat Autonoma de Barcelona,
Barcelona, Spain
In canine leishmaniasis (CanL), antibody titers are high when clinical signs are evident
and there is a direct relationship between clinical score and serology. Only dogs
with papular dermatitis or uveitis due to localized leishmaniasis are seronegative
or have low serology. However, there is the suspect of a modest number of dogs with
low or negative serology despite overt clinical signs of leishmaniasis other than
the two above presentations.
For this purpose, dogs diagnosed with leishmaniasis with low or negative serology
were reviewed. A total of 12 cases were finally included. Five dogs presented for
chronic diarrhea (4 small and 1 large intestine). One of these had ascites due to
protein‐losing enteropathy and one was pancytopenic. Two dogs presented for lethargy,
weight loss and systemic lymphadenomegaly and one of these also had multifocal alopecia
and blepharitis. One dog had diffuse exfoliative dermatitis and ulcerations. Two dogs
were referred for pyrexia of unknown origin (PUO). One of these also had thrombocytopenia
and moderate non‐regenerative anemia. Another dog presented for pancytopenia and one
for suspected non‐regenerative IMHA. Both dogs and those with PUO were on immunosuppressive
dose of steroids at time of presentation. Serology was low in 5 cases and negative
in 7; CanL was diagnosed based on a combination of the followings: PCR (blood = 3,
lymph nodes = 2, bone marrow = 1), bone marrow biopsy (n = 5), cytology of cutaneous
lesions (2), lymph nodes (1), spleen (1) and liver (1). Two dogs with chronic diarrhea
were diagnosed on histopathology with granulomatous ileitis and enterocolitis with
abundant Leishmania amastigotes, respectively. All dogs were treated with a combination
of allopurinol and meglumine antimoniate (11) or miltefosine (1) and the majority
of them (9) had a good response. Serology titers remained low or negative in all cases
with a favorable outcome.
If the antibody titer is low or negative, CanL is considered unlikely. However, as
shown by the present study, there is a population of dogs with leishmaniasis that
behaves differently. These dogs perhaps build a predominant Th1 immune response that
probably is not completely effective against the infection, allowing amastigotes to
disseminate. Four dogs were on immunosuppressive doses of steroids possibly causing
a reduced humoral immune response.
In conclusion, this is the first report describing cases of CanL other than papular
dermatitis or uveitis that, despite overt clinical signs, presented low or negative
serology. This is important to consider when evaluating dogs with suspected leishmaniasis.
Disclosures
No disclosures to report.
ISCAID‐P‐9
Development and validation of a species‐independent whole proteome tick‐borne encephalitis
virus antibody detection assay
N. C. Spitmann1, L. Wiesner2, M. Boelke3, C. Schulz3, R. Mischke1, C. Baechlein4,
P. Becher4, S. Becker5, I. Steffen6
1Internal medicine, Small Animal Clinic, University of Veterinary Medicine Hannover,
Foundation, Ha, Hannover, Germany; 2Biochemistry, Research Center for Emerging Infections
and Zoonoses, University of veterinary medicine, Hannover, Germany; 3Parasitology,
Research Center for Emerging Infections and Zoonoses, University of veterinary medicine
Hannover, Foundation, Hannover, Germany; 4Virology, University of veterinary medicine
Hannover, Foundation, Hannover, Germany; 5Parasitology, 2Research Center for Emerging
Infections and Zoonoses, University of veterinary medicine Hannover, Foundation, Hannover,
Germany; 6Biochemistry,Research Center for Emerging Infections and Zoonoses, University
of veterinary medicine Hannover, Foundation, Hannover, Germany
Tick‐borne encephalitis virus (TBEV) is a single‐stranded, positive‐sense RNA virus
of the Flaviviridae family and the causative agent of tick‐borne encephalitis in dogs.
TBEV rarely leads to clinical illness, but then is likely to have a fatal outcome.
Clinical manifestation ranges between individuals and can be asymptomatical to febrile
illness in the first phase and results in severe neurological complications like meningitis,
meningoencephalitis or meningoencephalomyelitis in the second phase. An early detection
of animals on risk would be preferable. To compare the protective role of anti‐TBEV
antibody responses in different hosts and between individuals, we developed a luciferase
immunoprecipitation system (LIPS) antibody detection assay. Antibody‐reactions from
overall 399 dog samples from unselected inpatients of a university animal hospital
located in Lower Saxony (Germany) were screened, resulting in a seroprevalence of
1 %. ELISA detected 4 positive and 4 questionable results. Validation of these samples
by LIPS showed 5 positive results, confirming the 4 ELISA‐positive samples and 1 of
the questionable samples. Results obtained by ELISA and LIPS assay showed a correlation
of 97.5 and 100%, indicating a good sensitivity of the LIPS assay. Expression of all
antigen fusion proteins was confirmed and appropriate assay performance was verified
with intra‐ and inter‐assay coefficients of variation of 21% and 17%, respectively.
