Recurrent Perineal Hernia in a Female Cat Diagnosed by Positive-Contrast Vaginourethrocystogram.

A 9 yr old female spayed domestic shorthair was presented with a 12-day history of stranguria. Six years previously, the cat had a bilateral perineal herniorrhaphy with cystopexy and pubic osteotomy. At presentation, survey radiographs and a positive-contrast vaginourethrocystogram were performed, which revealed cystolithiasis and recurrent bilateral perineal hernias with bladder retroflexion. A cystopexy was repeated, followed by bilateral perineal repairs using the internal obturator muscle flap transposition. To the authors' knowledge, this is the first reported case of a perineal hernia with recurrent bladder retroflexion after cystopexy diagnosed with positive-contrast vaginourethrocystogram in a female cat.

CT can identify characteristic features of hypaxial muscle abscesses in dogs due to presumed migrating vegetal foreign material as well as additional changes along the migratory tract in other anatomic regions.

Hypaxial muscle abscess is an important differential in dogs presenting for abdominal or back pain, lameness, and nonspecific signs like fever, lethargy, and hyporexia. It can occur concurrently with intrathoracic disease such as pyothorax secondary to migrating vegetal foreign material. Twelve dogs that underwent CT of the lumbar spine or abdomen and had a diagnosed hypaxial abscess on surgical and/or microbiological examination were included in this retrospective, descriptive case series. Computed tomography findings and findings from other imaging modalities employed were described. Eleven dogs were hunting breeds. Clinical signs included lethargy, fever, increased respiratory effort, and abdominal or back pain. Radiography and/or ultrasonography were employed during preliminary work up at clinician discretion and respectively revealed changes consistent with osteomyelitis in the cranial lumbar vertebrae and heterogenous, hypoechoic areas in the hypaxial musculature consistent with abscesses. Computed tomography findings included enlargement of hypaxial muscles with well-defined fluid attenuating noncontrast enhancing areas with a contrast-enhancing rim consistent with abscesses, periosteal reaction and lysis of vertebrae, and retroperitoneal effusion. Four of the 12 cases in this series had material identified and removed at surgery. The other eight cases were presumed to be the same disease process based on compatible signalment, imaging findings, and microbiological results. Migrating vegetal foreign bodies are a common problem at the authors' institution. Computed tomography provided expedient, thorough visualization of the relevant hypaxial lesions for diagnostic and surgical planning purposes and also characterized intrathoracic components of this disease.

Ultrasonographic findings of gastrointestinal histoplasmosis in dogs.

Histoplasmosis, a mycotic infection caused by Histoplasma spp, can infect the gastrointestinal tract of dogs. Clinical signs of gastrointestinal histoplasmosis can include diarrhea, profound weight loss, anorexia, and vomiting. Rectal scrape for cytology can provide a quick diagnosis, but if negative abdominal ultrasound is often pursued. Ultrasonographic abnormalities in dogs with gastrointestinal histoplasmosis have rarely been reported. This retrospective, single-center case series aimed to describe the ultrasonographic features of gastrointestinal histoplasmosis in dogs. Nineteen cases with a diagnosis of gastrointestinal histoplasmosis confirmed with gastrointestinal cytology or histopathology (N = 15) or gastrointestinal lymph node cytology (N = 4) that had undergone an abdominal ultrasound examination from 2005 to 2020 were included. Ultrasound images were reviewed by an American College of Veterinary Radiology (ACVR)-certified veterinary radiologist and diagnostic imaging resident. Eighteen cases had sonographic abnormalities within the gastrointestinal tract. The colon was the most affected organ. Colonic thickening and abnormal wall layering were the most frequent findings (N = 16 dogs); thickening ranged from 0.36 to 1.2 cm. Diffuse, multifocal, and focal thickening patterns were seen. Sixteen patients had abnormal wall layering of the colon (complete loss of layering or altered with partial loss of layering). Other frequent findings included lymphadenopathy, small intestinal thickening with abnormal wall layering and peritoneal effusion. Based on the authors' review of the literature, this is the first description of ultrasonographic findings of gastrointestinal histoplasmosis in a group of dogs. Although abnormal gastrointestinal wall layering seen sonographically is most frequently associated with neoplasia, this is not pathognomonic. Gastrointestinal histoplasmosis should be considered as a differential diagnosis due to the similarities and overlap of ultrasonographic features.

Investigation of suspected gadolinium neurotoxicity in a dog.

