High levels of stress and anxiety are common in children with Autism Spectrum Disorder (ASD). Within this study of school-aged children (20 male, 6 female) we hypothesised that functional hearing deficits (also pervasive in ASD) could be ameliorated by auditory interventions and that, as a consequence, stress levels would be reduced. The use of Ear-Level Remote Microphone devices and Classroom Amplification systems resulted in significantly improved listening, communication and social interaction and a reduction in physiologic stress levels (salivary cortisol) in both one-on-one and group listening situations.

Background: Serum symmetric dimethylarginine (SDMA) is a sensitive renal biomarker for detecting early chronic kidney disease (CKD) in nonhyperthyroid cats, but knowledge regarding its performance in hyperthyroid cats remains limited. Objectives: To determine the relationship between serum SDMA, creatinine and total thyroxine (TT4) concentrations in hyperthyroid cats before (T0) and 3 months after (T1) receiving a PO fixed dose of radioiodine. Animals: Eighty client‐owned hyperthyroid cats. Methods: Prospective cohort study. Serum TT4, and SDMA, creatinine concentrations, and urine specific gravity were measured at T0 and T1. Nonparametric tests were used to determine the relationship among SDMA, and creatinine and TT4 concentrations. Agreement between SDMA and creatinine regarding CKD staging at both time points was assessed using Goodman and Kruskal's gamma statistic. Results: Mean serum SDMA concentration increased after treatment of hyperthyroidism. However, 21 of 75 cats experienced a decrease in SDMA between T0 and T1, whereas creatinine decreased in only 2 cats. A moderate correlation between SDMA and creatinine was seen at T1 (r = 0.53; P < .001) but not at T0 (r = 0.13; P = .25). Where assessable at T1, poor agreement was observed between SDMA and creatinine and CKD stage (Goodman and Kruskal's gamma 0.20; P = .29). Conclusions and clinical importance: Discordant outcomes between SDMA and creatinine after radioiodine treatment in cats with hyperthyroidism suggest extrarenal factors may interfere with the reliability of SDMA to adequately reflect renal function. As a result, SDMA should not be interpreted in isolation in hyperthyroid cats treated with radioiodine.

Previously T-cell lymphomas of the gastrointestinal tract in human were classified as enteropathy-associated T-cell lymphoma (EATL) type I and type II. Type I is associated with celiac disease and characterized by large lymphocytes, whereas type II is not associated to enteropathies and characterized by small lymphocytes. In view of these differences, the nomenclature has been changed and EATL currently refers only to type I and type II has been renamed monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL).1 EATL has an aggressive clinical course and tumor cells most commonly have an αβ T-cell receptor phenotype. In comparison MEITL tumour cells express CD8, CD56, and megakaryocyte-associated tyrosine kinase. T-cell lymphoproliferative disorder (TLPD) is another type of small cell lymphoma described in the intestinal tract. This lymphoma has typically an indolent clinical course and commonly express CD8 and is negative for CD4 and CD56, Markers of T-cell lymphomas of the gastrointestinal tract have been much less extensively studied in cats and dogs and for this reason for the purpose of this lecture small cell lymphoma (SCL) will be used for neoplastic cells with nuclei smaller than 2 red blood cells in diameter and large cell lymphoma (LCL) for larger neoplastic cells. SCL characterized by infiltration of the intestinal mucosa by mature T-cells with variable epitheliotropism has been described for more than 10 years in cats. SCL has better outcome than other types of lymphoma in this species, with median survival times over 1.5 years.3 Although criteria have been described in cats to diagnose SCL, these are not as well defined in dogs. However, several recent studies support that SCL is also present in dogs and the clinical findings and outcome will be described in this presentation.

In this article, the studies about the prevalence of chronic enteropathy are reviewed as well as the information regarding short- and long-term prognosis for dogs treated with the three most common therapies; these include dietary modification, antibiotics, and immunosuppressants. Although the data available are limited, most studies support a good to excellent long-term response in dogs that have a successful food trial, whereas the response is poor with antibiotics or on-going treatment is required to retain remission. There is a risk of antimicrobial resistance developing with inappropriate use of antimicrobials such as in these situations. The published information highlights the need for alternative strategies to antibiotic treatment to manipulate the GI microbiome, and in the final part of this article studies on the use of probiotic for the treatment of chronic enteropathy are reviewed.