In conclusion, initial results indicate the LIPS assay to be a useful tool for detection
of TBEV antibodies.
Disclosures
No disclosures to report.
ISCAID‐P‐10
Therapeutic approach to glomerulonephritis secondary to canine leishmaniosis in Portugal:
a questionnaire‐based survey
M.N.E.M. Monteiro1, S. Prata1, L. Cardoso2, I. Pereira Da Fonseca3, R.A. Oliveira
Leal4
1Hospital Escolar Veterinário, Faculdade de Medicina Veterinária‐ULisboa, Lisbon,
Portugal; 2Dep. de Ciências Veterinárias, Universidade de Trás‐os‐Montes e Alto Douro(UTAD),
Vila real, Portugal; 3Centre for Interdisciplinary Research in Animal Health, Fac.
Vet. Med‐U.Lisboa, Lisbon, Portugal; 4Centro de Investigação Interdisciplinar em Sanidade
Animal, Fac Med Vet U.Lisboa, Lisbon, Portugal
Canine leishmaniosis (CanL) is endemic in southern Europe. Despite the Leishvet and
other existing guidelines, there is an important inconsistency about the medical management
of glomerulonephritis in dogs with CanL, particularly in advanced stages. This study
aims to investigate the main therapeutic approach of veterinarians in Portugal, regarding
stage IV CanL, with emphasis on glomerulonephritis management.
An online questionnaire was developed, including 24 to 65 questions, depending on
the answering pathway of each respondent. The questionnaire mainly focused on the
medical approach of clinical cases strategically elaborated to reflect five theoretical
scenarios of the LeishVet staging classification. After internal validation, it was
uploaded using an electronic platform and diffused online, over 8 weeks, via Portuguese
social network veterinary groups. For this study, only answers concerning LeishVet
stage IV were selected.
Eighty‐six answers were obtained. Faced with a theoretical scenario of a dog with
stage IV CanL, showing severe azotaemia (creatinine of 3.5 mg/dl [<1.4]) and proteinuria
(urinary protein/creatinine ratio of 6.2 [<0.5]), 72.1% of the respondents admitted
prescribing the association of allopurinol with meglumine‐antimoniate or miltefosine.
From these, 67.7% would use allopurinol with miltefosine, while 32.3% would prefer
allopurinol with meglumine‐antimoniate. Single‐therapy with allopurinol was considered
by 3.5% of the respondents and 2.3% would only prescribe supportive therapy, without
any other compound. Non‐scientific evidence‐based protocols were considered by 16.2%
of the respondents, while the remaining 5.8% elected euthanasia.
Concerning proteinuria management, 93.8% admitted treating it. From these, 97.4% would
switch to a renal diet. While 78.9% preferred angiotensine‐converting enzyme inhibitors
(ACEIs), 13.2% prioritized angiotensin‐receptor‐blockers. A few respondents still
mentioned calcium channel blockers (5.3%) and anti‐thrombotic therapy (2.6%). The
use of immunossuppressants was considered by 44.2% of the respondents, who tended
to prioritize prednisolone (94.7%) or mofetil mycophenolate (5.3%).
This study highlights that the association of allopurinol and miltefosine is the current
preferred protocol for the medical management of stage IV CanL in Portugal. This is
probably due to the assumed lower nephrotoxic effect of miltefosine when compared
with meglumine‐antimoniate. This study also shows that ACEIs are still the first therapeutic
choice for dogs with CanL and concurrent severe proteinuria. Almost half of the respondents
admitted using prednisolone when CanL associated glomerulonephritis is suspected,
probably due to an immune‐mediated etiology. These findings reinforce the urgent need
of guidelines reassessment for dogs with suspected immune‐mediated glomerulonephritis
secondary to CanL. Further studies are needed to extrapolate these conclusions to
other European countries.
Disclosures: Study funded by: Project UIDP/CVT/00276/2020 (funded by FCT).
ISCAID‐P‐11
A review of automated hand sanitizer dispensers in a teaching hospital
H. K. Walker1, K. Parker1, A. Gow1
1The University of Edinburgh, Edinburgh, UK
Alcohol‐based hand sanitizers are routinely used in healthcare establishments worldwide.
