Diagnosis of primary secretory otitis media in the cavalier King Charles spaniel.

BACKGROUND: Primary secretory otitis media (PSOM) is a disease reported in the cavalier King Charles spaniel (CKCS). The diagnosis of PSOM has been made based only on visualization of a bulging tympanic membrane and mucus in the middle ear post-myringotomy. No additional tests have been evaluated for the diagnosis of PSOM; CKCSs with early disease may have been missed. HYPOTHESIS/OBJECTIVES: The objective of this study was to compare otoscopy, tympanometry, pneumotoscopy and tympanic bulla ultrasonography, using computed tomography (CT) as the gold standard for the diagnosis of PSOM in the CKCS. ANIMALS: Sixty CKCSs with clinical signs suggestive of PSOM. METHODS: Otoscopy, CT scan, tympanic bulla ultrasonography, tympanometry and pneumotoscopy were performed; those CKCSs with a soft tissue density in the middle ear identified on CT had a myringotomy and middle ear flush. RESULTS: Forty-three (72%) CKCSs had PSOM (30 bilateral, 13 unilateral). A large bulging pars flaccida was identified in only those CKCS with PSOM (specificity of 100%); however, only 21 of 73 ears with PSOM had a large bulging pars flaccida (sensitivity of 29%). Sensitivity and specificity for tympanometry, pneumotoscopy and tympanic bulla ultrasonography were (84%, 47%), (75%, 79%) and (67%, 47%), respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Based on these results a large bulging pars flaccida indicates the presence of PSOM, whereas a flat pars flaccida may be present in CKCS that have PSOM as well as those that do not. In CKCSs with a flat pars flaccida none of the above diagnostic tests can be recommended in place of CT scan for the diagnosis of PSOM.

Ectopic ureters in male dogs: review of 16 clinical cases (1999-2007).

Ureteral ectopia is a well-described cause of urinary incontinence in female dogs, but this condition has not been completely characterized in male dogs. Sixteen male dogs with ectopic ureters were evaluated between Jan 1999 and Mar 2007. Male dogs were similar to female dogs with ectopic ureters in terms of breed, presenting complaint, age of onset, and bilateral nature of the ectopia. Diagnosis was made by expert interpretation of imaging techniques such as excretory urography and contrast-enhanced computed tomography (CT). Overall, 11 of 13 dogs that had surgical correction of ectopic ureters were incontinent preoperatively. Urinary continence was restored in 82% of those dogs.

Accuracy of computed tomography in determining lesion size in canine appendicular osteosarcoma.

Multidetector contrast enhanced computed tomography with acquisition of 0.625-mm thick transverse images was used to measure the extent of appendicular osteosarcoma in 10 dogs. The measured length of tumor based on CT was compared to the true length of tumor using histopathology. There was a statistically significant association with good correlation between the true length of osteosarcoma compared to the length of intramedullary/endosteal abnormalities on CT with a mean overestimation of 1.8% (SD = 15%). There was not a statistically significant association between the true tumor length and the length of periosteal proliferation on CT with a mean overestimation of 9.7% (SD = 30.3%). There was a statistically significant association, but with poor correlation, between the true tumor length compared to the length of abnormal contrast enhancement with a mean overestimation of 9.6% (SD = 34.8%). The extent of intramedullary/endosteal CT abnormalities assessed from submillimeter transverse images may be of value in assessing patient candidacy and surgical margins for limb-sparing surgery.

Fractures in regions of adaptive modeling and remodeling of central tarsal bones in racing Greyhounds.

