Dumon silicone stents can improve respiratory function in dogs with grade IV tracheal collapse: 12 cases (2019-2023).

OBJECTIVE: To evaluate the efficacy, complications, and outcome of Dumon silicone stent placement for dogs with grade IV tracheal collapse. ANIMALS: 12 client-owned dogs. CLINICAL PRESENTATION: Each dog was diagnosed with grade IV TC unresponsive to medical therapy and had severe obstructive respiratory failure. RESULTS: 12 dogs were included in the study. By the end of the study, 5 of 12 (41.7%) remained alive, while 7 of 12 (58.3%) dogs died. Survival times after stent placement ranged from 97 to 1,310 days (mean, 822.43 days; median, 810 days). Three of the 12 (25%) dogs died spontaneously, while 4 of 12 (33.3%) were euthanized. The cause of death was determined for 6 of 7 (85.7%) dogs and was TC related for 3 of 7 (50%). Causes of death related to TC were progressive airway collapse (2/3 [66.6%]) and incoercible cough (1/3 [33.4%]). Complications occurred in 9 of 12 (75%) cases and included granulation tissue growth (3/12 [25%]), incoercible cough (2/12 [16.7%]), stent migration (1/12 [8.3%]), and stent deformation (1/12 [8.3%]). Reduction of obstructive dyspnea and episodes of asphyxiation was achieved after Dumon silicone stent placement. CLINICAL RELEVANCE: The placement of an intraluminal Dumon silicone stent was a successful salvage treatment for TC in dogs that did not respond to medical management. Disease progression is inevitable, but substantial improvement of respiratory function may be achieved for months to years.

Presence of bronchial nodules, younger age, and heavier body weight are associated with a diagnosis of eosinophilic lung disease in dogs with cough.

OBJECTIVE: To describe the association between a diagnosis of eosinophilic lung disease (ELD) in dogs with signalment and bronchoscopic features and evaluate the accuracy of visualization of nodules for the diagnosis of ELD. ANIMALS: 781 dogs with cough that underwent bronchoscopy between 2014 and 2016. PROCEDURES: Data were extracted from the medical records of each included dog. Multivariable logistic regression was performed to investigate associations between ELD and patient characteristics. RESULTS: ELD was diagnosed in 113 (14.5%) dogs. More than 3 nodular lesions of the bronchial mucosa were detected in 64 (8.2%) dogs. The odds of having ELD were greater in dogs with nodules (adjusted OR [aOR], 26.0; 95% CI, 13.0 to 52.0) and static bronchial collapse (aOR, 2.3; 95% CI, 1.1 to 4.6), and lower in dogs having focal versus diffuse inflammation (aOR, 0.05; 95% CI, 0.01 to 0.37). The odds of having ELD decreased for each 1-year increase in age (aOR, 0.86; 95% CI, 0.80 to 0.92), and increased for each 1-kg increase in weight (aOR, 1.04; 95% CI, 1.01 to 1.06). Visualization of nodules during bronchoscopy had a overall accuracy of 89.4% (95% CI, 87.0% to 91.4%), sensitivity of 41.6% (32.4% to 51.2%), and specificity of 97.5% (96.0% to 98.5%) for a diagnosis of ELD. CLINICAL RELEVANCE: On the basis of high specificity and negative predictive value, lack of visualization of bronchial nodules during bronchoscopy can be used to preliminarily rule out ELD. However, visualization of bronchial nodules does not imply presence of ELD. This could be especially relevant when results of BAL cytology are available several days after the actual bronchoscopy.

Diagnosis and outcome of nasal polyposis in 23 dogs treated medically or by endoscopic debridement.

This study describes the clinical, diagnostic, and pathological characteristics of canine nasal polyps and how they responded to medical, endoscopic, and surgical treatments. The database of a multi-center veterinary endoscopy group was searched from 2010 to 2018. All dogs with a histological diagnosis of nasal polyposis that were undergoing endoscopic investigation (N = 23), were included. Clinical signs at presentation were sneezing (91%), nasal discharge (83%), stertor (74%), and frontonasal deformation (17%). Skull radiography on 13 dogs had alterations in 77% of cases, including turbinate lysis (6/13), increased radiopacity of one (4/13) or both (6/13) nasal cavities, and lysis of the nasal vomer bone (3/13). Nasal polyposis had a characteristic endoscopic appearance. There were clinical and diagnostic similarities between this cohort of dogs and dogs with nasal neoplasia, although dogs with nasal polyps were often younger and polypoid tissue was external to the nose. Steroid therapy alone was not effective in treating polyposis in dogs; however, endoscopic debulking with a laser and forceps was more effective.