Two milliliters of 85% ethanol gel is required to fulfill the FDA requirement of reducing
bacterial contamination by at least 2 log10. Sanitizers used by the teaching hospital
are metered to dispense 1.2mL, therefore 2 aliquots of minimum 1ml would fulfill these
requirements. There is a risk that automated dispensers may not achieve these volumes,
for example through large variation in the amount dispensed or operational issues.
This study aimed to assess if the dispensed volume fulfills FDA requirements and if
the implementation of a role in maintaining the sanitizers improved dispenser efficacy.
Samples were collected from 15 automated dispensers set to dispense 1.2 mL per aliquot.
Two aliquots of gel were collected, the weight and volume of gel dispensed for each
aliquot were calculated, and any malfunctions with the dispenser recorded. Samples
were collected daily on six consecutive days (time point 1). This was repeated immediately
following the assignment of a role to monitor and service the sanitizers (time point
2), and again eight months post implementation of the role (time point 3).
Of the 270 aliquots (135 samples) collected, 54 (20%) and 216 (80%) were <1 mL and
>1 mL, respectively. The mean volume dispensed in a single aliquot (1.092 mL, 95%
confidence interval = 1.055 ‐1.128 mL) was significantly different to the target (1.2
mL) (P = 1.05x10‐8). The volumes of sanitizer dispensed and the number of aliquots
<1 mL did not change significantly between the three time points (P = 0.829 and P
= 0.327, respectively). A significantly higher number of malfunctions were reported
when aliquots of <1 mL were dispensed compared to when aliquots ≥1 mL were dispensed
(P = 4.71x10‐7).
This study suggests that there is a high risk of inadequate hand sanitation when using
the automated dispensers, as twenty percent of samples (paired‐aliquots) fell below
FDA requirements. This may increase the risk of nosocomial infections in patients
and zoonotic disease transfer to staff. Using sanitizers automated to dispense larger
volumes of sanitizer and encouraging self‐reporting may reduce these risks more than
implementing a dispenser servicing role.
Disclosures
No disclosures to report.
SCH‐P‐1
Hepatocyte ploidy in cats with and without hepatocellular carcinoma
A. N. Johnston1, J. Post2, P. Mottran2, C. C. Liu2, C. R. Leveille‐Webster3, I. Langohr4
1Veterinary Clinical Sciences, LSU School of Veterinary Medicine, Baton Rouge, USA;
2LSU School of Veterinary Medicine, Baton Rouge, USA; 3Cummings School of Veterinary
Medicine, Tufts University, N. Grafton, USA; 4Pathobiological Sciences, LSU School
of Veterinary Medicine, Baton Rouge, USA
Hepatocellular carcinoma (HCC) is one of the most common causes of cancer related
death in humans, yet it is an uncommon neoplasm in the domestic cat. The difference
in prevalence and etiology between these two species is unexplained. Recent work in
mice has shown that hepatocyte polyploidy (>2N) is protective against the development
of hepatocellular carcinoma. Further, human hepatocarcinogenesis is associated with
a reduction in hepatocyte ploidy. Hepatocyte ploidy in the domestic cat has not been
previously evaluated. Our research objective is to establish a baseline hepatocellular
chromosome number in normal cats and cats with HCC. We hypothesize that hepatocyte
ploidy is significantly different between these groups. Samples were selected from
archival cases at two veterinary schools. Seven confirmed feline HCC cases and seven
age and sex matched normal control cases were selected following review by a veterinary
anatomical pathologists. Using a nuclear stain that stoichiometrically binds to DNA,
fluorescence intensity was measured to determine hepatocellular ploidy. Neoplastic,
peri‐tumoral, and normal hepatocytes were analyzed. There was a significant difference
between normal to peri‐tumoral, normal to neoplastic, and neoplastic to peri‐tumoral
hepatocytes. In addition, there is a significant difference between the number of
2N vs. 4N cells in normal and peri‐tumoral and neoplastic cells, and peri‐tumoral
to neoplastic. There is no statistical difference in the number of multinucleated
cells between other groups. Normal liver has a greater number of 4N cells than neoplastic
samples. This difference may contribute to development or be a cellular response to
carcinogenesis.
Disclosures
No disclosures to report.
