Optimising endotracheal length in adult cats: a retrospective CT study.

OBJECTIVES: The aim of this study was to determine the maximal endotracheal insertion length by measuring the larynx to carina (L-C) distance by means of CT. An additional objective was to establish certain anatomical landmarks to optimise the process of endotracheal intubation (ETI). METHODS: Head, neck and thoracic CT images from adult cats at a single referral hospital between 2013 and 2020 were retrospectively evaluated. After standardising and identifying key markers (larynx, carina and first rib) the L-C, larynx to first rib (L-1R) and first rib to carina (1R-C) distances were measured. RESULTS: Forty-five adult cats were enrolled in the study, from which a total of nine different breeds were identified. The L-C distance was 14.3 ± 1.1 cm. This was longer in male (14.7 ± 1.1 cm) than in female cats (13.5 ± 0.7 cm). The first rib (1R) was 8.8 ± 0.7 cm from the larynx and the mean 1R-C distance was 5.4 ± 0.7 cm. The carina was found within the fifth intercostal space in 93.3% (n = 42) of the cats. CONCLUSIONS AND RELEVANCE: The process of ETI in adult cats may be guided by using the L-C and L-1R distance for a maximal and optimal endotracheal tube introduction, respectively. In addition, the maximal insertion length may be guided by estimating the position of the carina parallel to the fifth intercostal space.

Magnetic resonance imaging of the caudal portion of the digastric muscle in canine idiopathic facial neuropathy.

Idiopathic is the most common etiology for acute onset of facial neuropathy in dogs with limited number of studies describing MRI characteristics. A retrospective, observational study was performed using archived records, aiming to describe the MRI features of the caudal portion of the digastric muscle in dogs diagnosed with idiopathic facial neuropathy and to determine correlation with prognosis. Client-owned dogs presented to a referral hospital between 2009 and 2019, diagnosed with unilateral idiopathic facial neuropathy and having undergone MRI, with images including the caudal portion of the digastric muscle, were included (n = 19). MRI appearance of the affected muscle, including degree of muscle atrophy, signal intensity, enhancement post-contrast, and enhancement characteristics of the affected facial nerve, was described and compared to the contralateral, clinically unaffected caudal portion of the digastric muscle. Correlation between MRI appearance and outcome at 1-month and 3-months following onset of clinical signs was investigated. The majority of patients demonstrated some degree of muscle atrophy (n = 17, 89%), hyperintensity in T2W (n = 17, 89%), and pre-contrast T1W (n = 15, 79%) images, as well as contrast enhancement of the affected muscle (n = 14, 74%) and affected facial nerve (n = 9, 47%). There was no statistically significant correlation between atrophy or enhancement of the affected caudal portion of the digastric muscle nor between enhancement of the affected facial nerve and outcome. Hyperintensity both in T2W images and pre-contrast T1W images was significantly correlated with a worse prognosis. Ensuring inclusion and evaluation of this muscle in MRI may therefore be indicated in canine idiopathic facial neuropathy.

Canine intrahepatic portosystemic shunt insertion into the systemic circulation is commonly through primary hepatic veins as assessed with CT angiography.

Congenital intrahepatic portosystemic shunts (IHPSS) in dogs are traditionally classified as right, left, or central divisional. There are few descriptive studies regarding the variation of IHPSS within these categories. This multicenter, analytical, cross-sectional study aimed to describe a large series of dogs with CT angiography (CTA) of IHPSS, hypothesizing that there would be variation to the existing classification. Ninety CTA studies were assessed for IHPSS type, insertion, and the relationship of the insertion to the primary hepatic veins. Ninety-two percent of IHPSS inserted into a primary hepatic vein (HV) or phrenic vein, 8% inserted directly into the ventral aspect of the intrahepatic caudal vena cava. The most common IHPSS type was a single right divisional (44%), including those inserting via the right lateral HV or the caudate HV. Left divisional IHPSS (33%) inserted into the left HV or left phrenic vein. Central divisional IHPSS (13%) inserted into the quadrate HV, central HV, dorsal right medial HV, or directly into the ventral aspect of the intrahepatic caudal vena cava. Multiple sites of insertion were seen in 9% of dogs. Within left, central, and right divisional types, further subclassifications can therefore commonly be defined based on the hepatic veins with which the shunting vessel communicates. Relating IHPSS morphology to the receiving primary HV could make IHPSS categorization more consistent and may influence the type and method of IHPSS attenuation recommended.

Survey of surgical specialists' content preferences in radiology reports for extrahepatic portosystemic shunts.

The aim of this prospective, survey study was to assess the opinions of specialist surgeons as to the preferred content, nomenclature, and classification of extrahepatic portosystemic shunts for inclusion in radiology reports. A link to an online survey was sent by email to members of the European College of Veterinary Surgeons and the Association of Veterinary Soft Tissue Surgeons, and was made available on the American College of Veterinary Surgeons web forum and Facebook page. There were 93 respondents (survey sent to over 2500 email addresses and made available in two online locations). Most respondents agreed that they both review the images themselves (87/92, 95%) and read the radiology report (82/92, 89%) prior to surgery. Most respondents believed that the radiology report should contain a detailed anatomic description of the insertion (83/92, 90%), origin (54/91, 59%), and course (70/92, 76%) of the shunt, as well as a measure of the diameter of the shunting vessel at its insertion (54/92, 59%). Most respondents (70/90, 78%) disagreed that a brief description of shunt type, such as portocaval or portophrenic, was sufficient. Respondents were undecided regarding the use of an alphanumeric classification system (36/92, 39% agree; 32/92, 35% disagree). There was agreement that details of the presence or absence of urolithiasis (91/93, 98%), renomegaly (54/93, 58%), and peritoneal fluid (72/92, 78%) should be included in the report. The results of this study will help to guide reporting radiologists in providing descriptions of extrahepatic portosystemic shunts that include information most preferred by the recipient surgeons.