LexaGene Announces Collaboration with Ethos Veterinary Health

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BEVERLY, Mass., April 04, 2018 (GLOBE NEWSWIRE) — LexaGene Holdings Inc. (OTCQB:LXXGF) (TSX-V:LXG) (the “Company”), a biotechnology company that develops instrumentation for pathogen detection, announced today that it has entered into collaboration with Ethos Veterinary Health, a veterinary health company with hospitals across the U.S. that provide advanced medical care for pets. This partnership will provide canine urine samples to LexaGene for testing on the Company’s LX6 prototype for more effective, rapid and on-site pathogen detection. The samples have been previously characterized using conventional technologies (MALDI-TOF / mass spectrometry) at its reference laboratory.

“In the coming weeks, veterinarians at Ethos will send LexaGene clinical annotated samples for processing, which will allow our team to continue to fine-tune and perfect our pathogen detection prototype’s testing capabilities,” said Dr. Jack Regan, LexaGene CEO. “This process is vital as we improve sensitivity to different isolates. We expect this to be a long-lasting collaboration as we work together to bring the best product possible to the veterinary market.”

“We’ve recently performed a market assessment for LexaGene’s technology by interviewing many emergency and critical care veterinarians, and – coupled with an internal financial assessment of the cost of conventional testing versus LexaGene’s projected testing costs – the results argue strongly for adopting LexaGene’s technology once available,” added Dr. Chand Khanna, Chief Science Officer, Ethos Veterinary Health. “We look forward to providing samples to LexaGene so that we can help them bring this product to market quickly and efficiently, ultimately enabling veterinarians to provide better care for clients in the near future.”

To be added to the LexaGene email distribution list, please subscribe on the Company website here.

To view the LexaGene website, click here.

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About LexaGene Holdings Inc.
LexaGene is a biotechnology company developing the very first fully automated pathogen detection platform that is open-access, the LX6.  The open-access feature will empower end-users to target any pathogen of interest, as they can load their own real-time PCR assays onto the instrument for customized pathogen detection.  End-users simply need to collect a sample, load it onto the instrument with a sample preparation cartridge, and press ‘go’. The instrument is expected to offer excellent sensitivity, specificity, and breadth of pathogen detection.  The instrument will be able to process six samples at a time, in an on-demand fashion, returning results in about 1 hour.  The company expects to sell its technology in the food safety, veterinary diagnostics, water quality monitoring, and aquaculture pathogen surveillance markets.

About Ethos Veterinary Health
Ethos is a veterinary health company with hospitals across the U.S. providing advanced medical care for pets. Our approach includes a focus on transformative science, continuous learning and growth for team members and collaboration. For more information, visit ethosvet.com.

View Dr. Chand Khanna’s bio here.

 

The TSX Venture Exchange Inc. has in no way passed upon the merits of the proposed transaction and has neither approved nor disapproved the contents of this press release. Neither TSX Venture Exchange nor its Regulation Services Provider (as that term is defined in the policies of the TSX Venture Exchange) accepts responsibility for the adequacy or accuracy of this release.

This news release contains forward-looking information, which involves known and unknown risks, uncertainties and other factors that may cause actual events to differ materially from current expectation. Important factors — including the availability of funds, the results of financing efforts, the success of technology development efforts, the cost to procure critical parts, performance of the instrument, market acceptance of the technology, regulatory acceptance, and licensing issues — that could cause actual results to differ materially from the Company’s expectations as disclosed in the Company’s documents filed from time to time on SEDAR (see www.sedar.com). Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this press release. The company disclaims any intention or obligation, except to the extent required by law, to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise.

Media Contacts
Caitlin Kasunich / Amy Singh
KCSA Strategic Communications
212.896.1241 / 212.896.1207
ckasunich@kcsa.comasingh@kcsa.com

Tightrope Cruciate Repair

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The Tightrope technique is an excellent alternative to the TPLO for treatment of cruciate ligament rupture in dogs of any size. This technique works similar to older suture techniques but is significantly stronger and simpler. The tightrope technique is stronger because it relies on small bone tunnels and stainless steel surgical “buttons” to secure the suture. This is much stronger than traditional methods of securing the suture. In addition, the suture is human orthopedic surgical grade material which is far superior to traditional materials used to stabilize the knee of dogs.

The Tightrope technique is an alternative for clients who are concerned with the bone cutting required in the TPLO.  The Tightrope can be performed with arthroscopic assistance so only a few small incisions are required.

Studies to date suggest that the Tightrope has  excellent results similar to those of the TPLO.

Case Study: Incontinence in Boxer

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JULIE FISCHER, DVM, DIPLOMATE ACVIM

HISTORY AND PHYSICAL EXAM
Samson was a 4-year old MC boxer presented with a 1 month history of incontinence and abnormal urination. Samson’s owners had noted that he was leaving small puddles of urine on his beds when he rested or slept, and that they occasionally found dribbles of urine on the floor as well. When taken
outside, Samson assumed a normal leg-lifted posture to urinate and initiated a urine stream that was swiftly attenuated. He often stood in the same position without straining but without producing a urine stream for several minutes, and if permitted, would repeat this behavior several times. With the exception of the incontinence and abnormal urination behavior, Samson’s behavior, appetite, activity, and general well-being were normal and unchanging according to the owners.

