Pathophysiology of hepatic encephalopathy.
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Animals↗
Biomedical subjects
R M Hardy
Publications and source records attributed to R M Hardy.
Hypernatremia.
Hypernatremia is a potentially life-threatening electrolyte abnormality. This problem develops most often because of loss of water from the animal, but in rare cases hypernatremia results from gain of sodium chloride. Important conditions predisposing to hypernatremia include diarrhea, vomiting, heat stroke, fever, limited access to water, excessive diuretic use, renal diseases, and pituitary diabetes insipidus. This condition rarely develops if animals have adequate access to water. Clinical signs relate to central nervous system derangements and can progress to seizures and coma. Diagnosis is based on the serum sodium concentration; treatment should be instituted if it is greater than 170 mEq per L. Treatment is based on knowledge of the volume status of the patient and the probable cause for the hypernatremia. In general, 5 per cent dextrose in water or other hypotonic fluids are given slowly intravenously. The rate of administration should be adjusted so the water deficit is replaced over 48 to 72 h. Too rapid correction of hypernatremia can lead to cerebral edema and worsening of the animal. In cases of salt intoxication, diuretics must be given in addition to slow water replacement to avoid the development of pulmonary edema.
Animals↗
Ultrasonographic appearance of primary and metastatic canine hepatic tumors. A review of 48 cases.
Forty-eight cases of dogs with primary and metastatic hepatic neoplasia were reviewed to determine if a predictable relationship between sonographic appearance and neoplastic cell type could be found. A focal mass was almost always a hepatocellular carcinoma (14 of 15) and 71% of these were hyperechoic. Focal or multifocal hyperechoic masses were most likely to be carcinomas (14 of 15). Focal or multifocal mixed neoplasms were most likely to be carcinomas (6 of 7). Two distinct patterns of lymphosarcoma were found: diffuse, mildly hyperechoic (6/11) and multifocal, hypoechoic (5/11). No neoplastic cell-type predictions could be made for focal or multifocal hypoechoic lesions. Diffuse fine or coarse patterns with minimal architectural distortions could be mistaken for normal or degenerative processes. However, in the presence of increased serum liver enzyme values, these subtle sonographic changes would warrant a liver biopsy to differentiate neoplastic infiltrate from non-neoplastic infiltrative and degenerative processes.
Animals↗
Reassessment of cytologic values in canine cerebrospinal fluid by use of cytocentrifugation.
Using cytocentrifugation, nearly one fourth of canine cerebrospinal fluid (CSF) samples with cell counts in the normal range had abnormalities in cell type or morphologic features. Cerebrospinal fluid samples from 145 dogs with neurologic disorders were evaluated by use of this method. These results indicate that low hemacytometer counts in canine CSF should not be interpreted as normal. By increasing the detection of abnormalities in CSF, cytocentrifugation might improve diagnosis and treatment of canine neurologic disease.
Animals↗
Thoracic vertebral osteochondroma in a cat.
A thoracic vertebral (T5) osteochondroma was discovered in a 1 1/2-year-old male blue Persian cat with a history of acute hind limb paresis. Myelography revealed a mass on the dorsal surface of the vertebral body, which resulted in dorsal compression of the spinal cord. A dorsal laminectomy was performed, and the mass was rongeured entirely from the vertebral body. Although the cat's progress was initially slow after surgery, its neurologic status was assessed to be near normal, 15 months later.
Animals↗
Clinical signs, diagnosis, and treatment of alkalemia in dogs: 20 cases (1982-1984).
