IV Versus Myelography Computed Tomography for Thoracolumbar Intervertebral Disc Extrusion Surgical Planning in French Bulldogs.

Accurate diagnostic imaging is required for surgical planning of acute thoracolumbar intervertebral disc extrusion. However, data comparing the accuracy of conventional IV contrast-injected computed tomography (CT) and myelography CT for hemilaminectomy localization and size assessment are sparse. In this study, IV contrast-injected CT and myelography CT were performed in 48 French bulldogs presenting with acute disc herniation and compared with postsurgical CT. CT images were evaluated by three raters. IV contrast-injected CT erroneously identified the compressive lesion site significantly more often than myelography CT. The length of the compressive lesion was significantly higher using myelography CT compared with conventional CT, but this did not lead to relevant consequences on the surgical opening site length. Myelography CT should therefore be recommended when thoracolumbar disc disease is suspected and multiple compressive lesions are visualized on IV-injected CT in French bulldogs.

Ultrasonographic findings may be useful for differentiating interdigital abscesses secondary to migrating grass awns and interdigital furunculosis in dogs.

Grass awn migration and furunculosis are common diseases in dogs that can lead to interdigital subcutaneous lesions with a similar clinical presentation, and occasionally similar ultrasonographic images, but different treatments are required. This retrospective, multicentric, analytical study aimed to determine whether epidemiological, clinical, and ultrasonographic features could be used to differentiate interdigital furunculosis and abscesses secondary to migrating grass awns. Fifty-nine dogs that underwent interdigital ultrasonography were included (interdigital furunculosis [IDF], n = 27; interdigital abscess secondary to a migrating grass awn [IAGA], n = 32). Ultrasonographic images were reviewed by two observers blinded to the diagnosis, who graded nine qualitative and four quantitative parameters for each patient. In both groups, pruritus/licking (IDF 74%, IAGA 70%), a discharging interdigital wound (63% for each group), and thoracic limb involvement (IDF 88%, IAGA 75%) were common features. On ultrasound, a subcutaneous multilinear hyperechoic main element was identified in most dogs (IDF 85%, IAGA 100%). The ability to display this element in a single plane (P < 0.01), the absence of additional hyperechoic linear elements in different planes (P < 0.01), and a surrounding hypoechoic halo (P < 0.05) were significantly more common in dogs with interdigital abscesses secondary to migrating grass awns. A cut-off value of 0.83 cm for the length of the main multilinear element provided a sensitivity of 91% and a specificity of 87% in the diagnosis of a migrating grass awn. Findings supported prioritizing a differential diagnosis of interdigital abscesses secondary to grass awns in dogs with these ultrasonographic characteristics.

Assessment of survey radiography as a method of diagnosing bilateral laryngeal paralysis in dogs.

The gold standard for diagnosis of laryngeal paralysis is laryngoscopy under light anesthesia. This prospective analytical cross-sectional study aimed to determine whether a radiographic assessment of the larynx could be used as a non-invasive screening tool for diagnosing laryngeal paralysis in non-sedated animals, as the laryngeal ventricles may appear wider in affected animals. The laryngeal ventricles of 18 dogs with bilateral laryngeal paralysis composing the affected group and 25 non-sedated dogs presenting no respiratory abnormality composing the control group were evaluated using right lateral radiography of the larynx. Three observers measured the ratios of the maximal ventricular length and surface to the body length of the third cervical vertebra (MVL/LC3 and VS/LC3, respectively). They also subjectively assessed the ventricular shape as either normal or rounded. The most accurate criterion was found to be MVL/LC3, as the respective areas under the ROC curves were 0.96 (95% confidence interval [CI]: 0.95-0.97), 0.89 (95% CI: 0.87-0.91), 0.80 (95% CI: 0.65-0.95) for MVL/LC3, VS/LC3, and ventricular shape evaluation, respectively. Based on ROC curve analysis, two thresholds of clinical interest were set for the MVL/LC3; bilateral laryngeal paralysis was very unlikely for values < 0.3 and very likely for values > 0.5. The findings of this study support the use of lateral laryngeal radiography as a screening tool for diagnosing bilateral laryngeal paralysis. However, further diagnostic tests remain required if MVL/LC3 lies between these threshold values or if clinically indicated. Further studies are warranted to explore the use of laryngeal radiography in unilateral paralysis and other laryngeal or oropharyngeal diseases.

Ultrasonographic evaluation of the coelomic cavity in Rhode Island Red hybrid hens (Gallus gallus domesticus).

