3150. How does a vet operate on a dog's limbal dermoid? Electro-surgery - superficial keratectomy

In this case, the video is about "How to excise a limbal  dermoid using electrosurgery".


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Shyan to re-make a new video, but note the following errors in the first video and use the amendments to create a really lively video. 

1. INSERT THIS VIDEO HOOK WITH MY NARRATION

https://www.youtube.com/watch?v=I1gp0HgUVZE&feature=youtu.be
Use footage approx  00:0 - 1:04 

2.  Then continue with your present introduction...and continue

3. At Video  01:21. Insert TITLE.  You narrated but did not insert the slide which would have been created by you.  Use the following slide.  It is important to show the title and narrate the text. 

4.  WHAT ARE OCULAR DERMOIDS AND WHAT TREATMENT WILL THE VET DO?

Dermoids are non-cancerous masses of fat, hair and skin found in an abnormal location of the body. Ocular dermoids are found in the eye. They are of two types.

Video  01:52. Replace the two dermoid slides with the following  3 slides and narrate them.   

There is the LIMBAL DERMOID. It is found in the limbus (junction of eye white and cornea).

The other type is the LIPODERMOID . It is located in the conjunctival tissues near the lateral canthus.

(Refer to the original video).

3. 2:05. Replace audio with the following: 

Sedation is by IV ketamine and xylazine. 
General anaesthesia is isoflurane gas and oxygen.  

CONCLUSION. 

TWO TYPES OF SURGICAL TREATMENT - SUPERFICIAL KERATECTOMY

3.1.  Electro-surgery. The process is shown in this video.  
3.2.  Excision using surgical blade No. 11 and scissors.

The following shows   

4.  2:57  Video footage of a Labrador Retriever puppy wearing an Elizabeth Collar after excision of the LIPODERMOID. The collar was won left for 14 days. 

Narrate: "This image shows a Labrador Retriever wearing an Elizabeth Collar for 14 days. He had a LIPODERMOID excised using scalpel blade and scissors. "  

14 days after surgical excision of the lipodermoid using scalpel blade

Show the following and a video clip at:https://www.youtube.com/watch?v=EUq423Djdwg  Use footage   0:00 - 0:09 around this clip section. Google how to download youtube video to get this video.

5. 
03:12  Replace POST SUGERY  with POST SURGERY. 

From the corneal healing at Day 9 when Dr Sing saw the dog, the outcome is excellent. No complaints from the owner for some months after the surgery as no news is good news.

6. 

04:12  Create a proper attractive slide. For this video, use the following:

7. FINAL SLIDE.   Should be "FOR MORE INFORMATION"....

use this slide: Narrate the text. 

8. Good initiative. However, do not voice "thumbs up" as this is not in the script. Use video footage of Singapore scenes of HDB apartments and condos (instead of the two slides I gave you) using your smartphone to capture some clips if possible. 

Intern to wait  a day and view the video to catch such grammatical errors before submission to me.

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THE FOLLOWING IS NOT PART OF THE SCRIPT.  THEY ARE RESEARCH NOTES.

Dermoids are non-cancerous masses of fat, hair and skin found in an abnormal location of the body. Ocular dermoids are found in the eye. They are of two types. One is the LIPODERMOID . It is located in the conjunctival tissues near the lateral canthus. The other is the LIMBAL DERMOID. It is found in the limbus (junction of eye white and cornea). The surgical excision using electricity of this limbal dermoid forms the case study in this video. Shih Tzu puppies appear to be the top species to suffer from ocular dermoids according to cases seen at Toa Payoh Vets over the past 30 years. Surgical excision by Surgical blade No. 11 or in this case, by electro-excision are options of treatment. In this case, the owner did not want to leave his dog for 14 days as an inpatient. He took the dog back at Day 4. From the corneal healing at Day 9 when Dr Sing saw the dog, the outcome is excellent. No complaints from the owner for some months after the surgery as no news is good news.

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SUMMARY GIVEN IN YOUTUBE VIDEO

Dermoids are non-cancerous masses of fat, hair and skin found in an abnormal location of the body. Ocular dermoids are found in the eye. They are of two types. One is the LIPODERMOID . It is located in the conjunctival tissues near the lateral canthus. The other is the LIMBAL DERMOID. It is found in the limbus (junction of eye white and cornea). The treatment is surgical excision using surgical blade No. 11 and scissors. I do not know whether other vets have had used electro-surgery as treatment.

