Emphysematous pyometra and emphysematous hepatitis caused by Klebsiella pneumoniae infection in a diabetic dog.

A 14-year-old intact female diabetic dog presented with seizures and hyperglycemic hyperosmolar syndrome. Radiographs revealed gas-filled tubular structures in the right and left caudal abdomen, raising concerns of emphysematous pyometra or small intestinal ileus. Ultrasonography played a pivotal role in confirming emphysematous pyometra, a technique previously documented only once in veterinary practice. This report also presents the first documented case of emphysematous pyometra in a diabetic dog attributed to Klebsiella pneumoniae and complicated by emphysematous hepatitis.

Computed tomography of the coelomic cavity in healthy veiled chameleons (Chamaeleo calyptratus) and panther chameleons (Furcifer pardalis).

Background: Veiled chameleon (Chamaeleo calyptratus) and panther chameleon (Furcifer pardalis) are two of the most popular pet chameleons, and consequently, these species are frequently evaluated in veterinary practices. According to our review of the literature, normal computed tomography (CT) anatomy of these lizards has not been previously described. Aim: The purposes of this prospective study were to describe the normal CT anatomy of the coelomic organs in healthy patients and to provide normal reference values in these species. Methods: Seventeen clinically healthy veiled chameleons and 15 clinically healthy panther chameleons were included. All CT studies were performed with the chameleons under light anesthesia and positioned in sternal recumbency. Studies were performed with a 16-slice helical CT scanner with a slice thickness of 0.625 mm. The authors recorded qualitative and quantitative CT characteristics of the coelomic structures. Macroscopic cross-sectional anatomy was performed for comparison of the CT findings. Results: Heart, lungs, liver, including caudal vena cava, hepatic vessels, gallbladder, esophagus, stomach, intestines, gonads, fat bodies, kidneys, and urinary bladder could be visualized with CT. The spleen, pancreas, and adrenal glands could not be identified. Conclusion: This study provides a guide to the normal cross-sectional and computed tomographic anatomy of the coelomic cavity in veiled and panther chameleons. Our results could be used as a reference for future research studies or comparison of clinically ill patients.

Calvarial hyperostosis syndrome in a Dalmatian dog.

Key Clinical Message: Calvarial hyperostosis syndrome is an uncommon and self-limiting disease affecting juvenile dogs. Only symptomatic treatment has been described, and diagnosis is based on clinical findings, imaging, and disease progression. Abstract: This is the first reported case of calvarial hyperostosis syndrome in a Dalmatian dog. It is an uncommon osteoproliferative disease with diagnosis frequently based on clinical signs, imaging findings, and disease progression, with only symptomatic treatment described. Case describes a 5-month-old Dalmatian dog presented with a facial mass and difficulty eating. After imaging, mass was observed to be osteoproliferative, nonaggressive, and without affection of the temporomandibular joints and mandibles. Histology revealed an osseous-cartilaginous and proliferative lesion, together with scant amount of neutrophiles. Clinical improvement was observed after symptomatic treatment, and moderate lesion regression was observed in a CT reevaluation 6 months later.

Needle tract seeding and malignant transformation of hepatocellular adenoma into well-differentiated hepatocellular carcinoma in a dog.

An 11-year-old neutered female Golden Retriever was referred for investigation of marked increases in liver enzyme activities. Abdominal ultrasound revealed a large pedunculated liver mass. Diagnosis of hepatocellular adenoma (HCA) was made when the mass was excised after a first unsuccessful attempt through ultrasound-guided core-needle biopsy. One and a half years after presentation, a nodule embedded between muscles of the abdominal wall appeared. The mass was first diagnosed as a well-differentiated hepatocellular carcinoma (HCC) through cytologic examination, which was later confirmed with histopathology. Ki 67 immunostaining of the abdominal wall nodule showed an increased immunoreactivity compared with the liver mass. Therefore, the present case documents the first needle-tract seeding of a hepatocellular epithelial tumor with possible malignant transformation of HCA into a well-differentiated HCC in a dog.