Backyard chickens are gaining popularity, and so is individual veterinary care for their health and management. Ultrasonography represents an important part of the imaging diagnostic arsenal in veterinary medicine; however, published data on its use in chickens are scarce and mostly focus on the reproductive tract. The objectives of this prospective, reference interval study were to describe a standard protocol for a full coelomic evaluation and the normal ultrasonographic appearance and measurements of the coelomic organs in awake and anesthetized healthy hens. The liver, gallbladder, gonad, gastrointestinal tract, pancreas, and spleen were clearly visualized in 21 Rhode Island Red hybrid hens (8 immatures, 13 adults) included in this study. In all animals, there was a scant amount of coelomic fluid, which was more visible at the cardiac apex. The cysticoenteric duct and hepatoenteric duct were visualized in 57% (12/21) of the hens. Seven hens were anesthetized and placed in dorsal decubitus, as the kidneys were not visualized in the hens while standing. Reference intervals were calculated for the splenic short and long axes, proventricular wall thickness, ventricular wall thickness, and duodenal wall thickness. Reference values were measured for the thickness of the pancreas, gallbladder wall, and kidneys, as well as the diameters of the biliary ducts. Moreover, five hens of different breeds were examined, and the results obtained were comparable to those of previous studies. The results of this study support the use of ultrasonography as a diagnostic tool in Rhode Island Red hybrid hens and provide reference ranges for use in hens with clinical diseases involving coelomic organs.

Sialocoele associated with the molar salivary gland in a British Shorthair cat.

CASE SUMMARY: A 16-year-old neutered female British Shorthair cat presented with a 5-year history of swelling lateral to the left mandible that intermittently discharged viscous, clear fluid from a small defect in the skin. CT, ultrasonography, physical characteristics and cytology of the fluid were suggestive of sialocoele. CT showed a large, cavitary, fluid-filled mass lateral to the left mandible. A ventral approach was used to resect the left mandibular, sublingual and molar salivary glands and sialocoele. Histopathology of the molar and mandibular and sublingual glands showed chronic active sialoadenitis with more severe changes in the molar gland. There were no signs of recurrence of the sialocoele 12 months after surgery. RELEVANCE AND NOVEL INFORMATION: This is the first report of a cranial cervical sialocoele potentially involving the molar salivary gland in a cat. Resection of the mandibular, sublingual and molar salivary glands should be considered in cats that present with a cranial cervical sialocoele.

Use of a cavitron ultrasonic surgical aspirator for parenchyma-sparing and complex liver resections in dogs.

OBJECTIVE: To report the clinical use of a cavitron ultrasonic surgical aspirator (CUSA) for the resection of hepatic lesions in dogs. STUDY DESIGN: Clinical prospective study. ANIMALS: Eleven client-owned dogs. METHODS: Dogs requiring a hepatic nodulectomy, segmentectomy, and/or a lobectomy (including complex lobectomies) were enrolled. The number and location of procedures, blood loss, duration of surgery, and short-term complications were recorded. RESULTS: Dogs underwent a mean of 2.3 ± 1.1 procedures. All masses were amenable to surgical excision regardless of their location and their relationship with major hepatic vessels. Dogs lost a median of 77 mL of blood (9.9-161), which corresponded to 4.3% of blood volume (0.8%-23.2%). The dog with the highest blood loss survived without requiring transfusion. The median duration of all CUSA procedures was 33.5 minutes (15-82). Short-term outcomes were assessed for the first 15 days, during which two complications were diagnosed. Cholangiohepatitis was diagnosed in one dog and resolved after medical management, and another dog developed necrotic pancreatitis and died. CONCLUSION: Liver parenchyma-sparing nodulectomies and segmentectomies and liver lobectomies including complex lobectomies were achieved with a CUSA in all dogs. CLINICAL SIGNIFICANCE: Use of a CUSA can be considered as an alternative for the removal of hepatic lesions in dogs.

Technological Advances in Diagnostic Imaging in Exotic Pet Medicine.

Diagnostic imaging relies on interpretation of interactions between the body tissue and various energies, such as x-rays, ultrasound, and magnetic or nuclear energies, to differentiate normal from abnormal tissues. Major technological improvements regarding emission and detection of the energetic waves, as well as reconstruction and interpretation of the images, have occurred. These advances made possible visualization of smaller structures, quantitative evaluation of functional processes, and development of unique imaging-guided procedures. This article reviews the technological advances that allowed development of cone beam computed tomography, dual-energy x-ray absorptiometry, and contrast-enhanced ultrasonography, which all could have applications in exotic pet medicine.

