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.

Comparison of imaging techniques to detect migrating foreign bodies. Relevance of preoperative and intraoperative ultrasonography for diagnosis and surgical removal.

OBJECTIVE: To report the relative sensitivity of different diagnostic imaging (DI) techniques to detect migrating foreign bodies (FB) in subcutaneous and underlying soft tissue structures of dogs and evaluate the value of intraoperative ultrasonography (intraop-US). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Forty-one dogs. METHODS: Medical records (2007-2019) of dogs that underwent surgery for a chronic abscess or draining tract were included when preoperative US (preop-US), computed tomography (preop-CT), or preop-MRI, and at least 6 months of follow-up information were available. Collected data included the DI techniques used, DI findings, and surgical findings. The relative sensitivity of each preoperative DI (preop-DI) technique was calculated. Dogs were divided into two groups, dogs that underwent only a preop-DI examination (group A) and dogs that underwent an additional intraop-US (group B). The success rates for FB surgical removal were compared between groups. RESULTS: The relative sensitivity of preop-US and preop-CT/MRI was 88% (95% CI, 70%-95.8%) and 57.1% (95% CI, 32.6%-78.6%), respectively. The success rate for FB removal was higher in group B (89.5%) than in group A (59.1%; P = .038). Clinical resolution occurred in 90.2% of dogs for a median duration of follow-up of 4.2 years (6 months to 9.3 years). CONCLUSION: Preoperative US seems more suitable than preop-CT/MRI for detection of migrating FB in subcutaneous and underlying soft tissue structures. The use of intraop-US increases the success rate for FB surgical removal. CLINICAL SIGNIFICANCE: Intraoperative US should be used in combination with preop-US to increase the likelihood of migrating FB surgical removal in dogs.

Multimodal Imaging Characteristics of a Migrating Oropharyngeal-Spinal Foreign Body in a Cat.

A 2.5 yr old female spayed domestic shorthair presented for acute tetraparesis, dull mentation, and fever. MRI and computed tomography identified a thin linear foreign body extending from the caudal nasopharynx through the atlanto-occipital joint and cervicomedullary junction. Signal changes within the musculature were consistent with myositis, edema, and abscessation. Inflammation and edema surrounded the foreign body, and a dorsal cervical myelopathy extended caudally to the level of C6. Computed tomography attenuation values of the foreign body were most consistent with plant material. Euthanasia was performed; postmortem dissection of the soft palate confirmed a plant stem with abscess.

CT is helpful for the detection and presurgical planning of lung perforation in dogs with spontaneous pneumothorax induced by grass awn migration: 22 cases.

Spontaneous pneumothorax induced by grass awns accounts for 5% of spontaneous pneumothorax and 22.5% of thoracic grass awn cases. Previous studies report limited interest of CT for spontaneous pneumothorax. Aims of this retrospective case series were to describe CT features of this condition and determine if CT features can efficiently localize the perforation site. Dogs that had a spontaneous pneumothorax, CT examination, thoracic surgery, and confirmed lung perforation due to a grass awn were included. Computed tomography studies were reviewed and compared to the surgical findings.  In 19 of 22 (86.4%) dogs, the pneumothorax or its recurrence were ipsilateral to the perforation site. The perforation site was identified in 21 of 22 (95.5%) dogs and involved the caudal lobes in 20 of 22 (90.9%) cases. The lateralization and the involved lung lobe corresponded to surgical findings in 21 of 22(95.5%) dogs. The perforation site was characterized as a soft tissue attenuating focus lying against an extensive pleural thickening in 21 of 22(95.5%) dogs. An adjacent defect in the visceral pleura was seen in 13 of 22(59.1%) dogs. A grass awn was seen in 11 of 22(50%) dogs.  The pneumothorax distribution and grass awn position consistently indicated the perforation side in this sample of dogs. The comparison with surgical findings suggests CT might be helpful for future presurgical planning of this etiology for pneumothorax.

Migration of retrobulbar wooden foreign body between diagnostic imaging and surgical extraction in a German shepherd dog.

