Paraneoplastic hypercalcemia in a canine patient with a mandibular salivary carcinoma.

OBJECTIVE: To describe a novel presentation of paraneoplastic hypercalcemia caused by a canine salivary carcinoma. ANIMAL: A 6-year-old intact male Husky with hypercalcemia and a spontaneous salivary carcinoma, stage III. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: The dog presented with polyuria, polydipsia, and hypercalcemia. Physical examination revealed a 37 X 43-mm firm mass in the ventrolateral aspect of the right-hand side of the neck, caudal to the temporomandibular joint. Incisional biopsy was suspicious of metastatic carcinoma to the mandibular lymph node. A full-body CT scan found a large, heterogenous, contrast-enhancing mass on the right ventrolateral neck that appeared to be originating from either the mandibular lymph node or right mandibular salivary gland. Parathyroid hormone-related protein was considered within normal reference intervals, and both parathyroid glands appeared ultrasonographically normal. TREATMENT AND OUTCOME: The patient was treated with a marginal surgical excision of the mass, without immediate complications. Histopathology confirmed the presence of a salivary carcinoma with narrow margins of excision and invasion of the mandibular lymph node. Twenty-four hours after surgery, ionized calcium returned to normal reference values and clinical signs completely resolved. CLINICAL RELEVANCE: Hypercalcemia is an urgent pathology with important systemic implications requiring prompt diagnosis and intervention. In this case report, we identify the first salivary carcinoma associated with a paraneoplastic hypercalcemia, including this pathology as a new differential diagnosis. The hypercalcemia resolved with marginal surgical excision, but interestingly the parathyroid hormone-related protein was not overexpressed, meaning that this neoplasia could mediate hypercalcemia by another pathophysiological mechanism.

Case report: MRI and CT imaging features of a melanocytic tumour affecting a cervical vertebra in an adult dog, and review of differential diagnosis for T1W-hyperintense lesions.

A 7-year-old Lhasa Apso presented with a history of left thoracic limb lameness and neck pain. Magnetic resonance imaging revealed a well-defined, extradural lesion that was hyperintense on T1-weighted (T1W) images and isointense on T2-weighted (T2W) images and T2* images located at the left lamina of the C4 vertebra. Computed tomography showed an isoattenuating and contrast-enhancing mass centered on the left C4 vertebral lamina with associated osteolysis. The mass was surgically debulked, and histopathology revealed a malignant melanocytic tumour. The patient recovered completely and received radiotherapy and three doses of the melanoma vaccine as adjunctive treatment. Eighteen months following treatment, the patient presented with neck pain again, but further investigations were declined at this stage, and the patient was euthanised. To the author's knowledge, this is the first case report describing the imaging characteristics of a cervical extradural melanocytic tumour in a dog. This case illustrates the MRI and CT imaging features and treatment of a canine melanocytic tumour of the cervical vertebrae.

Assessing teat canal morphology in the dry period and during lactation by high-resolution ultrasound.

Our objectives were to quantify the dimensions of a fully 'closed' teat canal in dry cows and to describe recovery of the teat canal between milkings in lactating cows to assess whether and when full closure is attained, since this is an important determinant of udder health. Using an ultrasound scanner, teat canal length and diameter (proximal, midpoint and distal), teat cistern width, teat end width, whole teat width and teat wall thickness in 77 dry and 39 lactating dairy cows were measured. The dry cows represented a cross section of the dry population, with days since dry off ranging from 0 to 69 (median: 27). Data from lactating cows were recorded just before milking, and every 3 h post-milking. To control for location a cross-over (parlour vs. barn) study design was used. In dry cows, teat canal length and diameter did not vary by quarter or days since dry off, but multiparous cows had significantly wider teat canals than primiparous cows. The dry cow measurements can be used as baseline for dimensions for closed teats. In lactating cows, all teat dimensions except teat end width changed significantly during the 12-h milking cycle. Location (parlour vs. barn) did not affect the measurements, except teat end width and teat wall thickness. Teat canal length increased after milking and returned to pre-milking values by 9 h. Proximal and midpoint teat canal diameters decreased slightly just after milking and then progressively increased to above the pre-milking values by 9 h. Distal teat canal diameter increased after milking, partially contracting by 9 h. We found that during the dry period the teat canal is in a steady state, but its diameter is not zero, while during the lactation, the teat canal is in a near constant state of remodelling.