Diagnostic et issue de la polypose nasale chez 23 chiens traités médicalement ou par débridement endoscopique. Cette étude décrit les caractéristiques cliniques, diagnostiques et pathologiques des polypes nasaux canins et comment ils ont répondu aux traitements médicaux, endoscopiques et chirurgicaux. La base de données d'un groupe multicentres d'endoscopie vétérinaire a été recherchée de 2010 à 2018. Tous les chiens avec un diagnostic histologique de polypose nasale qui faisaient l'objet d'une investigation endoscopique (N = 23), ont été inclus. Les signes cliniques à la présentation étaient des éternuements (91 %), un écoulement nasal (83 %), un stertor (74 %) et une déformation fronto-nasale (17 %). La radiographie du crâne de 13 chiens présentait des altérations dans 77 % des cas, y compris une lyse du cornet (6/13), une radio-opacité accrue d'une (4/13) ou des deux (6/13) cavités nasales et une lyse du vomer nasal (3/13). La polypose nasale avait un aspect endoscopique caractéristique. Il y avait des similitudes cliniques et diagnostiques entre cette cohorte de chiens et celle de chiens atteints de néoplasie nasale, bien que les chiens atteints de polypes nasaux étaient souvent plus jeunes et que le tissu polypoïde était externe au nez. La thérapie stéroïdienne seule n'a pas été efficace dans le traitement de la polypose chez les chiens; cependant, la réduction endoscopique avec un laser et une pince était plus efficace.(Traduit par Dr Serge Messier).

Diode laser treatment in a case of congenital tracheoesophageal fistula in a young dog.

An 8-month-old intact female mixed breed Maremma sheepdog with a history of chronic cough was examined. A diagnosis of congenital tracheoesophageal fistula was made. A novel endoscopic diode laser technique achieved closure of the fistula and resolution of the clinical signs. Our experience has shown that the diode laser technique is an appropriate mode of therapy.

Traitement au laser diode dans un cas de fistule trachée-oesophagienne congénitale chez une jeune chienne. Une chienne berger Maremma de race croisée intacte âgée de 8 mois avec une anamnèse de toux chronique a été examinée. Un diagnostic de fistule trachée-oesophagienne congénitale a été posé. Une nouvelle technique de laser diode endoscopique a réussi à fermer la fistule et a permis de résoudre les signes cliniques. Notre expérience a démontré que la technique au laser diode est un mode approprié de thérapie.(Traduit par Isabelle Vallières).

Comparison of 2 differently sized endoscopic biopsy forceps in the evaluation of intestinal disease in cats.

BACKGROUND: In clinical practice, histopathological diagnosis of chronic intestinal disease is challenging because of difficulty in obtaining adequate duodenal samples. At present, no studies have investigated the influence of biopsy forceps size on sample quality in cats. OBJECTIVES: Duodenal biopsy using larger biopsy forceps (2.4 mm) will provide higher quality samples. ANIMALS: Fifty client-owned cats underwent endoscopy of the upper gastrointestinal tract for evaluation of chronic gastrointestinal signs, with inflammatory bowel disease (IBD) or intestinal lymphoma as differential diagnoses. METHODS: For each cat, duodenal biopsy specimens were obtained using both small (1.8 mm) and large (2.4 mm) forceps and evaluated for adequacy, orientation, the presence of artifacts, villi morphology, the presence of inflammation, and neoplastic infiltration. RESULTS: The percentage of adequate and evaluable biopsy specimens obtained using the larger forceps was significantly higher than that collected using the smaller forceps. Agreement between the forceps was variable for histological features and substantial in the case of lymphoma. However, in case of disagreement, the proper diagnosis usually was achieved only with the larger biopsy forceps. CONCLUSIONS AND CLINICAL IMPORTANCE: Use of a larger biopsy forceps allows collection of a higher percentage of adequate and evaluable biopsy specimens compared to the commonly used smaller forceps and indirectly decreases the percentage of artifacts and increases the percentage of samples with evaluable villi. The use of a larger forceps could be helpful to obtain high-quality samples and improve diagnostic accuracy.