A 2-year-old, male castrated German shepherd dog was presented to the University of Tennessee Veterinary Medical Center (UTVMC) with periorbital swelling and conjunctival mucopurulent discharge 2 days following removal of a twig from the medial canthus by the owner. Diagnostic imaging was pursued due to the suspicion of a retrobulbar foreign body (FB). A cylindrical FB approximately 3.0 cm in length and 1.0 cm in diameter with concentric rings, suspected to be wooden material, was identified on computed tomography (CT) imaging. An attempt to remove the FB via a stab incision using ultrasound guidance was unsuccessful, and postmanipulation ultrasound confirmed the FB position was unchanged. An exploratory orbitotomy was performed, using the acquired CT images for guidance in locating the FB; however, the FB was not present at the predicted site. The CT imaging was repeated and showed that the FB had migrated rostrally approximately 3.0 cm, compared to the originally acquired study and its same location during attempted ultrasound-guided removal. A combination of CT-guided needle placement and contrast injection was then used with repeat imaging in an attempt to better localize the FB and its soft tissue tract. The dog was taken back into the operating room, and the wooden FB was successfully removed.

Utility of bronchoscopy combined with surgery in the treatment and outcomes of dogs with intrathoracic disease secondary to plant awn migration.

OBJECTIVE: To evaluate the diagnostic and therapeutic utility of bronchoscopy in dogs undergoing computed tomography (CT) and surgery for intrathoracic disease (pyothorax and pneumothorax) secondary to migrating plant awns (MPA) and to report outcomes in dogs that did and did not undergo bronchoscopy in addition to CT and surgery. STUDY DESIGN: Retrospective case series. ANIMALS: Thirty-seven client-owned dogs. METHODS: Medical records from 2008 to 2017 were reviewed for dogs with documented MPA in the thoracic cavity treated with CT and surgery with or without bronchoscopy. Information regarding diagnostics, treatments, complications, and outcomes relating to hospitalization was evaluated. RESULTS: At least one abnormal lung lobe was identified by CT in all dogs. Bronchial abnormalities were identified with bronchoscopy in 21 of 22 dogs (95.4%) with available reports. Agreement between CT and bronchoscopy findings ranged from 50% to 81.8%, depending on lung lobe. Thirty-six dogs had one or more lung lobes surgically removed. Thirty-seven MPA were retrieved via bronchoscopy in 10 of 27 (37%) dogs, and 39 MPA were retrieved at surgery in 26 of 37 (70.3%) dogs. Actinomyces spp. were cultured from surgical samples in 7 of 33 (21.2%) dogs. Thirty-five of 37 (94.6%) dogs survived to discharge. CONCLUSION: Migrating plant awns were successfully retrieved via bronchoscopy. Agreement between CT findings and bronchoscopy was inconsistent, so there may be roles for both modalities. Short- and long-term survival was excellent in this cohort. CLINICAL SIGNIFICANCE: Bronchoscopy may allow for diagnostic and therapeutic advantages compared with CT in dogs with endobronchial MPA. Actinomyces spp appear to be variably present in surgically acquired bacterial cultures in dogs with MPA.

Deep Vegetal Foreign Bodies in Cats: A Retrospective Study of 10 Cases.

The aim of this study was to describe the anatomic locations and treatments available for deeply located vegetal foreign bodies in cats. Ten cases of migrating vegetal foreign bodies (vFBs) requiring surgical removal are reported. The diagnoses of vFBs in the thoracic cavity (4/10), retroperitoneal space (2/10), and paratracheal region (1/10) were obtained by ultrasound examination; however, in the perineum or penile urethra (2/10) and peritoneum (1/10), the vFBs were found during surgery. Intraoperative ultrasound guidance helped remove vFBs from the retroperitoneal space and paratracheal tissues. Clinical signs resolved in 8 out of 10 cases, 1 out of 10 cases had recurrent draining fistula, and 1 out of 10 was euthanized for ethical reasons. The intrathoracic was the most common location in the present study, followed by retroperitoneal space and urethra/perineum. Ultrasound guidance was essential for the diagnosis and/or treatment of vFBs located in the thoracic, retroperitoneal, and cervical regions.

Laparoscopic retrieval of a hepatic foreign body in a dog.

A 4-year-old female pointer dog was presented with a 10-day history of tensed abdomen. Migration of a metallic foreign body to the liver was diagnosed using radiography and ultrasonography. Surgical retrieval of a sewing needle was successfully performed by laparoscopy using a 3-trocar technique, thus avoiding laparotomy. No intra- or post-operative complications occurred. The dog was discharged 24 hours after surgery. Ten months after surgery, the dog was in excellent physical condition with no recurrence of clinical signs. This is the first reported case of laparoscopic retrieval of a hepatic foreign body in a dog.