Gadolinium-based contrast agents are used across species to better visualize abnormalities during MRI and are considered generally safe in clinical practice. The aim of this study was to investigate central nervous system (CNS) gadolinium deposition in 11 dogs that had an MRI performed, received 0.22 mL/kg (0.1 mmol/kg) of gadopentetate dimeglumine, and were necropsied on the same hospital admission. The index case was a 5-year-old castrated male Australian Shepherd that presented for ataxia and following MRI developed seizure-like activity that became refractory to anticonvulsant therapy. Gadolinium concentration was quantified in CNS tissues by inductively-coupled plasma mass spectrometry and was 43-fold higher in the index case. These findings suggest the possibility of gadolinium toxicity in select patients.

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.

Extruded gallbladder mucoceles have characteristic ultrasonographic features and extensive migratory capacity in dogs.

Limited information is available on the ultrasonographic characteristics of extruded gallbladder mucoceles. The objective of this retrospective case series study was to describe the ultrasonographic features of extruded gallbladder mucoceles in a group of dogs. Medical records of four veterinary centers were searched between June 2010 and January 2018 for all dogs with a suspected extruded gallbladder mucocele based on abdominal ultrasound. Seven client-owned dogs met the inclusion criteria. All seven dogs had a discrete, heteroechoic, multilayered, stellate, or striated mass within the peritoneal cavity. Blood flow was not present in these structures. Four of these structures were identified in the caudal abdomen. In five cases, the gallbladder lumen was filled with material similar in appearance to the free-floating peritoneal mass. Four cases were confirmed surgically and one case was confirmed at necropsy. Histopathology of the gallbladder wall was evaluated in all surgical cases and analysis of the free-floating material was performed in one of the four cases. Extruded gallbladder mucoceles have common imaging characteristics that may be helpful in establishing a presumptive diagnosis. Additionally, these structures may have extensive migratory capacity. The results of the study justify the recommendation for exploration of the entire abdomen during cholecystectomy for gallbladder mucocele removal.

COMPUTED TOMOGRAPHIC FINDINGS IN 24 DOGS WITH LIPOSARCOMA.

Computed tomography (CT) continues to become more widely available for assessment of tumors in dogs, yet there are no studies describing the CT appearance of canine liposarcomas. In this retrospective, multicenter study, CT images of dogs with histologically confirmed liposarcomas were reviewed for size, location, attenuation, contrast enhancement, border definition, internal homogeneity, local infiltration, and mineralization. A total of 24 dogs with 26 liposarcomas were sampled. Mean attenuation was +15.2 (SD = 22.3) Hounsfield units (HU) with a range of -36 to +47.5 HU based on representative regions of interest. Twenty tumors (77%) contained focal areas of fat attenuation. All masses enhanced with contrast medium administration, which is distinct from what has been reported previously in infiltrative lipomas. Other CT features associated with canine liposarcomas included heterogeneous internal attenuation (81%) and lack of a clearly defined capsule (38%) suggesting infiltration of local structures. Six tumors (23%) had foci of mineralization. Findings from the current study indicated that liposarcoma should be considered as a differential diagnosis for mixed-attenuation, contrast-enhancing masses in dogs that contain at least one focus of fat attenuation on precontrast images; however, presence of foci of fat attenuation was not a necessary finding for the diagnosis of canine liposarcoma.

CARDIAC ASSESSMENT OF ZOO-KEPT, BLACK-TAILED PRAIRIE DOGS (CYNOMYS LUDOVICIANUS) ANESTHETIZED WITH ISOFLURANE.

Cardiomyopathy is suggested to be a relatively common disease condition in prairie dogs; however, there are no reports of normal cardiac echosonography and radiology in the prairie dog ( Cynomys spp.). The objective of this study was to report the ultrasonographic and radiographic measurements of the heart, and plasma troponin concentration in captive healthy anesthetized black-tailed prairie dogs ( Cynomys ludovicianus ). Zoo-kept prairie dogs with no signs of cardiac disease (n = 17) were evaluated. Each animal was anesthetized with isoflurane via face mask and a complete clinical assessment was performed, including complete blood cell count and plasma biochemistry, urinalysis, blood gasses, plasma troponin concentration, three-view whole body radiography, and echocardiogram. Standard measurements were taken. Few trivial findings were identified on echocardiographic evaluation. Further research with a larger sample size is needed to determine if these variations are normal, or represent early or mild cardiac disease. The data presented here can aid, with the necessary caution, in evaluating prairie dogs with possible cardiac disease, potentially resulting in earlier diagnosis and more successful treatment.

