Pseudomembranous Cystitis: An Uncommon Ultrasound Appearance of Cystitis in Cats and Dogs.

In veterinary medicine, pseudomembranous cystitis (PC) is a rare condition described only in cats. The purposes of this retrospective study were to describe ultrasound features of PC in cats and dogs, predisposing factors, comorbidities and outcomes. Cats and dogs with an ultrasonographic diagnosis of PC were included in the study. The bladder ultrasound findings that were recorded were: pseudomembranes' characteristics, abnormalities of the bladder's wall and content and anomalies of the pericystic peritoneal space. Ten cats and four dogs met the inclusion criteria. Four pseudomembrane adhesion patterns were described. The presence of pseudomembrane acoustic shadowing was observed in the 60% of cats. A total of 80% of the cats included were presented for urethral obstruction (UO) and/or had at least one episode of UO in the previous 2 months. Thirteen patients out of fourteen received only medical therapy, and all of them survived. PC is a rare disorder in cats and dogs and there are some ultrasonographic differences between the two species, suggesting a greater severity of the pathology in cats. Chronic cystitis and UO may have a potential role in the development of feline PC. Finally, the medical approach can be a non-invasive and effective approach for PC.

Evaluation of diagnostic and prognostic usefulness of abdominal ultrasonography in dogs with clinical signs of acute pancreatitis.

OBJECTIVE: To report abdominal ultrasonography (AUS) findings in dogs with clinical signs of acute pancreatitis (AP) during the first 2 days of hospitalization and to compare AUS findings with severity of disease and mortality rate. ANIMALS: 37 client-owned dogs with clinical signs of AP. PROCEDURES: Dogs suspected of having AP with complete medical records, AUS examinations performed throughout the first 2 days of hospitalization, and available frozen surplus serum samples for quantitative measurement of canine pancreatic lipase (cPL) concentrations at hospital admission met the criteria for study inclusion. Dogs were grouped as AUS+ or AUS- on the basis of positive or negative findings for AP on AUS, respectively. Abdominal ultrasonography findings of AP were stratified (as mild, moderate, or severe) by use of an AUS severity index, and a canine acute pancreatitis severity score was calculated. RESULTS: 24 of 37 (64.8%) dogs had AUS findings of AP at hospital admission, whereas 10 had positive findings for AP on AUS within 2 days of hospitalization. Three (8%) dogs were AUS- but had serum cPL concentrations > 400 µg/L (ie, values considered diagnostic for AP). On the AUS severity index, 5 of 34 (14.7%) AUS+ dogs had mild findings, 18 (52.9%) AUS+ dogs had moderate findings, and 11 (32.4%) AUS+ dogs had severe findings. Severe findings were associated with a higher risk of death than mild and moderate findings. A significant association was found between canine acute pancreatitis severity scores and mortality rates. CONCLUSIONS AND CLINICAL RELEVANCE: For dogs with clinical signs of AP, repeated AUS examinations during hospitalization should be performed, severe findings on the AUS severity index may indicate an increased risk of death, and serum cPL concentrations may increase earlier than findings on AUS of AP.

Ultrasonographic Diagnosis of Urachal Anomalies in Cats and Dogs: Retrospective Study of 98 Cases (2009-2019).

This retrospective study investigated the prevalence of different urachal anomalies (UA) in cats (n = 60) and dogs (n = 38) and their association with clinical symptoms and urinalysis alterations. Among UA, the vesicourachal diverticulum was the most prevalent UA diagnosed in both cats (96.7%) and dogs (89.5%): the intramural vesicourachal diverticulum was diagnosed in 76.7% of cats and 71.1% of dogs, followed by extramural vesicourachal diverticulum (20.0% and 18.4% respectively). In both cats and dogs, bladder wall diffuse or regional thickening was the most prevalent alteration. The most common alterations of the urinary bladder content were urolithiasis sediment in cats (33.3%) and in dogs (31.6%). Dogs with UA were more often asymptomatic (p = 0.01). No difference was found in cats. Stranguria, hematuria, and urethral obstruction were the most frequently reported clinical signs, while hematuria and leukocyturia were the most prevalent abnormalities at urinalysis. In conclusion, our study confirmed UA as uncommon, and often incidental findings, with a high prevalence of animals without clinical signs.