Intracranial Granular Cell Tumours in Three Dogs: Atypical Magnetic Resonance Imaging Features and Immunohistochemical Study.

Intracranial granular cell tumours (GCT) are uncommon neoplasms of uncertain cellular origin that are rarely reported in dogs. This case series describes three aged dogs that presented with neurological signs in which magnetic resonance (MR) imaging revealed plaquelike extra-axial lesions that were hypointense on T2-weighted (T2w) images. The surgical biopsy of the lesions and necropsies were followed by histochemical characterisation with periodic acid-Schiff (PAS) staining and immunohistochemistry with ubiquitin, S-100, and SOX-10 to elucidate the cellular origin. The immunohistochemical study indicated that these intracranial GCTs were not of Schwann cell origin. In conclusion, GCTs should be considered a differential diagnosis of intracranial, extra-axial hypointense brain lesions on T2w MR images.

Anatomic, computed tomographic, and ultrasonographic assessment of the lymph nodes in presumed healthy adult cats: the abdomen, pelvis, and hindlimb.

BACKGROUND: The computed tomography (CT) and ultrasonography (US) features of lymph nodes of the abdomen, pelvis, and hindlimb in healthy cats are poorly described in the current literature. A prospective anatomic and reference interval study was therefore performed. The lymph nodes of six feline cadavers were identified, and dimensions were measured (length, width, and height). The lymph nodes from 30 healthy adult cats were identified and measured using CT (pre- and postcontrast) and US. The identification and dimensions of the separate lymph nodes were compared between imaging techniques and the anatomic study. RESULTS: The identification of lymph nodes was most frequent in CT, and the dimensions were overall larger than those identified and measured in US and the anatomic study. The caudal epigastric and sacral lymph nodes were not identified in the anatomic study. The ischiatic, lumbar aortic, internal iliac, and caudal epigastric lymph nodes were not visualized in US. The height presented the main statistical differences among techniques. The lymph nodes were mainly homogeneous in pre- and postcontrast CT and US images. Some lymph nodes showed a hyperattenuating periphery with a hypoattenuating center (on pre- and postcontrast images) and a hypo-/isoechoic periphery with a hyperechoic center, representing the hilar fat. The lymph nodes were commonly elongated and rounded except for the jejunal lymph nodes, which had an irregular shape. CONCLUSIONS: The assessment of most of the abdominal, pelvic, and hindlimb lymph nodes in the cat is feasible using CT and US, with CT performing best. Factors like the amount of adipose tissue and contrast administration subjectively improved the lymph node visualization and assessment. The measurements and features reported are proposed as reference values.

MRI features of canine hemangiosarcoma affecting the central nervous system.

Hemangiosarcoma is the most common metastatic tumor involving the brain in dogs but detailed published descriptions of the magnetic resonance imaging (MRI) features are lacking. The objective of this multi-center, retrospective case series study was to describe MRI characteristics of canine hemangiosarcoma affecting the central nervous system (CNS). Medical records of seven referral institutions were retrospectively reviewed. Dogs were included if they had a histopathologically confirmed diagnosis of hemangiosarcoma affecting the CNS and undergone an MRI of the brain and/or vertebral column. Lesions were independently evaluated by two observers. Twenty dogs met the inclusion criteria and one dog had both intracranial and intramedullary hemangiosarcoma. Consistent MRI features included heterogeneous (17/21) lesions in all sequences with mainly mixed signal intensity (12/21), presence of susceptibility artifact on T2*w (15/16), associated moderate to severe perilesional edema (21/21), and moderate to strong (20/21) heterogeneous (14/21) or ring-like (6/21) contrast enhancement. Intracranial hemangiosarcoma was frequently multiple and intra-axial, affecting consistently the telencephalon and no differences in MRI features were found between primary and metastatic hemangiosarcoma. This is the first MRI description of primary intracranial hemangiosarcoma and primary intracranial epithelioid hemangiosarcoma. Vertebral hemangiosarcomas were segmental poorly marginated polyostotic and highly aggressive lesions invading the thoracic vertebral canal and paraspinal tissues. Epidural hemangiosarcomas were single and well-marginated lesions in the thoracolumbar and/or lumbar region. Intramedullary hemangiosarcomas were cervical, metastatic in origin, and frequently (3/4) accompanied by intracranial lesions. These described MRI features will aid early identification of hemangiosarcoma guiding subsequent diagnostics and therapeutics.

