Case Report

Submitted by Olivia Obringer, Michigan State University

My personal pet, Merlin, an 8mo old MN DSH presented to MSU VMC for inability to urinate. He was adopted by myself 29 days prior and had no history of urinary issues. His bladder was firm and painful upon palpation. An IV catheter was placed, and Merlin was sedated and unblocked. This procedure was uneventful, and urinary catheter positioning was successful. A urinalysis was submitted and was positive for crystals and negative for bacteria and casts. An abdominal radiograph of the bladder revealed 2-3 mildly radiolucent stones in the bladder. Ultrasound of the bladder confirmed the stones (see image below).

A cystotomy was performed and the stones were removed and submitted to the Minnesota Urolith Center. Merlin recovered well from surgery and began a diet of Hill’s c/d. 

A few weeks later, the results of the stone submission confirmed Merlin had ammonium urate stones. Because of this result, bile acids were run, and the results were as followed:

Bile Acids Fasting (Enzyme cycling): 8.6H [Range: 0.5-7.9] umol/L

Bile Acid 2 Hour (Enzyme cycling): 88.5 H [Range: 1.9-11.3] umol/L

Two weeks later, Merlin was sedated for a CT with angiogram and bloodwork. His bloodwork results revealed:

Urea Nitrogen: 7 L [19-36] mg/dL
Total Bili 0.1 [0.1-0.3] mg/dL
Direct Bili 0.0 [0.0-0.1] mg/dL
Indirect Bili 0.1 [0.1-0.3] mg/dL
ALP 104 H [13-48] U/L
ALT 71 [25-76] U/L
AST 22 [14-36] U/L

His CT report revealed a “single extrahepatic splenophrenic portosystemic shunt”.

Merlin never had any neurological signs (ataxia, seizures, dysphoria) and only ever had a history of chronic diarrhea. Due to the blood’s diversion of the liver, Merlin accumulated ammonium in his body which promoted the stone formation in his bladder.

Merlin had a good prognosis with surgery, and that option was pursued. An ameroid constrictor was placed around the shunt, and he did well during surgery and post-operatively. He was discharged the day after. Unfortunately, Merlin developed post-attenuation neurological signs (PANS) a few hours after returning home. He was disoriented, ataxic, and experiencing central blindness. Despite proactive treatment, Merlin continued to decline and developed cluster seizures. He was humanely euthanized.

I will miss him dearly.

Case Report: Moose

Thank you to Sophie Cressman of The Ohio State University for sending this case write-up our way!  We always love to see the cases that our students work through each and every day!

Moose: Yorkshire Terrier Mix presenting in DKA crisis

Introduction:

Moose was a 5y10m MN Yorkshire terrier mix that presented for lethargy, increased urination, decreased appetite, and acute onset of vomiting with no previous history of systemic illness. After performing a thorough physical exam and in house diagnostics, it was determined that he was experiencing a diabetic ketoacidodic crisis and in a hyperosmolar hyperglycemic state. 

History:

Moose was a 5y10m MN Yorkshire terrier mix presenting for recent lethargy and inappetence, acute onset of frequent vomiting but no diarrhea, weight loss, and increased frequency of urination. He had been previously healthy at annual exams, is up to date on vaccines, has had no change in diet or known foreign material ingestion, and no recent travel. 

Acute inappetence w/ v+ r/o: gastritis, pancreatitis, dietary indiscretion, foreign material ingestion, toxin

Pollakiuria r/o: UTI, cystitis, cystolith, toxin

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Case: FDA Policy Effects on Antimicrobial Resistance in Salmonella Dublin Isolates

Submission Category: Cases and Abstracts

Assessing FDA policy effects on antimicrobial resistance in Salmonella Dublin isolates

Angelica Collins & Casey Cazer

Department of Population Medicine & Diagnostic Sciences, Cornell University College of Veterinary Medicine

In 2012 the Food and Drug Administration (FDA) prohibited the extra-label use of cephalosporin class antimicrobials in food-producing animals to reduce the risk of cephalosporin-resistant zoonotic bacteria. The objective of this study is to assess the prevalence of antimicrobial resistant (AMR) Salmonella enterica serotype Dublin before and after this policy change. We have analyzed Salmonella Dublin isolate antimicrobial susceptibility data collected by the National Antimicrobial Resistance Monitoring System at the slaughter stage between 1998 and 2017. Internationally accepted breakpoint values were used to determine if the isolates were resistant or susceptible. Chi-square tests were performed to compare the proportion of resistance before (2006-2011) and after (2012-2017) implementation of the policy. Survival analysis was used to assess shifts in MIC distributions; growth inhibition is used as the event and concentration of the antimicrobial that inhibits growth is used as the time.

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Case Study: Physical Rehabilitation

Physical Rehabilitation Using Therapeutic Exercise on an 8 Month Old Intact Male Miniature

Schnauzer Following Surgical Fixation of Acute Atlantoaxial Subluxation

Brittany Weicht

Virginia-Maryland College of Veterinary Medicine

Class of 2021

Edited by Mark D. Freeman, DVM, Diplomate ABVP, CVA

Introduction

Cervical vertebrae one and two (atlas and axis, respectively) play a crucial role in normal movement of the head through a pivoting motion of C1 around the dens of C2. The intervertebral joint space lacks an intervertebral disc and the integrity of the joint is largely maintained by ligaments.1 Toy breed dogs are predisposed to instability of this joint2 and are likely to develop clinical signs consistent with neurologic deficit following trauma to a congenital lesion. The patient in this study was diagnosed with atlantoaxial subluxation and fracture of the dens following an acute trauma. The patient was immediately taken to surgery where a ventral slot was performed to stabilize the fracture, and multimodal postoperative pain management and rehabilitation were instituted to improve prognosis. Following three months of home exercise and weekly rehabilitation sessions, the patient has regained his ability to perform normal daily living activities and his guardians report they are very pleased with the outcome, especially given the initial guarded prognosis.

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Mysterious Sudden Deaths in a Beef Cattle Herd - Continued

Did you guess correctly? Check out what Ali found below!

"We were specifically concerned with Grass Tetany (Magnesium deficiency), but the Magnesium values came back within normal limits for each deceased animal. We tested the water for lead and arsenic, checked for other environmental factors, and found nothing. We did surveillance chemistries on 4 random females of different ages. Magnesium was borderline-low on all of them. The post-mortem samples weren't representative because when the animals seized or twitched severely before they died, Magnesium was released from where it is stored in muscle, elevating serum levels. In animals that had not experienced muscle damage or twitching showed true Mg serum values. 

This herd is now being supplemented with Magnesium Oxide dusted on their feed and mixed in with their free-choice mineral mix, and they have not had any problems since!"

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