Vet Clin North Am Small Anim Pract
· 2026 Jul · PMID 42049583
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Fungal and atypical bacterial pneumonias are emerging infectious threats in companion animal medicine, fueled by ecological disruption, globalized pet travel, and immunomodulatory therapies being increasingly used. These...Fungal and atypical bacterial pneumonias are emerging infectious threats in companion animal medicine, fueled by ecological disruption, globalized pet travel, and immunomodulatory therapies being increasingly used. These infections challenge clinicians in ways that conventional bacterial pneumonia does not-presenting insidiously, extending beyond the lung, and not responding to empirical treatment. Delayed or missed diagnosis remains a costly, defining hallmark. Recognizing these conditions demands a shift in clinical thinking: one that weighs host susceptibility, exposure history, and geographic epidemiology alongside conventional diagnostics. This review equips clinicians with the knowledge to suspect, investigate, and treat complex pneumonias earlier and with greater confidence.
Vet Clin North Am Small Anim Pract
· 2026 Jul · PMID 41997781
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Biomarkers are measurable characteristics found in blood and other body fluids or tissues. Biomarkers serve as indicators of biological processes, and they can be applied to diagnose a disease, to monitor disease progres...Biomarkers are measurable characteristics found in blood and other body fluids or tissues. Biomarkers serve as indicators of biological processes, and they can be applied to diagnose a disease, to monitor disease progress, or to evaluate treatment response. Inflammatory biomarkers, C-reactive protein in dogs and serum amyloid A, are increasingly used as diagnostic and follow-up markers in pneumonia. Additionally, various biomarkers have been described for the diagnosis of canine idiopathic pulmonary fibrosis, to discriminate between cardiac and noncardiac causes of respiratory distress as well as for the detection of microaspiration.
Vet Clin North Am Small Anim Pract
· 2026 Jul · PMID 41997780
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Primary pulmonary vascular disease is an uncommonly diagnosed cause of pulmonary hypertension but left sided heart disease, parasitic lung disease, and several commonly encountered respiratory disorders can lead to this...Primary pulmonary vascular disease is an uncommonly diagnosed cause of pulmonary hypertension but left sided heart disease, parasitic lung disease, and several commonly encountered respiratory disorders can lead to this secondary complication. Clinical signs of cough, tachypnea, and exercise intolerance overlap with these cardiopulmonary diseases; however, syncope is commonly associated with and suggestive of pulmonary hypertension. Thoracic radiographs demonstrating right heart or pulmonary artery enlargement should also trigger investigation of pulmonary hypertension by use of echocardiography. Further investigation of underlying respiratory conditions can be extensive but might allow targeted therapy. Use of PDE5i and oxygen therapy can provide palliative benefit.
Vet Clin North Am Small Anim Pract
· 2026 Jul · PMID 41997779
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The aspiration of oral and/or gastrointestinal contents into the respiratory tract contributes to a diverse range of respiratory syndromes including aspiration pneumonia (AP) and pneumonitis (APn) in dogs and cats. Ident...The aspiration of oral and/or gastrointestinal contents into the respiratory tract contributes to a diverse range of respiratory syndromes including aspiration pneumonia (AP) and pneumonitis (APn) in dogs and cats. Identifying patients that are at risk for aspiration is critical for management as specific aspiration events may be unwitnessed or silent (ie, occult aspiration). Multimodal approaches are often needed to appropriately diagnose the underlying conditions driving AP, APn, and other aspiration associated respiratory syndromes. Management strategies should emphasize treating the underlying condition, in addition to respiratory disease, while promoting appropriate antimicrobial stewardship.