Diagnostic imaging and pathological findings of an abdominal mesenteric granular cell tumour in a dog.

A 12-year-old mixed-breed dog was presented for a follow-up examination after ablation of an auricular mast cell tumour. An abdominal ultrasound and computed tomography were performed and an irregular, ill-defined and partially mineralised lesion was observed around the caudal duodenal flexure without evidence of metastasis. The cytologic examination was highly suggestive of a granular cell tumour. Partial surgical ablation with histological and immunohistochemical examination of the lesion confirmed the diagnosis. According to our review of the literature, this is the first report documenting an abdominal granular cell tumour in a dog.

Anatomic, computed tomographic, and ultrasonographic assessment of the lymph nodes in presumed healthy adult cats: The head, neck, thorax, and forelimb.

Assessment of the lymph nodes is key in staging cancer patients. Descriptions of normal features of the feline lymph nodes using computed tomography (CT) and ultrasound (US) are limited. A prospective anatomic and comparative imaging study was performed. The frequency of identification and the size of the lymph nodes during gross pathology from 6 feline cadavers were compared to the images of lymph nodes from 30 presumed healthy adult cats obtained by CT and US. Measurements (length, width, and height) were compared among techniques. The CT and US features of the identified lymph nodes were also recorded. The frequency of identification of the lymph centers varied among techniques and individually. The mandibular lymph nodes were identified in 100% of the cadavers and in 100% of the healthy cats using CT and US. The medial retropharyngeal lymph nodes were identified in 100% of the cats using CT and US. The deep cervical lymph nodes were not visualized in the cadavers. The cranial mediastinal and tracheobronchial lymph nodes were not visualized using US. Lymph nodes showed a higher length on CT and higher width on US. The height was the most statistically significant variable measurement among techniques. On CT, lymph nodes were most frequently isoattenuating or slightly hypoattenuating to surrounding musculature, with homogeneous contrast enhancement. On US, most lymph nodes were isoechoic or hypoechoic to surrounding fat tissue. The lymph nodes were most frequently elongated or rounded.

Paradoxical Vestibular Syndrome Caused by a Presumptive Cerebellar Infarction in a Rabbit.

A 6-year-old, female spayed rabbit (Oryctolagus cuniculus) presented with right paradoxical vestibular signs. Magnetic resonance imaging was performed and findings were consistent with an ischemic infarct of the cerebellum. The patient improved gradually and was free of clinical signs at the time this article was written. To the authors' knowledge this is the first case report of a paradoxical vestibular syndrome in a rabbit secondary to a presumptive ischemic infarct. Strokes should be included in the differential diagnosis of central vestibular syndrome in rabbits.

Spontaneous emphysematous splenitis: Radiographic and ultrasonographic findings in three Golden Retriever dogs.

