Paraneoplastic hypercalcemia in a canine patient with a mandibular salivary carcinoma.

OBJECTIVE: To describe a novel presentation of paraneoplastic hypercalcemia caused by a canine salivary carcinoma. ANIMAL: A 6-year-old intact male Husky with hypercalcemia and a spontaneous salivary carcinoma, stage III. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: The dog presented with polyuria, polydipsia, and hypercalcemia. Physical examination revealed a 37 X 43-mm firm mass in the ventrolateral aspect of the right-hand side of the neck, caudal to the temporomandibular joint. Incisional biopsy was suspicious of metastatic carcinoma to the mandibular lymph node. A full-body CT scan found a large, heterogenous, contrast-enhancing mass on the right ventrolateral neck that appeared to be originating from either the mandibular lymph node or right mandibular salivary gland. Parathyroid hormone-related protein was considered within normal reference intervals, and both parathyroid glands appeared ultrasonographically normal. TREATMENT AND OUTCOME: The patient was treated with a marginal surgical excision of the mass, without immediate complications. Histopathology confirmed the presence of a salivary carcinoma with narrow margins of excision and invasion of the mandibular lymph node. Twenty-four hours after surgery, ionized calcium returned to normal reference values and clinical signs completely resolved. CLINICAL RELEVANCE: Hypercalcemia is an urgent pathology with important systemic implications requiring prompt diagnosis and intervention. In this case report, we identify the first salivary carcinoma associated with a paraneoplastic hypercalcemia, including this pathology as a new differential diagnosis. The hypercalcemia resolved with marginal surgical excision, but interestingly the parathyroid hormone-related protein was not overexpressed, meaning that this neoplasia could mediate hypercalcemia by another pathophysiological mechanism.

Evaluation of radiographs for the detection of sublumbar lymphadenopathy in dogs.

The purpose of this study was to evaluate radiographs for the detection of sublumbar lymph node (SLN) enlargement. Ultrasound was used to determine SLN size. Twenty-two dogs with anal gland adenocarcinoma or lymphoma were prospectively included, with 16/22 having SLN enlargement on ultrasound. Twenty-one dogs without enlargement were retrospectively included as controls. Three blinded observers evaluated 43 right lateral abdominal radiographs for the presence of SLN enlargement. Sensitivity and specificity of radiographs for the detection of SLN enlargement were 81%/70%, 94%/81%, and 75%/100% for a general practitioner, imaging resident, and radiologist, respectively. Ventral displacement of the colon, a soft tissue opacity in the caudal retroperitoneal space and loss of conspicuity of the ventral margin of the iliopsoas muscle were radiographic findings significantly associated with identification (P-values < 0.05). Markedly enlarged SLNs (> 21.5 mm) were consistently detected radiographically by observers with specialist imaging training. Key clinical message: Radiographic visualization should raise suspicion of neoplastic infiltration of SLN but lack of visualization does not exclude mild to moderate enlargement. Additional imaging such as ultrasound or computed tomography remains important to confirm or exclude sublumbar lymphadenopathy.

Évaluation de radiographies pour la détection de lymphadénopathie sub-lombaire chez des chiens. Le but de la présente étude était d'évaluer des radiographies pour détecter l'augmentation de taille des ganglions sub-lombaires (SLN). L'échographie fut utilisée pour déterminer la taille des SLN. Vingt-deux chiens avec un adénocarcinome des glandes anales ou un lymphome furent inclus prospectivement, avec 16/22 ayant des SLN augmentés lors de l'échographie. Vingt-et-un chiens sans augmentation de taille furent inclus rétrospectivement comme témoins. Trois observateurs ont évalué à l'aveugle 43 radiographies abdominales latérales droites pour la présence d'augmentation des SLN. La sensibilité et la spécificité des radiographies pour la détection d'augmentation des SLN étaient de 81 %/70 %, 94 %/81 % et 75 %/100 % pour un praticien généraliste, un résident en imagerie et un radiologiste, respectivement. Un déplacement ventral du côlon, une opacité des tissus mous dans l'espace rétropéritonéal caudal et une perte de visibilité de la bordure ventrale du muscle iliopsoas furent des trouvailles radiographiques associées significativement avec l'identification (P < 0,05). Des SLN avec une forte augmentation de taille (> 21,5 mm) étaient constamment détectés radiographiquement par des observateurs avec une formation spécialisée en imagerie.Message clinique clé:La visualisation radiographique devrait soulever des soupçons d'infiltration néoplasique des SNL mais le manque de visualisation n'exclu pas une augmentation de taille de légère à modérée. Des analyses en imagerie additionnelles, telles que l'échographie ou la tomodensitométrie, demeurent importantes pour confirmer ou exclure une lymphadénopathie sub-lombaire.(Traduit par Dr Serge Messier).

Effect of osteoarthritis on the repeatability of patella tendon angle measurement in dogs.