Primary hyperparathyroidism due to a cystic parathyroid adenoma in a cat.

A 15-year-old neutered female domestic shorthair cat was presented for weight loss, polydipsia/polyuria, and lethargy. A large fluctuant mass was palpated in the ventral right cervical region. Biochemistry results were consistent with primary hyperparathyroidism. Parathyroid hormone level in the fluid was higher to that observed in the plasma, consistent with a cystic parathyroid lesion. Right parathyroidectomy and thyroidectomy were performed without complications. Ionized calcium normalized within a few hours. Histopathology yielded a diagnosis of cystic parathyroid adenoma. Follow-up showed complete recovery of clinical signs and normalization of ionized calcium. This case shows an uncommon presentation of feline primary hyperparathyroidism secondary to a cystic parathyroid adenoma and is, to our knowledge, the first case presented with a large palpable mass in which parathyroid hormone concentration was measured. This report highlights the value of selective hormonal analyses of the cystic fluid to confirm the origin of the cystic lesion pre-operatively.

Multiple Infiltrative Intraosseous Lipomas in the Appendicular Skeleton of a Rose-breasted Cockatoo (Eolophus roseicapilla) with a Humeral Fracture.

A 9-year-old female rose-breasted cockatoo (Eolophus roseicapilla) was presented for a humeral fracture. At presentation, the bird was severely lethargic and obese. On physical examination, an open right humeral fracture, healed left ulnar fracture, and intertarsal joint swelling were present. Results of hematologic testing and biochemical analysis revealed severe leukocytosis with heterophilia and increased creatine kinase and aspartate aminotransferase activities consistent with musculoskeletal lesions. Radiographs confirmed a right humeral fracture and showed severe polyostotic lytic and expansile lesions of the appendicular skeleton, as well as an enlarged hepatic silhouette. Surgical repair of the fracture was attempted, but the bird died during the procedure. Postmortem examination revealed severe bone deformities involving the fractured humerus, both ulnas, and the left tibiotarsus. Histologic findings were consistent with multiple intraosseous lipomas of the long bones and severe hepatic lipidosis. To our knowledge, this is the first report of multiple intraosseous lipomas in a bird.

Simplified Minimally Invasive Surgical Approach for Prophylactic Laparoscopic Gastropexy in 21 Cases.

The objective of this study was to describe the operative technique and outcome of a simplified laparoscopic gastropexy approach in dogs. Twenty-one dogs undergoing prophylactic laparoscopic gastropexy with a simple continuous barbed suture without incising the seromuscular layer of the stomach and transversus abdominis muscle were reviewed. In 20 cases, additional procedures were performed (18 ovariectomies and 2 prescrotal castrations); 1 dog had two prior episodes of gastric dilation without volvulus and underwent gastropexy with a prophylactic intent. The gastropexy procedure had a median duration of 33 min (range 19-43 min). V-Loc 180 absorbable and the V-Loc PBT nonabsorbable suturing devices were used in 8 and 13 dogs, respectively. Minor intraoperative complications occurred in four cases: broken suture (1), needle dislodgement (2), and folded needle (1). Minor complications included self-limiting wound complications (3), abdominal discomfort (2), vomiting (1), and inappetence (2). Postoperative abdominal ultrasound performed after a median of 8 mo (6-36 mo) confirmed permanent adhesion at the gastropexy site in all dogs. One dog developed a fistula (1 yr postoperatively) and another a granuloma (3 mo postoperatively), both at the gastropexy site. Prophylactic laparoscopic gastropexy may be performed with knotless unidirectional barbed suture without creating an incision on the abdominal wall and stomach.

The computed tomographic "tree-in-bud" pattern: Characterization and comparison with radiographic and clinical findings in 36 cats.

