Objective: This study aimed to develop a reliable and valid Mixed State Severity Index (MSSI) to assess mood instability in patients with mood disorders and determine cutoff scores. Methods: Twenty-one items were selected based on Koukopoulos’ criteria for mixed depressive episode, historically referred to as agitated depression, and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision mixed features criteria. The MSSI was administered to 242 patients (major depressive disorder [n=92], bipolar disorder [BD] I [n=78], and BD II [n=72]) and 726 controls. Results: The MSSI demonstrated high internal consistency (α=0.78–0.90). Exploratory factor analysis revealed a stable four-factor structure. Based on receiver operating characteristic analysis, optimal cutoff scores were identified to distinguish mood disorder groups from controls, ranging from 19.5 to 27.5 depending on diagnosis. Conclusion The MSSI is a reliable and valid instrument for assessing the severity of mixed features in patients with mood disorders. The established cutoff scores enhance its clinical utility, providing robust diagnosis and treatment planning support.

This report presents the first detection of canine circovirus (CanineCV) in South Korea, which was identified in a dog with hemorrhagic diarrhea. A 5-year-old male Golden Retriever presented with acute, watery and bloody diarrhea that had persisted for three weeks. Pathologically, granulomatous inflammation, fibrinoid vasculitis, and hemorrhagic foci were observed in the small intestine and mesenteric lymph nodes. Characteristic intracytoplasmic amphophilic inclusion bodies were observed in histiocytic cells within the granulomatous lesions. CanineCV was amplified by polymerase chain reaction from the small intestine, mesenteric lymph nodes, and fecal samples. A genomic analysis of the complete capsid gene from the Korean strain of CanineCV revealed that it shares the highest nucleotide and amino acid sequence similarities, at 94.2% and 94.1% respectively, with the American UCD3-478 isolate. Phylogenetic analysis based on the nucleotide sequence of the capsid gene classified the Korean strain as type 4 CanineCV. This case highlights the importance of genomic surveillance for emerging pathogens in South Korea and lays the groundwork for further research into the epidemiology and pathogenicity of CanineCV in canine enteric diseases.

Multiple autoimmune syndrome (MAS) refers to the occurrence of three or more autoimmune diseases in a patient. This case describes a 12-year-old neutered male Shih Tzu with fever and neutropenia, previously diagnosed with immune-mediated thrombocytopenia, immune-mediated hemolytic anemia, and inflammatory bowel disease. Blood tests revealed leukopenia and neutropenia, and immune-mediated neutropenia was suspected after ruling out other causes of neutropenia. The dog showed no response to antibiotics, but treatment with prednisolone (2 mg/kg q24h) led to improvement. This case highlights the potential for MASs to occur in dogs and underscores the importance of their recognition in the diagnosis and management of immune-mediated diseases.

In this paper, we explore diagnosing and treating osteosarcoma in the mammary gland using a combination of tyrosine kinase inhibitors (TKIs) and cyclophosphamide. A case involving a 14-year-old female mixed-breed dog with a 12.4 × 11 cm singular mass in the mammary region is discussed. Initial cytological analysis from a fine-needle aspiration suggested the possibility of mixed-type mammary carcinoma and carcinosarcoma. The mass was surgically excised and sent for histopathological examination, which confirmed it as extraskeletal osteosarcoma of the mammary gland. Following surgery, metronomic chemotherapy with cyclophosphamide and fibrocoxib was implemented, along with targeted therapy using toceranib and cyclophosphamide. Seven months post-chemotherapy, the dog exhibited lameness in the right hind limb and metastasis in the 4th thoracic spine. Within 10 months, the condition progressed to tetraparesis, leading to euthanasia 1 month later. This case highlights the need for differential diagnosis among mammary gland mixed-type carcinoma, carcinosarcoma, osseous metaplasia, and osteosarcoma in the context of osteocytes for accurate prognosis. The dog survived 332 days post-surgery with the chemotherapeutic regimen involving toceranib and cyclophosphamide, indicating the effectiveness of TKI and metronomic chemotherapy in extending survival beyond the median for extraskeletal osteosarcoma.

A 7-year-old neutered male Shih Tzu presented with acute onset of progressive tetraparesis and generalized muscle atrophy. Neurological examination, electromyography (EMG), and muscle biopsy revealed findings consistent with denervation-induced muscular atrophy. Based on these results, a tentative diagnosis of immune-mediated neurogenic myopathy was established. Immunosuppressive therapy with cyclosporine and mycophenolate mofetil led to a marked clinical improvement. However, relapse following discontinuation of therapy indicated the chronic relapsing nature of the disease. This case demonstrates the diagnostic value of EMG and muscle biopsy in identifying neuromuscular disorders and underscores the importance of a multimodal diagnostic approach for the accurate diagnosis and management of suspected neurogenic myopathies.