Diagnosis of feline mesenchymal nasal hamartoma by squash preparation cytology.

BACKGROUND: Feline Mesenchymal Nasal Hamartoma (MNH) is a rare benign tumor-like lesion of the sinonasal tract affecting young cats. OBJECTIVES: This study aimed to determine the diagnostic significance of osteoblast-like (OB-L) and osteoclast-like cells (OC-L) in squash preparation cytology from endoscopic biopsies. METHODS: A 5-year database was retrospectively reviewed and included 109 cases of which 24 were diagnosed as MNH by histopathology. Slides were examined by two cytologists (one experienced and one inexperienced in nasal and squash cytology) in a double-blind study. The inexperienced cytologist counted OB-L and OC-L in 500 intact nucleated cells. The experienced cytologist assigned samples to four categories for OB-L (0, 1-5, 6-10, >10/field) and OC-L (0, 1-2, 3-5, >5/field). RESULTS: The presence of OB-L and OC-L was significantly associated (P < 0.001) with the histologic diagnosis of MNH. Receiver operating characteristic curves from the counts by the inexperienced cytologist revealed 3/500 OB-L and 2/500 OC-L as the best cut-offs for the diagnosis of MNH. Those of the experienced cytologist evaluation revealed that all the MNHs presented more than 10 OB-L/field and 3 or more OC-L/field. Both cytologists detected each cell type in all MNHs with an overall concordance of 0.93. CONCLUSIONS: The presence of OB-L and OC-L is a consistent finding in MNH, and thus, represents a reliable cytologic diagnostic criterion. The described methods are applicable in routine in-clinic laboratory settings and are easy to apply at any expertise level. Further prospective studies are needed to assess the accuracy of the proposed cut-off values.

Nasopharyngeal sialoceles in 11 brachycephalic dogs.

OBJECTIVE: To report clinical features, diagnosis, surgical treatment, and outcomes of brachycephalic dogs with nasopharyngeal sialoceles (NPS). STUDY DESIGN: Retrospective case series. ANIMALS: Eleven brachycephalic dogs with NPS. METHODS: Diagnosis of NPS was based on identification of cystic nasopharyngeal masses containing saliva-like mucoid material on retroflexed endoscopy. Biopsies were obtained to support the diagnosis. Surgical deroofing was performed under endoscopic guidance, and endoscopic examination was repeated at least 3 months after surgery. The owners rated the outcome of surgery via a follow-up telephone inquiry. RESULTS: Pugs (n = 8), French bulldogs (n = 2), and English bulldogs (n = 1) were included in this study. Eight of the NPS were ventral, 6 were obstructive, and 2 were multiple; both the obstructive and the multiple sialoceles were ventral. Surgical deroofing of the sialoceles was performed under endoscopic guidance with biopsy forceps in 5 cases and by diode laser in 6 cases. No recurrence was diagnosed. Ten of 11 owners reported that they were satisfied with the outcome. CONCLUSIONS AND CLINICAL SIGNIFICANCE: NPS may be an uncommon consequence of chronic nonphysiologic mechanical stress causing changes in minor nasopharyngeal salivary glands. Direct visualization by nasopharyngoscopy is the best technique for detection of NPS, and we advise routine examination of the nasopharynx by endoscope in all brachycephalic dogs before performing surgery. Either endoscopic guided biopsy forceps or diode laser surgery can be used for noninvasive, rapid, and effective resolution of NPS in all of the dogs.

Treatment of acquired nasopharyngeal stenosis using a removable silicone stent.