Physical examination was normal with the exception of a large bladder which could not be expressed with firm pressure. Neurological examination was normal. When taken out to urinate, Samson postured normally and produced a small urine stream that was attenuated after about 5 seconds. He held the
urination posture without straining for a minute, and then repeated this process twice more. After urination attempts, the bladder was still large.

PROBLEM LIST AND INITIAL DIFFERENTIALS

  1. Urine retention: inadequate detrusor contraction (neurogenic or myogenic), inadequate sphincter relaxation, mechanical obstruction of outlet
  2. Incontinence: In the face of pathological urine retention, incontinence is de facto due to overflow (bladder hypoaccommodation, urethral irritation, polyuria with overflow, anatomical anomaly at outflow, lower motor neuron lesion are other differentials that could possibly contribute, but are unlikely to be primarily responsible).

INITIAL PLAN

  1. CBC/chemistry panel: WNL
  2. Urinalysis: color = light yellow/brown, USG = 1.026, 3+ blood, 0-3 WBC/hpf, 5-10 RBC/hpf, 3_ amorphous debris
  3. Urine culture: no growth in 72 hours
  4. Urethral catheterization: no mechanical obstruction detected; after urination attempts, 800 ml urine removed from bladder
  5. Abdominal radiographs: large bladder, normal shape and positioning, no evidence of urinary stone disease
  6. Abdominal ultrasound exam: bladder is small to medium-sized with normal wall and no apparent prostatic or urethral abnormality
  7. Retrograde and voiding urethrogram: normal urethral distension, and no intraluminal space-occupying lesion seen with retrograde study; marked bladder compression resulted in intermittent and incomplete voiding, with inadequate distension of the proximal urethral lumen/ proximal urethral narrowing

ASSESSMENT
When incontinence occurs in the face of significant urine retention, it is generally (and by definition) overflow incontinence.
This does not rule out other contributing factors such as anatomical abnormality of the outflow tract (e.g., a trigonal tumor could both cause outflow obstruction and interfere with normal closure function). In this case, mechanical obstruction was ruled out with catheterization, contrast study, and ultrasound, leaving functional obstruction (inadequate outlet opening/relaxation) as the most likely differential for this dog’s urine retention. In normal voiding, the stimulus for urethral contraction is inhibited, permitting urethral relaxation and urine outflow. Our observations of this dog’s voiding pattern suggest dyssynergic voiding, a condition in which the urethra contracts instead of relaxes in response to detrusor
contraction (in theory, usually due to a subtle supra-sacral spinal lesion). The end result of this is inadequate bladder emptying, with eventual development of detrusor atony. In general, no more than 0.5-1.0 ml urine should remain in the bladder following full voiding attempts, so the 800 ml removed from this dog is radically abnormal. This is a disease seen almost exclusively in intact and castrated male dogs, usually large to giant breeds, and often in the young. In intact dogs, exacerbation of signs is often seen with psychological or sexual excitation.
Definitive documentation of detrusor-sphincter dyssynergia requires urethral pressure profilometry performed simultaneously with cystometrography to show simultaneous urethral and detrusor contraction. Practically speaking, we diagnose it presumptively based on observation of micturition and exclusion of other differentials, as above.

TREATMENT
Therapy for dyssynergia consists of relaxation of the proximal urethra and bladder emptying. Most dogs with dyssynergia have some degree of bladder atony at the time of diagnosis, and initial therapy should include hospitalization with a urinary catheter and closed collection system for 3-5 days to help start detrusor recovery. Bladder expression is not an adequate or appropriate means of urinary care in these dogs, and owners often will have to cleanly catheterize and empty the dog’s bladder at home 2-3 times daily during initial therapy.
Contraction of the proximal urethra occurs via stimulation of alpha-1 adrenergic-innervated smooth muscle, so relaxation of the proximal urethra is achieved via alpha-1 inhibition. Several medications are available for this purpose:

  • Phenoxybenzamine: Non-selective alpha 1-alpha 2 antagonist; less potent than alternatives, with greater risk of side-effects; obsolete in human medicine for urinary applications. There is no reason at this point to use phenoxybenzamine over alternatives for urinary purposes.
  • Prazosin: Selective alpha-1 antagonist; very inexpensive; useful in both cats and dogs. Can measurably decrease blood pressure, so not recommended in hypovolemic or hypotensive animals.
  • Tamsulosin (Flomax): Potent, uroselective alpha-1 antagonist; does not decrease blood pressure at normal doses; not shown to be safe in cats yet; more expensive than prazosin.