Vet Clin North Am Small Anim Pract
· 2026 Apr · PMID 41991460
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As veterinary artificial intelligence (AI) tools become more available, it is vital to ensure that they genuinely promote patient well-being and avoid harm. This article examines the ethics of AI in small animal veterina...As veterinary artificial intelligence (AI) tools become more available, it is vital to ensure that they genuinely promote patient well-being and avoid harm. This article examines the ethics of AI in small animal veterinary medicine, considering both "machine" and "human" aspects. The article then outlines appropriate accountability responsibilities for veterinary practitioners, as well as for AI developers and purveyors, hospital and clinic managers, and professional veterinary bodies. Understanding these ethical issues and accountability measures should help steer the creation, maintenance, and use of AI tools toward meeting the core veterinary medical obligation of improving animal health and welfare.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41887987
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Dietary management of chronic enteropathy is important to provide energy and nutrients, to support intestinal function, and to control clinical signs in food-responsive patients. Dietary strategies include high digestibi...Dietary management of chronic enteropathy is important to provide energy and nutrients, to support intestinal function, and to control clinical signs in food-responsive patients. Dietary strategies include high digestibility, novel ingredients, hydrolyzed protein, fat moderation, and fiber enrichment, among others. The best diet choice should be identified after a nutritional assessment and, depending on the clinical presentation, will often require several diet trials before success. Commercial therapeutic diets include gastrointestinal (including low fat), elimination, and fiber-enriched diets. Homemade diets can be a good option when commercial diets do not meet the needs for the patient.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41876339
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Bile acid dysregulation is an emerging yet underrecognized contributor to diarrhea in companion animals. This review explores the pathophysiology of bile acid malabsorption and its clinical manifestation as bile acid dia...Bile acid dysregulation is an emerging yet underrecognized contributor to diarrhea in companion animals. This review explores the pathophysiology of bile acid malabsorption and its clinical manifestation as bile acid diarrhea, emphasizing its relevance in veterinary practice. Mechanisms include defects in bile acid regulation, ileal dysfunction, and dysbiosis-driven alterations in bile acid metabolism. Clinical signs often mimic chronic enteropathy, complicating diagnosis. Current veterinary diagnostics are limited, making therapeutic response to bile acid sequestrants a practical diagnostic and treatment approach. Evidence-based strategies, including dietary management and bile acid sequestrant therapy, are discussed to guide clinicians in managing this challenging condition.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41876338
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Infectious colitis can cause large intestinal diarrhea and, in severe cases, systemic illness in dogs and cats. Causative agents include bacteria, protozoa, helminths, trematodes, fungi, oomycetes, and algae, with preval...Infectious colitis can cause large intestinal diarrhea and, in severe cases, systemic illness in dogs and cats. Causative agents include bacteria, protozoa, helminths, trematodes, fungi, oomycetes, and algae, with prevalence influenced by signalment, immune status, and environmental exposure. Parasites such as Trichuris vulpis and Tritrichomonas blagburni are common and should be routinely screened for. Management of bacterial colitis should prioritize supportive care and addressing underlying causes rather than routine antimicrobials. Disseminated fungal, oomycete, and algal infections often require prolonged, multiagent therapy. Escherichia coli-associated granulomatous colitis necessitates histopathologic diagnosis and susceptibility-guided antimicrobials. Prognosis varies with infectious agent and presence of dissemination.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41876337
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Short bowel syndrome (SBS) is a functional diagnosis referring to clinical manifestations from small intestinal mass loss. SBS primarily results from extensive surgical resection in veterinary patients. Clinical signs of...Short bowel syndrome (SBS) is a functional diagnosis referring to clinical manifestations from small intestinal mass loss. SBS primarily results from extensive surgical resection in veterinary patients. Clinical signs often include diarrhea and weight loss. Pathophysiological mechanisms involve alterations in nutrient absorption and gastrointestinal motility. Effective management focuses on nutritional assessment, individualized dietary modifications, and pharmacologic interventions to address malnutrition and motility disorders.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41876336
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The term "triaditis" represents concurrent inflammatory diseases of the pancreas, hepatobiliary system, and small intestines in cats. This combination of inflammatory disorders appears to be clinically prevalent, and the...The term "triaditis" represents concurrent inflammatory diseases of the pancreas, hepatobiliary system, and small intestines in cats. This combination of inflammatory disorders appears to be clinically prevalent, and their co-existence may influence diagnostic or therapeutic strategies. The exact origin of the term triaditis in veterinary medicine is undetermined, but some of the earliest references to its potential existence were noted in the 1980s and 1990s. Despite the long-standing recognition of concurrent digestive-associated inflammatory disease in cats ('triaditis'), it is unknown whether this reflects a causative or associative relationship.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41856840
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This article discusses the importance of accurately diagnosing feline gastrointestinal diseases, particularly differentiating inflammatory bowel disease from alimentary lymphoma. It emphasizes that precise diagnosis impa...This article discusses the importance of accurately diagnosing feline gastrointestinal diseases, particularly differentiating inflammatory bowel disease from alimentary lymphoma. It emphasizes that precise diagnosis impacts treatment decisions, prognosis, and research. The review covers diagnostic approaches, including clinical signs, diet trials, imaging, biopsies, histopathology, immunohistochemistry, and molecular testing. It explores the potential progression from chronic inflammation to lymphoma, highlighting similarities with human disease pathways. Ultimately, improved understanding and classification of these diseases will enhance patient management, guide targeted therapies, and advance translational research benefiting both feline and human medicine.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41856839