Spontaneous emphysematous splenitis is a life-threatening condition reported rarely in humans; however, published reports in dogs are currently lacking. The aim of this multicentric, retrospective, case series design study was to describe radiographic and ultrasonographic imaging findings in Golden Retriever dogs diagnosed with spontaneous emphysematous splenitis. A total of three dogs were sampled. All dogs had a history of lethargy, diarrhea, and weight loss. Radiographic findings in all dogs included a mass effect with focal or multifocal coalescing "vesicular-like" gas pattern in the splenic region and focal loss of serosal detail. Ultrasonographic findings in all dogs included focal or multifocal irregularly shaped, hypoechoic areas containing a mixture of hyperechoic fluid and gas within the splenic parenchyma, hyperechoic abdominal free fluid, and generalized hyperechoic mesenteric fat without evidence of splenic torsion. Pneumoperitoneum was detected ultrasonographically and radiographically in two dogs. All three dogs underwent splenectomy and splenic torsion was definitively ruled out at surgery. One dog died three days after surgery, whereas the other two dogs recovered uneventfully. Culture of the splenic tissue and free abdominal fluid was positive for Clostridium spp. in all three cases. Findings supported inclusion of spontaneous emphysematous splenitis and septic peritonitis as differential diagnoses for dogs with this combination of clinical and imaging characteristics.

Pre-contrast CT attenuation of the thyroid gland is lower in brachycephalic dogs versus non-brachycephalic dogs.

Computed tomography has been used in human medicine to evaluate the thyroid gland functional status by means of Hounsfield units (HU). Studies describing attenuation value abnormalities, other than those in thyroid neoplasia, lack in veterinary medicine. The authors have observed a subjective reduction in thyroid attenuation in some patients undergoing CT for reasons other than thyroid disease. This finding has been identified more frequently in brachycephalic breeds compared to non-brachycephalic breeds. In order to determine the thyroid gland attenuation variability on CT, a retrospective and prospective, analytical, cross-sectional study was performed. The thyroid attenuation values of 65 client-owned dogs were assessed using a 16-slice helical CT scanner. Differences in attenuation between brachycephalic and non-brachycephalic dogs were estimated by Welch's t-test. Serum TT4 and TSH levels were available in 26 patients. Statistically significant differences were observed in the pre-contrast attenuation value ranges between brachycephalic and non-brachycephalic dogs (P = .04). The pre-contrast attenuation value range for the brachycephalic group was 69.1-108 HU while being 75.8-121 HU for the non-brachycephalic group. No significant correlation was found between thyroid attenuation and serum thyroid hormone levels in our population (P > .6). All patients with hypoattenuating thyroid were brachycephalic and reported euthyroid. In conclusion, brachycephalic dogs seem to have a pre-contrast attenuation thyroid gland range lower than non-brachycephalic dogs. The present study contributes to the veterinary literature by providing a new thyroid attenuation value range for brachycephalic breeds. Additionally, hypoattenuating thyroid glands may be found in dogs with normal TT4 and TSH values.

CT characterisation of feline adrenal glands.

OBJECTIVES: The objectives of this study were to describe the CT characteristics of the adrenal glands in healthy cats, to provide normal reference biometry for adrenal gland size and attenuation values, and to investigate the association with age, sex, laterality and body weight. METHODS: Retrospective evaluation of 30 CT studies of healthy adult cats recruited from September 2013 to July 2015 was performed. Healthy cats >1 year of age were included based on the absence of clinical signs, unremarkable physical examination, normal results of the complete blood count, biochemical profile, feline immunodeficiency virus, feline leukaemia virus and Bartonella species infection tests. The relationship between gland biometry (size and attenuation values) and the age, sex, laterality and body weight of cats were tested by two-way ANOVA. The intraclass correlation coefficient was assessed and mean, SD, range and reference interval provided. RESULTS: Twenty-seven cats were included. Bilobed, arrowhead and oval adrenal gland shape patterns were recognised, the first being most common. No statistically significant differences were observed between the biometric parameters (length, height and attenuation values) and age, sex, laterality or body weight of the cats. Regarding the width of the adrenal glands, there was a statistically significant effect of sex and laterality. The length (11.6 ± 2.1 mm) and height (6.1 ± 1.3 mm) were the most consistent biometrical parameters to describe adrenal glands. CONCLUSIONS AND RELEVANCE: Adrenal gland shape, size and attenuation CT data of healthy feline patients are provided in this study, as well as normal reference intervals for morphometric characterisation based on adrenal length and height.