Samson’s owners could not afford hospitalization, but agreed to catheterize him at home 3-4 times daily initially, then 2-3 times daily as needed. For financial reasons, they elected to initially try prazosin at 1 mg/15 kg q 8 hrs. This improved Samson’s voiding, but did not normalize it, and his residual urine volume stayed >300 ml. After 2 weeks the owners switched Samson to tamsulosin at 0.125 mg/10 kg q day. Samson’s residual urine volume steadily decreased and the owners were able to stop catheterizing him after 2 additional weeks. Eighteen months later he is still voiding normally on daily tamsulosin, but relapses after a few weeks if the medication is discontinued.

 

Download the PDF for this case study here: Incontinence_in_Boxer

Adrenal Gland Tumors

What is the adrenal gland?

The adrenal glands are a set of paired glands found within the abdomen in cats and dogs that constitute a major portion of the hormonal (endocrine) system.  The adrenal gland can be split into two major regions.  The outer portion, the cortex, is responsible for producing cortisol (the main stress hormone of the body), some sex hormones, and substances which help regulate the body’s blood pressure and electrolyte balance.  The inner portion, the medulla, produces adrenaline and its precursors (epinephrine, norepinephrine).  The adrenal glands are located very near the kidneys and adjacent to the major blood vessels of the abdomen, the aorta and caudal vena cava.

Axial view of a CT scan of the abdomen in a dog with an adrenal mass. The orange arrow indicates the aorta. The red arrow indicates the position of the vena cava. The blue arrow points to the adrenal mass. The green arrow indicates the position of the left kidney.

How is an adrenal tumor diagnosed?

Most adrenal tumors are identified during abdominal ultrasound for evaluation of the source of symptoms caused by the adrenal tumor, or the tumors are seen incidentally when performing an ultrasound for other reasons.  A mass is identified when the adrenal gland is noted to be greater than 1.5cm on ultrasound measurement. Adrenal tumors can be divided into roughly two categories: functional tumors, which are associated with increased hormone secretion, and non-functional tumors.  After identification of an adrenal mass, further testing is often recommended to determine functional status, as this will improve the likelihood of a successful outcome with surgery.

Ultrasound measurement of a mass within the left adrenal gland. The mass measures 1.7 7 cm. A normal adrenal gland should be no larger than 1.5 cm in any dimension.

Masses which produce increased cortisol will often cause symptoms in animals, including increased appetite, thirst, and urination, panting, weight gain, and hair loss.  Confirmation of increased cortisol production can be achieved by performing a low dose dexamethasone suppression test, a blood test which is performed over 8 hours.

Masses which produce increased adrenaline can cause sudden spikes and drops in blood pressure.  This is manifested as fainting or episodes of collapse with diaexcitement. Diagnosis of these masses on physical examination can be difficult.  Occasionally retinal hemorrhage or elevations in blood pressure can be documented, but more often a history of collapsing episodes is the only supportive finding.  Measurement of urinary adrenaline can help strengthen the presumptive diagnosis.

Blue arrow: Adrenal mass as seen at surgery

How do you treat tumors of the adrenal glands?Adrenalectomy (surgical removal of the adrenal gland) is generally recommended when a functional adrenal tumor is diagnosed, or if features of malignancy are noted (enlargement of nearby lymph nodes, invasion of the mass into the blood vessels).  With larger tumors and tumors with evidence of growth into a blood vessel (vascular invasion) on ultrasound, a CT scan is generally performed prior to surgery.

Sagittal (side) view on CT scan of the abdomen in a dog with an adrenal mass. The orange arrow indicates the aorta. The blue arrow is the adrenal gland. The green arrow indicates the position of the left kidney. The head is to the left.

Green: Left kidney, Blue: Adrenal gland, Orange: Aorta

What are the complications of adrenalectomy?

Due to the close relationship of the adrenal gland with the blood supply of the abdomen (aorta, vena cava), hemorrhage is always a major concern during adrenalectomy.  Prior to surgery, each patient is blood typed in case a transfusion of red blood cells is needed during or following surgery.

Each type of functional adrenal mass carries its own associated risks with removal.  Masses which produce adrenaline can cause sudden spikes and drops in blood pressure while the mass is being handled during surgery.  Medications can be administered intraoperatively to help lessen the effect of these adrenaline releases on the heart and blood vessels.  The presence of a Veterinary Anesthesiologist is very beneficial in helping to reduce the risk of significant arrhythmias which can occur during surgery, and advances in anesthetic monitoring and care after surgery have decreased the risks of surgery significantly.

Adrenal mass removed surgically

Masses which produce cortisol can cause an increase in clot formation

in the body, as well as delay healing.  During surgery and in the immediate postoperative period, there is a risk for embolization (lodging) of blood clots into the blood vessels within the lungs.  If this happens there is impairment of the delivery of oxygen into the blood stream and the patient can have difficulty breathing which can progress to sudden death. The most recent papers suggest a mortality rate of 19-22% with surgery which is greatly improved over previous studies. Testing and medical treatment prior to surgery can help significantly reduce this risk.

Other complications can include mild electrolyte imbalances, delayed healing, coughing, and incisional complications (bruising, infection).

Chest x-ray (radiograph) of a dog with a large pulmonary thromboembolism (PTE) to the left side of the lungs. Note how the right side of the image is much more opaque, indicating a lack of air within the lung tissue.