Retrait d'un corps étranger dans le foie par laparoscopie chez un chien. Une femelle pointer de 4 ans fut présentée avec un historique d'inconfort abdominal et d'abdomen tendu. Un corps étranger métallique dans le foie a été identifié par radiographie et échographie. Le retrait d'une aiguille de couture fut réalisé par laparoscopie au moyen de trois ports instrumentaux, évitant ainsi le recours à une laparotomie. Aucune complication per ou post opératoire n'est survenue. La sortie de l'hôpital a eu lieu 24 heures après la chirurgie. Dix mois après la chirurgie, le chien était en excellent état général sans récidive des signes cliniques. Il s'agit du premier cas de retrait par laparoscopie d'un corps étranger dans le foie chez un chien.(Traduit par l'auteur).

IMAGING DIAGNOSIS-COMPUTED TOMOGRAPHY FINDINGS IN A DOG WITH SPONTANEOUS TRANSMURAL MIGRATION OF A TEXTILOMA INTO THE CECUM.

A 3-year-old spayed female dog was presented with 3-month history of severe bilateral uveitis subsequent to previous ovariohysterectomy. Physical examination revealed moderate abdominal pain. Computed tomography showed a nonobstructive heterogeneous mass-like lesion with a speckled gas pattern (spongiform pattern) within the cecum. Exploratory laparotomy revealed a surgical swab in the lumen of the cecum with severe adhesions. Histopathological examination demonstrated a chronic inflammatory pyogranulomatous reaction to the retained swab embedded within the intestinal wall, consistent with transmural migration of the swab from the peritoneal cavity into the cecum.

SMALL INTESTINAL INTRAMURAL HEMATOMA SECONDARY TO A MIGRATING WIRE FOREIGN BODY IN A DOG.

A 12-year-old spayed female Labrador retriever was presented for a 5-day history of vomiting and inappetence. Radiographic findings included poor peritoneal serosal contrast, segmental small intestinal dilation, and multiple linear, metal opaque, intestinal and peritoneal wire foreign bodies. Sonographic findings included septated, hypoechoic, mural expansion of the distal duodenum and jejunum; and an intramural, thin, linear hyperechogenicity with distal acoustic shadowing consistent with a foreign body. Exploratory laparotomy was performed with resection of the affected distal duodenum and proximal jejunum. Histopathology of the excised segment confirmed an intramural hematoma. This case represents an uncommon complication of migrating wire foreign bodies.

Diagnosis and treatment of massive porcupine quill migration in a dog.

A 5-year-old spayed female Boston terrier mixed breed dog was presented with porcupine quill migration. The quills were difficult to detect directly using computed tomography and magnetic resonance imaging. This case highlights difficulties faced in detecting porcupine quills with current diagnostic imaging modalities and describes surgical and medical management of a patient with massive quill migration.

Diagnostic et traitement de la migration massive des aiguilles de porc-épic chez une chienne. Une chienne Boston terrier de race croisée âgée de 5 ans a été présentée avec une migration des aiguilles de porc-épic. Les aiguilles ont été difficiles à détecter directement en utilisant une tomodensitométrieet une imagerie par résonance magnétique. Ce cas souligne les difficultés rencontrées lors de la détection des aiguilles de porc-épic avec les modalités d'imagerie de diagnostic actuelles et il décrit la gestion chirurgicale et médicale d'une patiente atteinte d'une migration massive d'aiguilles.(Traduit par Isabelle Vallières).

Hepatic abscesses in five outdoor-housed rhesus macaques (Macaca mulatta).

Hepatic abscesses are uncommon in non-human primates and usually occur as multifocal microabscesses originating from bacteremia. Necropsy, histopathology, and bacterial cultures were performed on five subadult to adult female rhesus macaques (Macaca mulatta) that died spontaneously. Necropsy findings included cavitating abscesses in the right central liver lobe of all five animals, with intralesional plant material in four animals. This is the first report of cavitating hepatic abscesses with intralesional plant material in non-human primates.

Imaging diagnosis--transesophageal ultrasound-guided removal of a migrating grass awn foreign body in a dog.

A 3-year-old English Setter dog was presented for an acute onset of coughing. Tracheobronchoscopic examination allowed localization and removal of one grass awn foreign body. A second migrated grass awn was suspected to be present in the left caudal lung lobe. Transesophageal ultrasound revealed an area of pulmonary consolidation in the dorsomedial portion of left caudal lobe and a linear hyperechoic structure consistent with a grass awn foreign body within the area of consolidation. Transesophageal ultrasonography was also used to provide anatomical landmarks that facilitated successful thoracoscopic removal of the foreign body.

