搜索结果：The Journal of small animal practice

To develop a palatine approach to the canine maxillary nerve and compare its feasibility and the spread of dye and contrast medium with that of the infraorbital technique. Ten canine cadaveric heads were used in this study. The maxillary nerve was approached bilaterally by inserting hypodermic needles into either the infraorbital or the palatine foramen on each side. Dye/contrast injections (1:1 solution) were followed by CT and anatomical dissections, performed to isolate the maxillary nerves and measure their stained portions. Procedural failure was defined as a nerve stain <6&#x2009;mm in length. Descriptive statistics, analysis of proportions and comparison of either means or medians were used for data analysis. The stained portion of the maxillary nerve was shorter for the palatine technique (0 (0 to 10) mm) than the infraorbital technique (35 (17 to 52) mm) (P&#x2009;=&#x2009;.015). Procedural failure rate was higher for the palatine technique (80%) compared to the infraorbital technique (20%; P&#x2009;=&#x2009;.025). For both techniques, imaging showed contrast spread along the nerve pathway in 70% of injections. Contrast medium contamination of nasal turbinates and nasal passages did not differ between approaches and was observed in 50% of palatine and 30% of infraorbital injections (P&#x2009;=&#x2009;.057). The novel palatine approach produced a higher procedural failure rate than the infraorbital technique and cannot be recommended as a suitable alternative to existing methods for canine maxillary nerve block.

To characterise multidrug antimicrobial resistance and pathogenicity profiles of bacteria isolated from different anatomical sites in bitches with pyometra, emphasising their clinical relevance for diagnosis and therapeutic decision-making in small animal practice. Bacteria were obtained from the faeces, urine, uterus and vagina of 23 dogs diagnosed with pyometra undergoing ovariohysterectomy. Antimicrobial resistance profiles were analysed for all identified isolates, together with phylogenetic classification of Escherichia coli and detection of virulence factor-encoding genes. Bacterial isolates obtained from faecal, urinary, uterine and vaginal samples showed predominantly positive growth for Escherichia coli, followed by Staphylococcus spp., Klebsiella pneumoniae and Proteus spp. Among these isolates recovered from each anatomical site, multidrug-resistant bacteria - defined as resistance to three or more classes of antimicrobials - were identified across all bacterial genera, with frequencies of 37.7% among faecal isolates, 16.7% among urinary isolates, 44.5% among uterine isolates and 100% among vaginal isolates, except for Enterobacter spp. Among dogs positive for Escherichia coli (11/23), phylogroups A/C (30.9%) were the most prevalent, followed by D/E (16.9%), B2 (15.5%), B1 (12.7%), A (12.7%), C (8.5%) and U (2.8%). In 90% (10/11) of cases, Escherichia coli isolates recovered from faecal, vaginal and/or uterine samples belonged to the same clonal family, suggesting faecal contamination. Overall, 77.4% of Escherichia coli isolates of uterine origin were classified as resistant or multidrug-resistant, and 83.9% harboured one or more virulence factor-encoding genes (hlyA, uspA, papC and predominantly fimH). Phylogroup B2 was the only group in which all assessed virulence factors were simultaneously detected. The presence of multidrug-resistant bacteria across all genera isolated in cases of canine pyometra underscores the clinical importance of antimicrobial susceptibility testing. Furthermore, the recovery of genetically related Escherichia coli isolates from intestinal and reproductive tract samples supports the intestinal microbiota as a relevant source of infection in affected bitches.

Like all antimicrobial use, surgical antimicrobial prophylaxis should only be administered when the benefits outweigh potential harms. The aim of this systematic review and meta-analysis was to assess the effectiveness of surgical antimicrobial prophylaxis to reduce surgical site infections in dogs and cats. Population, intervention, comparator and outcome were generated by a multidisciplinary guideline panel and clinical decision thresholds were derived from stakeholder interviews. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to evaluate the certainty of the evidence. Eight randomised controlled trials and seven observational studies met the eligibility criteria and were included in the review. Nine categories of surgical procedures were created based on organ system and wound classification and outcomes included surgical site infections, adverse events and mortality. Very low to moderate certainty evidence showed that surgical antimicrobial prophylaxis only had a trivial or small clinical effect on surgical site infection incidence in all surgical procedures. No adverse effects or mortalities related to surgical site infections were reported in any of the studies. The results of this study will be used to create evidence-based treatment guidelines.