SCH‐P‐2
Serum 25‐hydroxyvitamin D in dogs with gallbladder mucocele
J. A. Jaffey1, A. E. Declue2, J. Matheson2, K. Shumway2, C. Pacholec2, T. Ullal3,
Z. Tao4, R. R. Ringold5
1Specialty Medicine, Midwestern University College of Veterinary Medicine, Glendale,
USA; 2University of Missouri Veterinary Health Center, Columbia, USA; 3Colorado State
University, Fort Collins, USA; 4Midwestern University College of Veterinary Medicine,
Glendale, USA; 5VDI Laboratory, USA
Gallbladder hypokinesia is believed to have a large contributory role to the development
of gallbladder mucocele (GBM) in dogs. Ursodeoxycholic acid is a common medical intervention
in dogs with GBM that are subclinical; however, there are no clinical trials that
demonstrate effectiveness. Studies in humans have identified vitamin D deficiency
as a cause for gallbladder hypokinesia and oral vitamin D supplementation resolves
gallbladder stasis. These studies suggest that vitamin D could have potential causal
and therapeutic roles in dogs with GBM. Therefore, this study had two objectives 1)
to compare serum 25(OH)D concentrations between controls, clinical GBM, and subclinical
GBM and 2) to determine if serum 25(OH)D concentrations are different based on ultrasonographic
GBM type.
A prospective, multi‐center study was performed. Dogs with an ultrasonographic diagnosis
of GBM were eligible for inclusion. Control dogs were deemed healthy based on history,
physical examination, diagnostic test results, and an unremarkable ultrasonogram.
Static images from ultrasonograms were reviewed by two boarded radiologists and a
consensus GBM type (i.e., 1 through 5) was recorded. Dogs with GBM were classified
as clinical or subclinical based on whether they exhibited biliary tract clinical
signs in the 7 days preceding presentation. Serum 25(OH)D concentrations were measured
with a commercially available chemiluminescence immunoassay. A Kruskal‐Wallis test
with a post‐hoc multiple comparison procedure was used for multiple comparisons. A
P‐value of <0.05 was considered significant.
Sixty dogs with GBM (clinical n = 16; subclinical, n = 44) and 20 controls were included
in this study. Healthy controls had significantly greater serum 25(OH)D concentrations
(median, IQR; 63.4, 53.6‐86.0 ng/ml) than subclinical GBM dogs (51.2, 28.9‐71.4 ng/ml,
P = 0.024) and clinical GBM dogs (37.6, 35.6‐63.4 ng/ml, P = 0.027). There was no
difference in 25(OH)D concentration between subclinical and clinical GBM dogs (P = 1.00).
Serum 25(OH)D concentrations were not significantly different based on GBM type (P
= 0.056).
These data indicate that dogs with GBM have reduced serum vitamin D concentrations.
In people, hypovitaminosis D results in gallbladder hypokinesia and these data might
indicate a similar pathology in dogs. Additional studies are needed to assess if hypovitaminosis
D in GBM dogs is a cause or effect of their biliary disease and investigate if vitamin
D supplementation could be used as a preventative or treatment for GBM.
Disclosures
No disclosures to report.
SCH‐P‐3
Use of NanoString technology to evaluate gene expression patterns in dogs with neutrophilic
cholangitis
C. Martinez1, J. A. Browne1, E. J. O'Neill1, M. Ryan1, H. Jahns1, C. T. Mooney1, R.
E. Shiel1
1School of Veterinary Medicine, University College Dublin Veterinary Hospital, Dublin,
Ireland
Canine neutrophilic cholangitis is a liver disease which has been identified with
increased frequency over the last ten years. To date, the pathophysiological and immunological
mechanisms underpinning this liver disease remain poorly characterized. The aim of
this pilot study was to explore pathophysiological mechanisms by comparing the differential
gene expression in liver tissue from dogs with cholangitis and healthy controls.
Dogs with neutrophilic cholangitis (n = 20) and healthy controls (n = 12) were identified
by review of histopathology reports and formalin‐fixed, paraffin‐embedded (FFPE) liver
tissue blocks were retrieved from the pathology archive of the University College
Dublin Veterinary Hospital. Following deparaffinisation using Deparaffinisation Solution
(Qiagen, Hilden, Germany), RNA was isolated using RNeasy FFPE kit (Qiagen). A custom
codeset was designed to include 42 genes encompassing the pathways of fibrosis, apoptosis,
cholestasis, oxidative injury and immune response, as well as six reference genes.
The RNA concentration of all samples was adjusted to 20 ng/μl in preparation for analysis
using the Nanostring nCounter Analysis System (Nanostring Technologies, Seattle, WA).