Pulmonary complications in dogs with acute presentation of pancreatitis.

BACKGROUND: In humans, respiratory complications in patients with acute pancreatitis (AP) are a common life-threatening comorbidity. Since possible lung impairment has not been individually evaluated in canine AP, the aims of the present study were to: (1) describe the prevalence, types and severity of pulmonary complications in dogs with acute presentation of AP, and (2) evaluate their association with mortality. AP diagnosis was based on compatible clinical and laboratory parameters, abnormal canine pancreatic-lipase test, and positive abdominal ultrasound within 48 h from admission. The canine acute pancreatitis severity score (CAPS) was calculated for each dog at admission. Arterial blood gas analysis and thoracic radiography were performed at admission. Thoracic radiography was classified on the basis of pulmonary pattern (normal, interstitial or alveolar) and a modified lung injury score (mLIS) was applied to the ventrodorsal projections for each dog. VetALI/VetARDS were diagnosed using current veterinary consensus. Dogs were divided into non-survivors or survivors (hospital discharge). Clinical, radiological and blood gas parameters collected at presentation were compared between survivors and non-survivors and associated with mortality. RESULTS: This prospective cohort study included twenty-six client-owned dogs with AP. Twelve out of twenty-six dogs (46%) died or were euthanized. At admission, thirteen dogs showed respiratory distress at physical examination, which was associated with death (P < 0.001). Radiographic abnormalities were found in twenty-one dogs: alveolar (n = 11) and interstitial pattern (n = 10). Radiographic alterations and mLIS score were both associated with death (P = 0.02 and P = 0.0023). The results of the arterial blood-gas evaluation showed that non-survivors had lower PaCO2 and HCO3- levels, and higher A-a gradient than survivors (P = 0.0014, P = 0.019 and P = 0.004, respectively). Specifically, three dogs had aspiration pneumonia, and VetALI was diagnosed in nine dogs (34.6%), and no dogs met the criteria for VetARDS. The presence of VetALI was associated with mortality (P < 0.001). CONCLUSIONS: As with humans, possible lung impairments, such as VetALI, should be investigated in dogs with acute presentation of pancreatitis.

Sublumbar grass awns in two cats: ultrasonographic features and ultrasound-guided retrieval.

CASE SERIES SUMMARY: Two adult cats were evaluated because of recurrent abscesses of the right lateral thoracoabdominal wall. The abscesses receded with antibiotics but relapsed shortly after therapy interruption. Ultrasonography identified fluid-filled lesions containing linear, hyperechoic material with distal acoustic shadowing in the sublumbar region of both cats. Ultrasound-guided retrieval of grass awns was performed in both cases, which resulted in complete clinical resolution. RELEVANCE AND NOVEL INFORMATION: While sublumbar abscesses in dogs are a relatively common disease, their occurrence in cats is much less common. To our knowledge, this is the first report describing the ultrasonographic features of sublumbar abscessation induced by foreign bodies and their ultrasound-guided retrieval in cats.

Emphysematous cystitis: Retrospective evaluation of predisposing factors and ultrasound features in 36 dogs and 2 cats.

This retrospective study investigated predisposing factors and ultrasound features in dogs (n = 36) and cats (n = 2) with emphysematous cystitis (EC). Urinary tract infection was present in 25 patients (65.8%), impaired immune system in 10 (26.3%), bladder stones in 9 (23.7%) and neurologic bladder in 7 (18.4%). Diabetes mellitus was present in only 4 patients (10.5%). Most patients had positive urine culture (n = 35; 92.1%), with elevated concentration of Escherichia coli in 25 patients (71.4%). The most common ultrasound features were diffuse thickening of the urinary bladder (n = 15; 39.5%), polyps (n = 9; 23.7%), and focal thickening (n = 4; 10.5%). In 13 patients (34.2%) the bladder wall was not assessable, due to excessive bladder gas. Bladder gas was mostly identified in the lumen (n = 18; 47.4%), followed by the bladder wall (n = 11; 28.9%), and wall and lumen (n = 9; 23.7%).