Serotonin (5-hydroxytryptophan), implicated in a number of canine diseases, has a very short half-life in the serum. Urine concentration of its breakdown product 5-hydroxyindole acetic acid after an 8&#x2009;hour fast is a more reliable measure of circulating serotonin in humans. This study aimed to validate a commercially available ELISA assay to measure 5-hydroxyindole acetic acid concentrations in canine urine by comparing the analytical performance with the gold standard of liquid chromatography-tandem mass spectrometry. Urine was collected from 26 dogs undergoing routine diagnostic investigations at one referral centre and rapidly processed and stored prior to testing for 5-hydroxyindole acetic acid using the two methods. Deming regression and Bland-Altman analyses were used to compare the results between the two methods. The ELISA demonstrated acceptable precision and repeatability (coefficient of variation <20%). There was good agreement between the two methods (bias 0.92&#x2009;&#x3bc;mol/L; 95% limits of agreement -6.44 to 8.29&#x2009;&#x3bc;mol/L), although the ELISA was not tested at values close to the upper-end of the claimed analytical measurement range limit. The ELISA was likely to be very reliable at low concentrations but may exceed acceptable error limits at high concentrations. A commercially available ELISA was validated to measure urine 5-hydroxyindole acetic acid. This is a less invasive method than blood sampling for serotonin and should give a more reliable indication of long-term serum serotonin concentrations. More studies of normal and diseased dogs are needed to confirm these findings before applying them in a clinical setting.

This study aimed to (1) describe an ultrasound-guided trigeminal nerve injection technique in client-owned dogs undergoing extensive oncologic maxillofacial surgery; (2) characterise the distribution of a local anaesthetic-contrast mixture using CT; and (3) confirm the absence of intracranial distribution of the injectate on CT images in clinical patients. A secondary objective was to describe intraoperative nociceptive responses under a multimodal anaesthetic protocol. This prospective case series included seven client-owned dogs undergoing extensive oncologic maxillofacial surgery at a tertiary referral hospital. Unilateral or bilateral ultrasound-guided trigeminal nerve injections were implemented using a temporal approach. A combination of ropivacaine, dexmedetomidine and iohexol (1:15 contrast-to-local anaesthetic ratio) was injected at a total volume of 0.07&#x2009;mL/kg per injection site. CT imaging was performed 5 to 10&#x2009;minutes after injection to assess the injectate distribution and its proximity to the orbital fissure, rostral alar foramen and oval foramen. Intraoperative nociceptive responses were monitored by haemodynamic parameters and treated as required. Ten trigeminal nerve injections were performed (five left-sided, five right-sided; three dogs received bilateral injections). Sonoanatomical landmarks were consistently identified, and CT confirmed adequate injectate distribution within 5&#x2009;mm of the targeted foramina in 8/10 injections. No intracranial distribution of contrast medium was observed. Intraoperative short-lived rescue analgesia was required in 4/7 dogs, consisting of a single bolus of fentanyl (1&#x2009;&#x3bc;g/kg iv). No dogs required intraoperative redosing of rescue analgesia. No immediate or delayed adverse effects attributable to the injection technique or contrast administration were identified. Ultrasound-guided trigeminal nerve block combined with CT imaging provides detailed, in vivo anatomical information regarding injectate distribution before extensive oncologic maxillofacial surgery in dogs. Within the limitations of this small case series, its incorporation into a multimodal anaesthetic protocol was associated with limited intraoperative nociceptive events and minimal use of additional systemic analgesic interventions.

Myxomatous mitral valve disease, an acquired valvular degeneration, is the most common cardiac disorder in dogs, affecting approximately 10% of dogs in primary care veterinary practice. Dogs with myxomatous mitral valve disease frequently require anaesthesia for routine procedures. The American Society of Anesthesiologists physical status classification system shows increasing mortality with higher grades, but its subjectivity limits risk stratification in dogs with preclinical myxomatous mitral valve disease. Because Stage B1 and B2 dogs can vary widely in disease severity, even within the same American Society of Anesthesiologists category, a single American Society of Anesthesiologists score may not accurately reflect their anaesthetic risk. While a comprehensive echocardiogram remains the gold standard for myxomatous mitral valve disease staging, referral to a veterinary cardiologist is often cost-prohibitive and might involve long waiting periods. This narrative review proposes a practical framework for pre-anaesthetic risk assessment and protocol selection in dogs with myxomatous mitral valve disease, integrating accessible diagnostic tools including physical examination, radiographic measurements (vertebral heart size and vertebral left atrial size), cardiac biomarkers (N-terminal pro-B-type natriuretic peptide) and point-of-care ultrasound. Recommended anaesthetic protocols are provided for different clinical scenarios ranging from cases with limited diagnostics through grey zone presentations to confirmed cardiomegaly, alongside structured approaches to managing intraoperative complications. This spectrum of care approach recognises that while specialist evaluation remains ideal, practical alternatives can guide safe anaesthetic management for this commonly encountered cardiac condition in companion dogs.