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The intestinal microbiome plays a crucial role in host health. As intestinal dysbiosis can have different underlying causes, multimodal therapeutic approaches are often necessary. Dietary modulation potentially combined...The intestinal microbiome plays a crucial role in host health. As intestinal dysbiosis can have different underlying causes, multimodal therapeutic approaches are often necessary. Dietary modulation potentially combined with fibers should be the first-line approaches in all patients with acute or chronic enteropathy and help modulate the microbiome. A subset of animals with chronic intestinal disease have marked dysbiosis that results in abnormal microbial function and reflects underlying mucosal pathology, which often persists in chronic inflammatory enteropathy. Fecal microbiota transplantation can be a useful adjunct treatment of chronic disorders, but in patients with severe dysbiosis, repeated treatments are likely needed.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41791969
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Protein-losing enteropathy in dogs is a complex syndrome characterized by excessive intestinal protein loss, most commonly resulting from intestinal lymphangiectasia and chronic intestinal inflammation. While glucocortic...Protein-losing enteropathy in dogs is a complex syndrome characterized by excessive intestinal protein loss, most commonly resulting from intestinal lymphangiectasia and chronic intestinal inflammation. While glucocorticoid therapy is beneficial in many dogs, evidence increasingly shows that diet optimization, rather than aggressive immunosuppression, offers the best outcomes. The condition requires individualized management based on breed predisposition, diagnostic information, and patient response, with many steroid and immunosuppressive refractory cases responding to tailored dietary interventions.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41786560
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The microbiome-gut-brain axis (MGBA) is a complex network of gastrointestinal (GI) microbiota and host enteric, immune, neural, endocrine, and metabolic pathways. Disruptions to homeostasis promote dysbiosis, immune dysr...The microbiome-gut-brain axis (MGBA) is a complex network of gastrointestinal (GI) microbiota and host enteric, immune, neural, endocrine, and metabolic pathways. Disruptions to homeostasis promote dysbiosis, immune dysregulation, inflammation, and vagal signal disruption. Many disease states and behavioral disorders are associated with a change in GI microbial composition and diversity. Psychoactive treatments may specifically target the MGBA to reduce systemic and neuroinflammation linked to the pathogenesis of many GI and neuropsychiatric conditions.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41781216
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Large intestinal diseases in dogs and cats predominantly present as large bowel diarrhea, with constipation occurring less frequently. Etiologies are diverse and include infectious agents, parasites, inflammatory disease...Large intestinal diseases in dogs and cats predominantly present as large bowel diarrhea, with constipation occurring less frequently. Etiologies are diverse and include infectious agents, parasites, inflammatory disease, neoplasia, vascular malformations, and motility disorders. Diagnostic evaluation incorporates a thorough history, physical examination, fecal testing, diagnostic imaging, and, when indicated, colonoscopy with mucosal biopsy. Therapeutic strategies are directed toward the underlying cause, complemented by dietary modification and supportive care. Prognosis is contingent upon the specific etiology, disease severity, and timeliness of intervention.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41763984
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This review emphasizes that most cases of acute diarrhea (AD) in dogs and cats are self-limiting and primarily managed with supportive care, including hydration and nutrition. Diagnostic testing should be tailored to ind...This review emphasizes that most cases of acute diarrhea (AD) in dogs and cats are self-limiting and primarily managed with supportive care, including hydration and nutrition. Diagnostic testing should be tailored to individual cases, focusing on ruling out systemic illness or infectious causes. Recent evidence advocates against routine antibiotic use in uncomplicated AD to prevent antimicrobial resistance and microbiome disruption. Instead, targeted therapy is reserved for systemic or bacterial infections. Additional treatments such as antiemetics and careful hygiene are discussed. Clinicians should prioritize supportive care and judicious diagnostics, adhering to antimicrobial stewardship principles to optimize patient outcomes and combat resistance.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41763983
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Growing evidence in humans with inflammatory bowel disease reveals a critical subclinical phase during which pathologic changes silently accumulate-sometimes for up to a decade before diagnosis. Dogs with chronic enterop...Growing evidence in humans with inflammatory bowel disease reveals a critical subclinical phase during which pathologic changes silently accumulate-sometimes for up to a decade before diagnosis. Dogs with chronic enteropathy appear to follow a similar trajectory, developing subclinical intestinal pathology before manifesting overt clinical signs. This article synthesizes the current understanding of preclinical enteropathy across both species, examining the mechanistic changes that characterize this latent disease state. More importantly, it explores the translational implications of this knowledge: identifying the subclinical phase opens opportunities for early intervention, potentially preventing disease progression rather than merely managing established illness.
Vet Clin North Am Small Anim Pract
· 2026 May · PMID 41763982
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This article emphasizes the importance of strategic gastrointestinal biopsy collection, handling, and interpretation in dogs and cats. It highlights the need for high-quality, well-oriented samples, proper fixation, and...This article emphasizes the importance of strategic gastrointestinal biopsy collection, handling, and interpretation in dogs and cats. It highlights the need for high-quality, well-oriented samples, proper fixation, and detailed submission forms to ensure accurate diagnosis of inflammatory, neoplastic, and infectious diseases. The review discusses techniques for endoscopic biopsies, histopathologic evaluation, and ancillary testing, including immunohistochemistry and special stains. Proper communication among clinicians, histotechnologists, and pathologists is crucial for reliable results. Overall, optimized biopsy procedures and collaboration are essential for precise diagnosis, guiding effective treatment and improving patient outcomes in veterinary gastrointestinal medicine.