28 Sept 2015
Alex Gough
Job Title
Head trauma is often associated with severe morbidity and mortality.
In a retrospective case series, Yanai et al1 reviewed the results of MRI scans on 18 dogs within 48 hours of a head trauma.
Two dogs were euthanised, one died and one had serious long-term deficits. Nine other cases recovered, while five had minor long-term problems.
Intra-axial changes and extra-axial haemorrhage (best observed using FLAIR) were commonly detected on MRI.
A mass effect was present in nine cases, while five dogs had herniation – three of them transtentorial and two transcranial.
The subdural region was the most common location for extra-axial haemorrhage.
The authors conclude T2 and FLAIR images provide the most information when performing MRIs of acute head trauma.
Gastric antacids are prescribed regularly in veterinary medicine for conditions that would benefit from a rise in gastric pH, such as gastritis or gastric ulceration. But some medications have uncertain efficacy.
In a randomised, four-way crossover design, Šutalo et al2 investigated the effect of oral ranitidine and omeprazole on the gastric pH in eight cats.
They were given enteric-coated omeprazole either once or twice daily, ranitidine twice daily or placebo.
Only twice-daily omeprazole significantly increased intragastric pH. Once-daily omeprazole or twice-daily ranitidine did not change the pH significantly, compared with the cats treated with placebo.
Hyperthyroidism in cats can be treated in several ways, including surgery, drugs or radiotherapy.
Iatrogenic hypothyroidism is a possible complication and can reduce renal function.
Aldridge et al3 performed a study to assess the prevalence of iatrogenic hypothyroidism in cats being treated with methimazole and to assess the effect of thyroid hormones on serum creatinine.
They also compared total T4 and free T4 by equilibrium dialysis (fT4ed) to evaluate thyroid function.
Serum samples from 125 hyperthyroid cats receiving methimazole, which had total T4 concentrations less than or equal to 3.9µg/l, were included in the study. Total T4, fT4ed, thyroid stimulating hormone (TSH) and creatinine were measured in the serum.
The finding of increased TSH with a low total T4 or fT4ed was used to define iatrogenic hypothyroidism.
In total, 41 of the cases had increased TSH concentrations. 68% of cats with low total T4 had TSH concentrations above normal and 73% of cats with low fT4ed had increased TSH concentrations. 18% of cats with normal TSH had increased creatinine, compared with 39% of cats that had increased TSH.
The authors conclude fT4ed does not improve the detection of iatrogenic hypothyroidism compared to total T4, and that measuring TSH may be more useful if azotaemia is present.
The prevalence in this study was 20%.
Oclacitinib is a drug recently licensed to treat pruritus associated with allergic dermatitis and the clinical manifestations of atopic dermatitis in dogs.
Cosgrove et al4 performed a multi-centre open label study to assess the long-term safety, efficacy and quality of life of dogs treated with oclacitinib.
The study included 247 dogs with allergic skin disease and treated with oclacitinib. Owners filled in a quality of life survey and performed a visual analog scale (VAS) assessment of pruritus at each veterinary visit. Vets performed a similar VAS.
The scores were improved from the initial assessment at every clinic visit – 64% of dogs showed at least a 50% improvement in pruritus by day 90, and 66% showed at least a 50% improvement in dermatitis.
More than 90% of owners saw an improvement in quality of life.
Abnormal clinical signs reported during the study included urinary tract infection, vomiting, otitis, pyoderma and diarrhoea. Biochemistry and haematology remained normal.
The authors conclude that oclacitinib is safe and effective for long-term use and improves the quality of life of the treated dogs.
Alopecia is a common presentation in veterinary practice and has a wide variety of underlying causes.
Berger et al5 report on six cases of alopecia in dogs caused by transdermal exposure to human topical hormone replacement therapy.
The cases had alopecia of varying durations between two months and two-and-a-half years.
Distribution was around the ventral neck, thorax and abdomen, plus the proximo-lateral extremities and lateral trunk. Five of the dogs also showed evidence of feminisation on examination.
Skin biopsies were obtained in five cases that showed basal melanosis, hyperkeratosis and small sebaceous glands. Oestradiol levels were increased in all dogs, and progesterone levels in four cases.
Signs occurred around six months after owners started treatment and resolved within six months of their owners discontinuing treatment.