To investigate whether ventral coxofemoral luxation is more common in poodles and poodle crosses than other breeds, detail the role of trauma in development and retrospectively describe treatment and outcomes. Retrospective cohort study of 25 poodle or poodle crosses with ventral coxofemoral luxation. Records of all dogs sustaining coxofemoral luxation were reviewed, with poodles and poodle crosses suffering ventral coxofemoral luxation being retained for analysis. concurrent conditions, degree of trauma, previous hip luxation history, treatment at presentation, complications including incidence of reluxation and treatment thereof. Coxofemoral luxations were identified in 627 dogs. Of these, 123 were ventral. Fifty-one coxofemoral luxations occurred in poodles or poodle crosses, with 25 being ventral. Poodle and poodle crosses were significantly more likely to experience ventral luxation compared to other breeds (P&#x2009;<&#x2009;.001). Twenty-four cases sustained no major trauma. Initially, non-surgical treatment was performed in 17 cases, surgical treatment in five and no treatment in three. The use of hobbles (P&#x2009;=&#x2009;.554) or their duration (P&#x2009;=&#x2009;.445) was not associated with reluxation risk. Reluxation occurred in seven cases after non-surgical treatment, with five being revised surgically. In total, surgery was performed on 11 occasions: toggle pin (4), femoral head and neck ostectomy (6) and total hip replacement (1). Poodles and their crosses were shown to be at an increased risk of ventral coxofemoral luxation compared to all dogs with luxations. There was not a consistently successful management strategy for these cases and owners should be informed accordingly.

The aim of this systematic review was to critically assess the available evidence regarding risk factors associated with surgical site infections following tibial plateau levelling osteotomy. This study aims to identify clinically relevant determinants of surgical site infection following tibial plateau levelling osteotomy and inform future preventive strategies. This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. The review question was structured using the PECOS framework. Searches were performed in PubMed, Web of Science and Scopus without date restrictions, including all studies indexed up to June 2025. The search strategy combined terms related to surgical site infection, tibial plateau levelling osteotomy and dogs. Risk of bias was assessed across predefined methodological domains. The literature search yielded 436 results, and a total of 11 papers met the inclusion criteria. The study designs included two prospective clinical trials, one double-blinded randomised controlled trial and eight retrospective case series. Several risk factors for postoperative surgical site infection were investigated across the studies, with increased body weight being the most frequently identified. Most of the studies presented a high risk of bias in the domains of allocation concealment, blinding of participants and personnel and blinding of outcome assessment. In contrast, incomplete outcome data and selective reporting were generally assessed as low risk of bias. Knowledge of specific risk factors for surgical site infection after tibial plateau levelling osteotomy may support the clinician in tailoring antimicrobial prophylaxis and anticipating potential complications, thereby improving perioperative decision-making and patient outcomes.