The use of electricity to excise a limbal dermoid forms the case study in this video. Shih Tzu puppies appear to be the top species to suffer from ocular dermoids according to cases seen at Toa Payoh Vets over the past 30 years. Surgical excision by Surgical blade No. 11 or in this case, by electro-excision are options of treatment. In this case, the owner did not want to leave his dog for 14 days as an inpatient. He took the dog back at Day

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THIS IS PART OF THE NEW SCRIPT to be read together with the above mentioned amendments. Intern has to make a mind-map to connect all together in making a final script.

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15 Sep 2020. Script for Intern to create a BKTP video

(HOOK)

VIDEO HOOK WITH AUDIO

1. INSERT THIS VIDEO HOOK WITH MY NARRAION

https://www.youtube.com/watch?v=I1gp0HgUVZE&feature=youtu.be
Use footage approx  00:0 - 1:04 

2.  Then continue witH.................. 

Eyes are the first objects we see in a person or an animal. Pretty big clear eyes are attractive.

Eyes and a chrysanthemum-hair cut face make the Shih Tzu the top 3 small dog breeds as pets in Singapore. 

From my Toa Payoh Vets case files over the past 40 years, the Shih Tzu breed has the most incidence of ocular dermoid.  

Dermoids are non-cancerous masses with skin, hairs and fat. They can be found in people as well as dogs and cats.

There are two types. They are the limbal dermoid, being located in the limbus (sclera and corneal junction) 

and the lipodermoid which is sited in the lateral canthal area (where the eyelids meet in the corner towards the ear). 

As the hairs of the ocular dermoids cause eye irritation, most dogs feel uncomfortable and rubs the eyeball. The cornea becomes ulcerated and very painful. 

What is the treatment?
Surgical excision of the dermoid. The procedure is known as superficial keratectomy

Before surgical excision of the limbal dermoid in a Shih Tzu

Day 9 after superficial keratectomy

  THIS IS A BE KIND TO PETS VETERINARY EDUCATIONAL VIDEO: 

(Intern - to narrate the text in the slides above and below)

This video shows surgical procedures. Viewer discretion is advised. 

SINGAPORE is a city state with more than 80% of the residents living in apartments. Small dog breeds such as the Shih Tzus are most popular as apartment pets. 

The Shih Tzus appear to be the breed that is most affected by ocular dermoids, in cases seen at Toa Payoh Vets. 

SUPERFICIAL KERATECTOMY - ELECTRO-SURGERY - (Narrate above slide) 

I do not know whether other use electro-surgery to remove ocular dermoids from the cornea. This video shows the electro-surgical procedure to excise the limbal dermoid using electricity

THE SURGICAL PROCEDURES ARE AS FOLLOWS:

This is a normal left eye of the Shih Tzu. It has no dermoids

A limbal dermoid is at the junction of 
the sclera (eye white) and the cornea as in this case

Sedation is by IV ketamine and xylazine. 
General anaesthesia is isoflurane gas and oxygen. 

The dermoid is excised using electricity

3/4 of the dermoid has been excised.

The dermoid inside the cornea is being excised

More dermoid is excised using the circular loop

Be careful not to enter the eye 
causing rupture of the globe. No more excision
after over 90% of the dermoid has been cut out.

Care must be taken not to enter the eye when excising the dermoid. In this case, the site where the dermoid lay was not covered by a piece of transplanted cornea.  

A 3rd eyelid flap for 14 days facilitates healing of the exposed corneal epithelium. Antibiotic eye drops are applied daily for 14 days. An Elizabeth collar for 14 days prevents scratching of the eye.  In young puppies and kittens of less than 2 months, anti-inflammatory eye drops must not be used to prevent swelling and scarring. 

POST-SURGERY.
The owner did not permit me to ward the patient for 14 days after surgery. He wanted the dog back by Day 4. So, I took out the eyelid stitches sewing the eyelids together to facilitate corneal healing on Day 4 instead of Day 14. 

On Day 9 after surgery, I followed up and saw the corneal healing taking place. 

As to whether there will be corneal scarring later, I was unable to follow up. I electro-excised over 90% of the dermoid but not 100% as I did not want to risk the corneal laceration, rupturing the globe. 

