Veterinary Medicine - March 2009 - (Page 120) Hot Literature research recapped weekly on dvm360.com New Bartonella species isolated in people and sheep new species of Bartonella, Candidatus Bartonella melophagi, that has only recently been identified in sheep has now also been isolated in two women, which adds to the increasing number of Bartonella species that have been found in people in the past 10 years. One of the women had a two-year history of cyclical clinical symptoms, including fatigue, muscle pain, chills, chest pain, and weakness. Bartonella henselae was also isolated in this woman, and treatment with rifampin, azithromycin, and cefuroxime resolved her symptoms. The other woman had a six-month history of fatigue and weakness that was initially thought to be pericarditis. Although both women had histories of exposure to many arthropod and animal species, including sheep in the case of the second woman, a definitive transmission route could not be established. The vector in sheep is thought to be sheep keds. The clinical relevance of Candidatus B. melophagi infection in these patients remains to be established. But nonspecific abnormalities, including muscle weakness and joint pain, have been associated with isolation of Bartonella henselae and Bartonella vinsonii subspecies berkhoffi. Pericardial effusion is an infrequent complication of B. henselae infection in cases of classic cat-scratch disease. Dr. Edward Breitschwerdt, a veterinary internist from North Carolina State University, helped in the isolation of this species. Maggi RG, Kosoy M, Mintzer M, et al. Isolation of Candidatus Bartonella melophagi from human blood. Emerg Infect Dis [serial on the Internet]. 2009 Jan [01/15/1009]. A Does ascites affect survival time in dogs with chronic hepatitis? A scites is a known negative prognostic factor in people with liver disease, so the authors of a recent study published in the Journal of Veterinary Internal Medicine set out to determine whether this is true in dogs as well, especially since no definitive prognostic indicators have been established for chronic hepatitis in dogs. The study’s authors retrospectively identified 34 dogs diagnosed with chronic hepatitis at their institution, after excluding those dogs that were found to have an underlying cause of the liver disease such as toxicosis, infection, and copper storage abnormalities. Dogs with significant nonhepatic concurrent disease were also excluded. Of the 34 dogs, 14 had ascites. Those with ascites had significantly shorter survival times after initial diagnosis (0.4 months) than those without ascites had (24.3 months). In addition, the survival time after signs of chronic hepatitis were initially noted was shorter for the dogs with ascites (two months) than for those without (33 months). The dogs’ sex appeared to have no effect on the outcome of the study. The only significant differences between the groups related to treatment were that dogs with ascites more often received spironolactone and dogs without ascites more often had dietary therapy. Among the reasons that ascites may have such a negative association with these dogs’ survival are that the neuroendocrine abnormalities related to ascites may increase morbidity and that the ascites may only develop when severe liver pathology already exists. This study’s findings can help practitioners and owners make recommendations and decisions respectively when faced with chronic hepatitis and concurrent ascites in a dog. However, the researchers conclude that ascites is not necessarily a death sentence; some dogs with ascites survive for prolonged periods. Raffan E, McCallum A, Scase TJ, et al. Ascites is a negative prognostic indicator in chronic hepatitis in dogs. J Vet Intern Med 2009;23:63-66. 120 March 2009 VETERINARY MEDICINE http://www.dvm360.com
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