Pre-operative fibrous osteodystrophy and severe, refractory, post-operative hypocalcemia following parathyroidectomy in a dog.

A 13-year-old dog exhibited dramatic, radiographic osteopenia consistent with fibrous osteodystrophy secondary to primary hyperparathyroidism. Following parathyroidectomy, the dog developed severe, prolonged hypocalcemia, but was successfully treated and discharged 32 d after surgery. A variety of factors may have contributed to this dog's hypocalcemia including hypoparathyroidism and hungry bone syndrome.

Ostéodystrophie fibreuse préopératoire et hypocalcémie grave, réfractaire postopératoire après une parathyroïdectomie chez un chien. Un chien âgé de 13 ans a manifesté une ostéopénie radiographique dramatique conforme à une ostéodystrophie fibreuse secondaire à un hyperparathyroïdisme primaire. Après une parathyroïdectomie, le chien a développé une hypocalcémie grave et prolongée, mais il a été traité avec succès et a reçu son congé 32 jours après la chirurgie. Divers facteurs peuvent avoir contribué à l'hypocalcémie de ce chien, y compris l'hypoparathyroïdisme et l'hypocalcémie par avidité osseuse.(Traduit par Isabelle Vallières).

Emphysematous cystitis and pyelonephritis in a nondiabetic dog and a diabetic cat.

Emphysematous cystitis (EC) and emphysematous pyelonephritis (EPN) are the result of infection of the urinary bladder and kidneys by gas-producing microorganisms. Those infections are most often reported in diabetic patients and rarely occur concurrently. This article describes two cases of concurrent EC and EPN, one in a nondiabetic dog and the other in a diabetic cat. The use of diagnostic imaging is necessary in the diagnosis of emphysematous infections. Both radiography and ultrasonography were used in the diagnosis of EC and EPN in the patients described in this report.

Radiographic and histopathologic characteristics of pulmonary fibrosis in nine cats.

Pulmonary fibrosis is a progressive fatal interstitial lung disease that is often idiopathic, occurs in multiple species, and may be caused by a number of inciting factors. The purpose of this retrospective, multicenter study was to describe the radiographic and histopathologic characteristics of idiopathic and induced pulmonary fibrosis in a group of cats. Cats with thoracic radiographs and histopathologically confirmed pulmonary fibrosis were recruited using the American College of Veterinary Radiology list serve. A board-certified veterinary radiologist and diagnostic imaging intern reviewed radiographs and recorded characteristics by consensus. Findings from additional imaging modalities were also recorded when available. All histopathology samples were re-reviewed by a veterinary pathology resident. A total of nine cats met inclusion criteria. All patients had a broad range of radiographic characteristics that included broncho-interstitial pattern, alveolar pattern, pulmonary masses, pulmonary bullae, pleural effusion, and cardiomegaly. Cats with available echocardiographic studies had characteristics that included right ventricular dilation and hypertrophy and pulmonary arterial hypertension interpreted to be secondary to primary lung disease. Cats with available CT studies had characteristics that included focally increased soft tissue attenuation, masses, and ventral consolidation that exhibited no improvement with dorsal versus ventral recumbency. Histopathology showed pulmonary fibrosis, type II pneumocyte hyperplasia, and smooth muscle hypertrophy in all patients. Epithelial metaplasia was present only in one patient. Findings from the current study indicated that cats with pulmonary fibrosis have highly variable radiographic characteristics and that these characteristics may mimic other diseases such as asthma, pneumonia, pulmonary edema, or neoplasia.

Bronchoscopy-Guided High-Power Microwave Ablation in an in vivo Porcine Lung Model.