Alkalemia (pH greater than 7.50) was measured in 20 dogs admitted over a 3-year period for various clinical disorders. Alkalemia was detected in only 2.08% of all dogs in which blood pH and blood-gas estimations were made. Thirteen dogs had metabolic alkalosis (HCO3- greater than 24 mEq/L, PCO2 greater than 30 mm of Hg), of which 8 had uncompensated metabolic alkalosis, and of which 5 had partially compensated metabolic alkalosis. Seven dogs had respiratory alkalosis (PCO2 less than 30 mm of Hg, HCO3- less than 24 mEq/L); 4 of these had uncompensated respiratory alkalosis and 3 had partially compensated respiratory alkalosis. Ten dogs had double or triple acid-base abnormalities. Dogs with metabolic alkalosis had a preponderance of clinical signs associated with gastrointestinal disorders (10 dogs). Overzealous administration of sodium bicarbonate or diuretics, in addition to anorexia, polyuria, or hyperbilirubinemia may have contributed to metabolic alkalosis in 8 of the dogs. Most of the dogs in this group had low serum K+ and Cl- values. Two dogs with metabolic alkalosis had PCO2 values greater than 60 mm of Hg, and 1 of these had arterial hypoxemia (PaO2 less than 80 mm of Hg). Treatments included replacement of fluid and electrolytes (Na+, K+, and Cl-), and surgery as indicated (8 dogs). Six dogs with respiratory alkalosis had a variety of airway, pulmonary, or cardiac disorders, and 3 of these had arterial hypoxemia. Two other dogs were excessively ventilated during surgery, and 1 dog had apparent postoperative pain that may have contributed to the respiratory alkalosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Acid-Base Imbalance↗
Report of drug-associated hepatitis in dogs.
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Animals↗
Medical Research Council leukaemia trial--UKALL V: an attempt to reduce the immunosuppressive effects of therapy in childhood acute lymphoblastic leukemia. Report to the Council by the Working Party on Leukaemia in Childhood.
The Medical Research Council UKALL V trial for children with standard-risk acute lymphoblastic leukemia (ALL) (aged 1 to 14 years, leucocyte count less than 20 X 10(9)/L) was designed to determine whether the immunosuppressive effects of treatment could be reduced without sacrifice of antileukemic effect by alterations in the type of continuing therapy or in fractionation of cranial irradiation. Remission was achieved in 496 children on standard induction therapy, and 309 children received 24 Gy of cranial irradiation in ten to 16 fractions over 21 days, and 174 received 21 Gy in five to nine fractions over 21 days. The type of radiotherapy administered had no influence on relapse at any site or rate of death in remission. All 496 children were randomized to receive chemotherapy for 2 or 3 years with 6-mercaptopurine and methotrexate either as a continuous (group C) or a semicontinuous (group G) regimen or as a five-day pulse every 3 weeks (group I). All groups also received vincristine and prednisolone every 6 weeks. With a minimum follow-up of almost 7 years, patients in group I had significantly fewer remission deaths (P = .025) but a much higher rate of bone marrow relapse than those in group C or G (P = .002). There was an overall benefit for 3 years of chemotherapy compared with 2 years, which in contrast to previous studies, was more apparent in girls and in patients in groups C and G. Testicular relapse occurred in 37 boys, including 19 patients off therapy, with a previously negative biopsy. The overall results confirmed the prognostic significance of initial leucocyte count, even among these standard-risk patients, while girls had a superior rate of disease-free survival, but not of hematologic remission. It is concluded that, even among standard-risk patients, the prognosis is influenced by the height of the initial leukocyte count. While alterations in the fractionation of cranial irradiation do not appear to have influenced disease-free survival, intermittent continuing chemotherapy, although less immunosuppressive, is less effective than conventional continuous therapy in the treatment of ALL. In this study, 3 years of chemotherapy appeared superior to 2 years.
Adolescent↗
Inherited, chronic, progressive hepatic degeneration in Bedlington terriers with increased liver copper concentrations: clinical and pathologic observations and comparison with other copper-associated liver diseases.