Doxorubicin is an effective chemotherapeutic agent widely used in veterinary oncology, particularly as part of the CHOP protocol for canine lymphoma. Despite its therapeutic benefit, cardiotoxicity remains a serious dose-limiting adverse effect. Although clinically significant cardiotoxicity is typically reported at cumulative doses of 150-240 mg/m 2 in dogs, functional cardiac deterioration has been observed at lower doses, with progression to congestive heart failure rarely reported. This case report describes doxorubicin-induced cardiotoxicity below the established cumulative threshold in a dog with multicentric lymphoma, which presented with overt clinical signs of congestive heart failure, including coughing, syncope, and pleural effusion. The dog also exhibited marked echocardiographic changes, including right atrial enlargement and a reduction in fractional shortening from 33% to 21% over 2 weeks, ultimately resulting in death 53 days after symptom onset. The clinical diagnosis was supported by the temporal relationship with doxorubicin administration and serial cardiac imaging findings. This case highlights that severe cardiotoxicity can occur even below traditionally accepted cumulative thresholds, reinforcing the importance of individualized, ongoing cardiac monitoring and early intervention, regardless of dose.

Objective: This study aimed to elucidate the distinct response patterns exhibited by patients diagnosed with bipolar disorder (BD) and those with major depressive disorder (MDD) through the application of the short version of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A-SV). Methods: A total of 2,458 participants consisting of patients with MDD (n=288), BD (BD I, n=111; BD II, n=427), and control group (n=1,632) completed the TEMPS-A-SV. The response patterns of the participants were classified into distinct profiles using latent profile analysis. The study further examined the impact of covariates such as age, sex, and diagnostic group on derived latent profile memberships. Results: The following three latent profiles were identified: High Affective Temperament Group (17.86%), Low Affective Temperament Group (41.25%), and Middle Affective Temperament Group (40.89%). Compared with the patient group with MDD and BD, the control group was more likely to belong in the Low Affective Temperament Group, which showed a higher score on hyperthymic temperament than the Middle Affective Temperament Group. Furthermore, compared with the patients with BD, the MDD patients were more likely to be in the Low Affective Temperament Group rather than the Middle Affective Temperament Group. Conclusion These results indicate that different affective temperaments exist between patients with MDD and BD. Attempting to classify response patterns using the TEMPS-A-SV can help diagnose MDD and BD correctly.

Objective: Interpersonal sensitivity, characterized by a heightened awareness of others’ behavior and emotions, is linked to mood disorders. However, current literature lacks a comprehensive analysis of how some items of the Interpersonal Sensitivity Measure (IPSM) interrelate and contribute to the overall construct. This study constructed a network for interpersonal sensitivity symptomatology to identify core IPSM items in patients with mood disorders. Methods: The IPSM, a 36-item self-report scale, was utilized to evaluate interpersonal sensitivity symptoms in 837 participants (major depressive disorder [MDD], n=265; bipolar I disorder [BD I], n=126; and bipolar II disorder [BD II], n=446). We performed exploratory graph analysis, employing regularized partial correlation models to estimate the network structure. Centrality analysis identified core IPSM symptoms for each mood disorder group. Network comparison tests assessed structural differences between the MDD and BD subgroups. Results: Network analysis detected five communities. Item 10 (“I worry about being criticized for things that I have said or done”) showed the highest value in strength. Multiple items on “Interpersonal Worry/Dependency” and “Low Self-Esteem” showed high strength centrality. Network structure invariance and global strength invariance test results indicated no significant differences between the MDD and BD subgroups. Conclusion Our findings emphasize the importance of addressing “Interpersonal Worry/Dependency” and “Low Self-Esteem” in the IPSM network among mood disorder patients based on core items of the network. Additionally, targeted treatments and comprehensive strategies in this aspect could be crucial for managing mood disorders.

Small B-cell lymphoma typically has a more favorable prognosis compared to diffuse large B-cell lymphoma (DLBCL). Here, we present the first documented case of canine DSBCL characterized by extensive lymphocyte infiltration in the spleen, leading to splenic rupture and death. A 10-year-old neutered male Shih Tzu presented with lethargy, skin lesions, and generalized lymphadenopathy. On the day of admission, the dog experienced shock, accompanied by bradycardia and hypotension, and subsequently died. Necropsy confirmed splenic rupture, and cytology, histopathology, and immunophenotyping of the lymph nodes confirmed the diagnosis of diffuse small B cell lymphoma (DSBCL). Similar neoplastic cells were identified in the spleen and inguinal skin, establishing a diagnosis of stage V lymphoma with multi-organ infiltration. This case shows that while non-DLBCL B-cell lymphomas are often indolent, certain subtypes, such as DSBCL, may exhibit aggressive behavior, emphasizing the need to carefully evaluate the extent of infiltration in such cases.

The immune-mediated destruction of erythroid precursors within the bone marrow can result in inefficient erythropoiesis, classified as precursor-targeted immune-mediated anemia (PIMA). Herein, we describe the case of a 1-year-old Scottish Fold cat who presented with a pale mucous membrane with a history of prior diagnosis with immune-mediated hemolytic anemia (IMHA), characterized by normocytic normochromic moderate anemia. The cat was administered six months of immunosuppressive therapy, including prednisolone, cyclosporine, or mycophenolate mofetil, but exhibited insufficient reticulocytosis. Bone marrow examination subsequently revealed a decreased myeloid to erythroid ratio of 0.35:1, and PIMA was diagnosed. Treatment modification with chlorambucil was implemented, and the cat remained well-managed without IMHA recurrence for 15 months. This case highlights the importance of careful evaluation methods, such as reviewing medication history and performing bone marrow examinations, in IMHA patients with an insufficient response to immunosuppressive therapy. These results further suggest the occasional need for medication adjustments during treatment.