Cystite emphysémateuse : évaluation rétrospective des facteurs prédisposants et des caractéristiques des échographies chez 36 chiens et 2 chats. Cette étude rétrospective a examiné les facteurs prédisposants et les caractéristiques chez des chiens (n = 36) et des chats (n = 2) atteints d'une cystite emphysémateuse (CE). Une infection des voies urinaires était présente chez 25 patients (65,8 %), un système immunitaire affaibli chez 10 patients (26,3 %), des calculs vésicaux chez 9 patients (23,7 %) et une vessie neurologique chez 7 patients (18,4 %). Le diabète sucré était présent chez seulement 4 patients (10,5 %). La plupart des patients avaient une culture d'urine positive (n = 35; 92,1 %), avec une concentration élevée d'Escherichia coli chez 25 patients (71,4 %). Les caractéristiques les plus courantes à l'échographie étaient un épaississement diffus de la vessie urinaire (n = 15; 39,5 %), des polypes (n = 9; 23,7 %) et l'épaississement concentrique (n = 4; 10,5 %). Chez 13 patients (34,2 %) la vessie n'a pas pu être évaluée en raison de gaz excessifs dans la vessie. Les gaz de la vessie ont surtout été identifiés dans la lumière (n = 18; 47,4 %), suivie de la paroi de la vessie (n = 11; 28,9 %) et de la paroi et la lumière de la vessie (n = 9; 23,7 %).(Traduit par Isabelle Vallières).

Ultrasonography-guided removal of plant-based foreign bodies from the lacrimal sac in four dogs.

BACKGROUND: Dacryocystitis is an inflammation of the lacrimal drainage system. One of the most common causes of dacryocystitis in dogs is due to plant-based foreign bodies typically located in the lacrimal sac. The aim of this case series was to describe an ultrasonography-guided technique for dogs with plant-based foreign bodies in the lacrimal sac, as both a diagnostic and therapeutic tool. CASE PRESENTATION: Four dogs with clinically suspected plant-based foreign body in the lacrimal sac (with a total of five eyes affected) were evaluated by ultrasound with a multifrequency (8-14 MHz) linear probe. Under general anesthesia, the foreign body was removed using Hartmann alligator forceps inserted thorough the upper puncta. Ultrasound was used to guide the forceps in grasping the foreign body. Ultrasound was positive in four out of five lacrimal sac diseases. All identified foreign bodies were successfully removed by the ultrasonography-guided technique. CONCLUSIONS: The results show that ultrasound is a fast, non-invasive, and inexpensive method for the assessment of dacryocystitis due to foreign bodies in dogs. Ultrasound is also useful not only for identification, but also in the non-invasive removal of the foreign body from the lacrimal sac. To the best of authors' knowledge, this is the first study to describe the sonographic approach to the palpebral medial cantus as an initial diagnostic step in canine dacriocystitis.

Safe Exploration Algorithms for Reinforcement Learning Controllers.

Self-learning approaches, such as reinforcement learning, offer new possibilities for autonomous control of uncertain or time-varying systems. However, exploring an unknown environment under limited prediction capabilities is a challenge for a learning agent. If the environment is dangerous, free exploration can result in physical damage or in an otherwise unacceptable behavior. With respect to existing methods, the main contribution of this paper is the definition of a new approach that does not require global safety functions, nor specific formulations of the dynamics or of the environment, but relies on interval estimation of the dynamics of the agent during the exploration phase, assuming a limited capability of the agent to perceive the presence of incoming fatal states. Two algorithms are presented with this approach. The first is the Safety Handling Exploration with Risk Perception Algorithm (SHERPA), which provides safety by individuating temporary safety functions, called backups. SHERPA is shown in a simulated, simplified quadrotor task, for which dangerous states are avoided. The second algorithm, denominated OptiSHERPA, can safely handle more dynamically complex systems for which SHERPA is not sufficient through the use of safety metrics. An application of OptiSHERPA is simulated on an aircraft altitude control task.