The normalized gene expression was determined for each gene within each sample using
nSolver 2.6 software (Nanostring Technologies).
In total, 18 (42.8%) of the 42 genes investigated were significantly over‐expressed
in the dogs with neutrophilic cholangitis compared to the control dogs. Genes with
significantly increased expression included: BSEP, CTGF, CXCL8, CYBB, IL‐10, IL‐12,
IL‐33, JAK2, JAK3, KLRG1, STAT3, TGF‐β1, TLR1, TLR2, TLR4, TLR6, TNFSF10, and TNF‐α,
(P < 0.002).
The up‐regulation of genes associated with neutrophil chemotaxis (CXCL8), the innate
immune response (TLR 1,2,4 and 6), JAK‐STAT pathway (JAK2, JAK3, KLRG1, STAT3) and
fibrosis (CTGF, IL‐33, STAT3) offer insight into the aetiopathogenesis of this poorly
characterized condition. The up‐regulation of a number of the TLRs indicates that
bacterial infection or bacterial proteins are likely to be a primary driving force
in the pathological progression of this disease. This suggests that early intervention
is warranted to reduce the inflammatory response and subsequent fibrotic processes
that occur over the course of the disease.
Disclosures
No disclosures to report.
SCH‐P‐4
The lidocaine/monoethylglycylxylidide liver function test to assess shunt closure
in dogs with attenuated congenital extrahepatic portosystemic shunts
N. Devriendt1, G. Serrano1, S. Croubels2, D. Paepe1, R. Nickel3, H. de Rooster1
1Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke,
Belgium; 2Department of Pharmacology, Toxicology and Biochemistry, Ghent University,
Merelbeke, Belgium; 3Tierärztliche Klinik für Kleintiere Norderstedt, Norderstedt,
Germany
Commonly used liver function tests do not always normalize after successful attenuation
of congenital extrahepatic portosystemic shunts (EHPSS) in dogs. In human medicine,
the hepatic metabolism of lidocaine is used as a dynamic liver function test. The
advantages of the use of lidocaine are its short elimination half‐life and its high
hepatic extraction ratio, that is blood flow dependent. This study aimed to assess
whether the dynamic lidocaine/monoethylglycylxylidide (MEGX) liver function test would
be a useful test to determine postoperative EHPSS closure.
Dogs with EHPSS were prospectively enrolled. The lidocaine/MEGX test was performed
at diagnosis, and at 1, 3, and 6 months postoperatively. At each time point, 1 mg/kg
lidocaine was injected intravenously and blood samples were taken before (T0) and
15 minutes after injection (T15). Plasma concentrations of lidocaine and its metabolite
MEGX were determined using a validated LC‐MS/MS method. Three months postoperatively,
a transsplenic portal scintigraphy was performed to determine EHPSS closure.
At T15, dogs with a closed EHPSS (n = 16) had significantly higher median MEGX concentrations
at postoperative time points compared to diagnosis (P < 0.001), whereas no significant
differences were noticed for dogs with persistent shunting (n = 5). Sensitivity and
specificity to determine shunt closure were 96.2% and 82.8%, respectively.
The lidocaine/MEGX test is a promising, rapid and non‐invasive dynamic liver function
test that seems helpful to determine EHPSS closure in dogs. Dogs with a normal fasted
ammonia concentration but high MEGX concentration at T15 after surgical attenuation
are very likely to have a closed EHPSS, and therefore additional medical imaging to
determine shunt closure is not of added value in the vast majority of cases. In dogs
with persistent shunting, advanced medical imaging remains important to differentiate
between persistent EHPSS and multiple acquired portosystemic shunts. Further studies
in a larger cohort of dogs are warranted to consolidate these promising findings.
Disclosures: This study was funded by the Gesellschaft zur Förderung Kynologischer
Forschung e.V.
SCH‐P‐6
Bile acid and bilirubin measurement in canine peritoneal fluid samples with and without
biliary tract rupture
M. Pascual1, H. Matson1, P. Monti2, M. Seth1, F. Valls Sanchez1
1Internal Medicine, Dick White Referrals, Cambridgeshire, UK; 2Clinical Pathology,
Dick White Referrals, Cambridgeshire, UK
Diagnosis of biliary tract rupture can be challenging in dogs. Abdominal ultrasound,
cytology and serum bilirubin do not detect all cases and evidence supporting the use
of fluid bilirubin concentration is lacking in the literature.
