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OBJECTIVE: The aim of this retrospective study was to decribe the intoxication with tremorgenic mycotoxins subsequent to the ingestion of walnuts in a large population of dogs and the evaluation of the development of the clinical signs under the initiated treatment. MATERIAL AND METHODS: The study included 54 dogs exhibiting signs of tremor, hyperesthesia, hyperthermia and ataxia, in particular a few hours following observed ingestion of walnuts or its justified suspicion. RESULTS: The patients were presented to the clinic mostly during winter and spring. Fifty-three of 54 dogs were hospitalized for symptomatic, decontaminating and eliminating therapy (98%). Symptomatic treatment comprised of anticonvulsant therapy in 14 dogs (26%) and an antiemetic therapy in for half of the patients (n=27; 50%). A forced emesis for decontamination was undertaken in only 6 patients due to the severity of their neurological symptoms (11%). For further decontamination, an oral administration of activated charcoal after improvement of clinical signs (n=39; 72%). The majority of dogs (n=45; 83%) additionally received an intravenous lipid therapy for toxin elimination and isotonic crystalloid solution to compensate fluid losses. There were no side effects observed following the administration of intravenous lipid therapy. The majority of dogs were hospitalized for a duration of 2 days (n=44; 81%). In most dogs, examination was unremarkable on the day of their release (n=39; 72%). Potential long-term sequelae of the intoxication were not recorded in any patient. CONCLUSION: Due to the lipophilic nature of mycotoxins, the use of intravenous lipid therapy may considered for toxin elimination purposes. The prognosis of mycotoxin intoxication following walnut ingestion is good with decontamination and elimination measures. CLINICAL RELEVANCE: In the case of unspecific neurological signs such as tremor, ataxia and hyperesthesia as well as a corresponding preliminary report, an intoxication with mycotoxin-containing walnuts should be considered.

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An acute, unilateral othematoma was diagnosed in a 9-year-old mixed-breed dog. There was no clinical or anamnestic evidence for the cause of the othematoma. During diagnostic work-up, marked hyperglobulinemia and marked thrombocytopenia were detected. This was a consequence of a multiple myeloma. This is the first case report of a dog with othematoma secondary to coagulopathy associated with multiple myeloma.

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OBJECTIVE: The measurement of beta-hydroxybutyrate (BOHB) carries high significance for the diagnosis, prognosis as well as treatment decisions in canine and feline diabetic ketoacidosis. The aim of this study was to establish clinically usable cut-off values for BHOB measurements in dogs and cats using the glucometer GlucoMen®LX Plus. MATERIAL AND METHODS: We measured BOHB with the GlucoMen®LX Plus in 4 patient groups (diabetic ketoacidosis, diabetic non-ketoacidic, catabolic non-diabetic status, control). These were classified based upon medical history and laboratory findings (pH, glucose-, HCO3 - concentrations, anion gap). The data was analyzed in a ROC-curve-analysis in order to create cut-off values. RESULTS: A total of 47 dogs and 55 cats were included into the study. In the differentiation between the two diabetic groups, cut-off values for dogs and cats amounted to 2.55 mmol/l and 4.05 mmol/l, respectively. Here, good sensitivity (100 %) and specificity (82 % and 100 %, respectively) were attained. In the comparison of the catabolic non-diabetic status group and the individuals with diabetic ketosis, the analysis resulted in a cut-off value of 0.25 mmol/l in dogs and 0.25 mmol/l in cats, carrying poor sensitivity (58 % and 59 %, respectively) and specificity (90 %). CONCLUSION: Measurements with the GlucoMen®LX Plus are suitable for a reliable differentiation between ketoacidosis and ketosis in dogs and cats. Here, the determined cut-off values carried high sensitivity and specificity. A distinction between non-diabetic catabolic individuals and patients with diabetic catabolic states, however, cannot be achieved with adequate consistency. CLINICAL RELEVANCE: The established cut-off values aid in the treatment decision-making process as well as the assessment of prognosis and treatment success in diabetic ketoacidosis. In representing a point of care technique, the method allows for direct owner communication of the results and immediate adjustment of the treatment regime. Concerning the initial diagnosis or a differentiation between non-diabetic and diabetic catabolic states, however, the presented method alone is not sufficient, therefore additional diagnostic procedures are warranted in order to ascertain a correct diagnosis.

