An 11-year-old neutered male Golden Retriever presented with lameness of the left forelimb, anorexia, and lethargy. Computed tomography revealed a left humeral mass displaying an aggressive bony lesion with sclerotic changes, raising suspicion of a malignant bone tumor. A hemogram showed marked mature lymphocytosis and moderate nonregenerative anemia. Additional diagnostic methods, including bone marrow aspiration and flow cytometry, definitively diagnosed T-cell chronic lymphocytic leukemia (CLL). Left forelimb amputation was performed, and osteosarcoma was diagnosed based on histopathological examination. Chemotherapy with chlorambucil and prednisolone was initiated for the CLL. Three weeks after treatment, the patient’s clinical signs of anorexia and lethargy resolved, with improvement in lymphocytosis and resolution of anemia. To the best of our knowledge, synchronous osteosarcoma and chronic lymphocytic leukemia have not been reported in veterinary medicine. The concurrent occurrence of osteosarcoma and leukemia has seldom been reported in human medicine, and genetic predisposition is proposed to be a potential risk factor. This is the first documented case report of concurrent osteosarcoma and chronic lymphocytic leukemia detailing its clinical features and diagnostic processes.

This retrospective study aims to evaluate the clinical outcomes of tracheal stent placement in dogs with tracheal collapse, identifying factors associated with success rates and adverse effects. Thirty-one dogs treated with intraluminal self-expanding nitinol stents for tracheal collapse at Smart Animal Hospital from 2018 to 2023 were analyzed. The investigation focused on median follow-up time (MFT), clinical outcomes, and factors affecting success and complications, including age at the time of stent placement, presence of stent-related complications, and concurrent bronchial collapse. The average follow-up time was 592 days, ranging from 35 to 2,189 days. As of December 31, 2023, 11 dogs were alive, 10 had died, and 10 were lost to follow-up. Excluding those lost to follow-up, 80% survived more than a year post-procedure. Yorkshire Terriers were the most common breed, followed by Pomeranians. The average age at the time of stent placement was around 9 years, with an average body weight of approximately 3 kg. There were no notable differences in MFT across age groups, indicating that age at the time of stent placement did not significantly affect survival outcomes. Postoperative outcomes were categorized as "Good" in 51.6% of cases, "Fair" in 32.3%, and "Poor" in 16.1%. Complications, including stent fracture, malposition, and migration, were observed in 23% of the dogs. The majority (83.9%) had concurrent bronchial collapse, which correlated with certain complications but did not significantly affect MFT. Overall, tracheal stent placement is a viable treatment option for canine tracheal collapse, demonstrating significant survival rates and manageable complications. This study underscores the importance of comprehensive postoperative monitoring and highlights the need for further research to optimize treatment strategies and improve patient outcomes in veterinary medicine.

Background: Despite the increasing use of continuous glucose monitoring (CGM) systems, limited data exist on their perceived benefits and challenges among patients and healthcare providers. This study explored CGM-related experiences in South Korea. Methods: An anonymous online survey was conducted between January and December 2021 at four university hospitals. Respondents included patients with diabetes mellitus (DM), physicians, and DM education nurses. The survey assessed the use of CGM, its benefits, and barriers. Most devices were first-generation CGMs: FreeStyle Libre 1 (Abbott Diabetes Care), Dexcom G6 (Dexcom Inc.), and Medtronic Guardian 3 (Medtronic MiniMed). Results: Among 1,010 patients (33.4% with type 1 DM [T1DM], 63.6% with type 2 DM [T2DM], and 3.1% others; mean age, 51.4±14.6 years), 92.7% found CGM helpful. Although 59.6% reported discomfort, 81.9% intended to continue using CGM, indicating that perceived benefits outweighed barriers. The key advantages were glucose monitoring without finger pricks (T1DM, 57.9%; T2DM, 56.2%) and maintenance of target glucose levels. Discomfort was related to discomfort during activities (53.8%), skin problems (45.0%), and pain (43.0%). Healthcare provider recommendations were associated with reduced discomfort (adjusted odds ratio, 0.36; 95% confidence interval, 0.21–0.60). Physicians (n=29) cited high costs as the main barrier (T1DM, 58.9%; T2DM, 64.8%); only 51.9% and 14.5% prescribed CGM for T1DM and T2DM, respectively. Insulin adjustment and glucose control were the main reasons for prescription, while cost (89.3%) and limited consultation time (67.9%) were barriers. DM educators (n=9) reported heavy workloads, with training and follow-up times averaging 31.7±7.5 minutes and 21.7±9.7 minutes, respectively; 77.8% of DM educators identified frequent patient inquiries as their greatest burden. Conclusion CGM provides significant clinical benefits but is limited by discomfort, costs, and educational burden. Sustained adoption requires device improvements, insurance support, and workforce expansion.