The aim of this prospective study was to characterise patient characteristics and the histories of cats with acquired nasopharyngeal stenosis (ANS), and to describe the use of a removable silicone stent for treatment. ANS was diagnosed in 15 cats with clinical signs present for a median of 4 months. Clinical signs included stertor and inspiratory difficulty, nasal discharge, sneezing, dysphagia, regurgitation, vomiting and anorexia. Radiographs revealed a dorsal deviation or deformation of the caudal part of the soft palate in 10 of the cats, a soft tissue density across the cranial nasopharynx in four and no abnormality in one. The stenosis was initially dilated with a Kelly forceps in 10 of the cats and by balloon dilatation in five. A segment of a 24 Fr silicone thoracic catheter was used for the stent in five cats; in the other 10 cats a segment of a 28 Fr catheter was used. The stent was removed after 3 weeks in 12 cats and after 4 weeks in the other three. Endoscopy revealed an adequate nasopharyngeal diameter in all of the cats. At both 3 and 10 months after surgery the response was considered to be satisfactory, with complete resolution of clinical signs in 14 cats and improvement in the remaining cat. The treatment of ANS by stenosis dilatation followed by temporary stenting with a silicone stent is a rapid, safe, economical and effective procedure.

Characterization of cytoplasmic hyaline bodies in a hepatocellular carcinoma of a dog.

This report describes the morphological and immunohistochemical features of intracytoplasmic inclusion bodies found in a 13-year-old Yorkshire dog with a hepatocellular carcinoma and referred for anorexia, lethargy and mild polydipsia. Fine-needle aspirates of the large abdominal mass revealed high number of pleomorphic neoplastic hepatocytes, containing round to polygonal, well-demarcated, hyaline bodies. Same findings were histologically confirmed on multiple biopsies. Immunohistochemically, the inclusion bodies were negative for alpha-1-antitrypsin, carcinoembryonary antigen, fibrinogen, IgG, IgM, cytokeratins 7, 8, 18, 19, 20. By transmission electron microscopy, the cytoplasmic inclusions were composed of granular homogeneous or reticulated electrondense matrix, enclosed within dilated rough endoplasmic reticulum or remnants of its membranes, consistent with proteinaceous material accumulated within neoplastic hepatocytes due to aberrant protein secretion or transport. This is the first detailed characterization of hyaline cytoplasmic inclusion bodies in canine hepatocellular carcinoma.

Cytologic, histologic, and immunohistochemical features of lingual liposarcoma in a dog.

A 9-year-old female spayed mixed-breed dog was presented to the referring veterinarian with a history of decreased appetite and difficulty with prehension and swallowing because of a firm oval mass in the tongue. On cytologic evaluation of a fine-needle aspirate of the mass there were numerous round to polygonal cells organized individually or in loose clusters with rare branching capillaries. The cells had eosinophilic granular cytoplasm, round to oval nuclei, and occasionally indistinct borders. The cytologic diagnosis was granular cell tumor (GCT) of the tongue. Impression smears of a biopsy sample of the lingual mass contained similar eosinophilic granular cells with variable numbers of clear vacuoles in the background, numerous perivascular arrangements, and occasional lipoblasts, suggestive of liposarcoma. On histologic examination the tumor was composed of numerous lipocytes with rare foci of round eosinophilic granular cells without evidence of vacuolation; occasionally, atypical mitotic figures were seen. Immunohistochemically, the cells were uniformly negative for periodic acid-Schiff and did not express smooth muscle actin, desmin, or cytokeratin but were immunoreactive for vimentin and S100. A diagnosis of well-differentiated liposarcoma was made on the basis of morphologic and immunohistochemical results. Eosinophilic granular cells may be a component of well-differentiated liposarcoma and are not limited to GCT. Liposarcoma should be considered in the differential diagnoses of lingual tumors in the dog when cytological evaluation reveals eosinophilic granular cells consistent with GCT.

Bronchial abnormalities found in a consecutive series of 40 brachycephalic dogs.

