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Biomedical subjects

R J Mellanby

Publications and source records attributed to R J Mellanby.

At least 19 recordsLinked to original sources
PubMed2007

Perceptions of veterinarians and clients to expressions of clinical uncertainty.

OBJECTIVES: The aim of this study was to explore the attitudes of veterinarians and clients towards expressions of clinical uncertainty. METHODS: Questionnaires that assessed the respondent's attitudes towards expressions of clinical uncertainty were completed by clients at six small animal practices. In addition, questionnaires that evaluated what veterinarians thought their client's attitudes would be towards expressions of clinical uncertainty were completed by veterinarians. The responses from clients and veterinarians were statistically compared. RESULTS: Veterinarians significantly underestimated the desire of clients to be told about uncertainties in treatment and significantly overestimated how the expression of uncertainty would generally reduce client confidence. Veterinarians significantly overestimated the loss of client confidence resulting from saying "I am not sure about this" and from asking a nurse for advice. Both clients and veterinarians considered that verbal expressions of uncertainty would lead to a greater reduction in client confidence than behavioural expressions of uncertainty. CLINICAL SIGNIFICANCE: This study suggests that most clients want to be told about their veterinarian's clinical uncertainties, and how this uncertainty is expressed can markedly influence client confidence.

Attitude of Health Personnel↗
PubMed2006

Plasma concentrations of parathyroid hormone-related protein in dogs with potential disorders of calcium metabolism.

The plasma concentrations of total calcium, ionised calcium, albumin, parathyroid hormone and parathyroid hormone-related protein (PTHrp) were measured in 25 dogs with lymphoma, nine dogs with primary hyperparathyroidism and seven dogs with adenocarcinoma of the apocrine gland of the anal sac. Plasma total calcium, ionised calcium, albumin and parathyroid hormone-related protein were measured in 18 clinically normal control dogs. The concentration of PTHrp was high in 12 of the 14 dogs that were hypercalcaemic because of an underlying malignancy but was within the reference range in all the control dogs, in the 17 normocalcaemic dogs with lymphoma and in the seven dogs which were hypercalcaemic because of a parathyroid adenoma.

Adenocarcinoma↗
PubMed2006

Hypercalcaemia associated with granulomatous lymphadenitis and elevated 1,25 dihydroxyvitamin D concentration in a dog.

A seven-year-old Labrador was presented with weight loss and mild generalised lymphadenopathy. Histopathology of an excised lymph node by the referring veterinarian demonstrated granulomatous lymphadenitis. At the time of referral, fine-needle aspirates of the lymph nodes confirmed the presence of ongoing granulomatous inflammation. Further investigations revealed marked hypercalcaemia, a low parathyroid hormone concentration, a parathyroid hormone related protein concentration within the reference range, and an elevated serum concentration of 1,25 dihydroxyvitamin D. An underlying cause of the granulomatous lymphadenitis could not be identified. The clinical signs, hypercalcaemia and elevated serum concentrations of 1,25 dihydroxyvitamin D resolved following prednisolone treatment. In contrast to dogs, hypercalcaemia occurred secondarily to granulomatous disease and elevated 1,25 dihydroxyvitamin D concentrations is a well-recognised condition in human beings. To the authors' knowledge, this is the first case report to describe elevated serum calcium and 1,25 dihydroxyvitamin D concentrations in a dog with histologically confirmed granulomatous disease.

Animals↗
PubMed2005

Long-term survival of 23 dogs with pericardial effusions.

Twenty-three dogs with pericardial effusions were identified from case records made between 1992 and 2000. Fourteen of the 23 were diagnosed with idiopathic pericardial effusions, and three of these were treated successfully by one pericardiocentesis. In the remaining 11 cases the pericardial effusion recurred; six cases were managed long-term by either two (three cases), three (two cases), or 11 repeated pericardiocenteses, and the remaining five were treated by pericardiectomy. The median survival time of the six dogs treated by repeated pericardiocentesis was five years and nine days.

Animals↗
PubMed2005

Cardiac troponin I: evaluation I of a biomarker for the diagnosis of heart disease in the dog.

OBJECTIVES: To assess the value of measuring blood levels of the myocardial protein cardiac troponin I (cTnl) in the diagnosis of congenital and acquired heart disease in the dog and in the evaluation of the severity of heart failure. METHODS: Serum samples obtained from healthy dogs (n = 26) and from dogs diagnosed with a variety of congenital and acquired heart conditions (n = 35) were assayed for cTnl concentration using an automated immunoassay method. Results were also analysed according to the degree of heart failure as assessed using the International Small Animal Cardiac Health Council's scheme. RESULTS: Healthy dogs had very low or undetectable blood cTnl levels, as did dogs with congenital heart disease. However, cTnl levels were significantly elevated in dogs with acquired mitral valve disease, dilated cardiomyopathy and pericardial effusion. Blood cTnl levels also varied with severity of heart failure. CLINICAL SIGNIFICANCE: Measurement of blood cTnl levels may be a useful aid in the diagnosis of dogs with suspected heart disease and in indicating the severity of heart failure.