OBJECTIVE: To evaluate and compare bone modeling and remodeling in fractured and non-fractured central tarsal bones (CTBs) of racing Greyhounds. SAMPLE: Paired cadaveric tarsi from 6 euthanized racing Greyhounds with right CTB fractures and 6 racing Greyhounds with other nontarsal injuries. PROCEDURES: CTBs were dissected and fractured CTBs were reconstructed. Central tarsal bones were evaluated through standard and nonscreen high-detail radiography, computed tomography, and histologic examination. The bone mineral density (BMD) was calculated adjacent to fracture planes and as a gradient on sagittal computed tomographic images. Sagittal and transverse plane sections of bone were obtained and submitted for subjective histologic assessment. Linear mixed-effects models were used to compare findings. RESULTS: Fractured right CTBs had greater BMD in the dorsal and midbody regions of the sagittal plane sections than did nonfractured CTBs. The BMD ratios from bone adjacent to the dorsal slab fracture planes were not different between fractured and nonfractured right CTBs. CONCLUSIONS AND CLINICAL RELEVANCE: Findings supported the existence of site-specific bone adaptation in CTBs of Greyhounds, with modeling and remodeling patterns that were unique to fractured right CTBs. The dorsal and midbody regions of fractured bones had greater BMD, and fractures occurred through these zones of increased BMD.

Effects of treatment on respiratory rate, serum natriuretic peptide concentration, and Doppler echocardiographic indices of left ventricular filling pressure in dogs with congestive heart failure secondary to degenerative mitral valve disease and dilated cardiomyopathy.

OBJECTIVE: To evaluate the effects of treatment on respiratory rate, serum natriuretic peptide concentrations, and Doppler echocardiographic indices of left ventricular filling pressure in dogs with congestive heart failure (CHF) secondary to degenerative mitral valve disease (MVD) and dilated cardiomyopathy (DCM). DESIGN: Prospective cohort study. ANIMALS: 63 client-owned dogs. PROCEDURES: Physical examination, thoracic radiography, analysis of natriuretic peptide concentrations, and Doppler echocardiography were performed twice, at baseline (examination 1) and 5 to 14 days later (examination 2). Home monitoring of respiratory rate was performed by the owners between examinations. RESULTS: In dogs with MVD, resolution of CHF was associated with a decrease in respiratory rate, serum N-terminal probrain natriuretic peptide (NT-proBNP) concentration, and diastolic functional class and an increase of the ratio of peak velocity of early diastolic transmitral flow to peak velocity of early diastolic lateral mitral annulus motion (E:Ea Lat). In dogs with DCM, resolution of CHF was associated with a decrease in respiratory rate and serum NT-proBNP concentration and significant changes in 7 Doppler echocardiographic variables, including a decrease of E:Ea Lat and the ratio of peak velocity of early diastolic transmitral flow to isovolumic relaxation time. Only respiratory rate predicted the presence of CHF at examination 2 with high accuracy. CONCLUSIONS AND CLINICAL RELEVANCE: Resolution of CHF was associated with predictable changes in respiratory rate, serum NT-proBNP concentration, and selected Doppler echocardiographic variables in dogs with DCM and MVD. Home monitoring of respiratory rate was simple and was the most useful in the assessment of successful treatment of CHF.

Advanced imaging of the spine in small animals.

Computed tomography (CT) and magnetic resonance imaging (MRI) are extremely valuable techniques in the diagnosis of spinal disorders. This article reviews the fundamentals, indications, key technical aspects, and advantages and disadvantages of each modality. The CT and MRI features of common spinal diseases are discussed and illustrated. Comparative studies using advanced and nonadvanced imaging modalities are also presented.

Effects of orthopedic implants with a polycaprolactone polymer coating containing bone morphogenetic protein-2 on osseointegration in bones of sheep.