OBJECTIVE: To detect abnormalities of the lower respiratory tract (trachea, principal bronchi, and lobar bronchi) in brachycephalic dogs by use of endoscopy, evaluate the correlation between laryngeal collapse and bronchial abnormalities, and determine whether dogs with bronchial abnormalities have a less favorable postsurgical long-term outcome following correction of brachycephalic syndrome. DESIGN: Prospective case series study. ANIMALS: 40 client-owned brachycephalic dogs with stertorous breathing and clinical signs of respiratory distress. PROCEDURES: Brachycephalic dogs anesthetized for pharyngoscopy and laryngoscopy between January 2007 and June 2008 underwent flexible bronchoscopy for systematic evaluation of the principal and lobar bronchi. For dogs that underwent surgical correction of any component of brachycephalic syndrome, owners rated surgical outcome during a follow-up telephone survey. Correlation between laryngeal collapse and bronchial abnormalities and association between bronchial abnormalities and long-term outcome were assessed. RESULTS: Pugs (n = 20), English Bulldogs (13), and French Bulldogs (7) were affected. A fixed bronchial collapse was recognized in 35 of 40 dogs with a total of 94 bronchial stenoses. Abnormalities were irregularly distributed between hemithoraces; 15 of 94 bronchial abnormalities were detected in the right bronchial system, and 79 of 94 were detected in the left. The left cranial bronchus was the most commonly affected structure, and Pugs were the most severely affected breed. Laryngeal collapse was significantly correlated with severe bronchial collapse; no significant correlation was found between severity of bronchial abnormalities and postsurgical outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Bronchial collapse was a common finding in brachycephalic dogs, and long-term postsurgical outcome was not affected by bronchial stenosis.

Differential cell counts in canine cytocentrifuged bronchoalveolar lavage fluid: a study on reliable enumeration of each cell type.

BACKGROUND: Bronchoalveolar lavage (BAL) allows cell recovery from the lower respiratory tract; differential cell counts of BAL fluid gives important information in the assessment of various bronchial and pulmonary diseases. To the best of our knowledge no study has investigated the relation between the number of cells counted and the reproducibility of BAL fluid differential cell counts. OBJECTIVE: The purpose of this study was to investigate using statistical methods how many cells should be counted in cytocentrifuged BAL fluid preparations in order to obtain a reliable enumeration of each cell type. METHODS: BAL fluid samples from dogs with suspected bronchopulmonary disease were obtained during fiberoptic bronchoscopy with a standardized protocol. Differential cell counts were performed on May-Grünwald-Giemsa-stained cytocentrifuged preparations by 2 independent observers. Reproducibility for the enumeration of each cell type was expressed as the intraclass correlation coefficient. We considered a threshold level of >or=0.90 to be high and a threshold level of >or=0.85 to be adequate. RESULTS: Forty BAL fluid samples were included in the study. For neutrophils, alveolar macrophages, and eosinophils high reproducibility was reached by counting 200 cells; adequate reproducibility was reached for lymphocytes and bronchial epithelial cells by counting 500 cells. CONCLUSIONS: A 500-cell differential count is required for all types of cells to be quantified with adequate reproducibility in canine cytocentrifuged BAL fluid samples.

Cytologic detection of Call-Exner bodies in Sertoli cell tumors from 2 dogs.

A 14-year-old Italian Griffon and an 11-year-old mixed breed dog were presented to our clinic with monolateral testicular enlargement. In both dogs, a firm, nodular, and nonpainful mass was palpated, and ultrasonographic examination of testicular parenchyma showed a large and irregular nodular area with hyperechogenic features. Fine-needle aspirates of the masses were highly cellular and consisted of populations of large elongated vacuolated cells in sheets and palisades, with finely granular chromatin and prominent nucleoli, consistent with neoplastic Sertoli cells. A variable number of structures also were observed that consisted of a central round area of amorphous, deeply eosinophilic, hyaline material surrounded by a peripheral, rosette-like arrangement of single or multiple rows of Sertoli cells. These structures were suggestive of Call-Exner bodies. Histologic sections of the tumors obtained following castration confirmed the diagnosis of Sertoli cell neoplasia and the presence of Call-Exner bodies. The Call-Exner bodies were intensely positive with PAS, toluidine blue, and Ziehl-Neelsen stains, moderately positive with alcian blue, and negative with Congo red and Luxol fast blue. Call-Exner bodies, thought to represent an attempt by neoplastic cells to form basement membrane, are seen most frequently in granulosa cell tumors, but are occasionally reported in testicular tumors that contain epithelial elements of sex-cord origin. To our knowledge, this is the first description of Call-Exner bodies in cytologic specimens from dogs, and only the fifth report of their presence in canine testicular neoplasms.

Gastric dilatation-volvulus associated with diaphragmatic hernia in three cats: clinical presentation, surgical treatment and presumptive aetiology.