Animals↗
PubMed2005

Hypercalcaemia in two dogs caused by excessive dietary supplementation of vitamin D.

A three-year-old Border collie was presented with a two-week history of lethargy, stiff gait, polydipsia and polyuria. Biochemical analysis revealed hypercalcaemia. Serum concentrations of 25-hydroxyvitamin D (25[OH]D) and 1,25-dihydroxyvitamin D (1,25[OH]2D) were markedly elevated and parathyroid hormone was undetectable. Subsequent analysis of the dog's diet revealed that the food contained excessive amounts of vitamin D. The hypercalcaemia resolved following treatment with bisphosphonates and dietary change. Hypervitaminosis D was diagnosed in a second unrelated dog, which had been fed the same brand of dog food as case 1. The dog was also hypercalcaemic and had markedly elevated serum concentrations of 25(OH)D and 1,25(OH)2D. Hypervitaminosis D in dogs has been reported to occur secondarily to ingestion of either rodenticides containing cholecalciferol or antipsoriatic ointments that contain vitamin D analogues. Hypervitaminosis D has also been reported following the treatment of hypoparathyroidism. To the authors' knowledge, this is the first report of hypervitaminosis D in dogs following the accidental over supplementation of a commercial diet with vitamin D. While the benefits of adequate dietary vitamin D are well established in dogs, the potential deleterious effects of over supplementation of vitamin D should also be acknowledged.

Animals↗
PubMed2005

Hypocalcaemia associated with low serum vitamin D metabolite concentrations in two dogs with protein-losing enteropathies.

Protein-losing enteropathies were diagnosed in two dogs that were initially presented with diarrhoea and weight loss. Plasma biochemistry in both cases revealed low concentrations of albumin, calcium and ionised calcium. Both dogs had an elevated plasma parathyroid hormone concentration and low serum 25-hydroxyvitamin D (25[OH]D) concentration. The first dog was diagnosed with lymphangiectasia on postmortem examination, and the second dog was diagnosed with chronic lymphocytic/ plasmacytic enteritis and severe cystic mucoid changes based on endoscopic duodenal biopsies. While a causal effect was not demonstrated, the protein-losing enteropathies may have caused reduced intestinal absorption of vitamin D leading to low plasma concentrations of ionised calcium and secondary hyperparathyroidism. To the authors' knowledge, this is the first report of low ionised calcium concentrations, low 25(OH)D and 1,25-dihydroxyvitamin D concentrations, and high parathyroid hormone concentrations in dogs with protein-losing enteropathies.

Animals↗
PubMed2004

Survey of mistakes made by recent veterinary graduates.

To investigate the incidence and types of mistakes made in veterinary practice, and to assess the impact the mistakes had on the veterinarians involved, a questionnaire was sent in November 2002 to all the veterinary graduates of the Universities of Bristol, Edinburgh, Glasgow, London and Liverpool in 2001. One hundred and eight (27 per cent) of 402 questionnaires were returned completed; 87 of 106 respondents (82 per cent) worked frequently or always unsupervised and only 46 (43 per cent) could always rely on support from other veterinarians in the practice. Since starting work, 82 of 105 respondents (78 per cent) stated that they had made a mistake, defined as an erroneous act or omission resulting in a less than optimal or potentially adverse outcome for a patient and in many cases these mistakes had had a considerable emotional impact on the veterinarians involved. The survey highlights that a large number of recently graduated veterinarians work with little supervision and that many veterinarians beginning their year in practice do not always have access to assistance from other veterinary colleagues.

Adult↗
PubMed2004

Congenital phimosis in a cat.

An 8-week-old domestic shorthair cat was presented with a history of pollakiuria and polydipsia. No abnormalities were detected during the clinical examination other than the penis could not be extruded from the prepuce. Urine culture demonstrated a growth of E. coli, which was treated with a prolonged course of amoxycillin. The polydipsia resolved and the pollakiuria improved but did not completely abate after antibiotic treatment and the cat had occasional bouts of haematuria. Because of the history of pollakiuria and polydipsia and the ongoing, occasional bouts of haematuria, the cat underwent surgical correction of the congenital phimosis. A small wedge of the dorsal prepuce was removed and the ipsilateral edges of the prepuce were apposed using a simple interrupted pattern. The procedure was quick, easy to perform and led to a resolution of the occasional bouts of haematuria and pollakiuria.