Clinical and MRI findings of a suspected cortical malformation presented as a giant cerebral pseudomass in a German Shepherd dog.

A 5-month-old German Shepherd dog was presented with cluster seizures. MR imaging showed a large irregular pseudomass in the central region of the cranial cavity, compatible with a malformation of cortical development. Despite the extensive changes, the patient was neurologically normal interictally 1 year following diagnosis.

Feline Emphysematous Gastritis in a Cat with Pancreatitis and Secondary Hepatic Lipidosis.

A 7 yr old female neutered domestic shorthair was presented with a 2 mo history of lethargy and hyporexia progressing to anorexia. Initial diagnostics indicated pancreatitis with secondary hepatic lipidosis. Supportive care, including the placement of an esophageal feeding tube, was initiated. The feeding tube was removed traumatically by the cat and thus replaced. The cat acutely deteriorated while hospitalized, developing marked hypersalivation and an obtunded mentation. Radiographs were taken to confirm placement of the feeding tube in case tube dislodgement was contributing to the hypersalivation; results confirmed appropriate positioning and gastric pneumatosis. Despite intensified medical management, the patient suffered cardiopulmonary arrest 7 days after hospital admission. Post-mortem examination confirmed necrotizing gastritis with emphysema alongside segmental mucosal necrosis in the jejunum, focal pancreatic necrosis, and diffuse hepatic lipidosis. Gas in the gastric wall is a rare finding in veterinary medicine and can arise due to gastric pneumatosis or emphysematous gastritis; there are scant reports of either in feline medicine. This report documents a case of emphysematous gastritis in a cat with concurrent pancreatitis and hepatic lipidosis. The cat developed emphysematous gastritis without undergoing gastrointestinal surgery which is currently the only reported feline predis-posing factor for development.

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.

Comparison of CT features of 79 cats with intranasal mass lesions.

OBJECTIVES: This retrospective multicentre study compared the CT characteristics of cats diagnosed with intranasal mass lesions to determine if defining imaging features exist between different tumour types and between neoplastic and non-neoplastic lesions. METHODS: The medical records of two institutions were reviewed for cats with CT findings consistent with an intranasal mass lesion with subsequent histopathological examination. For each CT scan the mass location, growth pattern, margin distinction, contrast enhancement pattern and presence of intralesional areas of mineralisation or necrosis were recorded. The presence of facial deformity, the location and type of bone changes, extranasal extension of the mass lesion and the regional lymph nodes size, contrast pattern and hilus visibility were also documented. RESULTS: Thirty-five cats with nasal lymphoma, 28 cats with non-lymphomatous nasal neoplasia (carcinoma or sarcoma) and 16 cats with inflammatory lesions met the inclusion criteria. Cats with non-lymphomatous nasal neoplasia were more likely to show unilateral nasal changes (odds ratio [OR] 3.9), areas of intralesional calcification (OR infinity) and extension of the mass lesion within the frontal sinus (OR 4.5), while cats suffering from nasal lymphoma were more likely to show a mixed (OR 4.5) and expansile growth pattern (OR 7.8), and a regional lymphadenomegaly (OR 2.4). The CT findings in cats diagnosed with inflammatory mass-like lesions were highly variable and overlapped with findings for nasal neoplasms but were significantly associated with the absence of bony changes to the nasal cavity boundaries (OR 10.2). CONCLUSIONS AND RELEVANCE: Findings from the current study support the ability of CT to aid in the discrimination of tumour type in cats presented with an intranasal mass lesion.

Evaluation of radiographs for the detection of sublumbar lymphadenopathy in dogs.