To evaluate the clinical benefit of faecal microbiota transplantation administered via a single retention enema, as an adjunctive treatment in the management of dogs with chronic enteropathy. Blinded, randomised controlled trial. Dogs with chronic enteropathy (>3&#x2009;weeks of small or mixed intestinal diarrhoea) were randomly allocated to either the faecal microbiota transplantation or standard treatment group (ratio 1:1) via blinded selection. Dogs in the standard treatment group had a diet change only, while dogs in the faecal microbiota transplantation group had a diet change and faecal microbiota transplantation. faecal microbiota transplantation was performed using fresh faecal material from donor dogs, screened for selected enteropathogens and administered via retention rectal enema. Outcomes measured included the Canine Inflammatory Bowel Disease Activity Index, faecal score and the owner's reported improvement. Group comparisons were made using Fisher's exact tests (owner-reported outcomes) and Kruskal-Wallis tests adjusted for ties (Canine Inflammatory Bowel Disease Activity Index and faecal score). Forty-two dogs with chronic enteropathy (median Canine Inflammatory Bowel Disease Activity Index score 6 [range 4 to 11]) were included in the study. Twenty-five dogs were randomly assigned to receive faecal microbiota transplantation, while 17 dogs were allocated to standard treatment. A progressive improvement in stool consistency (reduced faecal score) was recorded over time for most dogs in both groups. By Day 90, the rates of owner-defined clinical improvement were 76% (CI 54% to 90%) in the faecal microbiota transplantation group and 73% (CI 40% to 92%) in the standard treatment group. No significant differences were evident between the two groups based on the proportion of owners that reported clinical improvement, Canine Inflammatory Bowel Disease Activity Index score or faecal score. This study did not demonstrate a clear clinical benefit for adjunctive faecal microbiota transplantation via single retention enema in dogs with chronic enteropathy compared to diet change alone, although the small sample size means that a type II error cannot be excluded. The similar outcome for both groups supports high rates of food responsiveness among this cohort of chronic enteropathy dogs.

To report the medium- to long-term outcomes and complications of a larger case series of patients undergoing combined phallopexy and preputial advancement for treatment of paraphimosis of unknown aetiology. Retrospective case series: Medical records of a single small animal referral centre were searched for male dogs treated for idiopathic paraphimosis with combined phallopexy and preputial advancement between January 2010 and October 2023. Data collected included signalment, presenting clinical signs, surgical technique, peri-/post-operative complications and outcome. Outcome was based on owner questionnaire. Sixteen dogs met the inclusion criteria and were included in the study. Median surgical time was 60&#x2009;minutes (45 to 75&#x2009;minutes) and there were no intraoperative complications. Two of the 16 (12.5%) dogs had major complications. One of the 16 (6.25%) cases had minor complications. Eight dogs (50%) had no recurrence of paraphimosis following surgery, three (18.75%) had some intermittent recurrence requiring no treatment, three (18.75%) had intermittent recurrence requiring occasional medical management but an improvement from presurgical condition and two dogs (12.5%) had no major improvement from pre-surgical condition. In conclusion, preputial advancement and phallopexy can be used to treat paraphimosis refractory to medical management with reasonable levels of success leading to improvement in 87.5% (14/16) of dogs. However, complication rates and risk of recurrence are similar to those previously reported with phallopexy or preputial advancement alone.

This study aimed to assess the effectiveness of a protocol involving the application of topical products (DOUXO&#xae; S3 SEB Shampoo and Mousse; Ceva Sant&#xe9; Animale) containing ophytrium for managing feline keratinisation disorders. Nineteen client-owned cats with a history of keratinisation disorders exhibited greasy or dry seborrhoea. Cats were treated with either a shampoo or mousse on day 0 (D0) and subsequently with the mousse every 48 to 72&#x2009;hours for 3&#x2009;weeks. Clinical signs were evaluated on D0, D7 and D21 using a modified Skin Seborrheic Index, which measured the percentage of body area affected, scaling, coat greasiness and secondary dermatological signs. Both veterinarians and owners provided subjective evaluations of overall skin condition and product efficacy. Of the 17 cats that completed the study, SSI scores improved significantly by D7 and D21, with reductions of &#x2265;50% in 82.4% of cats. By D21, the affected body surface had decreased by 92.9%, scaling by 70.5% and greasiness by 68.3%. Veterinarians rated the improvement as satisfactory, good or excellent in 100% of cases. The protocol was deemed effective and practical by 100% and 88.2% of owners, respectively, with 94.1% declaring an improved condition of their cats' skin and coat. The ophytrium-containing mousse and shampoo protocol was well tolerated and effective in significantly reducing seborrhoea in cats with keratinisation disorders. High satisfaction levels were reported by both veterinarians and owners, highlighting the protocol's efficacy and practicality.