CONCLUSION. 
SUPERFICIAL KERATECTOMY USING SURGICAL BLADE NO. 11 is the other option is to excise the limbal dermoid. 

A stay suture to elevate the eyeball can be placed on the conjunctiva at the medial canthus area for easier surgery. 

The outcome of the superficial keratectomy surgery is usually good. Care must be taken not to cut into the cornea in the excision of the limbal dermoid!

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22 Sep 2020.

THIS IS THE PREVIOUS SCRIPT - do not use this script.

15 Sep 2020. Script for Intern to create a BKTP video

(HOOK)
Eyes are the first objects we see in a person or an animal. Pretty big clear eyes are attractive.

Eyes and a chrysanthemum-hair cut face make the Shih Tzu the top 3 small dog breeds as pets in Singapore. 

From my Toa Payoh Vets case files over the past 40 years, the Shih Tzu breed has the most incidence of ocular dermoid.  

Dermoids are non-cancerous masses with skin, hairs and fat. They can be found in people as well as dogs and cats.

There are two types. They are the limbal dermoid, being located in the limbus (sclera and corneal junction) 

and the lipodermoid which is sited in the temporal area (where the eyelids meet in the corner towards the ear - lateral canthus). 

THIS IS A BE KIND TO PETS VETERINARY EDUCATIONAL VIDEO: 

This video shows surgical procedures. Viewer discretion is advised. 

SINGAPORE is a city state with more than 80% of the residents living in apartments. Small dog breeds such as the Shih Tzus are most popular as apartment pets. 

The Shih Tzus appear to be the breed that is most affected by ocular dermoids, in cases seen at Toa Payoh Vets. 

ELECTRO-SURGERY - EXCISION OF AN OCULAR DERMOID IN A DOG
Dr Sing Kong Yuen, BVMS (Glasgow), Toa Payoh Vets 

I do not know whether other use electro-surgery to remove ocular dermoids from the cornea. This video shows the electro-surgical procedure to excise the limbal dermoid using electricity

SURGICAL PROCEDURES ARE AS FOLLOWS:

This is a normal left eye of the Shih Tzu. It has no dermoids

A limbal dermoid is at the junction of 
the sclera (eye white) and the cornea as in this case

Sedation is by IV ketamine and xylazine. 
General anaesthesia is isoflurane gas and oxygen. 

The dermoid is excised using electricity

3/4 of the dermoid has been excised.

The dermoid inside the cornea is being excised

More dermoid is excised using the circular loop

Be careful not to enter the eye
causing rupture of the globe. No more excision
after over 90% of the dermoid has been cut out.

Care must be taken not to enter the eye when excising the dermoid. In this case, the site where the dermoid lay was not covered by a piece of transplanted cornea.  

A 3rd eyelid flap for 14 days facilitates healing of the exposed corneal epithelium. Antibiotic eye drops are applied daily for 14 days. An Elizabeth collar for 14 days prevents scratching of the eye.  In young puppies and kittens of less than 2 months, anti-inflammatory eye drops must not be used to prevent swelling and scarring. 

POST-SURGERY.
The owner did not permit me to ward the patient for 14 days after surgery. He wanted the dog back by Day 4. So, I took out the eyelid stitches sewing the eyelids together to facilitate corneal healing on Day 4 instead of Day 14. 

On Day 9 after surgery, I followed up and saw the corneal healing taking place. 

As to whether there will be corneal scarring later, I was unable to follow up. I electro-excised over 90% of the dermoid but not 100% as I did not want to risk the corneal laceration, rupturing the globe. 

CONCLUSION. 

SUPERFICIAL KERATECTOMY USING SURGICAL BLADE NO. 11 is the other option is to excise the limbal dermoid.

A stay suture to elevate the eyeball can be placed on the conjunctiva at the medial canthus area for easier surgery. 

The outcome of surgery is usually good. Care must be taken not to cut into the cornea in the excision of the limbal dermoid!

3149. Puppies with splayed legs (Swimming puppy syndrome)

A figure-of-eight rope around both hind legs --- help the puppy to walk normally.
Non-slippery floor. 
Lots of patience and love.
 
Hard to succeed as most breeders put the puppy to sleep.

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See:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743573/#:~:text=Swimmers%20syndrome%2C%20also%20known%20as,an%20inability%20to%20stand%20or

article reproduced below:

Can Vet J. 2013 Sep; 54(9): 869–872.