The purpose of this study was to evaluate radiographs for the detection of sublumbar lymph node (SLN) enlargement. Ultrasound was used to determine SLN size. Twenty-two dogs with anal gland adenocarcinoma or lymphoma were prospectively included, with 16/22 having SLN enlargement on ultrasound. Twenty-one dogs without enlargement were retrospectively included as controls. Three blinded observers evaluated 43 right lateral abdominal radiographs for the presence of SLN enlargement. Sensitivity and specificity of radiographs for the detection of SLN enlargement were 81%/70%, 94%/81%, and 75%/100% for a general practitioner, imaging resident, and radiologist, respectively. Ventral displacement of the colon, a soft tissue opacity in the caudal retroperitoneal space and loss of conspicuity of the ventral margin of the iliopsoas muscle were radiographic findings significantly associated with identification (P-values < 0.05). Markedly enlarged SLNs (> 21.5 mm) were consistently detected radiographically by observers with specialist imaging training. Key clinical message: Radiographic visualization should raise suspicion of neoplastic infiltration of SLN but lack of visualization does not exclude mild to moderate enlargement. Additional imaging such as ultrasound or computed tomography remains important to confirm or exclude sublumbar lymphadenopathy.

Évaluation de radiographies pour la détection de lymphadénopathie sub-lombaire chez des chiens. Le but de la présente étude était d'évaluer des radiographies pour détecter l'augmentation de taille des ganglions sub-lombaires (SLN). L'échographie fut utilisée pour déterminer la taille des SLN. Vingt-deux chiens avec un adénocarcinome des glandes anales ou un lymphome furent inclus prospectivement, avec 16/22 ayant des SLN augmentés lors de l'échographie. Vingt-et-un chiens sans augmentation de taille furent inclus rétrospectivement comme témoins. Trois observateurs ont évalué à l'aveugle 43 radiographies abdominales latérales droites pour la présence d'augmentation des SLN. La sensibilité et la spécificité des radiographies pour la détection d'augmentation des SLN étaient de 81 %/70 %, 94 %/81 % et 75 %/100 % pour un praticien généraliste, un résident en imagerie et un radiologiste, respectivement. Un déplacement ventral du côlon, une opacité des tissus mous dans l'espace rétropéritonéal caudal et une perte de visibilité de la bordure ventrale du muscle iliopsoas furent des trouvailles radiographiques associées significativement avec l'identification (P < 0,05). Des SLN avec une forte augmentation de taille (> 21,5 mm) étaient constamment détectés radiographiquement par des observateurs avec une formation spécialisée en imagerie.Message clinique clé:La visualisation radiographique devrait soulever des soupçons d'infiltration néoplasique des SNL mais le manque de visualisation n'exclu pas une augmentation de taille de légère à modérée. Des analyses en imagerie additionnelles, telles que l'échographie ou la tomodensitométrie, demeurent importantes pour confirmer ou exclure une lymphadénopathie sub-lombaire.(Traduit par Dr Serge Messier).

Cholelithiasis in the Dog: Prevalence, Clinical Presentation, and Outcome.

Canine cholelithiasis is considered to be an uncommon condition and is frequently cited as being an incidental finding. However, there is a paucity of contemporary literature to support these assertions. The aim of this retrospective cross-sectional study was to report the prevalence, clinical presentation, and long-term follow-up of cholelithiasis in dogs. The electronic database at the Small Animal Hospital, University of Glasgow was searched to identify dogs that were diagnosed with cholelithiasis on ultrasound between 2010 and 2018. Sixty-eight dogs were identified, giving an overall prevalence of cholelithiasis in our hospital of 0.97% (confidence interval 0.76-1.22%). Medical records of 61 dogs were available for review. Cholelithiasis was classified as an incidental finding in 53 (86.9%) dogs, with 8 (13.1%) dogs being classified as symptomatic, having complications of cholelithiasis that included biliary duct obstruction, biliary peritonitis, emphysematous cholecystitis, and acute cholecystitis. Follow-up was available for 39 dogs, with only 3 dogs (7.7%) developing complications attributed to cholelithiasis, including biliary duct obstruction and acute cholecystitis, within the subsequent 2 yr. Cholelithiasis is an uncommon but frequently incidental finding in dogs. Within the follow-up period, few of the dogs with incidental cholelithiasis went on to be become symptomatic.