OBJECTIVE: To evaluate the influence of osteoarthritis on the measurement of patella tendon angle (PTA) and determine intraobserver and interobserver variability. STUDY DESIGN: Retrospective clinical study. SAMPLE POPULATION: Eighty-seven mediolateral radiographs that were obtained prior to tibial tuberosity advancement. METHODS: Radiographic osteoarthritis was scored by 2 observers using guidelines derived from the International Elbow Working Group Protocol. Patella tendon angle was measured by 3 observers on 3 occasions, with at least 7 days between measurements. The data were statistically analyzed via weighted κ and Kruskal-Wallis testing. RESULTS: A fair strength of agreement was found among observers scoring osteoarthritis, with the same grades in 48% of radiographs. The intraobserver average bias between PTA measurements 1 and 3 ranged from -0.38° to -0.94°. Interobserver bias in angle measurement ranged from -0.92° to -2.00°. Observer 1 had the narrowest range of PTA differences (12.1°), and observer 3 had the highest range of PTA differences (23.5°). Observer 2 had the lowest mean bias (-0.38°). The mean bias was lowest between observers 1 and 2 (-0.92°) and highest between observers 1 and 3 (-2.0°). The mean intraobserver standard deviation of the PTA measurement differences was 2.90°, and interobserver standard deviation of the PTA measurement differences was 2.26°. The degree of osteoarthritis did not influence PTA measurements or their variability. CONCLUSION: The current study did not find evidence of an influence of osteoarthritis on PTA or on the repeatability of measurements. CLINICAL SIGNIFICANCE: Our findings suggest that osteoarthritis should not affect the radiographic planning for tibial tuberosity advancement surgery. The high variances in PTA measurement in less experienced observers may influence the clinical outcome of surgery.

Nonsurgical management of traumatic pneumoperitoneum in a cat.

OBJECTIVE: To describe the nonsurgical management of a cat with traumatic pneumoperitoneum. CASE SERIES SUMMARY: A 4-year-old cat was presented following vehicular polytrauma. Thoracic radiographs revealed 4 rib fractures, a scapular fracture, and pneumothorax. Abdominal ultrasound revealed a small volume of free abdominal fluid. Computed tomography showed a mild pneumoretroperitoneum and a pneumoperitoneum in the region of the porta hepatis. The cat was managed conservatively with close monitoring. Exploratory laparotomy was not pursued given patient stability and static serial imaging studies revealing no indications for surgical intervention. After 6 days, the pneumoperitoneum was no longer detectable. NEW OR UNIQUE INFORMATION PROVIDED: To the authors' knowledge, this is the first report of successful nonsurgical management of traumatic pneumoperitoneum in a cat.

Imaging findings in 11 cats with feline dysautonomia.

Dysautonomia is caused by degeneration of the autonomic ganglia. Failure of the autonomic system affecting the gastrointestinal and urinary tracts can cause oesophageal distension and/or dysfunction, gastric and bowel distension and hypomotility, and urinary bladder distension. The aim of this retrospective study was to describe diagnostic imaging findings in cats with dysautonomia. Common findings were megaoesophagus and/or oesophageal dysfunction, gastric distension and signs of intestinal ileus. Associated aspiration pneumonia and megacolon appeared less commonly. Although diagnostic imaging findings are not specific for this disease, if findings in multiple systems are detected, along with consistent clinical signs and neurological deficits, dysautonomia should be considered among the differential diagnosis.

Computed tomographic features of incomplete ossification of the canine humeral condyle.

OBJECTIVES: To describe computed tomographic (CT) features of canine elbows with incomplete ossification of the humeral condyle (IOHC) and investigate co-existing incongruence in the elbow joint. STUDY DESIGN: Case control study. ANIMALS: Dogs with IOHC (n=20; 38 elbows) and 25 normal elbows. METHODS: Elbows with IOHC and normal elbows were assessed by CT. Standardized dorsal and sagittal reconstructions were created at 3 levels using image analysis software to obtain single measurements of the humero-radial and humero-ulnar joint spaces. On dorsal plane reconstructions, joint space measurements were obtained at the center point of the humero-radial and humero-ulnar articulations. Joint incongruity was defined as the difference between the humero-radial and the humero-ulnar joint spaces. RESULTS: Nineteen dogs (95%), all Spaniel breeds, had either bilateral IOHC demonstrable as a saw-toothed intercondylar complete or incomplete hypoattenuating defect with hyperattenuating margins, or IOHC with contralateral humeral condylar fracture (HCF). Joint incongruity values for IOHC were compared with those of normal elbows. Significant differences were noted at the levels of the medial coronoid apex (P<.0001) and base (P<.004) indicative of humero-ulnar incongruence. Evidence of medial coronoid disease in 10 elbows (26%) and degenerative joint disease in 30 elbows (79%) was also found. CONCLUSIONS: Presence of elbow incongruence may be an underlying factor in failure of ossification centers to fuse leading to IOHC. CLINICAL RELEVANCE: IOHC is clearly defined by CT, and it should be considered in larger Spaniel breeds, with a chronic forelimb lameness or HCF.

A comparison of the rostrocaudal open mouth and rostro 10 degrees ventro-caudodorsal oblique radiographic views for imaging fluid in the feline tympanic bulla.

Fluid within the tympanic bulla is an indication of middle ear disease. Radiography has a relatively low accuracy for the detection of soft tissue opacification in the tympanic bulla, and the most useful radiographic projection, the rostrocaudal open mouth (RCd (open mouth)), is technically difficult to perform in dogs and cats. An alternative projection for the feline tympanic bulla, the rostro 10 degrees ventro-caudodorsal oblique (R10 degrees V-CdDO), was compared to the RCd (open mouth) in 41 feline cadaver heads with the tympanic bullae randomly filled with KY jelly. Computed tomography was used as the gold standard. Each tympanic bulla was recorded as being positive or negative for soft tissue opacification. Although there was no significant difference between the accuracy of the two views, the R10 degrees V-CdDO was subjectively more accurate and easier to perform, and in a live patient may be performed without the need for general anesthesia. The R10 degrees V-CdDO projection is a good alternative to the RCd (open mouth) projection for detecting otitis media in the cat.