OBJECTIVE: To determine elution characteristics of bone morphogenetic protein (BMP)-2 from a polycaprolactone coating applied to orthopedic implants and determine effects of this coating on osseointegration. ANIMALS: 6 sheep. PROCEDURES: An in vitro study was conducted to determine BMP-2 elution from polycaprolactone-coated implants. An in vivo study was conducted to determine the effects on osseointegration when the polycaprolactone with BMP-2 coating was applied to bone screws. Osseointegration was assessed via radiography, measurement of peak removal torque and bone mineral density, and histomorphometric analysis. Physiologic response was assessed by measuring serum bone-specific alkaline phosphatase activity and uptake of bone markers. RESULTS: Mean +/- SD elution on day 1 of the in vitro study was 263 +/- 152 pg/d, which then maintained a plateau at 59.8 +/- 29.1 pg/d. Mean peak removal torque for screws coated with polycalprolactone and BMP-2 (0.91 +/- 0.65 dN x m) and screws coated with polycaprolactone alone (0.97 +/- 1.30 dN.m) did not differ significantly from that for the control screws (2.34 +/- 1.62 dN x m). Mean bone mineral densities were 0.535 +/- 0.060 g/cm(2), 0.596 +/- 0.093 g/cm(2), and 0.524 +/- 0.142 g/cm(2) for the polycaprolactone-BMP-2-coated, polycaprolactone-coated, and control screws, respectively, and did not differ significantly among groups. Histologically, bone was in closer apposition to the implant with the control screws than with either of the coated screws. CONCLUSIONS AND CLINICAL RELEVANCE: BMP-2 within the polycaprolactone coating did not stimulate osteogenesis. The polycaprolactone coating appeared to cause a barrier effect that prevented formation of new bone. A longer period or use of another carrier polymer may result in increased osseointegration.

Influence of bone cements on bone-screw interfaces in the third metacarpal and third metatarsal bones of horses.

OBJECTIVE: To compare biomechanical strength, interface quality, and effects of bone healing in bone-implant interfaces that were untreated or treated with calcium phosphate cement (Ca-cement), magnesium phosphate cement (Mg-cement), or polymethylmethacrylate (PMMA) in horses. ANIMALS: 6 adult horses. PROCEDURES: 4 screw holes were created (day 0) in each third metacarpal and third metatarsal bone of 6 horses. In each bone, a unicortical screw was placed in each hole following application of Ca-cement, Mg-cement, PMMA, or no treatment (24 screw holes/treatment). Screws were inserted to 2.82 N m torque. Horses were euthanized and bones were harvested at day 5 (16 screw holes/treatment) or day 182 (8 screw holes/treatment). Radiography, biomechanical testing, histomorphometry, and micro-computed tomography were performed to characterize the bone-implant interfaces. RESULTS: Use of Mg-cement increased the peak torque to failure at bone-implant interfaces, compared with the effects of no treatment and Ca-cement, and increased interface toughness, compared with the effects of no treatment, Ca-cement, and PMMA. Histologically, there was 44% less Ca-cement and 69% less Mg-cement at the interfaces at day 182, compared with amounts present at day 5. Within screw threads, Ca-cement increased mineral density, compared with PMMA or no treatment. In the bone adjacent to the screw, Mg-cement increased mineral density, compared with PMMA or no treatment. One untreated and 1 Ca-cement-treated screw backed out after day 5. CONCLUSIONS AND CLINICAL RELEVANCE: In horses, Mg-cement promoted bone-implant bonding and adjacent bone osteogenesis, which may reduce the risk of screw loosening.

Computed tomographic arthrography of the stifle for detection of cranial and caudal cruciate ligament and meniscal tears in dogs.

The purpose of this study was to evaluate the utility of single-detector computed tomographic arthrography (CT arthrography) for the diagnosis of cranial and caudal cruciate ligament and meniscal lesions in the dog stifle. Four normal and 25 abnormal stifle joints, determined to have lesions related to intra-articular ligamentous insufficiency based on clinical history, orthopedic examination, and survey orthogonal radiographs, were imaged using a previously developed CT arthrography protocol. Surgery was performed immediately following the CT procedure. Three board-certified radiologists inexperienced at interpreting CT stifle arthrograms reviewed all CT studies independently, and then as a group, without knowledge of surgical or necropsy findings. Sensitivity, specificity, positive predictive value, and negative predictive value for determination of cranial and caudal cruciate and meniscal tears were calculated for each individual reviewer and based on group consensus. All reviewers identified the normal canine stifle joints imaged correctly. Reviewers did well in discriminating normal from torn cranial cruciate ligaments, with sensitivities of 96-100% and specificities of 75-100%. No reviewer correctly identified the solitary caudal cruciate ligament tear and specificity ranged from 89.3% to 100%. Reviewers were less adept at discriminating normal from torn meniscal fibrocartilage, with sensitivities of 13.3-73.3% and specificities of 57.1-100%. Interpretive accuracy improved slightly when consensus scores were compared with surgical findings. Single-detector CT arthrography may be useful for identifying pathology of the canine cruciate ligaments but is of limited value for assessing the menisci.