Animals↗
PubMed2004

Acute B cell lymphoblastic leukaemia in a 12-week-old greyhound.

A 12-week-old greyhound had a two-day history of lethargy, inappetence and shifting lameness. Clinical examination revealed pyrexia and hepatosplenomegaly. Haematological examination showed anaemia, thrombocytopenla, neutropenla and large numbers of atypical mononuclear leucocytes. A diagnosis of acute B cell lymphoblastic leukaemia was made following flow cytometric immunophenotyping of the leucocytes. The owner declined further evaluation and the dog was treated symptomatically with antibiotics. After a brief improvement, the dog's condition deteriorated and it was euthanased four days after initial presentation. The case was unusual because acute lymphoid leukaemia in the dog is most frequently reported in mature animals. This is in contrast to humans, where acute leukaemia is one of the most common childhood cancers.

Animals↗
PubMed2004

Urethral haemangiosarcoma in a boxer.

A seven-year-old, entire female boxer presented with a history of restless behaviour and inappetence. Physical examination revealed that the dog was listless and had a hunched gait. Neurological examination was normal. Abdominal ultrasonography revealed a 4 cm x 4 cm mass in the cranial pelvic canal. Neurological abnormalities were detected three days after presentation, and progressed from proprioceptive deficits to loss of deep pain sensation in the pelvic limbs over a two-day period. The dog was euthanased and postmortem examination revealed that the pelvic mass was a urethral haemangiosarcoma with metastasis to the second lumbar vertebra. This case is unusual as urethral tumours are usually transitional cell carcinomas and frequently present with signs of dysuria.

Animals↗
PubMed2004

Immune-mediated haemolytic anaemia associated with a sarcoma in a flat-coated retriever.

A seven-year-old flat-coated retriever presented with a history of lethargy, dyspnoea and inappetence of several days' duration. Clinical examination revealed pale mucous membranes and tachypnoea, and haematology demonstrated marked autoagglutination. Thoracic radiographs revealed an increased opacity in the perihilar region. The owners declined further evaluation and the dog was treated symptomatically with immunosuppressive doses of prednisolone and azathioprine. The dog's demeanour improved, although it was eventually euthanased seven weeks later because of dysphagia and worsening dyspnoea. Postmortem examination revealed a widespread, poorly differentiated sarcoma involving the lungs, pericardium, thoracic lymph nodes and spleen. Immune-mediated haemolytic anaemia is a well recognised condition in dogs and is occasionally associated with neoplastic conditions. This is the first case report to describe immune-mediated haemolytic anaemia associated with a diffuse, poorly differentiated sarcoma.

Anemia, Hemolytic, Autoimmune↗
PubMed2003

Panniculitis associated with pancreatitis in a cocker spaniel.

A 13-year-old, male cocker spaniel presented with a history of inappetence, depression and reluctance to stand. The dog had multiple, ulcerated skin lesions which were diagnosed as panniculitis by histopathology. A diagnosis of pancreatitis was made on the basis of markedly elevated serum lipase concentrations, abdominal ultrasonography which showed an abnormal lobulated area of hypoechoic tissue in the body and right lobe of the pancreas, and a fine needle biopsy from this area which revealed large numbers of degenerate neutrophils. After treatment with antibiotics and prednisolone, the dog made a full clinical recovery and was free of clinical signs for four months. The dog was euthanased five months later and postmortem examination revealed chronic, active pancreatitis and a pancreatic adenoma. This is the first report of antemortem diagnosis of pancreatitis and panniculitis in a dog.

Adenoma↗
PubMed2003

Owners' assessments of their dog's quality of life during palliative chemotherapy for lymphoma.

The owners of 25 dogs with multicentric lymphoma which were treated by multidrug chemotherapy were interviewed to assess the quality of their pet's life during treatment. Sixty-eight per cent of the owners considered their dog's quality of life to be the same as before the lymphoma occurred, and the remaining 32 per cent felt that their pet's quality of life on chemotherapy treatment was acceptable but poorer than before the lymphoma occurred. Treatment complications were reported by 52 per cent of owners. Ninety-two per cent of owners had no regrets about treating their dog with multidrug chemotherapy. The results suggest that, while many dogs developed treatment complications during multidrug chemotherapy, most owners felt that the quality of life of their pets was good during treatment and had no regrets about opting for palliative chemotherapy.

Animals↗