PMCID: PMC3743573

PMID: 24155492

Language: English | French

Home-care treatment of swimmer syndrome in a miniature schnauzer dog

Sun-A Kim, Ki-Jeong Na, Jong-Ki Cho, and Nam-Shik Shin

Author information Copyright and License information Disclaimer

Go to:

Abstract

A 50-day-old, female miniature schnauzer dog was presented for astasia, dorsoventral flattening of the thorax, hypoplasia of hind-limb muscles, stiffness of hind-limb joints, paddling leg motion, and panting. The dog was diagnosed with swimmers syndrome. The dog recovered completely following 40 days of home-care treatment that involved environmental and nutritional management along with intensive physiotherapy.

Swimmers syndrome, also known as swimming-puppy syndrome, flat-puppy syndrome, swimmer puppy syndrome, flat-pup syndrome, twisted legs, or turtle pup, is an uncommon developmental deformity of newborn dogs and cats whereby the limbs, primarily the hind limbs, are splayed laterally resulting in an inability to stand or walk. Forward movement with this affliction is only accomplished by lateral pedaling motions (1–6). Swimmers syndrome has generally been considered to be untreatable; therefore, animals that present with symptoms of the syndrome have tended to be euthanized (5,6). However, there have been several notable cases in which clinicians successfully treated animals — (1 kitten and 3 puppies) suffering from the syndrome with a combination of intensive physiotherapy, bandaging, external splinting, and hospitalization (2,4). In the present case, this miniature puppy with swimmers syndrome demonstrates that owners can provide satisfactory home-care and physiotherapy. Also, this case has been followed for over 10 y, and the dog is still alive, thus providng information about the prognosis.

This study presents the case of a dog that was born with swimmers syndrome; the original veterinarian had advised euthanization, but the owner chose to donate the dog to a teaching hospital. One of the authors adopted the dog and has been caring for it for the past 10 y. As a result of the home-care treatment, the dog recovered from the syndrome and continues to live a healthy life.

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Case description

A 50-day-old, female miniature schnauzer was presented with astasia, dorsoventral flattening of the thorax, stiffness of hind-limb joints, hypoplasia of hind-limb muscles, paddling leg motion, and panting (Figure 1). A severe exorotation of both hind paws and a pronounced hyperextension of both tarsal joints were present. In addition, there was an inability to adduct the hind limbs and zero range of motion in the hind-limb joints was observed. Neither of the hind legs could be placed in a normal standing position even with manual support. At rest, the dog remained in sternal recumbency; if positioned in dorsal recumbency the dog was unable to right herself.

Figure 1

Swimmer puppy. A — Before treatment — note the outward projection of the hind limbs, the flat thorax, and the rough hair coat. B — After treatment — note the resemblance to a normal puppy.

The owner brought the dog to the hospital and described its situation and signs. The owner explained that the dog was smaller than its littermates and that this, combined with its immobility, meant it had difficulty feeding. Moreover, the owner noted that the dog regurgitated its food after every feed. The regurgitation contributed to the dog’s low weight (the puppy weighed only 850 g when she arrived at the hospital).

In addition, the dog’s ventrum was covered with erosive lesions from urine and fecal scalding. A neurological examination identified no abnormalities. Thoracic radiographs revealed dorsoventral thoracic compression and displacement of the heart and lungs (Figure 2). A complete blood (cell) count (CBC) was normal. The level of blood urea nitrogen (BUN) (0.83 mmol/L, reference range: 2.14 to 7.83 mmol/L) was low and other serum chemistry panels (including albumin, alkaline phosphatase, aspartate aminotransferase, calcium, creatine phosphokinase, creatinine, glucose, lactic dehydrogenase, magnesium, and total protein) were within the reference ranges.

Figure 2

Survey thoracic radiographs of the dog before treatment. Dorsal deviation of the sternum and left deviation of the cardiac silhouette were found. A — Right lateral view, B — Ventrodorsal view.