In humans, a CT "tree-in-bud" pattern has been described as a characteristic of centrilobular bronchiolar dilation, with bronchiolar plugging by mucus, pus, or fluid. Aims of this retrospective, descriptive, multi-center study were to characterize the CT appearance of a "tree-in-bud" pattern in a group of cats, and compare this pattern with radiographic and clinical findings. Databases from four hospitals were searched during the period of January 2012 to September 2015 and cats with thoracic radiographs, thoracic CT scans and CT reports describing findings consistent with a "tree-in-bud" pattern were included. Images were reviewed by two veterinary radiologists and characteristics were recorded based on consensus. Clinical findings were recorded by one observer from each center. Thirty-six cats met inclusion criteria. Six cats were asymptomatic, 12 were diagnosed with bronchial disease and 23 were suspected to have bronchial disease. Right cranial and right caudal lung lobes were most commonly affected on both imaging modalities. Localization of the "tree-in-bud" pattern was most often peripheral. On radiographs, the CT "tree-in-bud" pattern often appeared as soft-tissue opacity nodules; their number and affected pulmonary segments were often underestimated compared with CT. In conclusion, the "tree-in-bud" pattern should be considered as a differential diagnosis for radiographic soft tissue opaque nodules in feline lungs. Based on lesion localization and presence or suspicion of a concomitant bronchial disease for cats in this sample, authors propose that the CT "tree-in-bud" pattern described in humans is also a characteristic of bronchial or bronchiolar plugging and bronchial disease in cats.

Ultrasonographic, endoscopic and histological appearance of the caecum in clinically healthy cats.

Objectives The aim of the study was to describe the ultrasonographic and endoscopic appearance and characteristics of the caecum in asymptomatic cats, and to correlate these findings with histology. Methods Ex vivo ultrasonographic and histologic evaluations of a fresh caecum were initially performed. Then, 20 asymptomatic cats, privately owned or originating from a reproductive colony, were recruited. All cats had an ultrasonographic examination of the ileocaecocolic junction, where the thickness of the caecal wall, ileocolic lymph nodes and the echogenicity of the local fat were assessed. They all underwent a colonoscopy with a macroscopic assessment of the mucosa and biopsies for histology. Results An ultrasonographic hypoechoic nodular inner layer, which corresponded to the coalescence of multiple lymphoid follicles originating from the submucosa and protruding in the mucosa on histology, was visible in all parts of the caecum. The combined mucosa and submucosa was measured ultrasonographically and defined as the follicular layer. Although all cats were asymptomatic, 3/19 cats showed mild caecal inflammation on histology. The most discriminatory ultrasonographic parameter in assessing this subclinical inflammation was the thickness of the follicular layer at the entrance of the caecum, with a cut-off value of 2.0 mm. All cats (20/20) showed some degree of macroscopic 'dimpling' of the caecal mucosa on endoscopy. Conclusions and relevance Lymphoid follicles in the caecal mucosa and submucosa constitute a unique follicular layer on ultrasound. In asymptomatic cats, a subtle, non-clinically relevant inflammation may exist and this is correlated with an increased thickness of the follicular layer on ultrasound. On endoscopy, a 'dimpled aspect' to the caecal mucosa is a normal finding in the asymptomatic cat.

Ultrasonographic, endoscopic and histological appearances of the caecum in cats presenting with chronic clinical signs of caecocolic disease.

Objectives This study aimed to describe the ultrasonographic, endoscopic and histological characteristics of the caecum and ileocaecocolic junction in cats suffering from chronic clinical signs compatible with caecocolic disease. Methods Cats presenting with clinical signs suggestive of a caecocolic disease were prospectively recruited. All cats underwent an ultrasonographic examination of the caecum, ileum, colon, ileocolic lymph nodes and local mesenteric fat, in addition to comprehensive abdominal ultrasonography. This was followed by a colonoscopy with a macroscopic assessment of the caecocolic mucosa; caecocolic tissue samples were systematically collected for histologic analysis. Results Eighteen cats were included. Eleven of 18 cats had ultrasonographic abnormalities adjacent to the ileocaecocolic junction (lymphadenopathy, local steatitis) and 13/18 cats had abnormalities directly related to the junction (wall thickening, loss of wall layering). Seventeen of 18 cats had at least one ultrasonographic abnormality. Endoscopically, hyperaemia, oedema, discoloration and/or erosions were found in all cats. Each cat was classified as having mild or moderate-to-severe lesions according to endoscopic results; no classification could be established statistically for ultrasonographic results. The accentuation of the dimpled pattern tended to be inversely related to the severity of endoscopic lesion scoring. Histologically, a large proportion of cats showed typhlitis (13/16), one had lymphoma and two were normal. All cats with typhlitis also had colitis. There was only slight agreement between endoscopic and histological caecal results regarding the severity of lesions. Loss of caecal wall layering on ultrasound was found in 7/18 cats and, surprisingly, did not appear as a reliable predictor of the severity of inflammation or of malignancy; neither did local steatitis nor lymph node size. Conclusions and relevance Ultrasonography and endoscopy should not be used as the sole methods to investigate the ileocaecocolic region in cats with clinical signs suggestive of caecocolic disease. The presence of chronic clinical signs should routinely prompt histological biopsy.