A Review of the Pathophysiology, Classification, and Analysis of Canine and Feline Cavitary Effusions

Suzanne M. Dempsey, DVM, Patty J. Ewing, DVM, MS, Diplomate ACVP
Am Anim Hosp Assoc 201147:1–11. DOI 10.5326/JAAHA-MS-5558.

Effusion is the abnormal accumulation of fluid within a body cavity that can result from a variety of disease processes. This article reviews the normal production and resorption of body cavity fluid and the pathophysiology of abnormal fluid accumulation. In addition, classification schemes, differential diagnoses, and currently available diagnostic tests for evaluation of effusions are reviewed.

Guidelines for Reducing Veterinary Hospital Pathogens: Hospital Design and Special Considerations

Joshua A. Portner, DVM, DACVECC, 

Justine A. Johnson, DVM, DACVECC

Compendium

May 2010 (Vol 32, No 5)

Prevention of nosocomial infection begins with the hospital layout and identification of special considerations for particular patients. The construction of a new hospital or renovation of an existing hospital requires careful planning and consideration of the needs of the expected patient population and hospital staff. This article discusses considerations for preventing cross-contamination of pathogens through hospital design, as well as special considerations for particular patients, specifically those in isolation areas and surgical suites.

Laboratory Tests for Diagnosis of Gastrointestinal and Pancreatic Diseases

Olivier Dossin DVM, PhD, Dipl. ECVIM-C

Topics in Companion Animal Medicine
Volume 26, Issue 2 , Pages 86-97, May 2011

The panel of laboratory tests available for diagnosis of gastrointestinal (GI) diseases in dogs and cats is wide, and, recently, several new tests have been developed. This article will focus on advances in laboratory tests that are available for the general practitioner for diagnosis of GI diseases. Laboratory tests for diagnosis of gastric and intestinal infectious diseases include fecal parasite screening tests, enzyme-linked immunosorbent assays for parvoviral enteritis, and some specific bacterial tests like fluorescent in situ hybridization for identification of specific bacteria attached to the intestinal epithelial cells. Serum concentrations of folate and cobalamin are markers of intestinal absorption, but are also changed in exocrine pancreatic insufficiency and intestinal bacterial overgrowth. Hypocobalaminemia is common in GI and pancreatic disease. Decreased serum trypsin-like immunoreactivity is a very sensitive and specific test for the diagnosis of exocrine pancreatic insufficiency in dogs and cats. Serum pancreatic lipase is currently the most sensitive and specific test to identify pancreatic cell damage and acute pancreatitis. However, serum canine pancreas-specific lipase is less sensitive in canine chronic pancreatitis. Increased serum trypsin-like immunoreactivity is also specific for pancreatic damage but is less sensitive. It is very likely that further studies will help to better specify the role of these new tests in the diagnosis of canine and feline 

Interpretation of Laboratory Tests for Canine Cushing’s Syndrome

Chen Gilor DVM, PhD, Dipl. ACVIM and
Thomas K. Graves DVM, PhD, Dipl. ACVIM
Topics in Companion Animal Medicine
Volume 26, Issue 2, May 2011, Pages 98-108

Hypercortisolism (HC) is a common disease in dogs. This article will review the laboratory tests that are available for diagnosis of HC and laboratory tests for differentiating between causes of HC. An emphasis will be made on the clinical process that leads to the decision to perform those tests and common misconceptions and issues that arise when performing them. To choose between the adrenocorticotropic hormone (ACTH)–stimulation test and the low-dose dexamethasone suppression test (LDDST), the advantages and disadvantages of both tests should be considered, as well as the clinical presentation. If the index of suspicion of HC is high and other diseases have been appropriately ruled out, the specificity of the ACTH stimulation test is reasonably high with an expected high positive predictive value. Because of the low sensitivity, a negative result in the ACTH stimulation test should not be used to rule out the diagnosis of HC. The LDDST is more sensitive but also less specific and affected more by stress. A positive result on the urine cortisol:creatinine ratio does not help to differentiate HC from other diseases. A negative result on the urine cortisol:creatinine ratio indicates that the diagnosis of HC is very unlikely. The LDDST is useful in differentiating pituitary-dependent HC from an adrenal tumor in about two thirds of all dogs with HC. Differentiation of HC from diabetes mellitus, liver diseases, and hypothyroidism cannot be based solely on endocrine tests. Clinical signs, imaging studies, histopathology, and response to treatment should all be considered

When Normal Is Abnormal – Keys to Laboratory Diagnosis of Hidden Endocrine Disease

Graves TK. Source
Topics Companion Animal Medicine 

2011 May;26(2):45-51

Although veterinary clinicians commonly rely on panels of laboratory tests with individual results flagged when abnormal, care should be taken in interpreting normal test results as well. There are several examples of this in evaluating patients with endocrine disease. The finding of a normal leukogram (absence of a stress leukogram) can be indicative of adrenal insufficiency in dogs, and this disorder can be especially elusive when there are no overt indicators of mineralocorticoid deficiency. Cats with hyperthyroidism can have normal serum thyroid hormone concentrations, normal hematocrits, and normal serum concentrations of creatinine despite the presence of disease that affects these parameters. A normal serum phosphorus concentration, in the face of azotemia, isosthenuria, and hypertension can point a clinician toward a diagnosis of primary hyperaldosteronism rather than primary renal disease. A normal serum parathyroid hormone concentration in the face of hypercalcemia is inappropriate and can indicate the presence of primary hyperparathyroidism. Similarly, hypoglycemia accompanied by a normal serum insulin concentration can be found in cases of hyperinsulinism. These normal findings in abnormal patients, and their mechanisms, are reviewed

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