Environmental modification, nutritional support, and physiotherapy were recommended as treatment. As an environmental modification, a non-slippery floor was constructed with a cotton carpet, and an absorbent pad, which was frequently changed, was placed on the bed. In addition, the ventrum was wiped regularly with a wet cloth, and baby powder was applied regularly to prevent further erosions. A mixture of 2 pet foods — Science Diet Prescription p/d canned (Hill’s Pet Nutrition, Topeka, Kansas, USA) and Science Diet Prescription a/d canned (Hill’s Pet Nutrition), 10 g each — was fed to the dog every 2 h, 9 times a day. The dog consumed 15 to 20 g at each feeding. The total calorie intake for the dog was 173.2 to 230.94 kcal per day, an appropriate amount for a young dog weighing 850 g. After feeding, the dog was lifted upward and massaged gently from head to tail for 5 min to prevent regurgitation.

A standardized physiotherapy routine was performed every 2 h for 40 d following admission. The dog was placed in dorsal recumbency, and the physiotherapy session began with a gentle stroking massage from the head to the hind limbs for 20 s. Then, for the flat thorax, both lateral sides of the thorax were gently pressed and released using the palms of the hands, every 5 s for 1 min. For the hind limbs, an effleurage massage was applied from the hip to the digits for 20 s, followed by a kneading massage that was applied from the digits to the hip for 20 s.

After the massage session, each of the hind-limb joints was put through a series of passive range of motion exercises in the sequence outlined. First, to improve digit flexion and extension, the practitioner gently flexed and extended the dog’s digits for 10 s, while supporting the carpus with 1 hand and the digits with the other. Second, to improve the stifle flexion and extension, the practitioner gently flexed and extended the dog’s stifle for 10 s, while supporting the distal femur with 1 hand and the tibia with the other. Third, to improve hip flexion and extension, the practitioner gently flexed and extended the dog’s hip for 10 s, while supporting the proximal femur in 1 hand and the pelvis in the other. Fourth, to improve movement in the hip joints, the practitioner applied a gentle stroking massage with the fingers to both the dog’s hip joints for 20 s. To improve rotation in the joints, gentle pressure was applied medially, and excessive pressure was avoided during all massages and passive range of movements. In future cases, it is recommended that, as in this case, the passive range of motion on each joint be performed separately to prevent applying excessive stress on the joints. Finally, the dog was held in a normal standing position with all 4 limbs touching the ground for 1 min. After 40 d of treatment, the puppy was able to ambulate normally but experienced bilateral grade I medial patella luxation up to 1 y of age, after which the condition spontaneously resolved. Survey thoracic radiographs of the dog after treatment are shown in Figure 3.

Figure 3

Survey thoracic radiographs of the dog after treatment. A — Right lateral view, B — Ventrodorsal view.

The dog, now 10 y old, has not suffered from any health issues, other than those seen in the first year of treatment; the dog has regular heartworm prevention medication and vaccinations.

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Discussion

Swimmers syndrome is similar to myofibrillar hypoplasia syndrome, which is seen in piglets (1); the cause of each syndrome is unknown (1,6,7). However, it has been suggested that genetic and environmental factors may be responsible, including hard or slippery floors, weight gain exceeding skeletal development, dysfunction of synaptic or ventral horn cells, abnormal myelinization, delayed neuromuscular development, and obesity (2,4,6). In addition, it has been proposed that in-utero viral or fungal infections may cause muscular dystrophy in the developing fetus of piglets (1). In the disease of piglets, the histological appearance of affected muscles resembles that of experimentally induced glucocorticoid myopathy, suggesting that the condition could result from stress during pregnancy (7).

Pectus excavatum is a malformation of the sternum and costocartilages that results in dorsoventral flattening and narrowing of the thorax (1,8,9). Swimmers syndrome and pectus excavatum can occur independently or concurrently. Pectus excavatum is a congenital thoracic skeletal deformity, while the main symptoms of swimmers syndrome are the inability to stand or walk by the normal age of 3 wk, the limbs being splayed laterally; the inability to stand or ambulate; and forward movement being accomplished only by lateral pedaling motions (1–6). In this case, the dog was unable to stand or walk, and it was diagnosed with swimmers syndrome.

Environmental modifications can help improve the health and hygiene of dogs suffering from swimmers syndrome. To help swimmer dogs in their efforts to stand, it is necessary to provide a non-slippery floor to prevent slippage and further injury. In addition, because swimmer puppies urinate and defecate where they rest, it is suggested that an absorbent pad be placed on or near the bed, baby powder be applied after each movement of the bowels or bladder, and that they be wiped regularly to prevent urine and fecal scalding.