Myxomatous mitral valve disease (MMVD) is a degenerative disease of the valve leaflets, causing left atrial dilatation and eccentric hypertrophy of the left ventricle by hemodynamic instability. Red cell distribution width (RDW) is a hematologic parameter that indicates the variation of red blood cell volume and size, reflecting anisocytosis. Human studies have found that anisocytosis is associated with poor prognosis in heart disease patients, and recent veterinary studies have also confirmed that the increase in RDW is associated with high mortality in MMVD patients. Medical records of 37 Maltese dogs with MMVD were retrospectively reviewed. When comparing RDW among the MMVD stage groups, there was a significant difference between stage B1, B2 and C. A significant and strong correlation between RDW and the left atrial-to-aortic ratio was identified. RDW was significantly correlated with the reticulocyte count independent of hematocrit, and the reticulocyte count exhibited a significant increase at stage C. This suggests that the congestive heart failure secondary to MMVD could be a contributory factor leading to an elevation in RDW. In conclusion, elevated RDW may associated with left atrial enlargement and progression of MMVD.

Purpose: We aimed to identify the genetic causes of hypospadias in children using targeted gene panel sequencing for disorders of sex development (DSD). Materials and Methods: This study included 18 twin boys with hypospadias: seven and two pairs were monozygotic and dizygotic twins, respectively, and six were discordant and three were concordant twins. Targeted gene panel sequencing for 67 known DSD genes was performed. Sequence variants were classified into five different categories, pathogenic, likely pathogenic, variants of uncertain significance, likely benign, and benign, following the American College of Medical Genetics and Genomics Standards and Guidelines. Results: The mean gestational age and birth weight were 35.3±2.0 weeks and 1.96±0.61 kg, respectively, with seven patients being small for gestational age. Hypospadias was present in 12 patients, with posterior type in 33.3% and anterior type in 66.7%.In three families with twins, both siblings had hypospadias. In addition, cryptorchidism was observed in one subject. Surgical correction of hypospadias was performed at a mean age of 22.1 months. Molecular analysis identified 12 different genetic variants, including two pathogenic mutations in the AMH (p.E389*) and SRD5A2 (p.R246Q) genes, found in subjects with hypospadias, respectively. However, only heterozygous mutations were detected. Conclusions This study did not identify a definitive genetic component contributing to the development of hypospadias; however, the findings suggest that intrauterine growth retardation may play a significant role.

Background: Recently, there has been a growing interest in stem cells for human medicine.Limited feline endometrial mesenchymal stem cell (fEM-MSC) research in veterinary medicine necessitates reporting for future feline disease research and therapy. Objectives: This study aimed to isolate fEM-MSCs from feline endometrial tissues and evaluate their morphology, proliferative ability, differentiation ability, and immunophenotype. Methods: Feline endometrial tissues were obtained from the ovariohysterectomies of healthy cats and isolated using an enzymatic method. The morphology and proliferative ability of the isolated cells were assessed using a doubling time (DT) assay from passages 3 to 6 (P3 − P6). We measured pluripotency gene expressions of cells in P2 using quantitative realtime polymerase chain reaction (qRT-PCR). To investigate MSC characteristics, a trilineage differentiation assay was conducted in P4, and cells in P4 were immunophenotyped using flow cytometry. Results: fEM-MSCs showed a typical spindle-shaped morphology under a microscope, and the DT was maintained from P3 to P6. fEM-MSCs could differentiate into adipocytes, osteoblasts, and chondrocytes, and expressed three pluripotency markers (OCT4, SOX2, and NANOG) by qRT-PCR. Immunophenotypic analysis showed that the fEM-MSCs were CD14− , CD34− , CD45− , CD9+ , and CD44+ . Conclusions In this study, the feline endometrium was a novel source of MSCs, and to the best of our knowledge, this is the first report on the isolation method and characteristics of fEM-MSCs.

