Vet Clin North Am Small Anim Pract
· 2025 May · PMID 40316374
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Many patients with ureteral obstructions are critically ill at the time of diagnosis, especially if there is dysfunction of the contralateral kidney. They may present with varying severities of uremia and acute kidney in...Many patients with ureteral obstructions are critically ill at the time of diagnosis, especially if there is dysfunction of the contralateral kidney. They may present with varying severities of uremia and acute kidney injury as well as systemic inflammation and sepsis secondary to infection. Medical management, which may consist of rehydration and restoration of intravascular volume with intravenous fluid therapy, osmotic diuresis, ureteral muscle relaxation, and antimicrobials for infection, is important in ureteral obstruction patients. Unstable patients may require more emergent intervention to relive the obstruction and address the life-threatening sequelae to acute kidney injury.
Vet Clin North Am Small Anim Pract
· 2025 May · PMID 40316373
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Mechanical ventilation (MV) is a lifesaving intervention that is used in small animals to manage a variety of conditions. Broad indications for MV include severe hypoxemia, severe hypercapnia, and an increase in work of...Mechanical ventilation (MV) is a lifesaving intervention that is used in small animals to manage a variety of conditions. Broad indications for MV include severe hypoxemia, severe hypercapnia, and an increase in work of breathing. MV requires intensive monitoring in the ICU and a thorough knowledge of the available modes of ventilation. Nursing care is a vital component of management of these uniquely fragile patients. Ultimately, successful weaning from ventilator support in veterinary patients depends on the underlying disease process, with patients with nonpulmonary diseases generally having a more favorable prognosis than patients with primary pulmonary parenchymal disease.
Vet Clin North Am Small Anim Pract
· 2025 May · PMID 40316372
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Biomarkers are objectively measurable parameters that provide clinicians with timely information to guide diagnosis and patient management beyond that which can be obtained from routinely available data. The literature c...Biomarkers are objectively measurable parameters that provide clinicians with timely information to guide diagnosis and patient management beyond that which can be obtained from routinely available data. The literature contains thousands of articles on biomarkers in veterinary medicine. Specifically reviewed are the acute kidney injury markers neutrophil gelatinase-associated lipocalin, cystatin, clusterin, and kidney-injury molecule-1; the cardiac troponins and natriuretic peptides as biomarkers of heart disease; the acute phase protein C-reactive protein; procalcitonin; inflammatory cytokines; the markers of neutrophil extracellular trap formation cell-free DNA and nucleosomes; and markers of injury to the endothelium and endothelial glycocalyx including hyaluronan.
Vet Clin North Am Small Anim Pract
· 2025 May · PMID 40316371
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Evidence suggests that the intestinal microbiome may play an important role in the pathogenesis and progression of acute critical illness in humans and other mammals, although evidence in small animal medicine is sparse....Evidence suggests that the intestinal microbiome may play an important role in the pathogenesis and progression of acute critical illness in humans and other mammals, although evidence in small animal medicine is sparse. Moreover, the intestinal microbiota plays many important metabolic roles (production of short-chain fatty acids, trimethylamine-N-oxide, and normal bile acid metabolism) and is crucial for immunity as well as defense against enteropathogens. The use of probiotics and fecal microbiota transplantation as instruments to modulate the intestinal microbiota seems to be safe and effective in studies on critically ill dogs with acute gastrointestinal diseases.
Vet Clin North Am Small Anim Pract
· 2025 May · PMID 40316370
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Corticosteroids are ubiquitous endogenous compounds that are essential for most body functions. Exogenous steroids are routinely used for a plethora of conditions associated with substantial and sometimes detrimental inf...Corticosteroids are ubiquitous endogenous compounds that are essential for most body functions. Exogenous steroids are routinely used for a plethora of conditions associated with substantial and sometimes detrimental inflammation or immune-mediated tissue destruction. In this article, we will review the relevant physiology of steroids, pharmacology of the common exogenously administered steroids, common side effects of glucocorticoid administration, as well as some of the more controversial and less researched indications for steroid therapy in veterinary medicine. Relevant human literature as well as available information on veterinary species will be presented to augment the discussion.
Vet Clin North Am Small Anim Pract
· 2025 May · PMID 40316369
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This review will explore the current knowledge, beginning with the physiologic underpinnings and delve into the evolving scientific literature, encompassing the inextricably intertwined diagnosis and management of sepsis...This review will explore the current knowledge, beginning with the physiologic underpinnings and delve into the evolving scientific literature, encompassing the inextricably intertwined diagnosis and management of sepsis and septic shock in human and small animal patients. Sepsis is a significant cause of morbidity and mortality in patients, mostly for failure to recognize or treat promptly and adequately. Diagnosis is based on the individual patient, clinical context, and clinical acumen. High quality supportive care in the intensive care unit setting is patient-centered with intensive nursing, focused on physiologic systems, goal-oriented, and multi-disciplinary with a team-based approach to patient care.