Computed tomographic features of destructive granulomatous rhinitis with intracranial extension secondary to leishmaniasis in a cat.

A 5-year-old castrated male Domestic Shorthair cat presented for evaluation of chronic history of nasal discharge and nasal stridor. On computed tomography (CT), a destructive ill-defined mass of soft tissue attenuation was occupying the right nasal cavity and extending into the left nasal cavity, nasopharynx, and rostral cranial cavity. Histopathology of the rhinoscopically excised samples consisted with destructive granulomatous rhinitis secondary to Leishmania spp. Chronic granulomatous rhinitis with intracranial and nasopharyneal extension secondary to Leishmania spp. infection should be included as a differential diagnosis for a destructive nasal mass of soft tissue attenuation, especially in endemic regions for leishmaniasis.

CT characterisation of the feline os penis.

OBJECTIVES: The aim of this study was to investigate the frequency of identification and to describe the CT features of the os penis in cats without genitourinary disorders. METHODS: CT studies from cats that underwent an abdominal or pelvic examination between October 2013 and May 2019 were reviewed retrospectively. Cats with no signs of urinary disease and with the external genitalia included in the scan were recruited. Length, width, height and pre- and post-contrast attenuation values of the os penis in soft tissue and bone algorithms were measured independently by two observers. RESULTS: Twenty-three cats met the inclusion criteria. A cylindrical bone-attenuating structure inside the glans penis compatible with the os penis was visible in 20/23 (87%) cats. Mean length, width and height values were 3.48 mm × 1.41 mm × 1.37 mm in the soft tissue algorithm, and 3.26 mm × 1.15 mm × 1.06 mm in bone algorithm. The size of the os penis was not significantly different in neutered vs intact cats, but it was significantly larger in soft tissue vs bone algorithm. Age and body weight did not influence os penis size. Pre-contrast mean ± SD attenuation was 216.7 ± 69.5 Hounsfield units (HU) for soft tissue and 320.1 ± 135.9 HU for bone algorithms. Post-contrast attenuation was 289.1 ± 68.8 HU for soft tissue and 383.4 ± 130.9 HU for bone algorithms. A significant correlation between the attenuation in bone algorithm with body weight was noted, where the os penis was less attenuating with increased body weight (pre-contrast: r = -0.479; P = 0.038). CONCLUSIONS AND RELEVANCE: The feline os penis is commonly seen on CT images, being more frequently detected than on radiographs. Its presence should not be mistaken for uroliths in the penile urethra.

Ultrasonographic appearance of the coelomic cavity organs in healthy veiled chameleons (Chamaeleo calyptratus) and panther chameleons (Furcifer pardalis).

Veiled chameleons (Chamaeleo calyptratus) and panther chameleons (Furcifer pardalis) are the most popular chameleons over the world, and consequently, two of the most frequent species presenting to veterinary practices. However, published studies on normal ultrasonographic anatomy for these lizards are currently lacking. The objectives of this prospective anatomic study were to develop an ultrasound protocol for evaluation of the coelomic cavity in these species and describe the normal ultrasonographic anatomy of the coelomic organs. Seventeen healthy veiled chameleons and 15 healthy panther chameleons were included. A linear 18 MHz transducer was used. Chameleons were sedated and restrained in right lateral recumbency by an assistant. Longitudinal and transverse images were acquired, and authors recorded qualitative and quantitative ultrasonographic characteristics of the coelomic structures. The kidneys, liver, caudal vena cava, hepatic veins, portal vein, gallbladder, wall of the stomach and intestine, gonads and, when distended, urinary bladder could be visualized during ultrasonography of the coelomic cavity in both species. The spleen, pancreas, and adrenal glands could not be identified. Findings from the current study supported the use of ultrasonography for veiled chameleons (Chamaeleo calyptratus) and panther chameleons (Furcifer pardalis) with suspected intracoelomic diseases and provided normal reference information for future studies of these chameleon species.