The dog in this study had a low BUN. Possible causes for decreased BUN in a dog are malnutrition, liver dysfunction due to infectious diseases, toxins, and portosystemic shunts (10). However, the latter factors were excluded because the liver enzyme and CBC values were within the reference ranges; thus, malnutrition due to competition among the littermates was regarded as most likely. To treat the malnutrition, we selected a canned diet rich in calories and protein and with a desirable texture, and fed small, frequent amounts to improve the dog’s nutritional status (11).

These dogs may be at greater risk of inhalation pneumonia from regurgitation after feeding, as shown in a previous report of a German shepherd dog afflicted with swimmers syndrome (6).The dog herein was therefore lifted regularly and massaged from head to tail to prevent regurgitation.

In a previous case, in which a 6-month-old swimmer dog was euthanized, the dog never gained weight, was undersized (18 kg), walked unsteadily, and tired easily after moderate exercise (6). In the present case, while the dog was smaller than its littermates, weighing only 3.5 kg at 6 mo and 4.5 kg at 1 y, being undersized did not lead to any further health issues once the dog had recovered from swimmers syndrome. This indicates that, while swimming puppies may remain underweight, they can function normally, as long as the nutritional support is appropriate.

It has been suggested that hobbling, or tying the hind limbs of piglets suffering from myofibrillar hypoplasia syndrome together below the hocks with adhesive tape may accelerate recovery and help affected piglets to stand and move around more freely (7). Some veterinarians have suggested hobbling the hind limbs together to prevent the splay-legged stance in dogs. However, while hobbling reduced the permanent dorsoventral flattening in swimming puppies, there was no effect on the speed of functional improvement (1). In addition, care must be taken not to cause swelling, edema, or ischemia by hobbling (2).

Physiotherapy is beneficial in increasing muscle tone and strength, activating limb coordination, and stimulating circulation of the tissues (2,12–14). Stroking, effleurage, and kneading massage techniques were applied. The stroking technique exerts a calming and soothing effect that helps animals become accustomed to being touched, reduces tension and anxiety, lowers muscle tone, and thus serves as a useful way to start and to finish massage sessions. The effleurage technique reduces swelling and edema, removes chemical by-products of inflammation, maintains mobility of soft tissues, and stretches the muscles. Kneading increases circulation and lymphatic flow, mobilizes soft tissues, removes chemical by-products of inflammation, increases sensory stimulation and invigoration, relaxes the animal, and lowers muscle tension (13,14).

Passive movement is the movement of a joint by external forces and is generally used when a patient is incapable of moving the joint on its own or when active motion may be injurious to the patient (13,15). The ability to maintain or increase muscle length and flexibility is one benefit of passive movements. Other benefits include the prevention of adhesions in articular capsules and joints that helps maintain joint range; improvement of articular nutrition by increasing synovial fluid production and diffusion; and maintaining mobility between different tissues. Furthermore, producing or maintaining normal patterns of movement and stimulating mechanoreceptors in joints, muscles, skin, and other soft tissues help to improve proprioceptive awareness and increase circulatory and lymphatic return (12,13,15). Thus, physiotherapy includes massages and passive range of motion exercises to develop and strengthen muscles and joint flexibility.

As muscles develop and are strengthened through therapy, animals will begin to self-correct their own walking. Therapy that commences before 3 to 4 wk of age has a better prognosis (1,3). In a previous report, an English bulldog puppy was treated by splinting and hospitalization for 14 d (2). However, the present case shows that home care with intensive physiotherapy is an effective alternative to bandaging or external splinting. Home care reduces stress to patients and provides better protection from infectious diseases compared with hospitalization.

As our case shows, swimmers syndrome is treatable with appropriate home-care treatment that involves environmental and nutritional management along with intensive, diligent physiotherapy. This case has been followed for over 10 y, and is, therefore, an invaluable resource for information about the prognosis. Owner education for treatment is important, with emphasis on the importance of maintaining regular physiotherapy.

3148. Final Video: A Yangon cat has pyometra

13 Sep 2020 Final Video: A Yangon Cat has pyometra https://www.youtube.com/watch?time_continue=2&v=eKheu1XulUg&feature=emb_logo

3147. Rabbit blood test

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INTERPRETING LAB TEST RESULTS ON RABBITS

by Lucile Moore

Understanding those emailed or printed results we get after our rabbit’s lab test can be difficult. I hope that the following explanations of two commonly‐ordered tests will help readers interpret their rabbit’s test results.