Results of excision of thymoma in cats and dogs: 20 cases (1984-2005).

OBJECTIVE: To provide long-term follow-up information for a series of dogs and cats with invasive and noninvasive thymomas treated by excision alone. DESIGN: Retrospective case series. ANIMALS: 9 cats and 11 dogs with thymoma. PROCEDURES: Medical records were reviewed. The following factors were analyzed for their effect on prognosis: age of dog or cat, invasiveness of the tumor, percentage of lymphocytes in the mass (percentage lymphocyte composition) on histologic evaluation, and mitotic index of the mass. RESULTS: All patients were treated with excision of the tumor alone. Median overall survival time for the cats was 1,825 days, with a 1-year survival rate of 89% and a 3-year survival rate of 74%. Median overall survival time for the dogs was 790 days, with a 1-year survival rate of 64% and a 3-year survival rate of 42%. Recurrence of thymoma was observed in 2 cats and 1 dog, and a second surgery was performed in each, with subsequent survival times of 5, 3, and 4 years following the first surgery. Percentage lymphocyte composition of the mass was the only factor that was significantly correlated with survival time; animals with a high percentage of lymphocytes lived longer. CONCLUSIONS AND CLINICAL RELEVANCE: Results of this study indicated that most cats and dogs with thymomas did well after excision. Even cats and dogs with invasive masses that survived the surgery and the few cats and dogs with recurrent thymomas or paraneoplastic syndromes had a good long-term outcome. Excision should be considered an effective treatment option for dogs and cats with thymomas.

Radiographic, computed tomographic, and arthroscopic evaluation of experimental radio-ulnar incongruence in the dog.

OBJECTIVE: To compare the diagnostic value of arthroscopy, computed tomography (CT), and radiography for evaluation of radio-ulnar incongruence (RUI). STUDY DESIGN: Experimental evaluation of induced progressive RUI. SAMPLE POPULATION: Cadaveric Labrador forelimbs (n=11). METHODS: The radius was shortened by 1, 2, and 3 mm with a surgical model of RUI. RUI was scored on radiographs, CT (2 radiologists), and arthroscopy (2 surgeons) before and after each modification. The sensitivity and specificity of each modality were compared. The effects of arthroscope and elbow position on arthroscopy observations were evaluated. Agreement between surgeons, radiologists, and each imaging technique and the known status of the elbow was calculated. RESULTS: Complete arthroscopic sessions had an averaged sensitivity of 94% and specificity of 81.9%. The ability to detect mild incongruity (1 mm step) was greater at the incisure than other locations (P<.001). The average sensitivity and specificity of radiography were 99.3% and 42.4%, and for CT were 85.05% and 45.8%, respectively. The average agreement between imaging techniques and the known status of the elbows was greater with complete arthroscopic sessions (89.75%) than radiography (70.1%) and CT (76.85%). Inter-investigator agreement was greater between surgeons scoring arthroscopic examinations (88.6%) than radiologists scoring CT studies (43.9%). CONCLUSIONS: Evaluation of arthroscopic images allows sensitive and reproducible detection of experimental RUI, especially at the incisure. Arthroscopic evaluation of experimental RUI reached a higher diagnostic value than radiographs and CT images, because of its specificity and reproducibility. CLINICAL RELEVANCE: The diagnostic value and reproducibility of arthroscopy may compare favorably with those of CT when evaluating RUI in dogs with elbow disease.

Vertebral heart size in retired racing Greyhounds.