Spongiform leucoencephalomyelopathy in border terriers: clinical, electrophysiological and imaging features.

A novel spongiform leucoencephalomyelopathy was reported in border terrier puppies in 2012 causing a shaking puppy phenotype, but no information regarding clinical progression, imaging or electrophysiological findings were available. The aim of the present study was to describe the clinical, electrophysiological and MRI features of this disease in seven dogs and compare them with human white matter disorders. All cases presented with cerebellar ataxia and severe generalised coarse body tremors, which started at three weeks of age. The three cases that were not euthanased showed slow but progressive improvement over several months. Brainstem auditory evoked response demonstrated a normal wave I, reduced amplitude of wave II and an absence of waves III-VII. MRI revealed bilateral and symmetrical T2-weighted hyperintensities affecting the brainstem and cerebellar white matter. Histological examination of the brain and spinal cord showed spongiform change affecting the white matter of the cerebellum, brainstem and spinal cord with decreased myelin content. In summary, this leucoencephalomyelopathy has a pathognomonic clinical presentation with defining MRI and electrophysiological characteristics, and it is the first report to describe a long-term improvement of this condition.

Effect of osteoarthritis on the repeatability of patella tendon angle measurement in dogs.

OBJECTIVE: To evaluate the influence of osteoarthritis on the measurement of patella tendon angle (PTA) and determine intraobserver and interobserver variability. STUDY DESIGN: Retrospective clinical study. SAMPLE POPULATION: Eighty-seven mediolateral radiographs that were obtained prior to tibial tuberosity advancement. METHODS: Radiographic osteoarthritis was scored by 2 observers using guidelines derived from the International Elbow Working Group Protocol. Patella tendon angle was measured by 3 observers on 3 occasions, with at least 7 days between measurements. The data were statistically analyzed via weighted κ and Kruskal-Wallis testing. RESULTS: A fair strength of agreement was found among observers scoring osteoarthritis, with the same grades in 48% of radiographs. The intraobserver average bias between PTA measurements 1 and 3 ranged from -0.38° to -0.94°. Interobserver bias in angle measurement ranged from -0.92° to -2.00°. Observer 1 had the narrowest range of PTA differences (12.1°), and observer 3 had the highest range of PTA differences (23.5°). Observer 2 had the lowest mean bias (-0.38°). The mean bias was lowest between observers 1 and 2 (-0.92°) and highest between observers 1 and 3 (-2.0°). The mean intraobserver standard deviation of the PTA measurement differences was 2.90°, and interobserver standard deviation of the PTA measurement differences was 2.26°. The degree of osteoarthritis did not influence PTA measurements or their variability. CONCLUSION: The current study did not find evidence of an influence of osteoarthritis on PTA or on the repeatability of measurements. CLINICAL SIGNIFICANCE: Our findings suggest that osteoarthritis should not affect the radiographic planning for tibial tuberosity advancement surgery. The high variances in PTA measurement in less experienced observers may influence the clinical outcome of surgery.

Nonsurgical management of traumatic pneumoperitoneum in a cat.

OBJECTIVE: To describe the nonsurgical management of a cat with traumatic pneumoperitoneum. CASE SERIES SUMMARY: A 4-year-old cat was presented following vehicular polytrauma. Thoracic radiographs revealed 4 rib fractures, a scapular fracture, and pneumothorax. Abdominal ultrasound revealed a small volume of free abdominal fluid. Computed tomography showed a mild pneumoretroperitoneum and a pneumoperitoneum in the region of the porta hepatis. The cat was managed conservatively with close monitoring. Exploratory laparotomy was not pursued given patient stability and static serial imaging studies revealing no indications for surgical intervention. After 6 days, the pneumoperitoneum was no longer detectable. NEW OR UNIQUE INFORMATION PROVIDED: To the authors' knowledge, this is the first report of successful nonsurgical management of traumatic pneumoperitoneum in a cat.