Introduction: Percutaneous microwave ablation (MWA) is clinically accepted for the treatment of lung tumors and oligometastatic disease. Bronchoscopic MWA is under development and evaluation in the clinical setting. We previously reported on the development of a bronchoscopy-guided MWA system integrated with clinical virtual bronchoscopy and navigation and demonstrated the feasibility of transbronchial MWA, using a maximum power of 60 W at the catheter input. Here, we assessed the performance of bronchoscopy-guided MWA with an improved catheter (maximum power handling of up to 120 W) in normal porcine lung in vivo (as in the previous study). Methods: A total of 8 bronchoscopy-guided MWA were performed (n = 2 pigs; 4 ablations per pig) with power levels of 90 W and 120 W applied for 5 and 10 min, respectively. Virtual bronchoscopy planning and navigation guided transbronchial or endobronchial positioning of the MWA applicator for ablation of lung parenchyma. Following completion of ablations and post-procedure CT imaging, the lungs were harvested and sectioned for gross and histopathologic ablation analysis. Results: Bronchoscopy-guided MWA with applied energy levels of 90 W/5 min and 120 W/10 min yielded ablation zones with short-axis diameters in the range of 20-28 mm (56-116% increase) as compared to ∼13 mm from our previous study (60 W/10 min). Histology of higher-power and previous lower-power ablations was consistent, including a central necrotic zone, a thermal fixation zone with intact tissue architecture, and a hemorrhagic periphery. Catheter positioning and its confirmation via intra-procedural 3D imaging (e.g., cone-beam CT) proved to be critical for ablation consistency. Conclusion: Bronchoscopy-guided MWA with an improved catheter designed for maximum power 120 W yields large ablations in normal porcine lung in vivo.

A Prevalence Study of Canine Humeral Condylar Fractures Over a Ten-Year Period at an Academic Teaching Hospital.

OBJECTIVE: The aim of this study was to investigate the prevalence, breed predisposition and fracture conformation of humeral condylar fractures (HCF) over a 10-year period. Results were compared with published studies emanating from the United Kingdom exploring effect of breed on HCF. METHODS: Data for all canine admissions to the Veterinary Teaching Hospital at Kansas State University were extracted for the period January 2010 to October 2020. Humeral fractures were recorded and further subclassified as medial, lateral and 'T'/'Y' condylar fractures. The associations between HCF and subtypes with breed were assessed using univariate logistic regression with a comparison group. Multivariable logistic regression was used to evaluate the effect of breed while accounting for dog age, sex and neuter status. RESULTS: Of the 44,952 canine patients seen during the study period, period prevalence (95% confidence interval [CI] for HCF was 0.26% [0.22, 0.31]). After adjustment for age and neuter status, French Bulldogs were 49 times more likely to be diagnosed with a HCF compared with the comparison breed group (odds ratio [OR], 49.0; 95% CI, 26.9-89.3). After adjustment for age and neuter status, Cocker Spaniels (OR, 42.8; 95% CI, 16.8-108.6), Boston Terriers (OR, 22.9; 95% CI, 11.0-47.9) and Brittany Spaniels (OR, 21.5; 95% CI, 7.3-63.1) had the next highest increase in HCF compared with the comparison group. CONCLUSION: Based on a study population from the United States, French Bulldogs were 49 times more likely to be diagnosed with a HCF compared with the comparison breed group.

Pathology in Practice.

In collaboration with the American College of Veterinary Pathologists.

What Is Your Diagnosis?

In collaboration with the American College of Veterinary Radiology.

Feline sarcomatoid renal cell carcinoma with peritoneal carcinomatosis and effusion.

A 9-y-old, castrated male, domestic medium-hair cat diagnosed previously with chronic kidney disease developed anorexia and vomiting. Ultrasonography revealed abdominal effusion and a left renal perihilar mass. Cytologic evaluation of the peritoneal fluid and mass identified atypical epithelioid cells suspected to be of renal epithelial or possible mesothelial origin. Immunohistochemical (IHC) evaluation of a formalin-fixed, paraffin-embedded peritoneal fluid cell block indicated both pancytokeratin and vimentin expression in the atypical epithelioid cell population. With scanning electron microscopic evaluation, similar epithelioid cells lacked the cell-surface microvilli expected of mesothelium, supporting an antemortem diagnosis of probable carcinoma. On postmortem examination, the left kidney was effaced by an infiltrative neoplasm with myriad similar nodules throughout the peritoneum. The neoplasm was composed primarily of polygonal-to-spindle-shaped cells with strong vimentin and weak pancytokeratin cytoplasmic immunolabeling. Further IHC characterization with PAX8, CK18, KIT, napsin A, SMA, desmin, CD18, and claudin 5 was performed. Histologic and IHC findings supported a diagnosis of sarcomatoid renal cell carcinoma with peritoneal carcinomatosis. An in vitro cell culture line of neoplastic cells harvested from the primary tumor was successfully established for future research endeavors.

Web-based documentation of clinical skills to assess the competency of veterinary students.