To evaluate a juvenile dog population that sustained diaphyseal femoral fractures surgically stabilised with an angle-stable interlocking nail and evaluate for evidence of proximal femoral malformation both periooperatively and at skeletal maturity. Retrospective study of ten skeletally immature dogs sustaining diaphyseal femoral fractures stabilised using an angle-stable interlocking nail between January 2010 and June 2023. Standardised orthopaedic examination, Canine Brief Pain Inventory and radiographic review were performed at skeletal maturity. Radiographic review included subjective assessment for proximal femoral malformation and objective assessment of anatomic and mechanical angles of alignment in both the frontal and sagittal planes, immediately post-operatively, perioperatively and at long-term follow-up. A Wilcoxon signed rank test was used to assess femoral measurements using the unaffected femur as a control in each dog. Six of the nine dogs scored 0 on the Canine Brief Pain Inventory, while the remaining three had low scores (maximum of 10/100). No case had evidence of proximal femoral malformation during perioperative follow-up. Two dogs developed bilateral coxofemoral joint osteoarthritis at skeletal maturity. CORONA1 was the only significantly different measurement when comparing the surgical to the unaffected femur at skeletal maturity. Use of an angle-stable interlocking nail to stabilise femoral diaphyseal fractures in skeletally immature dogs can be performed without significant risk of developing proximal femoral malformation. Reductions in CORONA1 values may be anticipated due to reducing natural femoral procurvatum. Angle-stable interlocking nails should not be considered contraindicated for use in canine juvenile diaphyseal femoral fracture repair.

Two middle-aged, unrelated cocker spaniels were investigated for apparent jaw pain and slowly progressive restriction of mouth opening, in the absence of previous trauma or jaw-locking episodes. Computed tomographic evaluation was suggestive of a dynamic impingement between the coronoid process of the mandible and the medial surface of the zygomatic arch, trapping the temporalis muscle. Bilateral, single-session, partial resection of the coronoid process and zygomatic arch resulted in complete resolution of the clinical signs. This form of impingement should be considered when evaluating cases with a mechanically restricted, painful opening of the mouth.

This case series aims to describe the use of video-assisted thoracoscopic surgery for the treatment of pectus excavatum. Six male, intact kittens, with a median age of 3.3&#x2009;months (range, 2.5 to 4 months) and median weight of 1.75&#x2009;kg (range, 0.44 to 2&#x2009;kg), were presented to one of two referral institutions for evaluation of a concave sternal deformity. On presentation the kittens were found to have radiographically moderate (n&#x2009;=&#x2009;3) to severe (n&#x2009;=&#x2009;3) pectus excavatum of the caudal sternum with mild to moderate respiratory signs reported at home. Surgical correction included the use of video-assisted thoracoscopic surgery to facilitate external sternal splint placement. Use of video-assisted thoracoscopic surgery allowed for direct visualisation of needle passage to place the circumsternal sutures, potentially reducing the risk of complications given the proximity of intrathoracic vasculature and organs. All patients recovered from anaesthesia uneventfully, and post-operative thoracic radiographs revealed reduction in sternal concavity and increase in thoracic height at the level of the original deformities. One cat suffered respiratory arrest 36&#x2009;hours post-operatively for unknown reasons. Video-assisted thoracoscopic surgery-assisted external splint placement for pectus excavatum may help reduce intraoperative risks associated with pectus excavatum repair, though additional research is warranted.

To determine the prevalence and distribution of dentigerous cysts among unerupted teeth in adult dogs based on age, sex, reproduction status and cranial conformation. Cross-sectional radiographic study. Medical records were reviewed to obtain clinical data, including breed, age, sex and reproduction status. Diagnostic dental radiographic imaging was reviewed. Binomial logistic regression was used to investigate factors contributing to the likelihood of having a cyst in dogs with one or more unerupted teeth. Two hundred and eighty-five unerupted teeth and 95 (33.3%) dentigerous cysts were identified in 206 dogs out of approximately 13,000 records examined between 01/2017 and 06/2023. The highest frequency of unerupted teeth was found on the mandibular first premolars, mandibular third molars and mandibular central incisors.&#x2009;Regardless of tooth type, prevalence per site was under 50% for all but the mandibular second incisor. Brachycephalic dogs had higher odds of having cysts than non-brachycephalic or mixed breed dogs (odds ratios of 3.39 and 2.79), and neutered male dogs had higher odds than intact females (odds ratio of 1.58). Results suggest that close monitoring of unerupted teeth without radiographic evidence of associated cysts may be an appropriate minimally invasive treatment method in lieu of prophylactic extraction.