Immune-mediated hemolytic anemia (IMHA) is an important cause of morbidity and mortality in dogs. IMHA also occurs in cats, although less commonly. IMHA is considered secondary when it can be attributed to an underlying disease, and as primary (idiopathic) if no cause is found. Eliminating diseases that cause IMHA may attenuate or stop immune-mediated erythrocyte destruction, and adverse consequences of long-term immunosuppressive treatment can be avoided. Infections, cancer, drugs, vaccines, and inflammatory processes may be underlying causes of IMHA. Evidence for these comorbidities has not been systematically evaluated, rendering evidence-based decisions difficult. We identified and extracted data from studies published in the veterinary literature and developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria for IMHA, comorbidities, and causality. Succinct evidence summary statements were written, along with screening recommendations. Statements were refined by conducting 3 iterations of Delphi review with panel and task force members. Commentary was solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted. The resulting document is intended to provide clinical guidelines for diagnosis of, and underlying disease screening for, IMHA in dogs and cats. These should be implemented with consideration of animal, owner, and geographical factors.

Chronic enteropathy (CE) in dogs is characterized retrospectively per treatment response as food-responsive enteropathy (FRE), antibiotic-responsive enteropathy (ARE), and immunosuppressant-responsive enteropathy (IRE) - the latter most resembling inflammatory bowel disease in people. The aim of this study was to characterize duodenal macrophages (Mϕ) in CE using immunohistochemistry; with calprotectin (CAL) as a marker of early differentiated Mϕ and CD163 expression as a marker for resident Mϕ in the duodenum before and after treatment. Prior to treatment, dogs with FRE and IRE had a lower CD163+/CAL+ ratio than control dogs (CTRL) in crypts; this increased significantly and normalized compared with CTRL after treatment. Conversely, the CD163+/CAL+ ratio in dogs with ARE was comparable to that in healthy dogs before and after treatment. In summary, these results suggest that Mϕ play a role in the pathogenesis of CE in FRE and IRE, with a decrease in resident Mϕ and an increase in early differentiated Mϕ, but not in ARE dogs. Mϕ normalize after successful treatment.

A pharmacodynamic assay has been previously developed to monitor ciclosporin treatment in dogs by assessing inhibition of cytokine transcription after whole blood stimulation with 12-myristate 13-1 acetate and ionomycin (PMA/I). In this study, whole blood stimulation with either PMA/I or lipopolysaccharide (LPS) was used to assess the effect of multiple drugs (azathioprine, ciclosporin, mycophenolate, leflunomide and prednisone) after a 7-day treatment course on production of cytokines measured with a multiplex assay in healthy dogs (n = 4 for each treatment). Interleukin-10 (IL-10), interferon gamma (IFN?) and tumour necrosis factor alpha (TNFa) were significantly activated by PMA/I stimulation and IL-6, IL-10 and TNFa by LPS stimulation, in the absence of immunosuppressive drugs. After ciclosporin treatment, IL-10, IFN? and TNFa production was significantly reduced after stimulation with PMA/I compared to pre-treatment. After prednisone treatment, TNFa production was significantly reduced after stimulation with PMA/I or LPS compared to pre-treatment. No significant change was observed after treatment with azathioprine, leflunomide or mycophenolate. This methodology may be useful to monitor dogs not only treated with ciclosporin, but also with prednisone or a combination of both. Further studies are needed to assess the use of this assay in a clinical setting.

Abdominal ultrasound is frequently used to assess the canine adrenal gland (AG) and subjective and objective features of normal AGs have been described. The effect of the dogs' recumbency position on the accuracy of AG measurement acquisition is not known. This prospective study, performed in dogs with non-adrenal illness, compared ultrasonographic AG measurements made in dogs placed in dorsal recumbency with those made in left or right lateral recumbency. AG length, height and width measurements made in the longitudinal image plane, and height and width measurements from the transverse image plane were assessed. The level and limits of agreement between the dorsal and lateral recumbency for each of the measurements were determined using the Bland-Altman analysis. The measurement with the best agreement between the dorsal and lateral recumbency was the caudal pole thickness (CPT) from the longitudinal image plane. Agreement between lateral and dorsal recumbency was poorer for the measurements derived from the transverse image plane and poorest for measurements of AG length in the longitudinal plane. This study demonstrates that there is some difference in the measurements acquired in dorsal compared with lateral recumbency; however, the difference is small for the CPT from the longitudinal plane. This finding suggests that the CPT from the longitudinal image plane is the most reliable measurement in terms of agreement between dorsal and lateral recumbency in dogs with non-AG illness.

Disseminated toxoplasmosis is a potentially fatal complication in dogs receiving immunosuppressive therapy, particularly if multiple immunosuppressive drugs are used. Toxoplasmosis should be considered if signs of acute respiratory or hepatic disease develop, and diagnosis would rely on demonstration of organisms via cytology or PCR rather than a single time-point serological assay.