Printed results of the tests may be presented in graphical or numerical form. They usually include the test name and/or abbreviation, results, and the low and high ends of the normal range for that test. Results that fall outside the normal range may be noted in some way. It is important to compare the results to the range provided by the laboratory rather than ranges published in texts or online as different methodologies used for the test will result in slightly different ranges.

Rarely, errors in taking, handling or analyzing the sample will cause erroneous results, particularly if the sample is not stored correctly or is not analyzed soon enough after taking it. If you have concerns about the validity of a test result discuss it with your vet. In some cases a new test may be warranted.

Haematology.

In a CBC, or complete blood cell count, the amounts of the different kinds of blood cells present are tested.

Red blood cell (RBC or erythrocyte) count: Male rabbits and older rabbits tend to have higher counts than female and younger rabbits. Dehydration and stress from cold temperatures can cause high RBC counts. High counts of nucleated RBCs can be a sign of a bacterial infection; a very high count of nucleated RBCs can be a sign of a bad flea infestation or internal bleeding.

Slightly elevated counts of nucleated RBCs are not an abnormal finding in rabbits. The HCT (Hct, haematocrit) is a test in which the percent of red blood cells is calculated. A low value may be a sign of anemia. Hb, or hemoglobin concentration, can be used to help diagnose anaemia (low Hb) and its origin. Female rabbits tend to have much lower HB and Hct than males. Rabbits that get a lot of exercise may have elevated RBC, HB, and Hct values.

Platelets: High counts may be associated with iron‐deficiency anaemia and chronic bleeding. Cold stress can also cause elevated platelet values, as may drugs such as glucocorticoids and epinephrine. Low levels may be a sign of a severe allergic reaction, massive bleeding, aplastic anaemia, and systemic bacterial or fungal infections. Low values can also be caused by storing the sample for too long before it is analyzed.

White blood cells (WBC, leukocytes): White blood cell counts vary depending upon the age,  sex, breed and season of the year. WBC counts may include counts for specific types, such as monocytes, lymphocytes, neutrophils/heterophils and basophils. In rabbits it is often the proportion of the differing kinds rather than the total WBC count that helps determine the presence of an infectious disease. The proportion of neutrophils to lymphocytes should be 1:1; in a rabbit with an acute infection the proportion will often be nearer 2:1. A high value for monocytes can be a sign of chronic infection and a high value for eosinophils and/or basophils can be a sign of a parasitical infection.

Serum/blood chemistry. The focus on these tests is on parameters of blood other than cell counts.

Serum glucose: Although high glucose can be a sign of kidney disease, it is often caused by stress, including the stress of the trip to the vet and having blood drawn. High glucose values can also occur in rabbits with acute intestinal obstruction, hepatic lipidosis, hyperthermia, and shock. Some drugs can also cause elevated glucose levels, as can diabetes, but diabetes is extremely rare in rabbits. Low glucose levels can be caused by anorexia, digestive tract problems, liver disease, and septicaemia.

BUN (blood urea nitrogen): A key test used to assess kidney function. Urea levels depend upon a wide variety of factors, including the time of day, the amount of protein in the diet and how hydrated the rabbit is. Slightly high values are not uncommon in healthy rabbits. High values may indicate there is some kind of kidney disease. Elevated values can also be a sign of encephalitozoonosis (EC). Low levels may be caused by anabolic steroids or liver damage.

Rabbits on corticosteroids, tetracycline, or aminoglycosides may have elevated levels; rabbits on chloramphenicol can have either low or high levels.

 Creatinine: High values are often a sign of severe kidney or muscle damage. This test is less influenced by external factors than the BUN. However, levels may be high in rabbits that have gone a few hours without drinking water. A disadvantage of this test is that it does not show high levels until there has been substantial loss of kidney function (excepting temporarily high levels caused by dehydration, which do not involve such loss of function).

