OBJECTIVE To determine whether urolithiasis is associated with chronic kidney disease (CKD) in cats. DESIGN Retrospective case-control study. ANIMALS 126 cats (59 and 67 with and without urolithiasis, respectively). PROCEDURES Medical records from June 2006 to July 2013 were searched to identify cats that underwent abdominal or focal urinary tract ultrasonography and for which serum creatinine concentration and urine specific gravity data were obtained ≤ 14 days before or after the examination. In cats with (urolithiasis group) and without (control group) urolithiasis, the presence of CKD was determined according to International Renal Interest Society guidelines. Information recorded included signalment, body weight, serum creatinine concentration, and urine specific gravity; when present, the location and number of uroliths were noted. Differences between groups and associations between group and categorical variables were analyzed statistically. RESULTS Age, weight, sex, and breed did not differ between groups. The prevalence of CKD was significantly higher in cats with urolithiasis than in the control group. Among cats with urolithiasis, there was a negative association between CKD and presence of cystoliths. There was no association between urolithiasis and the stage of CKD or between presence of CKD and location of nephroliths in the kidney. CONCLUSIONS AND CLINICAL RELEVANCE Results confirmed a positive association between urolithiasis and CKD in the feline population studied and suggested that cats with urolithiasis should be evaluated for CKD. Further research is warranted to assess the nature of the relationship between CKD and urolithiasis in cats.

Objective—To evaluate the ability of signal attenuation–based quantitative magnetic resonance imaging (QMRI) to estimate subchondral bone mineral density (BMD) as assessed via quantitative computed tomography (QCT) in osteoarthritic joints of horses. Sample Population—20 metacarpophalangeal joints from 10 horse cadavers. Procedures—Magnetic resonance (MR) images (dorsal and transverse T1-weighted gradient recalled echo [GRE] and dorsal T2*-weighted GRE fast imaging employing steady-state acquisition [T2*-FIESTA]) and transverse single-slice computed tomographic (CT) images of the joints were acquired. Magnetic resonance signal intensity (SI) and CT attenuation were quantified in 6 regions of interest (ROIs) in the subchondral bone of third metacarpal condyles. Separate ROIs were established in the air close to the joint and used to generate corrected ratios and SIs. Computed tomographic attenuation was corrected by use of a calibration phantom to obtain a K₂HPO₄-equivalent density of bone. Correlations between QMRI performed with different MR imaging sequences and QCT measurements were evaluated. The intraobserver repeatability of ROI measurements was tested for each modality. Results—Measurement repeatability was excellent for QCT (R² = 98.3%) and QMRI (R² = 98.8%). Transverse (R² = 77%) or dorsal (R² = 77%) T1-weighted GRE and QCT BMD measurements were negatively correlated, as were dorsal T2*-FIESTA and QCT (R² = 80%) measurements. Decreased bone SI during MR imaging linearly reflected increased BMD. Conclusions and Clinical Relevance—Results of this ex vivo study suggested that signal attenuation–based QMRI was a reliable, clinically applicable method for indirect estimation of subchondral BMD in osteoarthritic metacarpophalangeal joints of horses.

Objective—To compare glomerular filtration rate (GFR) as estimated from Patlak plot analysis by use of single-slice computed tomography (CT) with that obtained from clearance of plasma inulin in pigs. Animals—8 healthy anesthetized juvenile pigs. Procedures—All pigs underwent precontrast, whole-kidney, helical CT; postcontrast single-slice dynamic CT; and postcontrast, whole-kidney CT for volume determination. On dynamic images, corrected Hounsfield unit values were determined for each kidney and the aorta. A Patlak plot for each kidney was generated, and plasma clearance per unit volume was multiplied by renal volume to obtain whole-animal contrast clearance. Mean GFR determined via inulin clearance (Inu-GFR) was measured from each kidney and correlated to mean GFR determined via CT (CT-GFR) for the left kidney, right kidney, and both kidneys by use of linear regression and Bland-Altman analyses. Results—CT-GFR results from 7 pigs were valid. Total and right kidney Inu-GFR were correlated with total and right kidney CT-GFR (total, R² = 0.85; right kidney, R² = 0.86). However, left kidney CT-GFR was poorly correlated with left kidney Inu-GFR (R² = 0.47). Bland-Altman analysis revealed no significant bias between Inu-GFR and CT-GFR for the left kidney, right kidney, or both kidneys. Conclusions and Clinical Relevance—CT-GFR as determined by use of a single-slice acquisition technique, low-dose of iohexol, and Patlak plot analysis correlated without bias with Inu-GFR for the right kidney and both kidneys (combined). This technique has promise as an accurate CT-GFR method that can be combined with renal morphologic evaluation.

Objective—To identify the prevalence of fragmentation of the proximal tubercle of the talus (FPTT) in a hospital population of horses, characterize the anatomic features of the affected area and fragments, and describe clinical findings, diagnosis, treatment, and outcome for horses with FPTT. Design—Retrospective case series. Animals—9 horses with FPTT. Procedures—2,543 radiographic views of the tarsal region of 1,526 horses that were evaluated between June 2004 and December 2010 were reviewed. Medical case records for horses with detectable FPTT were retrieved, and signalment, history, clinical signs, diagnostic methods, treatment, and outcome were recorded for assessment. Results—9 horses (median age, 5 years; age range, 1 to 12 years) with FPTT were identified. Seven horses were warmbloods. Diagnosis was made on the basis of radiographic findings, occasionally along with results of ultrasonography and CT. The only horse that was lame in the affected limb had a history of a prior traumatic event and resultant lateral tibial malleolus fracture. One horse underwent arthroscopy, but fragments were not found and were presumed to be extra-articular. Outcome was available for 7 horses; mean ± SD duration of stable radiographic and clinical examination findings was 3 ± 1 years (range, 1 to 4 years). Conclusions and Clinical Relevance—FPTT appeared to occur more frequently in warmbloods and was not usually associated with lameness. Affected horses remained clinically and radiographically stable over time. These data have provided some information regarding the importance of FPTT for practitioners who perform radiographic screenings during prepurchase examinations.

Background/Objective: Despite surgery being the primary curative treatment for cancer, patients with compromised preoperative physical, nutritional, and psychological status are often at a higher risk for complications. While various screening tools exist to assess physical, nutritional, and psychological status, there is currently no standardised self-reporting tool, or established cut-off points for comprehensive risk assessment. This study aims to develop, validate, and implement an online self-reporting preoperative screening tool that identifies modifiable risk factors in cancer surgery patients. Methods: This mixed-methods study consists of three distinct stages: (1) Development—(i) a scoping review to identify available physical, nutritional, and psychological screening tools; (ii) a Delphi study to gain consensus on the use of available screening tools; and (iii) a development of the online screening tool to determine patients at high risk of postoperative complications. (2) Testing—a prospective cohort study determining the correlation between at-risk patients and postoperative complications. (3) Implementation—the formulation of an implementation policy document considering feasibility. Conclusions: The timely identification of high-risk patients, based on their preoperative physical, nutritional, and psychological statuses, would enable referral to targeted interventions. The implementation of a preoperative online screening tool would streamline this identification process while minimising unwarranted variation in preoperative treatment optimisation. This systematic approach would not only support high-risk patients but also allow for more efficient provision of surgery to low-risk patients through effective risk stratification.