Dystrophic mineralisation in chronic exogenous lipid pneumonia in cats.

CASE SERIES SUMMARY: Exogenous lipid pneumonia with mineralisation of the lung parenchyma was diagnosed in three cats with radiographs, CT and/or bronchoalveolar lavage cytological findings. All three cats had a common clinical history of chronic constipation and long-term forced oral administration of mineral oil. All three cases showed radiographic findings compatible with aspiration pneumonia, with an alveolar pattern in the ventral part of the middle and/or cranial lung lobes. Minor improvement of the radiographic lung pattern in the follow-up studies was seen in two cats, and a miliary 'sponge-like' mineralised pattern appeared in the previously affected lung lobes months to years after the diagnosis. In one cat, patchy fat-attenuating areas in the consolidated lung lobes were present on thoracic CT. Cases 1 and 2 showed respiratory signs at the initial presentation, while in case 3 the radiographic findings were incidental and the cat had never exhibited respiratory signs. RELEVANCE AND NOVEL INFORMATION: This is the first report to describe dystrophic mineralisation of the lung in exogenous lipid pneumonia and also the first to describe the CT features in cats. Exogenous lipid pneumonia should be included in the differential diagnosis in cases of miliary 'sponge-like' mineral opacities in the dependent part of the lung lobes on thoracic radiographs or CT in cats, especially in cases of chronic constipation, previously exposed to mineral oil.

Hypercalcemia of Malignancy in a Dog Diagnosed With Cholangiocellular Carcinoma.

A 4-year-old, neutered male Golden Retriever was presented with a 1-week history of weight loss, polyuria, and polydipsia. The diagnostic workup showed an increased ionized calcium concentration, mild increase in serum creatinine and urea concentration, and severe hyperlipasemia. A complete abdominal ultrasound revealed multiple hepatic nodules. A cytological diagnosis of malignant epithelial neoplasia, highly suggestive of bile duct adenocarcinoma was made. In order to confirm the presumptive diagnosis of hypercalcemia of malignancy due to the presence of a hepatic neoplasia, serum parathormone-related peptide concentration was measured, and the result revealed an increased concentration. The dog was hospitalized and received supportive treatments consisting of intravenous furosemide and fluid therapy. After ruling out lymphoma and hypoadrenocorticism, oral prednisone was initiated and ionized calcium concentration decreased gradually down to normal concentration after 7 days of hospitalization. Chemotherapy with intravenous epirubicin was initiated based on the cytological diagnosis. One month after diagnosis and due to the worsening of its clinical condition, the dog was humanely euthanized. Postmortem examination confirmed a cholangiocellular carcinoma. To our knowledge, this is the first report of malignant hypercalcemia associated with cholangiocellular carcinoma in a dog.

Description of digital fluoroscopic excretory urography in healthy New Zealand rabbits (Oryctolagus cuniculus).

Disorders of the kidneys and urinary tract are relatively common in rabbits. Survey radiographs and abdominal ultrasound have inherent limitations in the evaluation of the urinary tract in this species; because of that, contrast study modalities are a valuable diagnostic tool in rabbits with urinary disorders. The aims of this study were to describe digital fluoroscopic excretory urography (DFEU) and to determine the urogram phases in healthy New Zealand rabbits. The median time of beginning of the nephrographic and pyelographic phases was 10 seconds (IQR: 10-12 seconds) and 1.39 minutes (IQR: 1.27-1.60 minutes). The median time in which the contrast medium was visible in the urinary bladder was 1.58 minutes (IQR: 1.44-1.72 minutes). Results of this study indicate that DFEU provides a good degree of opacification of the kidneys as well as the ureters, and allows the evaluation of the urogram phases. Text not justifed in the proof version.