IMAGING DIAGNOSIS-MAGNETIC RESONANCE IMAGING OF DIFFUSE LEPTOMENINGEAL OLIGODENDROGLIOMATOSIS IN A DOG WITH "DURAL TAIL SIGN".

A case of diffuse leptomeningeal oligodendrogliomatosis affecting the brain and spinal cord of a dog is presented. A 7.5-year old, male neutered Staffordshire bull terrier presented for evaluation of a chronic history of tetraparesis and seizures, with a multifocal neuroanatomical localization was determined. Extra-axial intradural lesions with an atypical presentation of a dural tail sign were seen on MRI. Histologically, the lesions were consistent with leptomeningeal oligodendrogliomatosis. To the authors' knowledge, a dural tail sign has not previously been reported as an MRI characteristic of diffuse leptomeningeal oligodendrogliomatosis in dogs.

Ultrasonographic identification of the dorsal atlantoaxial ligament in dogs.

OBJECTIVE: To determine the ability to identify the dorsal atlantoaxial ligament during ultrasonographic examination of dogs. STUDY DESIGN: Canine cadaveric study. SAMPLE POPULATION: Canine cervical spines (n = 35). METHODS: Thirty-five canine cadavers with an estimated body weight of 6-35 kg were retrieved. Five cervical spines were dissected to assess the length and thickness of the dorsal atlantoaxial ligament and correlate ultrasound-guided injection of ink with anatomical dissection. Ultrasonographic evaluation of the dorsal atlantoaxial ligament was performed on 30 cadavers. The visibility of the dorsal atlantoaxial ligament in both the transverse and the sagittal planes was subjectively scored (0-3). RESULTS: The dorsal atlantoaxial ligament was detectable on ultrasonographic examination in all cadavers: 27/30 and 28/30 were graded as moderately visible (grade 2) or clearly visible (grade 3) in the sagittal and transverse view, respectively. Only 1/30 cadaver specimen of a large breed dog was graded as 1 (indistinct) in both the sagittal and transverse planes. None of the cadavers were graded as 0 (not visible) in any view. CONCLUSION: The dorsal atlantoaxial ligament can be identified in ultrasonographic examination of normal canine cadavers. Future studies on animals with clinical atlantoaxial instability/subluxation are needed to evaluate the role of this imaging technique in providing a safer diagnosis of this condition. CLINICAL RELEVANCE: Ultrasonographic examination of the dorsal atlantoaxial ligament could potentially provide a noninvasive and safe imaging technique that may contribute to the diagnosis of atlantoaxial instability/subluxation in dogs.

Retrospective evaluation of thoracic computed tomography findings in dogs naturally infected by Angiostrongylus vasorum.

Angiostrongylus vasorum (A. vasorum) is an important emerging disease of canidae. Cardiorespiratory signs are common in affected dogs, therefore thoracic imaging is critical for diagnosing and monitoring disease. Descriptions of thoracic computed tomography (CT) findings in dogs naturally infected with A. vasorum are currently lacking. Aims of this multicenter, retrospective study were to describe thoracic CT findings in a group of dogs with confirmed disease, determine whether any changes were consistent among dogs, and propose standardized terms for describing thoracic CT findings. Nine UK-based referral centers' clinical and imaging databases were searched for dogs that had a confirmed diagnosis of A. vasorum, and had undergone thoracic CT examination. Eighteen dogs, from seven of the centers, fulfilled the inclusion criteria. The lung lobes were divided into the following three zones and the CT changes described in each: pleural (zone 1), subpleural (zone 2), and peribronchovascular (zone 3). The predominent abnormality was increased lung attenuation due to poorly defined ground-glass opacity or consolidation. There were regions of mosaic attenuation due to peripheral bronchiectasis. Nine/18 (50%) dogs showed hyperattenuating nodules of varying sizes with ill-defined margins. The distribution always affected zones 1 and 2 with varied involvement of zone 3; this resulted in clear delineation between zones 2 and 3. Tracheobronchial lymphadenomegaly was frequently noted. Findings were nonspecific and there was considerable overlap with other pulmonary conditions. However, authors recommend that A. vasorum be considered a likely differential diagnosis for dogs with a predominantly peripheral distribution of lung changes.