The vertebral heart size (VHS) is used to objectively assess cardiac dimensions on thoracic radiographs. A high VHS suggest the presence of cardiac pathology, such as dilated cardiomyopathy, degenerative atrioventricular valvular disease, pericardial effusion, pericardioperitoneal diaphragmatic hernia, tricuspid dysplasia, ventricular septal defect, or patent ductus arteriosus, among others. However, breed or body conformation can influence the VHS. Because Greyhounds have a high prevalence of physiologic systolic murmurs associated with high aortic velocity, and large cardiac dimensions when compared with dogs of similar size, they are frequently suspected of having heart disease. The purpose of this study was to compare the VHS in normal Greyhounds with those in Rottweilers, and a group of dogs from various other breeds using both analog and digital radiology. The VHS was significantly higher in Greyhounds (P< 0.0001), when compared with Rottweilers and to other dog breeds. The mean VHS on lateral radiographs for Greyhounds was 10.5 +/- 0.1, for Rottweilers it was 9.8 +/- 0.1, and for mixed breed dogs it was 10.1 +/- 0.2. This study confirms that the relative cardiomegaly reported in necropsy and echocardiographic studies in Greyhounds is easily detected using plain radiography and the VHS.

Subchondral bone density and cartilage degeneration patterns in osteoarthritic metacarpal condyles of horses.

OBJECTIVE: To evaluate and correlate patterns of subchondral bone density and articular cartilage degeneration (derived by use of gross, histologic, and computed tomographic [CT] examinations) in equine third metacarpal condyles with and without osteoarthritis. SAMPLE POPULATION: 8 metacarpophalangeal (MCP) joints (n = 4 horses) without osteoarthritis and 6 osteoarthritis-affected MCP joints (4). PROCEDURES: Horses were euthanized. The third metacarpal condyles of the joints were examined grossly and via CT (3 slice images/condyle). For 6 condylar zones, mean bone density and pattern of density distribution were determined. Data for osteoarthritis-affected and control joints were compared. Histomorphometric point count analyses identified areas of bone density for comparison with CT density measurements. RESULTS: Osteoarthritis-affected condyles had heterogeneous subchondral bone with focal resorptive lesions and patterned sclerosis, whereas control condyles had symmetric bone density distribution. In osteoarthritis-affected condyles, bone density determined via gray scale image density analysis was greater (dorsal and medial pattern), compared with control condyles, and differed among zones because of resorption and sclerosis. With regard to bone density in osteoarthritis-affected condyles, histologic findings correlated with CT images, and bone lesions were significantly correlated with cartilage lesions. CONCLUSIONS AND CLINICAL RELEVANCE: In horses, heterogeneous distribution and greater subchondral bone density were characteristic of osteoarthritis-affected condyles, compared with control condyles. Subchondral bone lesions correlated with overlying cartilage lesions in osteoarthritis-affected MCP joints. Identification of CT image characteristics appears to predict the presence of a cartilage lesion in MCP joints of horses with osteoarthritis.

Effects of a magnesium adhesive cement on bone stability and healing following a metatarsal osteotomy in horses.

OBJECTIVE: To compare biodegradable magnesium phosphate cement (Mg-cement), calcium phosphate cement (Ca-cement), and no cement on bone repair, biocompatibility, and bone adhesive characteristics in vivo in horses. ANIMALS: 8 clinically normal adult horses. PROCEDURES: Triangular fragments (1-cm-long arms) were created by Y-shaped osteotomy of the second and fourth metatarsal bones (MTII and MTIV, respectively). Fragments were replaced in pairs to compare Mg-cement (MTII, n = 8; MTIV, 8) with Ca-cement (MTIV, 8) or with no cement (MTII, 8). Clinical and radiographic evaluations were performed for 7 weeks, at which time osteotomy sites were harvested for computed tomographic measurement of bone density and callus amount, 3-point mechanical testing, and histologic evaluation of healing pattern and biodegradation. RESULTS: All horses tolerated the procedure without clinical problems. Radiographically, Mg-cement secured fragments significantly closer to parent bone, compared with Ca-cement or no treatment. Callus amount and bone remodeling and healing were significantly greater with Mg-cement, compared with Ca-cement or no cement. Biomechanical testing results and callus density among treatments were not significantly different. Significantly greater woven bone was observed adjacent to the Mg-cement without foreign body reaction, compared with Ca-cement or no cement. The Mg-cement was not fully degraded and was still adhered to the fragment. CONCLUSIONS AND CLINICAL RELEVANCE: Both bone cements were biocompatible in horses, and Mg-cement may assist fracture repair by osteogenesis and fragment stabilization. Further studies are warranted on other applications and to define degradation characteristics.

