Use of 1% polidocanol and pre- and post-computed tomography for treatment of a suspected nasolacrimal duct cyst in a dog.

OBJECTIVE: To describe the efficacy of the sclerosing agent 1% polidocanol in the treatment of a suspected nasolacrimal duct cyst in a dog. ANIMAL STUDIED: A 5-year-old castrated male Golden Retriever with chronic epiphora of the right eye. PROCEDURES: Ocular examination revealed epiphora and a negative Jones test of the right eye and was otherwise normal. Computed tomography with dacryocystography confirmed a cystic structure in the right ventral orbit that extended into the caudal nasal cavity adjacent to the orbit, causing partial physical obstruction of the right nasolacrimal duct. Cytologic analysis of fluid from the lesion was supportive of a diagnosis of a cyst. One percent polidocanol (compounded, People's Custom Rx, Memphis, TN) was injected into the cyst. RESULTS: Epiphora was resolved by two weeks post-injection. Repeated computed tomography with dacryocystography was performed 8 months post-injection, revealing complete resolution of the cyst and demonstrating mild enophthalmos of the right globe. CONCLUSIONS: Intralesional 1% polidocanol therapy was successful in resolving a suspected nasolacrimal duct cyst in a dog.

Intradural Dirofilariasis in a Dog with Chronic Cervical Pain.

A 7 yr old female spayed Yorkshire terrier was referred to the author's institute for a 5 mo history of recurrent cervical spinal pain. Neurologic examination did not reveal any deficits. Hematologic and serum analyses were within normal limits. Thoracic radiographs that incorporated the cervical spine did not show structural abnormalities. Magnetic resonance imaging of the cervical spine demonstrated a contrast enhancing, intradural extramedullary lesion at the level of the C2 vertebra. Hemilaminectomy was performed, during which a long, narrow nematode was visualized upon opening of the dura mater. The parasite was alive when removed during surgery, and the dog recovered with complete resolution of symptoms. The parasite was submitted and confirmed as a male adult Dirofilaria immitis. This is a novel case of an intradural D. immitis infection in the dog with a magnetic resonance imaging description of spinal D. immitis.

Ventricular pneumocephalus, cervical subarachnoid pneumorrhachis, and meningoencephalitis in a dog following rhinotomy for chronic fungal rhinitis.

CASE DESCRIPTION: A 5-year-old 35.8-kg (78.8-lb) neutered male Labrador Retriever was evaluated for chronic nasal discharge associated with a fungal infection. The dog had previously been prescribed antimicrobials and antifungal treatment, but owner compliance was lacking. CLINICAL FINDINGS: Bilateral mucopurulent nasal discharge, mild ulceration of the left nasal commissure, and hyperkeratosis of the dorsal nasal planum were present. Computed tomography revealed destruction of the intranasal structures, focal lysis of the cribriform plate, and invasion of a soft-tissue mass into the frontal cortex. Rhinoscopy revealed a large pale mass in the caudal aspect of the right nasal passage; a biopsy sample was consistent with Aspergillus sp on histologic evaluation. TREATMENT AND OUTCOME: Initial treatment included medical management with an antifungal agent. Approximately 3 months later, a large fungal granuloma in the right frontal sinus was removed and debridement was performed via dorsal rhinotomy. One month after surgery, the dog was evaluated for signs of cervical pain and altered mentation. An MRI and CSF analysis were performed; diagnoses of ventricular pneumocephalus, subarachnoid pneumorrhachis, and meningoencephalitis were made. Management included oxygen therapy and administration of antimicrobials, analgesics, and antifungal medications. On follow-up 9 months after initial evaluation, neurologic deficits were reportedly resolved, and the dog was doing well. CONCLUSIONS AND CLINICAL RELEVANCE: This report emphasizes the importance of prompt, appropriate treatment of fungal rhinitis in dogs. Although rare, pneumocephalus and pneumorrhachis should be included as differential diagnoses for neurologic signs following treatment for this condition. In this dog, the complications were not considered severe and improved over time with supportive care.

Comparative evaluation of the liver in dogs with a splenic mass by using ultrasonography and contrast-enhanced computed tomography.

Evaluation of dogs with splenic masses to better educate owners as to the extent of the disease is a goal of many research studies. We compared the use of ultrasonography (US) and contrast-enhanced computed tomography (CT) to evaluate the accuracy of detecting hepatic neoplasia in dogs with splenic masses, independently, in series, or in parallel. No significant difference was found between US and CT. If the presence or absence of ascites, as detected with US, was used as a pretest probability of disease in our population, the positive predictive value increased to 94% if the tests were run in series, and the negative predictive value increased to 95% if the tests were run in parallel. The study showed that CT combined with US could be a valuable tool in evaluation of dogs with splenic masses.

Clinical signs and results of treatment in cats with patellar luxation: 42 cases (1992-2002).