A 6-year-old neutered male Poodle with a body weight of 2.7 kg was diagnosed with a congenital extrahepatic portoazygos shunt presented with progressive hepatic encephalopathy. Five days after surgical attenuation, the patient showed post-attenuation neurological signs (PANS) such as generalized tonic-clonic seizure, dull mentation, and tremor. PANS were successfully managed with antiepileptic drugs, but third-space fluid accumulation (ascites and peripheral edema) and phlebectasia were newly identified, suggesting marked portal hypertension (PHT). Telmisartan, spironolactone, carvedilol, and prednisolone were sequentially administered. Three months after surgery, both abnormal clinicopathological values such as anemia and hypoalbuminemia, and clinical signs completely resolved. Herein, we report successful management strategies for PANS and PHT in a dog following surgical attenuation of a congenital portoazygos shunt.

A 13-year-old spayed female Golden Retriever with clinical signs of weight loss and lethargy presented with two esophageal masses and one sessile polyp on computed tomography and esophagoscopy. Endoscopic snare resection was performed, and histopathological examination was requested. Based on histopathology and immunohistochemistry of multiple myeloma oncogene 1 staining, the patient was diagnosed with esophageal extramedullary plasmacytoma.The patient remained clinically well without any clinical signs during a follow-up period of 12 months. Herein, we report the successful diagnosis and management of esophageal extramedullary plasmacytoma in a dog using endoscopy.

Myxomatous mitral valve disease (MMVD) is the most common cardiac disease in dogs. Vertebral heart score (VHS) is used for the diagnosis, treatment, and monitoring of MMVD, and it is one of the criteria used to distinguish between stages B1 and B2 according to the American College of Veterinary Internal Medicine (ACVIM) guidelines. The thoracic inlet heart score (TIHS) method is simple to perform and provides practitioners with an additional tool for evaluating dogs with clinical signs compatible with MMVD stage B. Previous studies have evaluated TIHS. In our study, we assessed correlations of TIHS with other radiographic and echocardiographic indices in Maltese dogs with MMVD stages B1 and B2. Eighty-seven Maltese dogs with MMVD stage B1 or B2, which visited Chungnam National University Veterinary Medicine Teaching Hospital, were included in this study. Each dog was diagnosed with MMVD ACVIM stage B1 or B2 through physical examination, cardiac auscultation, thoracic radiography, and echocardiography, with evaluation of TIHS, VHS, vertebral left atrial size (VLAS), left atrial to the aotic root ratio (LA:Ao ratio), and left ventricular internal diameter in diastole, normalized for body weight (LVIDDn). TIHS increased as the disease progressed and showed a significant difference between stages B1 and B2. Furthermore, TIHS positively correlated with VHS, LA:Ao ratio, and LVIDDn.The correlation coefficients revealed the strongest significant correlations between TIHS and VHS. In conclusion, TIHS can help diagnose and monitor MMVD in Maltese dogs, in addition to measuring VHS.

Background: Enavogliflozin is a novel sodium-glucose cotransporter-2 inhibitor currently under clinical development. This study evaluated the efficacy and safety of enavogliflozin as an add-on to metformin in Korean patients with type 2 diabetes mellitus (T2DM) against dapagliflozin. Methods: In this multicenter, double-blind, randomized, phase 3 study, 200 patients were randomized to receive enavogliflozin 0.3 mg/day (n=101) or dapagliflozin 10 mg/day (n=99) in addition to ongoing metformin therapy for 24 weeks. The primary objective of the study was to prove the non-inferiority of enavogliflozin to dapagliflozin in glycosylated hemoglobin (HbA1c) change at week 24 (non-inferiority margin of 0.35%) (Clinical trial registration number: NCT04634500). Results: Adjusted mean change of HbA1c at week 24 was –0.80% with enavogliflozin and –0.75% with dapagliflozin (difference, –0.04%; 95% confidence interval, –0.21% to 0.12%). Percentages of patients achieving HbA1c <7.0% were 61% and 62%, respectively. Adjusted mean change of fasting plasma glucose at week 24 was –32.53 and –29.14 mg/dL. An increase in urine glucose-creatinine ratio (60.48 vs. 44.94, P<0.0001) and decrease in homeostasis model assessment of insulin resistance (–1.85 vs. –1.31, P=0.0041) were significantly greater with enavogliflozin than dapagliflozin at week 24. Beneficial effects of enavogliflozin on body weight (–3.77 kg vs. –3.58 kg) and blood pressure (systolic/diastolic, –5.93/–5.41 mm Hg vs. –6.57/–4.26 mm Hg) were comparable with those of dapagliflozin, and both drugs were safe and well-tolerated. Conclusion Enavogliflozin added to metformin significantly improved glycemic control in patients with T2DM and was non-inferior to dapagliflozin 10 mg, suggesting enavogliflozin as a viable treatment option for patients with inadequate glycemic control on metformin alone.