Contrast-enhanced computed tomographic imaging of the auditory tube in mesaticephalic dogs.

Computed tomography after contrast medium injection was performed in three mesaticephalic canine cadavers to image the auditory tube. Cadavers were positioned in lateral recumbency for imaging. A myringotomy incision was made in the left tympanic membrane of each dog, and contrast medium was infused into the ear canal and middle ear through a balloon-tip catheter. With this method, contrast medium filled the left bulla and auditory tube in all three cadavers. Computed tomography following contrast medium injection was effective for evaluation of the canine auditory tube. Future studies are required to determine the usefulness, as well as the safety, of this procedure in the evaluation of the auditory tube in other breeds of dogs as well as dogs with otitis

Vestibular, vaginal, and urethral relations in spayed dogs with and without lower urinary tract signs.

The purpose of this study was to evaluate the urogenital anatomy in female spayed dogs with and without signs of lower urinary tract disease by using conventional vaginourethrography, computed tomography (CT) vaginourethrography, and uroendoscopy. Nineteen dogs with lower urinary tract disease and 12 normal dogs were evaluated prospectively. Measurements made included vaginal length, vaginal height, vaginal width, vestibule length, vestibule height, vestibule width, vestibulovaginal ratios, cingulum height, cingulum width, cingulum area, urethral length, urethral height, urethral width, angle of urethra to vestibule, and angle of vaginal to vestibule. Group comparisons were made between dogs with and without lower urinary tract disease. Comparisons between conventional vaginourethrography and CT vaginourethrography were made when the same anatomical measurement was made by the 2 imaging modalities. There was no significant difference in all of the measurements (P > .01), including vestibulovaginal ratios and cingulum areas, between dogs with and without lower urinary tract disease. There was a larger proportion of dogs with a vestibulovaginal ratio <0.33 in normal dogs (8 of 12) compared with the clinical dogs (8 of 16). A significant difference between vestibulovaginal ratios or cingulum areas between dogs with and without lower urinary tract disease could not be identified. This suggests that a vestibulovaginal ratio of <0.33 may only be an incidental finding and the term "vestibulovaginal stenosis" may need to be redefined.

Comparison of conventional spin-echo and fast spin-echo magnetic resonance imaging in the canine brain.

T2-weighted fast spin echo and conventional spin echo are two magnetic resonance (MR) pulse sequences used to image the brain. Given the same scan parameters the resolution of fast spin-echo images will be inferior to that of conventional spin-echo images. However, fast spin-echo images can be acquired in a shorter time allowing scan parameters to be optimized for increased resolution without increasing the time to an unacceptable level. MR imaging of the brain of 54 dogs, suspected of having parenchymal brain abnormalities was performed using a 1.5 T scanner. Acquisition time ranged from 4 min 24 s to 7 min 16 s (average = 5 min 15 s) for fast spin-echo scans and from 6 min 32 s to 11 min 26s (average = 7 min 55s) for conventional spin-echo scans. All reviewers consistently rated the resolution of fast spin-echo images higher than the conventional spin-echo images (P = 0.000). The potential disadvantages of fast spin-echo acquisitions (motion artifacts, blurring, and increased hyperintensity of fat) did not affect the resolution of the images. Fast spin echo offers increased resolution in a comparable time to conventional spin echo by increased number of excitations and finer matrix size, thus improving the signal-to-noise ratio and spatial resolution, respectively.