Kansas State University implemented a Web-based program to assess students' competency to perform technical skills during clinical rotations throughout the fourth year of the veterinary curriculum. The classes of 2009 and 2010 recorded a minimum number of procedures (104 and 103, respectively) from a menu of more than 220 recommended procedures. Procedures were categorized by species (small animal, equine, food animal) and disciplines (imaging, anesthesia, diagnostic medicine/necropsy). Ophthalmology was added as a fourth discipline for the class of 2010. Students recorded procedures into the Web-based system, including information about the patient, procedure performed, supervisor, and a self-assessment of performance. Faculty, staff, and house officers evaluated the procedures electronically by confirming that they witnessed the procedure and providing qualitative and written feedback. The class of 2009 recorded 18,492 procedures (M=171/student) and the class of 2010 recorded 16,935 procedures (M=158/student). Two students from each class (2009 and 2010) did not complete the minimum required skills during clinical rotations and returned to perform procedures immediately before (n=3) or immediately after (n=1) graduation to receive their diploma. The Web-based system captured a large number of assessments of technical competency performed in the clinical setting. The system provided students with formative feedback throughout the clinical year, ensured equitable distribution of procedural opportunities across the student body, and required minimal additional resources.

Quantitative contrast-enhanced ultrasonographic analysis of perfusion in the kidneys, liver, pancreas, small intestine, and mesenteric lymph nodes in healthy cats.

OBJECTIVE: To evaluate perfusion of abdominal organs in healthy cats by use of contrast-enhanced ultrasonography. ANIMALS: 10 young healthy anesthetized cats. PROCEDURES: Contrast-enhanced ultrasonography of the liver, left kidney, pancreas, small intestine, and mesenteric lymph nodes was performed on anesthetized cats. RESULTS: Typical perfusion patterns were found for each of the studied organs. Differences in perfusion among organs were associated with specific physiologic features. The liver was enhanced gradually and had a more heterogeneous perfusion pattern because of its dual blood supply and close proximity to the diaphragm, compared with other organs. An obvious and significant difference in perfusion was detected between the renal cortex and medulla. No significant differences in perfusion were detected among the pancreas, small intestine, and mesenteric lymph nodes. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that contrast-enhanced ultrasonography can be used in cats to estimate organ perfusion as in other species. Observed differences in perfusion variables can be mostly explained by physiologic differences in vascularity.

The effect of differing Audience Response System question types on student attention in the veterinary medical classroom.

The purpose of this study was to evaluate the ability of specific types of multiple-choice questions delivered using an Audience Response System (ARS) to maintain student attention in a professional educational setting. Veterinary students (N=324) enrolled in the first three years of the professional curriculum were presented with four different ARS question types (knowledge base, discussion, polling, and psychological investment) and no ARS questions (control) during five lectures presented by 10 instructors in 10 core courses. Toward the end of the lecture, students were polled to determine the relative effectiveness of specific question types. Student participation was high (76.1%+/-2.0), and most students indicated that the system enhanced the lecture (64.4%). Knowledge base and discussion questions resulted in the highest student-reported attention to lecture content. Questions polling students about their experiences resulted in attention rates similar to those without use of ARS technology. Psychological investment questions, based on upcoming lecture content, detracted from student attention. Faculty preparation time for three ARS questions was shorter for knowledge base questions (22.3 min) compared with discussion and psychological investment questions (38.6 min and 34.7 min, respectively). Polling questions required less time to prepare (22.2 min) than discussion questions but were not different from other types. Faculty stated that the investment in preparation time was justified on the basis of the impact on classroom atmosphere. These findings indicate that audience response systems enhance attention and interest during lectures when used to pose questions that require application of an existing knowledge base and allow for peer interaction.

The use of intermittent positive pressure ventilation to differentiate pneumonia from atelectasis during anesthesia in a red panda (Ailurus fulgens).

Radiography is a valuable tool for assessment of pulmonary disease. Specifically, radiographs utilizing positive pressure ventilation can distinguish between anesthesia-induced atelectasis and pulmonary disease when survey radiographs are ambiguous. Positive pressure ventilation can be used to radiographically prove or disprove pulmonary disease. This is of particular clinical importance when working with exotic, zoo, or wildlife species because the majority of these patients require general anesthesia to perform physical examinations and diagnostics such as radiography safely and efficiently. This report is a case example of pulmonary disease in a red panda (Ailurus fulgens) and demonstrates how positive pressure ventilation verified both the presence of pulmonary disease and the eventual resolution of the disease. Anesthetized patients on gas anesthesia will rapidly become atelectic. Through the use of positive pressure ventilation, anesthesia-induced atelectasis and true pulmonary disease can readily be distinguished. This is a technique that should not be overlooked when performing thoracic radiography in zoo species.