Vet Clin North Am Small Anim Pract
· 2025 Jul · PMID 40307104
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Inflammatory biliary tract disease (cholangitis) is the commonest liver disease in cats but remains poorly understood. There are chronic lymphocytic and acute neutrophilic forms together with chronic neutrophilic cholang...Inflammatory biliary tract disease (cholangitis) is the commonest liver disease in cats but remains poorly understood. There are chronic lymphocytic and acute neutrophilic forms together with chronic neutrophilic cholangitis which may overlap both these categories. Acute suppurative cholangitis is often associated with bacterial infections and interruptions to bile flow. Lymphocytic forms may be immune-mediated but there is evidence of heterogenicity in histologic and clinical appearance and response to treatment which may suggest several distinct diseases. This review discusses current knowledge, presentation, and diagnosis of feline cholangitis and suggests avenues for future research.
Vet Clin North Am Small Anim Pract
· 2025 Jul · PMID 40280782
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Drug-induced liver injury (DILI) is an underrecognized cause of hepatic disease in dogs and cats. Successful identification of cases requires an initial suspicion by the practitioner, a thorough drug exposure history, an...Drug-induced liver injury (DILI) is an underrecognized cause of hepatic disease in dogs and cats. Successful identification of cases requires an initial suspicion by the practitioner, a thorough drug exposure history, and knowledge of the toxic potential for common veterinary drugs. This article reviews the pathogenesis, classification, and diagnosis of DILI in small animals. It also discusses the clinical presentation, prevalence, and outcomes of DILI for several drugs important in veterinary medicine including azathioprine, azole antifungals, carprofen, diazepam, doxycycline, lomustine, methimazole, phenobarbital, rifampin, sulfonamide antibiotics, and zonisamide, as well as the toxic potential for nutraceuticals and herbal preparations.
Vet Clin North Am Small Anim Pract
· 2025 Jul · PMID 40274472
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Patients with a single congenital portosystemic shunt (PSS) often fail to thrive and routinely experience episodes of hepatic encephalopathy. Although medical therapy may mitigate clinical signs, shunt attenuation improv...Patients with a single congenital portosystemic shunt (PSS) often fail to thrive and routinely experience episodes of hepatic encephalopathy. Although medical therapy may mitigate clinical signs, shunt attenuation improves long-term outcomes and allows for improved liver function. Intrahepatic PSSs are less common than their extrahepatic counterparts and pose some unique challenges. Minimally invasive intravascular approaches are generally recommended to treat IHPSSs with some exeptions including some patients with patent ductus venosus. Outcomes with percutaneous transvenous coil embolization are generally good, with low perioperative mortality rates and clinical improvement reported in greater than 80% of cases.
Vet Clin North Am Small Anim Pract
· 2025 May · PMID 40082121
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Intravenous fluid therapy is a regular component of care for cats and dogs with goals of restoring tissue perfusion, preventing organ dysfunction, and maintaining homeostasis. Veterinarians have a plethora of fluid choic...Intravenous fluid therapy is a regular component of care for cats and dogs with goals of restoring tissue perfusion, preventing organ dysfunction, and maintaining homeostasis. Veterinarians have a plethora of fluid choices, including hypertonic, hypotonic, and isotonic crystalloids, as well as synthetic and natural colloids. Studies published in both the human and veterinary medical literature have documented adverse events associated with synthetic and natural colloids. Reports of increased incidences of acute kidney injury, need for renal replacement therapy, and mortality in a variety of patient populations have called into question the use of synthetic colloids in humans and companion animals.
Vet Clin North Am Small Anim Pract
· 2025 May · PMID 40044515
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Canine parvoviral enteritis is one of the most common causes of morbidity and mortality in young dogs worldwide. The virus is endemic in the environment and can be infective to unvaccinated or poorly vaccinated dogs. Sta...Canine parvoviral enteritis is one of the most common causes of morbidity and mortality in young dogs worldwide. The virus is endemic in the environment and can be infective to unvaccinated or poorly vaccinated dogs. Standard in-patient therapies include use of antiemetics, intravenous fluids, antibiotics and provision of enteral nutrition. The use of antiviral drugs, immunomodulators and monoclonal antibody therapy are newer possibilities that may potentially improve outcome. Outpatient therapy also remains a viable possibility for treatment if financial constraints exist.
Vet Clin North Am Small Anim Pract
· 2025 Mar · PMID 39824732
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Feline aural inflammatory polyps originate from the tympanic bulla and less frequently from the auditory tube, representing the most common benign tumor of the feline ear. Clinical signs may be compatible with otitis ext...Feline aural inflammatory polyps originate from the tympanic bulla and less frequently from the auditory tube, representing the most common benign tumor of the feline ear. Clinical signs may be compatible with otitis externa, media, and/or interna with rare occurrences involving meningoencephalitis or abscessation of periauricular tissue. Traction and avulsion is an effective treatment procedure with a relatively low recurrence rate, especially when systemic glucocorticoids are given after polyp removal. Secondary infections should be addressed with topical and systemic antimicrobials along with lavage of the ear. Bulla osteotomy may be recommended in complicated cases.