Vertebral venous system abnormalities identified with magnetic resonance imaging in sighthounds.

In humans, abnormalities of the vertebral venous system are considered rare but significant causes of radiculopathy and myelopathy. Published information on abnormalities of the canine vertebral venous system is currently lacking. Aims of this retrospective descriptive study were to characterize magnetic resonance imaging (MRI) abnormalities of the vertebral venous system in a population of sighthounds, report prevalence of vertebral venous system abnormalities within that population and explore possible clinical significance. Our hospital database was searched over the period of 2002-2013 for sighthounds with MRI studies of the vertebral column. Medical records and MRI studies for included dogs were retrieved and findings were recorded by a single observer. A total of 92 sighthounds were sampled. Eleven cases (prevalence 12%) showed abnormal enlargement of the internal vertebral venous plexus (10/11 unilaterally, 1/11 bilaterally), external vertebral venous plexus (7/11 cases unilaterally), and/or intervertebral veins (8/11 unilaterally, 2/11 bilaterally, and 1/11 unilaterally and bilaterally at different sites). The majority of the abnormalities were right sided and the most common location for abnormalities was C6/7. Of the 11 cases, nine did not have a definitive diagnosis. Seven of those nine cases had an abnormality in a neuroanatomical localization that could wholly or partly explain the clinical signs. Findings indicated that, while the prevalence of vertebral venous system abnormalities was low in this sample of sighthounds, the majority of dogs with these abnormalities had clinical signs that matched the location of the abnormalities. Further prospective research is needed to investigate potential underlying aetiologies for vertebral venous system abnormalities in dogs and clarify their clinical significance.

Further characterization of computed tomographic and clinical features for staging and prognosis of idiopathic pulmonary fibrosis in West Highland white terriers.

Idiopathic pulmonary fibrosis is an interstitial lung disease of unknown etiology resulting in progressive interstitial fibrosis, with a known predilection in West Highland white terriers. In humans, computed tomography (CT) is a standard method for providing diagnostic and prognostic information, and plays a major role in the idiopathic pulmonary fibrosis staging process. Objectives of this retrospective, analytical, cross-sectional study were to establish descriptive criteria for reporting CT findings and test correlations among CT, clinical findings and survival time in West Highland white terriers with idiopathic pulmonary fibrosis. Inclusion criteria for affected West Highland white terriers were a diagnosis of idiopathic pulmonary fibrosis and available CT, bronchoscopy, bronchoalveolar lavage, echocardiography, and routine blood analysis findings. Clinically normal West Highland white terriers were recruited for the control group. Survival times were recorded for affected dogs. The main CT lung pattern and clinical data were blindly and separately graded as mild, moderate, or severe. Twenty-one West Highland white terriers with idiopathic pulmonary fibrosis and 11 control West Highland white terriers were included. The severity of pulmonary CT findings was positively correlated with severity of clinical signs (ρ = 0.48, P = 0.029) and negatively associated with survival time after diagnosis (ρ = -0.56, P = 0.025). Affected dogs had higher lung attenuation (median: -563 Hounsfield Units (HU)) than control dogs (median: -761 HU), (P < 0.001). The most common CT characteristics were ground-glass pattern (16/21) considered as a mild degree of severity, and focal reticular and mosaic ground-glass patterns (10/21) considered as a moderate degree of severity. Findings supported the use of thoracic CT as a method for characterizing idiopathic pulmonary fibrosis in West Highland white terriers and providing prognostic information for owners.