 Cholesterol and triglycerides: To obtain accurate values for cholesterol the animal must be fasting. Since it is unsafe to fast rabbits for more than a couple of hours, not to mention that it is essentially impossible to fast most rabbits because of consumption of cecotrophs, results from this test should be considered only in conjunction with other tests. High cholesterol values can be caused by obesity, a diet high in fats, pancreatitis and chronic kidney failure. Values also be high if the rabbit is not eating enough, but this is a sign of advanced hepatic lipidosis and has a poor prognosis. High triglyceride levels may be a sign of chronic kidney failure.

Calcium and phosphorus: Calcium levels are primarily influenced by the calcium content of the diet. High blood calcium levels in conjunction with clear urine (showing it is not being excreted as it should) are a sign of kidney failure. Low calcium levels are rare but can occur in rabbits with poor nutrition. High phosphorus levels can be a sign of chronic kidney failure or soft tissue trauma.

Serum protein: Total protein levels may be high in rabbits that are dehydrated, whether from gastrointestinal hypomotility (stasis) or other reasons. Low levels can be caused by malnutrition or liver disease. Low levels of albumin (a specific protein) can be a sign of a heavy infestation of parasites, and high levels are a sign of advanced liver disease.

Bilirubin: High serum bilirubin levels in young rabbits are often caused by hepatic coccidiosis; in older rabbits they are more likely to be caused by an obstruction of the bile duct by neoplasia (cancer) or an abscess.

AP (ALP, alkaline phosphatase): The normal range for this test is wide and varies with age (young rabbits have higher levels) and breed. A high value may be a sign of diseases affecting liver function such as hepatic coccidiosis, liver abscesses, and neoplasia.

 ALT (alanine aminotransferase), also called GPT and SGPT: Another test that helps the vet assess whether there has been any liver damage. Mildly high levels may be found in rabbits that appear healthy and it is thought they may be caused by low concentrations of toxins such as aflatoxins in food or compounds in wood‐based litters. High levels may be a sign of hepatic lipidosis or liver damage from hepatic coccidiosis.

AST (aspartate aminotransferase), formerly called SGOT: High values in conjunction with high ALT, AP, or protein may be a sign of liver damage. High levels may also be caused by the rabbit struggling during collection of the sample.

Urinalysis

The urinalysis is another lab test that is ordered fairly frequently. More so than in blood work the normal value is often “negative,” or the absence of the tested‐for compound.

 Protein: The normal finding is negative to trace amounts. High amounts can be a result of kidney damage/disease. High levels can also be caused by dehydration, strenuous exercise or stress, and for this reason protein is best looked at in conjunction with the specific gravity and the ratio of protein to creatinine. Dilute urine with a high protein value is more likely to be a sign of kidney damage/disease than concentrated urine with a similar protein value. Low protein levels can be a sign of malnutrition.

SG (specific gravity): An SG level at the lower end of the normal range when combined with high creatinine and BUN is a sign of poor kidney function.

pH: Normal rabbit urine has a high pH (7.5‐9). Lower pH can be caused by high‐protein diets, severe anorexia, and fever.

Glucose: The normal finding for glucose is negative, although trace amounts may be found in healthy rabbits. Higher amounts can be caused by stress, including pain or any experience which is frightening to the rabbit.

Ketones: The normal finding is negative. The presence of ketones indicates starvation or severe anorexia. Ketones may be seen in rabbits with severe dental disease that prevents them from eating or in rabbits on hay‐only diets that have severely impacted cecums. Rarely, ketones in the urine may be caused by diabetes mellitus.

Bilirubin: High levels of bilirubin in rabbit urine are unusual but elevated levels may be caused by poisoning from aflatoxins in contaminated food, hepatic coccidiosis, or neoplasia.

 Haematuria: Normally there is no blood present in rabbit urine. A positive result may be caused by inflammation and/or a urinary tract infection, crystals, or, less often, neoplasia.

Sediment: Calcium carbonate sediment is a normal finding in rabbit urine. Other crystals can be caused by drugs the rabbit is taking, and struvite crystals can be a sign of bacterial infection.

Urobilinogen: The finding for a healthy rabbit is negative. High levels may be caused by liver damage or drugs such as sulfonamides; low levels can be caused by long exposure to light.

Nitrate and nitrite: Urine normally contains nitrates, but some bacteria convert nitrate to nitrite. The normal result for nitrite is negative; a positive result is caused by bacteria in the urine. However, not all bacteria are able to convert nitrates to nitrite, so a negative result does not mean a UTI is not present.