Vet Clin North Am Small Anim Pract
· 2025 Mar · PMID 39824731
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Proliferative and necrotizing otitis externa (PNOE) is characterized by thick, adherent dark red, brown, or black crusts. It most commonly affects the concave pinnae and vertical ear canals bilaterally. Lesions may also...Proliferative and necrotizing otitis externa (PNOE) is characterized by thick, adherent dark red, brown, or black crusts. It most commonly affects the concave pinnae and vertical ear canals bilaterally. Lesions may also be seen on the face, and it may rarely present in a generalized form. There is no known cause of PNOE, but it responds to treatment with topical and systemic immunomodulatories and is therefore thought to be immune-mediated. Twenty-one cases have been described in the literature and are summarized here.
Vet Clin North Am Small Anim Pract
· 2025 Mar · PMID 39757083
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Nasal planum dermatoses in dogs can be infectious, immune-mediated, allergic, neoplastic, and metabolic in nature. Recognizing key lesions and features and knowing how and when to biopsy can help distinguish between simi...Nasal planum dermatoses in dogs can be infectious, immune-mediated, allergic, neoplastic, and metabolic in nature. Recognizing key lesions and features and knowing how and when to biopsy can help distinguish between similar diseases. The focus of this article is to review the most commonly encountered nasal planum dermatoses in dogs and to enable the veterinary practitioner to recognize and differentiate between them to obtain a diagnosis.
Vet Clin North Am Small Anim Pract
· 2025 Mar · PMID 39757082
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Worldwide, a variety of mycobacterial species have been associated with skin lesions in dogs and cats. Lesions may result from systemic dissemination or local cutaneous inoculation. Only infections with Mycobacterium tub...Worldwide, a variety of mycobacterial species have been associated with skin lesions in dogs and cats. Lesions may result from systemic dissemination or local cutaneous inoculation. Only infections with Mycobacterium tuberculosis complex organisms have the potential to be transmitted from companion animals to humans, but even then, zoonotic risk is considered low. Diagnosis of mycobacterial infections is based on identification of intralesional acid-fast bacteria using cytology or histopathology, culture at experienced facilities, and use of PCR-sequencing. Treatment typically requires prolonged combination therapy with antimycobacterial drugs, and the prognosis varies depending on the mycobacterial species involved and presence of underlying immunosuppression.
Vet Clin North Am Small Anim Pract
· 2025 Mar · PMID 39755502
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Laser usage in veterinary dermatology has increased in popularity over the last several decades. Carbon dioxide (CO) laser is the leading modality in surgical laser for veterinary dermatology because of its unmatched per...Laser usage in veterinary dermatology has increased in popularity over the last several decades. Carbon dioxide (CO) laser is the leading modality in surgical laser for veterinary dermatology because of its unmatched performance with soft tissue, particularly the skin. This laser cuts and coagulates tissue via the photothermal effect of laser energy when interacting with soft tissues with high water content, such as skin. CO laser modality has many indications for the diagnosis and treatment of dermatologic conditions in animals. This article will review the basics of CO laser and how to utilize it in veterinary dermatology.
Vet Clin North Am Small Anim Pract
· 2025 Mar · PMID 39734106
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Papillomaviruses (PV) affect dogs and cats. Oral papillomas are common in young dogs and generally do not require treatment because they resolve spontaneously. The virus is spread via direct contact during play, or via i...Papillomaviruses (PV) affect dogs and cats. Oral papillomas are common in young dogs and generally do not require treatment because they resolve spontaneously. The virus is spread via direct contact during play, or via indirect contact (from the environment, through fomites). Cutaneous papillomas are less common and less likely to resolve spontaneously. Cryosurgery, CO laser ablation, surgical excision, or topical imiquimod are options for bothersome or nonregressing papillomas. Papillomas in older dogs occur due to systemic immunosuppression and diagnostic investigation is warranted. Cutaneous or oral papillomas in cats are uncommon and feline PV are associated with certain skin neoplasms.
Vet Clin North Am Small Anim Pract
· 2025 Mar · PMID 39732548
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Canine atopic dermatitis (cAD) and feline atopic skin syndrome are inflammatory and pruritic skin diseases with both environmental and genetic factors. Genetic factors may include barrier defects and a predisposition to...Canine atopic dermatitis (cAD) and feline atopic skin syndrome are inflammatory and pruritic skin diseases with both environmental and genetic factors. Genetic factors may include barrier defects and a predisposition to mount T helper 2 lymphocyte immune response when allergens are encountered. These diseases have repeatable patterns of skin and ear inflammation and commonly lead to Staphylococcal and Malassezia skin and ear infections. Early life environmental factors and an indoor lifestyle may increase the risk of cAD. The most ubiquitous environmental allergen is house dust mite with pollens, molds, foods, and Malassezia yeast potentially playing a role in affected individuals.