To compare the postoperative complication rates and outcomes of client-owned dogs treated surgically for humeral intracondylar fissures and/or humeral condylar fractures either as unilateral or bilateral simultaneous procedures. Hospital records from a single referral centre in the United Kingdom were reviewed retrospectively. Dogs were categorised into the unilateral and bilateral groups and then further subdivided according to the surgical procedure performed. Clinical follow-up and a client evaluation scheme were used to identify complications and assess functional outcomes. Medical records of 75 skeletally mature dogs met the inclusion criteria. The overall complication rate was 36.0%. There was a 1.57-fold increase in the complication rate in bilateral humeral intracondylar fissure compared to unilateral humeral intracondylar fissure and a 2.22-fold increase in humeral intracondylar fissure/humeral condylar fracture compared to unilateral humeral condylar fracture. When minor complications were excluded, the complication rate for bilateral surgeries overall was double that of unilateral procedures. Major surgical complications predominated in the bilateral groups, while major medical complications predominated in the unilateral groups. Surgical site infection was 1.68-fold more prevalent in bilateral humeral intracondylar fissure compared to unilateral humeral intracondylar fissure and 4.45-fold more prevalent in bilateral humeral intracondylar fissure/humeral condylar fracture than in unilateral humeral condylar fracture. Unilateral humeral intracondylar fissure and humeral condylar fracture consistently outperformed the bilateral procedures in functional recovery. Across all bilateral groups, no postoperative complications were detected in the prophylactically treated limb. Single-stage bilateral surgery is associated with markedly increased complication rates, particularly in bicondylar fractures. Delaying intervention on the prophylactic limb until the onset of clinical signs might be considered due to higher complication rates in single-stage procedures.

Mycobacterium abscessus is a rapidly growing non-tuberculous mycobacterium known for intrinsic antimicrobial resistance. While well characterised in humans, reports in dogs remain limited. To describe the clinical presentation, diagnostic findings, treatment strategies and outcomes of Mycobacterium abscessus infections in six dogs. Canine medical records between 2017 and 2025 were retrospectively reviewed. Dogs were included based on confirmed Mycobacterium abscessus infection by mycobacterial culture and/or polymerase chain reaction. Data collected included signalment, clinical signs, diagnostics, treatment protocols, outcomes and follow-up. Six dogs of various breeds and ages were included in the study. Two dogs presented with chronic respiratory signs (2/6) (coughing and hacking), whereas the other four had cutaneous/subcutaneous nodules with draining tracts, frequently located on the right side of the trunk. All cases occurred during the winter months. Diagnosis was confirmed by culture and polymerase chain reaction in all cases; one isolate was additionally identified via MALDI-TOF. Cutaneous histopathology (performed in two dogs) showed pyogranulomatous dermatitis and panniculitis. Clarithromycin was the primary treatment in all dogs. Polytherapy with the use of additional antimicrobials varied. Clinical outcomes/follow-up were available for five dogs, with one dog fully recovered, one relapsed after discontinuation of therapy and two were euthanased. Two dogs had a concurrent staphylococcal infection. Mycobacterium abscessus infections in dogs can mimic other chronic infections and present significant diagnostic and therapeutic challenges. Disease patterns (respiratory or cutaneous) closely resemble human cases. Culture and polymerase chain reaction are essential for diagnosis, and clarithromycin remains a key therapeutic option despite variable susceptibility.

An intraluminal aortic mass was incidentally found on CT scan in a 2-year-old Flat coated retriever. The mass was larger on repeat CT and was biopsied via right femoral artery catheterisation using endoscopic biopsy forceps. Histopathological examination confirmed an aortic chondrosarcoma. The aortic chondrosarcoma was treated with stereotactic body radiation therapy with 8&#x2009;Gy delivered in three fractions every other day to a 24 Gy total dose. Follow-up CT 5&#x2009;months post stereotactic body radiation therapy showed stable disease. No adverse effects secondary to the biopsy procedure or stereotactic body radiation therapy were observed; however, progressive disease was noted 8&#x2009;months post stereotactic body radiation therapy. The same SBRT protocol was repeated. The dog remained clinically well until presentation 84&#x2009;days later with signs of multiple organ dysfunction syndrome and was subsequently euthanised.

This mini-review describes the pathophysiology of the disrupted hypothalamic-pituitary-adrenal axis in dogs, and probably cats, with the MDR1 (ABCB1) mutation, ABCB1-1&#x394; in dogs and ABCB11930-1931del TC in cats. Clinical consequences in affected animals are discussed and therapeutic interventions to consider are presented.