Pathology in Practice.

In collaboration with the American College of Veterinary Pathologists.

Noncardiogenic pulmonary edema associated with ozone exposure in three kittens.

CASE DESCRIPTION Three 21-week-old sexually intact female sibling domestic shorthair cats were brought to an emergency clinic because of signs of sudden respiratory distress that were noted by the owner after the cats had been confined for approximately 10 hours in a room with an operating ozone-generating air purifier. No other potential toxicant exposures were reported. CLINICAL FINDINGS On initial examination, the 3 cats were severely dyspneic and tachypneic. Pulmonary crackles were audible on thoracic auscultation. Thoracic radiography revealed a marked peribronchial, unstructured interstitial pulmonary pattern that coalesced to a patchy alveolar pattern, consistent with noncardiogenic pulmonary edema. TREATMENT AND OUTCOME A diuretic (furosemide, 2 mg/kg [0.9 mg/lb], IV) and bronchodilator (terbutaline sulfate, 0.01 mg/kg [0.005 mg/lb], IM) were administered, and supplemental oxygen was provided by placing the cats in an oxygen cage at 80% oxygen saturation. By 24 hours after placement in the oxygen cage, all cats had unremarkable respiratory rates and thoracic auscultation findings. Complete resolution of the respiratory signs and radiographic pulmonary lesions was achieved within 48 to 72 hours after initial evaluation. At a recheck examination performed 3 months after initial evaluation, the cats remained free of respiratory signs, and no radiographic pulmonary lesions were detected. CLINICAL RELEVANCE To the authors' knowledge, this was the first reported case of pulmonary toxicosis believed to have been caused by ozone exposure in cats. Associated respiratory signs were successfully and rapidly reversed following oxygen supplementation and medical treatment.

Computed tomographic assessment of a new nonsurgical sinus trephination technique using a medical bone marrow drill.

The objective of this study was to determine the feasibility of trephination of the frontal sinus and injection of antifungal cream using a medical bone marrow drill in dogs. Results were compared with frontal sinus trephination using a standard surgical technique. Bilateral trephination of the frontal sinuses was carried out in the heads of 11 cadavers using a medical bone marrow drill and a surgical bone chuck. The time taken to carry out the procedure using both techniques was compared. Before and after injection of antifungal cream into the frontal sinuses, computed-tomography (CT) scanning was done to assess for iatrogenic trauma and to determine the degree to which the sinuses were filled with each technique and evaluate the diffusion of the cream into the nasal cavity of each dog. The mean volume of the sinuses was 8.8 mL (3.1 to 14.3 mL). Trephination, flushing, and injecting of antifungal cream were significantly faster using the medical technique. There was no significant difference in the mean filling of the frontal sinuses between the medical (82.7%) and the surgical (82.4%) technique (P-value = 0.3). Filling of the nasal cavity was classified as very good in 6/11 cases, with evidence of trauma caused by the surgical trephination technique in 1 head. Findings suggest that use of the medical bone marrow drill is highly feasible for frontal sinus trephination. Injection of antifungal cream into the frontal sinuses using the bone marrow needle resulted in good diffusion into the ipsilateral nasal cavity and could be used to treat aspergillosis when debridement or sinusoscopy is not deemed necessary.

L'objectif de cette étude est d'évaluer l'utilisation d'une perceuse de moelle osseuse pour la trépanation du sinus frontal et l'injection de crème antifungique chez le chien. Les résultats sont comparés à la trépanation du sinus par une technique chirurgicale classique. Les sinus frontaux de 11 têtes de cadavres de chiens ont été trépanés, en utilisant une perceuse pour moelle osseuse ou un trépan chirurgical. La durée de la procédure avec chaque technique est comparée. Les sinus frontaux sont examinés par tomodensitométrie avant et après injection de crème antifungique, afin de noter de potentielles lésions iatrogéniques, d'évaluer le degré de remplissage du sinus frontal pour chaque technique, et d'apprécier la diffusion de la crème dans les cavité nasales pour chaque chien. Le volume moyen des sinus était de 8,8 ml (3,1 à 14,3 ml). La trépanation, le flush et l'injection de crème antifungique étaient significativement plus rapide avec la perceuse médicale. Il n'y avait pas de différence significative entre le remplissage moyen des sinus par la technique médicale (82,7 %) ou chirurgicale (82,4 %) (P = 0,3). Le remplissage des cavités nasales était qualifié de très bon dans 6 cas sur 11. Une lésion iatrogénique fut constatée dans un cas, avec la technique chirurgicale. Ces résultats semblent montrer qu'une perceuse médicale pour moelle osseuse est facilement utilisable pour trépaner le sinus frontal chez le chien. L'injection de crème dans le sinus frontal par le trocart de la perceuse pour moelle osseuse permet un bon remplissage de la cavité nasale ipsilatérale, et pourrait donc être utilisée dans le cadre du traitement de l'aspergillose canine, dans les cas où un débridement du sinus n'est pas nécessaire.(Traduit par Docteur Serge Messier).