Historical Signs Research Articles

Endogenous benzodiazepine activity in the peripheral and portal blood of dogs with congenital portosystemic shunts.

The purpose of this study was to determine whether an endogenous benzodiazepine receptor ligand (EBZ) was present in the arterial and portal blood of dogs with congenital portosystemic shunts (CPSS). The presence or absence of an EBZ was determined by the collection of systemic and portal blood from dogs with CPSS. Fifteen client-owned dogs with a confirmed CPSS. All dogs had historical signs compatible with hepatic encephalopathy. Eight healthy dogs were used as controls. In all dogs, systemic blood samples were collected after they were anesthetized. Portal blood samples were collected intraoperatively. EBZ was measured by radioreceptor assay. In 10 of 15 dogs, the portal blood concentration of EBZ was significantly elevated compared with normal dogs (mean, 13.2 +/- 18.55 ng/mL). Five dogs had elevated systemic blood EBZ levels (mean, 8.2 +/- 16.08 ng/mL). Eleven of 15 dogs had a higher portal than systemic blood concentration of EBZ. In contrast, control dogs had extremely low EBZ concentrations detected in their portal blood (mean, 0.16 +/- 0.3 ng/mL) and systemic blood (0 ng/mL). The mean portal and systemic blood concentrations in dogs with CPSS were significantly greater than in control dogs (P < .05). Elevated blood levels of EBZ were found in dogs with CPSS. The portosystemic gradient noted in 11 dogs suggests the gastrointestinal tract as a possible source for the endogenous ligand. Generalized motor seizures have been reported in dogs after surgical correction of CPSS. If the presence of a CPSS results in stimulation of brain receptors for benzodiazepines, post-CPSS ligation seizures may result from a withdrawal of EBZ after ligation of the portosystemic shunt.

Adrenal Incidentalomas: Diagnostic Workup of the Incidentally Discovered Adrenal Mass

The incidentally discovered adrenal mass is a diagnostic dilemma veterinarians are likely to face with increasing frequency in the coming years. Dogs and cats may be more prone to functional adrenal lesions than are humans. Most adrenal tumors are benign, but a significant number of adrenocortical carcinomas (approximately 12%) and metastatic lesions within the adrenal glands (3% to 34%) do occur. Evaluation for hypertension, hypokalemia, and loss of hypothalamic-pituitary-adrenal responsiveness to a low dose of dexamethasone is appropriate for all patients with adrenal incidentalomas. The value of clinical and historical signs of hormonal overexpression should not be underestimated. More invasive or expensive diagnostic testing should be predicted on suspicions raised by the history and clinical signs. New diagnostic clinicopathologic tests, including plasma CgA and serum DHEAS, should be investigated in veterinary patients. Advanced diagnostic imaging using nuclear scintigraphy and chemical-shift MRI may offer veterinarians sensitive and specific noninvasive tools to consider for the evaluation of these patients. Patients with large masses, tumors with signs of malignancy, or productive adrenal tumors (plus or minus cortisol-producing tumors in which chemical ablation with mitotane can be attempted) should be considered candidates for exploratory surgery.

Pretreatment clinical and laboratory evaluation of cats with diabetes mellitus: 104 cases (1992–1994)

Objective To assess pretreatment clinical and laboratory findings in cats with diabetes mellitus and to determine the influence of ketoacidosis on pretreatment findings. Design Retrospective case series. Animals 104 cats with diabetes melliitus, 38 of which had ketoacidosis. Procedure Medical records of cats with diabetes mellitus examined over a 20-month period were reviewed. Cats that had received previous treatment for diabetes mellitus, or for which medical records were incomplete, were excluded from this study. Results Cats ranged in age from 1 to 19 years (median, 11 years). Male cats were twice as likely to develop diabetes as females. The most common historical signs were polyuria, polydipsia, weight loss, and diminished activity. Anorexia or poor appetite was reported more commonly than polyphagia, especially in cats with ketoacidosis. Diminished activity, anorexia, weakness, and vomiting were all significantly more common in ketoacidotic cats than in nonketoacidotic cats. Forty-four cats were considered thin, and 34 were considered obese. All cats had hyperglycemia and most had hypercholesterolemia and high activities of 1 or more hepatic enzymes. Compared with nonketoacidotic cats, ketoacidotic cats were more likely to have had low serum electrolyte values. All cats had glucosuria and 42 (40.4%) had ketonuria. Baseline serum insulin concentrations were measured in 18 cats and were low or at the low end of the reference range in 14 (77.8%) cats. Serum fructosamine concentration, determined in 22 cats, was high in 20 (90.9%) cats. Twenty-three of the 104 (22.1%) cats had concurrent disease, the most common of which were hyperthyroidism, inflammatory bowel disease, and eosinophilic granuloma complex. Clinical Implications In more than a third of cats, diabetes mellitus is complicated by development of ketoacidosis, which increases the severity of clinical and laboratory abnormalities. Diagnosis of diabetes mellitus is made on the basis of signalment (eg, middle-aged to old male cats), owner complaints (eg, polyuria, polydipsia, and weight loss), physical examination findings (eg, lethargy or muscle wasting), and laboratory findings {eg, hyperglycemia and glucosuria). (J Am Vet Med Assoc 1996,209:943-949)

Signs Taken for Wonders: Essays in the Sociology of Literary Forms

This work of literary analysis examines the great works of modern literature, from Shakespeare's tragedies to Joyce's Ulysses as historical signs - literary systems that are tokens of wider cultural and political realities. Covering such diverse genres as baroque tragedy, horror, detective fiction and classical realism, the book presents an analysis of the relations between high and mass culture.

Down's Anomaly

The title of this monograph, Down's Anomaly , gives credit to Langden Down, a London physician, who in 1866 recognized a distinct clinical entity which he named Mongolian idiocy. Professor Penrose's long interest in this syndrome and his many personal contributions to its understanding are reflected in the completeness with which the subject is presented: 25 pages of references form the last section of the monograph. In this book the authors present, in essence, an organized abstract of the world's literature on mongolism. It is difficult to be critical of what is said, but we can, perhaps, question the manner in which it is presented. In general the text reads well, but the reviewer found the continuous insertion of authors' names a frequent source of distraction—a relatively minor complaint of a very scholarly work. The contents include historical background, physical signs, biochemistry, and cytogenetics. The section on dermatoglyphics is very detailed