One hundred nineteen hepatic tissue samples from 117 Bedlington Terriers were divided into 6 groups depending on the severity of histopathologic hepatic changes. Group 0 comprised dogs with microscopically normal livers. Group I dogs had copper-positive, lipofuscin-containing lysosomes present in centrilobular hepatocytes. Microfoci of hepatic necrosis, in addition to the increased numbers of the copper-positive, lipofuscin-containing lysosomes in centrilobular and periportal hepatocytes, were present in group II dogs. Group III dogs had more copper-positive, lipofuscin-containing lysosomes present translobularly and morphologic changes consistent with chronic active hepatitis. Mixed micro- or macronodular cirrhosis and translobular presence of copper-positive, lipofuscin-containing lysosomes characterized group IV dogs. Dogs in group V had massive hepatic necrosis and morphologic changes that were consistent with the changes in group III and IV dogs. Histochemical staining for copper was useful in making the microscopic diagnosis of this disease and was shown to be necessary in early diagnosis (group I) when other clinical and pathologic values associated with this syndrome were not consistently abnormal. Copper histochemical stains varied in sensitivity. Timm's silver sulfide was more sensitive for copper than was rubeanic acid, which was more sensitive than rhodanine staining. The brown pigment associated with the copper in the lysosomes was shown to be lipofuscin pigment with the aid of histochemical staining with orcein, Prussian blue, periodic acid-Schiff, and acid-fast stains together with fluorescent microscopy (excitation maxima: 365 nm; emissions: 420 + nm). Since these were positive only in later stages of the hepatic disease, they were not especially useful in its early diagnosis. The severity of the histopathologic hepatic changes was shown to increase with age and was associated with increasing hepatic copper concentration. These observations illustrate that this inherited, chronic hepatic degeneration in the Bedlington Terrier is progressive. Clinical chemical tests were diagnostically useful only in later stages of the disease. Alanine transaminase activity was of most value, but was not always abnormal, even when severe hepatic damage was present. Clinical signs of hepatic disease were seen in dogs in groups III, IV, and V. Death due to hepatic failure occurred only in dogs in groups III, IV, and V. Hemosiderin was present in increased amounts in the liver, bone marrow, spleen, and lymph nodes of affected Bedlington Terriers, indicating that a possible defect in iron metabolism and/or an increase in RBC turnover existed.(ABSTRACT TRUNCATED AT 400 WORDS)
Alanine Transaminase↗
Hepatic cirrhosis associated with long-term primidone therapy in a dog.
The anticonvulsant drug, primidone, was believed to be responsible for the development of hepatic cirrhosis in a 9-year-old German Shepherd Dog with idiopathic epilepsy. Marked increases in serum alanine aminotransferase, serum alkaline phosphatase, total bilirubin, and sulfobromophthalein retention, as well as decreases in albumin and BUN supported the diagnosis of hepatic failure. Biochemical abnormalities improved after primidone was discontinued. Previous reports indicated a poor prognosis for anticonvulsant-induced hepatic failure; however, this dog has remained stable for over a year after diagnosis and proper therapy.
Animals↗
Chronic hepatitis. An emerging syndrome in dogs.
Chronic active hepatitis has been recognized in humans since the 1950s but has been recognized only recently as a disease syndrome in dogs. The author describes this diverse group of chronic inflammatory liver diseases and discusses the factors related to its etiology, pathogenesis, diagnosis, and therapy.
Animals↗
Pancreatic islet cell adenocarcinoma: clinical and diagnostic features of six cases.
The clinicopathologic aspects of pancreatic islet cell adenocarcinoma in 6 dogs were compared. Diagnosis was based on insulin-glucose ratios in 5 dogs. Surgical excision of the tumor resulted in absence of clinical signs for at least 1 year in 3 dogs.
Adenoma, Islet Cell↗
Water deprivation test in the dog: maximal normal values.
Studies were undertaken to determine maximal urine osmolality and urine specific gravity following water deprivation for 20 dogs with normal renal function. In addition, the reliability of body weight, skin pliability, total plasma protein concentration, and packed cell volume as indices of negative water balance was assessed. Following water deprivation for periods sufficient to induce dehydration, the mean maximal urine osmolality was 2,289 mOsm/kg. The corresponding mean maximal urine specific gravity was 1.062 and ranged from 1.050 to 1.076. The ratio of mean maximal urine osmolality to mean serum osmolality at the time of peak urine concentration was 7.3. There was no detectable difference in urine concentration indices between males and females. Changes in skin pliability and packed cell volume proved unreliable as estimates of dehydration. Weight loss and increases in total plasma protein concentration proved to be more consistent indicators of hydration status. Abnormal increases in serum urea nitrogen and serum creatinine concentrations occurred rarely, even though some dogs had water withheld for periods of up to 96 hours.
Animals↗
Arthrocentesis and synovial membrane biopsy.
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Animals↗
Urolithiasis in immature dogs.
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Animals↗