OBJECTIVE: To describe clinical signs and results of treatment in cats with patellar luxation. DESIGN: Retrospective case series. ANIMALS: 42 cats in which patellar luxation had been diagnosed on the basis of results of palpation of the stifle joints. PROCEDURES: Degree of luxation was graded on a scale from 1 to 4, and severity of lameness was graded on a scale from 0 to 5. Radiographs of stifle joints were evaluated for signs of osteoarthritis. Long-term function was classified as poor, fair, good, or excellent. RESULTS: 34 cats had bilateral luxation and 8 had unilateral luxation. Only 7 (17%) cats had a history of trauma. Mean age of the cats was 3.3 years, and mean weight was 4.26 kg (9.4 lb); 26 (62%) were domestic shorthairs. Seventy-three of the 76 (95%) affected joints had medial patellar luxation. Luxation grades could be assigned to 65 joints, with grade 2 (30 joints) and 3 (22 joints) luxation being most common. Lameness grades could be assigned to 73 joints, with grade 1 lameness (27 joints) most common. Outcome was excellent for 8 of 17 joints treated without surgery and for 23 of 35 joints treated surgically. Complications attributable to surgery were reported in 8 cats. CONCLUSIONS AND CLINICAL RELEVANCE: Patellar luxation should be considered as a cause of hind limb lameness in cats. Low-grade luxation can be associated with lameness of the same severity as high-grade luxation. Surgical correction of patellar luxation in cats with grade 2 or 3 lameness can result in a favorable outcome.

Use of computed tomography for evaluation of lung lesions associated with spontaneous pneumothorax in dogs: 12 cases (1999-2002).

OBJECTIVE: To evaluate use of computed tomography (CT) of the lungs, compared with conventional radiography, for detection of blebs and bullae associated with spontaneous pneumothorax in dogs. DESIGN: Retrospective case series. ANIMALS: 12 dogs with spontaneous pneumothorax. PROCEDURE: Medical records were reviewed, and information was collected that included signalment, body weight, initial owner complaint, laboratory findings, radiographic findings, CT findings, medical and surgical treatment, histologic findings, complications, duration of hospitalization, and final outcome. RESULTS: Radiographs were excellent for identifying pneumothorax (sensitivity, 100%) but poor for identifying the underlying cause (bullae or blebs); these were identified in radiographs of only 2 of 12 dogs. Computed tomography allowed identification of bullae or blebs in 9 of 12 dogs. Ten of the 12 dogs were treated via surgery, and 17 affected lung lobes were identified. Four of the 17 affected lobes were identified via radiography. Thirteen of the 17 affected lobes were identified via CT; however, 1 lobe was incorrectly identified as the right caudal lobe instead of the right cranial lobe. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that CT is better than radiography for identifying the underlying causes of spontaneous pneumothorax.

Foramen magnum decompression for treatment of caudal occipital malformation syndrome in dogs.

A method for foramen magnum decompression (FMD) in dogs with caudal occipital malformation syndrome (COMS) and results for 16 dogs are described. In brief, a dorsal approach to the caudal portion of the occiput and arch of the atlas was made, and a high-speed drill was used to remove a portion of the occiput in the region of the foramen magnum and the dorsal aspect of C1. The meninges that were exposed were removed or marsupialized to surrounding tissues. Foramen magnum decompression was performed in 16 dogs. No intraoperative complications occurred, and postoperative complications occurred in only 2 dogs after initial surgery and in 1 of these dogs after follow-up surgery. In both dogs, postoperative complications after the initial surgery resolved without additional treatment. One dog was nonambulatory tetraparetic after follow-up surgery and died of a suspected ruptured viscus 9 days after surgery. Four dogs developed evidence of scar formation at the surgery site and required additional surgery. Overall, 14 dogs survived, 1 died, and 1 was euthanatized. Clinical signs resolved in 7 of the 14 dogs that survived, improved in 6, and did not change in 1. Results suggest that FMD may be an effective treatment for dogs with COMS, especially if performed early in the course of the disease.

Four cats with fungal rhinitis.

Fungal rhinitis is uncommon in the cat and cases of nasal aspergillosis-penicilliosis have been rarely reported. Signs of fungal rhinitis include epistaxis, sneezing, mucopurulent nasal discharge and exophthalmos. Brachycephalic feline breeds seem to be at increased risk for development of nasal aspergillosis-penicilliosis. Computed tomography (CT) imaging and rhinoscopy are useful in assessing the extent of the disease and in obtaining diagnostic samples. Fungal culture may lead to false negative or positive results and must be used in conjunction with other diagnostic tests. Serological testing was not useful in two cats tested. The cats in this study were treated with oral itraconazole therapy. When itraconazole therapy was discontinued prematurely, clinical signs recurred. Hepatotoxicosis is a possible sequel to itraconazole therapy.

Clinical evaluation and long-term follow-up of dogs having coronoidectomy for elbow incongruity.

A retrospective study was performed describing the clinical presentations, radiographic findings, and surgical outcomes of 17 dogs (18 elbows) following medial coronoidectomy for the treatment of elbow joint incongruity as a sole disease entity. Complete resolution of lameness was achieved in 100% of the cases. The mean radiographic arthrosis grade progressed in 70% of the cases. Results of this study indicate that resolution of clinical lameness may be achieved with medial coronoidectomy in dogs with elbow incongruity; however, progression of degenerative joint disease with unknown, long-term clinical significance can be expected after surgery.

External hydrocephalus in two cats.

External hydrocephalus describes an accumulation of cerebrospinal fluid (CSF) between the cerebral hemispheres and the overlying arachnoid membrane, rather than within the lateral ventricles. Two young cats with encephalopathic signs were diagnosed with external hydrocephalus, one via magnetic resonance imaging and one via computed tomography. Both cats had abnormally large, broad heads, with no evidence of open fontanelles. A surgical shunt was placed in each cat to divert the accumulated CSF within the cranial cavity to the peritoneal space. Both cats improved dramatically soon after surgical shunting was performed, and they continue to do well clinically, approximately 42 months and 8 months postoperatively, respectively.