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OBJECTIVES: The detection of ketone bodies in urinary samples often underestimates the degree of ketonuria and may lead to false negative results due to the lack of detection of ß-hydroxybutyrate. In human medicine, the standard method used to quantify and monitor ketonemia is the measurement of ß-hydroxybutyrate in whole blood samples which is associated with a higher sensitivity. For this, only few devices have to date been evaluated in veterinary medicine. These have shown limitations in areas of high ß-hydroxybutyrate concentrations. The aim of the study was to compare the portable ketone meter GlucoMen®LX PLUS with a reference method for measurement of ß-hydroxybutyrate in canine and feline venous blood samples. MATERIAL AND METHODS: In this prosepctive study, a total of 47 dogs and 55 cats were enrolled. These cases comprised patients with diabetic ketoacidosis, diabetes mellitus and catabolic metabolism as well as healthy individuals. Comparison between the GlucoMen®LX PLUS ketone meter and an enzymatic reaction method by an automated chemistry analyzer was performed. Measurement results of dogs and cats were evaluated separately. RESULTS: There was a high correlation between measurement values of the GlucoMen®LX PLUS and the enzymatic reaction laboratory method in dogs (R = 0.99, p < 0.001) and cats (R = 0.98, p < 0.001). Mean difference was 0.01 mmol/l (SD ± 0.20) in dogs and 0.05 mmol/l (SD ± 0.29) in cats. In 44 % of all dogs and cats the GlucoMen®LX PLUS measured lower values in comparison to the reference method. Greater differences between the 2 measurement methods were apparent in both high and low ß-hydroxybutyrate concentration ranges (dogs, R = -0.762 and cats, R = -0.86). In high concentration areas, the GlucoMen®LX PLUS led to slightly lower results, whereas in low concentration areas slightly higher values were measured. CONCLUSION: The GlucoMen®LX PLUS shows a strong correlation with the standard reference method and is useful for measurement of ß-hydroxybutyrate in canine and feline venous blood samples. Limitations can be seen in high concentration ranges of ß-hydroxybutyrate in which the GlucoMen®LX PLUS resulted in slightly lower measurement values. CLINICAL RELEVANCE: The GlucoMen®LX PLUS is a cost-effective portable device representing a viable alternative to urinary ketone body measurement.

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CASE SUMMARY: This report describes the clinical and parasitological findings in a domestic shorthair cat with isolated thoracic tetrathyridiosis. The cat was a stray from Malta that had lived in Germany for several years since as an indoor-only cat. Therefore, the process of infection remains very unusual. In this case it must be considered that the cat had been infected years previously while in Malta, and had lived at least 4 years without any clinical signs. It was possible to diagnose this uncommon disease and initiate an effective treatment with fenbendazole, praziquantel and supportive care. Clinical signs, as well as radiographic findings, were regressive with this treatment. RELEVANCE AND NOVEL INFORMATION: Tetrathyridiosis is a rare finding in cats, especially in Germany, but it seems to be a potential differential diagnosis of pleural effusion. Mesocestoides corti, which was the causative parasite in this case, has not previously been isolated in Germany. Because tetrathyridiosis is only diagnosed post mortem in most cases, little is known about effective therapeutic options. Furthermore, clinical signs of this disease can be absent for several years and can potentially be triggered by neoplastic conditions or immunosuppression. Tetrathyridiosis seems to be a treatable disease that can be controlled by adequate antiparasitic therapy.