The aim of this study was to evaluate bile acid and bilirubin concentrations in peritoneal
effusions of dogs and determine whether there were any differences in the concentration
of these analytes between dogs with biliary tract rupture and other causes of ascites.
Thirty‐seven dogs with peritoneal effusion were included in this prospective observational
study and divided based on the presence or absence of biliary tract rupture, determined
by ultrasonographic and surgical findings. Bile acids and bilirubin were measured
in serum and peritoneal effusion of all cases, as were fluid‐to‐serum bile acid and
bilirubin ratio, fluid cell counts, protein measurement and cytologic evaluation.
Four dogs were diagnosed with gallbladder rupture (4/37, 11%). The most frequent other
conditions were septic peritonitis (8/37, 22%), neoplastic conditions (7/37, 16%)
and chronic gastrointestinal pathologies (4/37, 11%). Bile acid and bilirubin concentrations
in serum and peritoneal fluid were significantly higher in the group with biliary
tract rupture, as was the fluid‐to‐serum bile acid ratio (P < 0.05). Fluid‐to‐serum
bilirubin ratio was not significantly different between groups. Receiver operating
characteristic curve analysis identified the abdominal fluid bile acid concentration
to be 100% sensitive and specific for the diagnosis of biliary tract rupture with
a cut off above 769 μmol/l.
Based on this limited number of cases, determination of bile acids concentration in
canine peritoneal effusion may be a highly sensitive and specific test for the diagnosis
of biliary tract rupture. Furthermore, fluid‐to‐serum bilirubin ratio, which is commonly
used, was found not be significantly different between groups
Disclosures
No disclosures to report.
SCH‐P‐7
Culture and maintenance of well‐differentiated canine hepatic organoids and urinary
bladder organoids
V. Gabriel1, C. Iennarella‐Servantez2, T. Atherly2, S. Minkler2, S. Thenuwara2, S.
Mao2, M. R. Colosimo2, L. A. Kurr2, D. Borcherding2, A. Bourgois‐Mochel2, A. E. Jergens2,
J.P. Mochel2, K. Allenspach‐Jorn2
1College of Veterinary Medicine, Iowa State University, Ames, USA; 2Iowa State University,
Ames, USA
Recent advances in 3D culture technology allow adult mammalian stem cells to exhibit
their remarkable self‐organizing properties in vitro. The resulting organoids reflect
key structural and functional properties of organs and can therefore be used to model
canine pathologies. Additionally, patient‐derived organoids hold promise to predict
drug response/toxicity in a personalized fashion and in combination with gene editing
technology open up new avenues for regenerative medicine. Adult hepatic stem cells
have previously been utilized to culture canine hepatic organoids termed “hepatoids”.
However, previously described culture media maintain hepatoids in a cystic, pre‐differentiated
state that do not fully replicate in vivo biological functions.
Our group has previously established culture and maintenance conditions for healthy
and diseased (small and large) intestinal organoids in dogs. In this study, we aimed
to refine culture conditions for healthy hepatic organoids to induce differentiation
into budding organoids, which more closely reproduce the adult physiology of canine
hepatocytes. Furthermore, we investigated whether the same culture media could be
used to grow and maintain canine organoids from healthy urinary bladder tissues with
the objective to expand the portfolio of available canine organoids for translational
biomedical research.
Canine hepatic organoids were isolated from wedge biopsies of 3 healthy dogs. Culture
media were adapted from our previously published protocols in enteroids without addition
of recombinant human IGF‐1, HGF or FGF‐2. Our results show that we are able to achieve
differentiation of cystic organoids into budding hepatoids. Organoid survival was
confirmed over three passages and successful repeat cultivation after multiple cycles
of freezing (‐80°C)/thawing. Bladder biopsies from 2 healthy dogs were processed for
stem cell isolation as previously reported by our group. Organoids were cultured in
the same medium as described above and differentiated into budding organoids within
7‐10 days of culture. After differentiation, bladder organoids displayed hollow structures
or solid spheres, as previously described for mouse and human bladder organoids.
Findings from this study demonstrate that our stem cell culture medium developed for
the culture of canine enteroids/colonoids can be used to establish in vitro organoid
cell lines from multiple tissues, including hepatic and bladder epithelial cells.
This is the first report of successful organoid culture from healthy bladder tissues.
Importantly, and as opposed to previous description from the literature, our medium
induces differentiation of hepatic cystic organoids into budding, differentiated organoids.
Next steps are to phenotypically and functionally characterize these canine hepatoids
and bladder organoids for further biomedical applications.
Disclosures
No disclosures to report