Three cats were examined because of acute dyspnoea and sudden abdominal enlargement. In all cats, radiographs revealed gastric dilatation-volvulus (GDV) and diaphragmatic hernia. Cardiovascular shock and dyspnoea were treated by intravenous fluid-therapy, oxygen administration and relief of diaphragmatic pressure by means of stomach decompression and in one case placing the patient in an inclined position. Gastric decompression was performed by needle gastrocentesis, placement of a rhino-gastric tube, or a combination of these. Diaphragmatic herniorrhaphy was performed in either case; one cat also underwent gastropexy. The immediate postoperative period resolved uneventfully and the cats were doing well at follow-up. Feline GDV is a rare event in which diaphragmatic hernia may be a predisposing factor.

Squash-preparation cytology from nasopharyngeal masses in the cat: cytological results and histological correlations in 30 cases.

Upper airway obstruction in cats can be a life-threatening condition. Early recognition of clinical signs and an appropriate diagnostic approach increases the possibility of appropriate therapeutic choices. The purpose of this study was to assess the efficacy and diagnostic value of squash-preparation cytology in providing an accurate diagnosis of masses growing in the nasopharynx of cats. Cytological specimens prepared by a squash technique from nasopharyngeal masses in 30 cats were collected under direct endoscopic guidance and classified into four groups: benign inflammatory/hyperplastic mass, lymphoma, carcinoma and sarcoma. The cytopathological diagnosis was compared with the final histopathological diagnosis and indices of diagnostic test accuracy were calculated. The results showed good agreement between the cytological and histological diagnosis with a sensitivity of 0.94, a specificity of 0.81, a positive likelihood ratio of 0.9, a negative likelihood ratio of 0.9 and an overall accuracy of 0.9. Squash-preparation cytology is considered an accurate diagnostic tool for distinguishing benign from malignant nasopharyngeal masses in cats. For differentiation of lymphoma and lymphoid reactions histopathological confirmation is recommended.

A true "triphasic" pattern: thoracolumbar spinal tumor in a young dog.

An 8-month-old male Bernese Mountain Dog was referred with a history of hindlimb weakness that progressed to paresis on the right side. An intradural mass was detected in the spinal canal at the level of the 2nd and 3rd lumbar vertebrae. During surgical removal, 2 small fragments of the mass were prepared for cytologic examination by the squash technique. Cytologic examination revealed 3 different cell types: mesenchymal (stromal) cells, epithelial cells, and small undifferentiated hyperchromatic cells. On the basis of location and the triphasic cytologic pattern, a diagnosis of spinal nephroblastoma (thoracolumbar spinal tumor of young dogs) was made; histologic examination of the mass confirmed the cytologic diagnosis. To our knowledge, this is the first report of a triphasic pattern in a cytologic sample; recognizing this pattern is an important aid in reaching a definitive cytologic diagnosis.

Diagnostic value of cytologic examination of gastrointestinal tract tumors in dogs and cats: 83 cases (2001-2004).

OBJECTIVE: To determine results of cytologic examination of fine-needle aspirates and impression smears of gastrointestinal tract tumors in dogs and cats. DESIGN: Retrospective case series. ANIMALS: 38 dogs and 44 cats with histologically confirmed gastrointestinal tract tumors. PROCEDURES: Results of cytologic examination of fine-needle aspirates (n = 67) or impression smears (31) were compared with the histologic diagnosis, and extent of agreement was classified as complete, partial, none, or undetermined. RESULTS: For 48 of the 67 (72%) fine-needle aspirates, there was complete or partial agreement between the cytologic and histologic diagnoses. For 12 (18%) aspirates, the extent of agreement could not be determined because the cytologic specimen was considered unsatisfactory. For 29 of the 31 (94%) impression smears, there was complete agreement between the cytologic and histologic diagnoses, and for 2 (6%), there was partial agreement. None of the impression smears were considered unsatisfactory. Proportion of samples with complete agreement and proportion of samples with complete or partial agreement were significantly higher for impression smears than for fine-needle aspirates. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that there was moderate agreement between results of cytologic examination of fine-needle aspirates from dogs and cats with gastrointestinal tract neoplasia and the definitive histologic diagnosis. The agreement between results of cytologic examination of impression smears and the histologic diagnosis appeared to be higher.