Migrating Porcupine Quills: Sudden Death of a Yearling American Black Bear (Ursus americanus) at a Wildlife Rehabilitation Center.

A yearling, intact, apparently healthy male American black bear (Ursus americanus) died peracutely at a rehabilitation facility in Ontario, Canada while overwintering, after recovery from porcupine quilling a few months previously. The postmortem examination findings support that porcupine quill migration should be a differential for cause of sudden death in wildlife.

Surgical retrieval of a metallic foreign body from the spleen of a dog.

This is the first report of a metallic foreign body in the spleen of a dog. The animal had abdominal discomfort with a tucked-up abdomen and occasional vomition. Radiography and ultrasonography were used to identify a splenic foreign body which was surgically removed through a ventral midline celiotomy. Migration of the foreign body through the stomach wall was suspected as the most likely cause.

Identification of an intra-cranial intra-axial porcupine quill foreign body with computed tomography in a canine patient.

An intra-cranial intra-axial foreign body was diagnosed in a golden retriever dog through the use of computed tomography (CT). Confirmed by necropsy, a porcupine quill had migrated to the patient's left cerebral hemisphere, likely through the oval foramen. This case study demonstrates the efficacy of CT in visualizing a quill in the canine brain.

Video-assisted thoracoscopic surgery for pneumothorax induced by migration of a K-wire to the chest.

A 2 yr old female English setter dog was admitted for acute dyspnea. The dog underwent treatment of a T9T10 thoracic vertebral fracture subluxation at the authors' institution 15 mo earlier. Upon admission, a chest X-ray revealed a pneumothorax and a metallic foreign body in the left hemithorax. An emergency video-assisted thoracoscopic surgery was successfully performed to remove a 4.6-mm long Kirschner wire that migrated from the thoracic vertebral column to the thoracic cavity. The operating time was 27 min. The dog made an uneventful recovery and was discharged on the third day after surgery. Pneumothorax should be considered in patients that develop acute dyspnea and have a history of wire fixation in the thoracic vertebral column. Video-assisted thoracoscopic surgery is a safe and effective treatment of this condition.

Mouse barley awn (Hordeum murinum) migration induced cystolithiasis in 2 male dogs.

Two male dogs were presented with cystic uroliths composed of magnesium ammonium phosphate (struvite). Each had an atypical nidus, a mouse barley awn (Hordeum murinum). To our knowledge, this is the first report of grass awns located in the bladder lumen of dogs. The composition of uroliths and the pathophysiology of grass awn migration to the urinary bladder are discussed.

Mini-invasive approach for removal of iliopsoas migrating grass awns with an atraumatic wound retractor.

This case series describes a novel mini coeliotomy approach using a radial, atraumatic self-retaining retractor for the retrieval of migrant plant foreign bodies from the iliopsoas muscles of six male dogs under intra-operative ultrasonographic guidance. Four dogs had a history of pulmonary disease potentially compatible with inhalation of a foreign body approximately 2-4 months before presentation. Under ultrasonographic guidance, the grass awns were identified in the iliopsoas muscle and were completely removed. In this case series, the annular ring device provided an excellent view of the surgical field for intra-abdominal manipulations. Patient follow-up at 15 days and 6 to 12 months after surgery indicated a full recovery, and no grass awn fragment residues were identified.

Delayed spinal cord injury following microchip placement in a dog.

A three-year-old female, entire Yorkshire Terrier dog was examined because it had progressive non-weight-bearing left forelimb lameness and tetraparesis of two weeks duration. Clinical signs were first observed following mating. Examination confirmed non-weight-bearing left forelimb lameness and tetraparesis. Left forelimb muscle atrophy was also noticed. Survey radiography revealed a metallic foreign body consistent with a microchip in close proximity to the left articular facets between the fifth and sixth cervical vertebrae. Computed tomography identified the exact location of the foreign body encroaching on the left dorsolateral vertebral canal, and osteolysis of the lamina of the sixth cervical vertebra. Surgical removal of the foreign body was performed via a dorsal approach to the caudal cervical vertebral column. Two weeks following surgery the dog showed return of left forelimb function and resolving tetraparesis. Microchip implantation had been performed three years previously.