Peripheral nerve stimulation under ultrasonographic control to determine the needle-to-nerve relationship.

OBJECTIVE: To determine the needle-to-nerve distances during electrical nerve location in dogs at different currents and pulse duration using a peripheral nerve stimulator (PNS) under ultrasound control (US), and the minimal electrical thresholds (MET) necessary to obtain a motor response (MR) after achieving needle-to-nerve contact. STUDY DESIGN: Prospective in vivo experimental trial in a clinical setting ANIMALS: Thirty dogs, scheduled for locoregional anaesthesia of the sciatic nerve. METHODS: Needle-to-nerve distance was measured ultrasonographically after obtaining the MR of sciatic nerve with 2, 1 and 0.5 mA and pulse duration 0.1 ms (NS0.1). Thereafter the needle was placed in contact with the nerve and MET was determined. The procedure was repeated with 0.3 ms (NS0.3). Finally the needle was reintroduced to contact the sciatic nerve guided only by US, thus MET-US was determined. Data were analysed using Kruskal-Wallis or Mann-Whitney tests. RESULTS: Needle-to-nerve distances were greater when MR was obtained with 2 mA than with 1 and 0.5 mA at 0.1 and 0.3 ms. No significant differences were observed between the needle-to-nerve distances using 0.1 or 0.3 ms. The MET [median (range)] was 0.4 (0.18-1.3) mA in NS0.1, 0.32 (0.12-0.8) mA in NS0.3; while MET-US was 0.7 (0.32-1.5) mA. When the needle contacted the nerve, the MR achieved with currents below 0.3 mA was obtained in 17.2, 40 and 0% of cases using NS0.1, NS0.3 and US respectively. CONCLUSIONS AND CLINICAL RELEVANCE: The electrical current necessary to obtain a MR decreased as the needle moved towards the nerve. However when the needle tip contacted the nerve, an MR with low current intensity could not be obtained. Thus the absence of motor response at currents below 0.3 mA cannot rule out needle-epineurium contact. When ultrasound is combined with PNS, it is more important to assess the correct needle position than searching for an MR at low currents.

Micronodular ultrasound lesions in the colonic submucosa of 42 dogs and 14 cats.

Micronodular ultrasound lesions have been detected in the colonic submucosa of dogs and cats at our hospital. The lesions had rounded/oval shapes, measured 1-3 mm in size, and exhibited a hypo/anechoic ultrasonographic pattern. To our knowledge, these lesions have not been previously reported in human or veterinary patients. The purpose of this retrospective study was to determine whether micronodular lesions were associated with other abdominal ultrasound abnormalities or clinical findings. Medical records of dogs and cats with sonographic reports describing micronodular lesions within the colonic submucosa were reviewed. Concurrent ultrasonographic abnormalities were recorded and compared with clinical sidgns and follow-up data. A total of 42 dogs and 14 cats met inclusion criteria. Concurrent sonographic abnormalities included the following: increased colon wall thickness (12.5%); small bowel wall thickening, altered layering, and/or hyperechoic mucosa (45%); abdominal effusion (29%); caudal mesenteric lymphadenopathy (46%); mesenteric lymphadenopathy (27%); and pericolic peritoneal fat reactivity (9%). Fifty of 56 animals presented with diarrhea. Twenty-seven cases had clinical signs of colitis and ultrasonographic lesions were limited to the colonic submucosa. In nine cases, follow-up examination at 6-8 weeks showed resolution of clinical and ultrasonographic signs. Ultrasonographic and clinical examinations in 17 patients at 12-18 months and in 20 patients at 18-30 months from initial diagnosis showed resolution of submucosal lesions and clinical signs of enteropathy. The authors propose that micronodular submucosal ultrasound lesions may represent reactive intraparietal lymphoid follicles and may be indicators of colonic inflammatory diseases in dogs and cats.