Ultrasonography of diffuse liver disease. A review.

Radiographically, the liver may appear normal even if severely diseased. Ultrasonography can be an important adjunct in the evaluation of diffuse parenchymal hepatic disease. Diffuse liver disease appears ultrasonographically as a change in liver echogenicity from normal when compared with the renal cortex or spleen. Diffuse liver disease can be characterized as either hyperechoic due to fatty change, steroid hepatopathy, and cirrhosis or hypoechoic due to congestion, suppurative hepatitis, and lymphoma. Ultrasonographic diagnosis of diffuse liver disease should be substantiated by biopsy and histopathologic evaluation.

Clinical and diagnostic features of portosystemic shunt in a foal.

Portosystemic shunt was diagnosed in a 6-month-old Quarter Horse filly with acute onset of apparent blindness and a 3-month history of depression, lethargy, and ataxia. Clinicopathologic test results indicated slightly high gamma-glutamyl transpeptidase activity and serum total bilirubin concentration. Sulfobromophthalein half time was prolonged, and plasma ammonia and serum bile acid concentrations were high as well. Histopathologic findings of percutaneous liver biopsy included widespread hepatocyte atrophy and numerous prominent small arterioles in the area of the portal triad. On the basis of history, clinical findings, and clinicopathologic abnormalities, a presumptive diagnosis of portosystemic vascular anomaly was made. To confirm the tentative diagnosis, nuclear hepatic scintigraphy and operative mesenteric portography were performed. Medical treatment was unsuccessful, and the foal was euthanatized. Portosystemic shunts have been described in dogs and cats, but few cases have been reported in large animal species. Other, more common causes of neurologic abnormalities in foals, such as trauma, vertebral body abscesses, brain abscesses, and meningitis, must be ruled out before portosystemic shunt is considered.

Doctors and AIDS.

Just a year ago most authorities considered the chances of patients contracting AIDS from doctors and other healthcare workers a virtual impossibility. But last week a Florida woman who got AIDS from her dentist lay near death, and two Minneapolis physicians admitted they had treated hundreds of patients since being diagnosed with the virus. Although doctors are at far greater risk than patients, the Minneapolis cases renewed the debate over the right of sides to know each other's HIV status.

Accuracy of localization of cervical intervertebral disk extrusion or protrusion using survey radiography in dogs.

Sixty-four dogs with histories and clinical signs consistent with cervical intervertebral disk disease were presented for evaluation. Survey spinal radiographs were obtained, followed by myelography. In 61% of the survey radiographs, evaluators identified sites of disk extrusion or protrusion based on radiographic findings. Of those radiographs where a site was identified, ability to accurately identify the correct site of disk extrusion ranged from 53% to 67%, with an average of 58%. Therefore, the overall accuracy rate for correct identification of the site(s) of disk extrusion for all survey radiographs was 35%. Twelve cases had more than one site of disk extrusion or protrusion evident myelographically. In cases where multiple sites of extrusion were confirmed myelographically, the ability to localize at least one of the sites on the corresponding survey radiographs ranged from 63% to 80%, with an average of 70%. The major site of disk extrusion or protrusion was incorrectly identified in 16% to 31% of the survey radiographs, with an average of 26%. The use of survey radiographs alone is an inaccurate means for localization of cervical intervertebral disk extrusion or protrusion.

Incidence, location and classification of 371 third carpal bone fractures in 313 horses.

The medical records and radiographs of all horses with a third carpal bone fracture admitted to The Ohio State University Veterinary Hospital from 1979 to 1987 were reviewed. Three hundred and seventy-one fractures were found in 313 horses; 57 percent were Standardbreds, 41 per cent were Thoroughbreds, and only 1.6 per cent were Quarterhorses. All were young racehorses (average age = 3.1 years). Third carpal fractures occurred more frequently in the right limb (60 percent) than the left limb (40 percent); Thoroughbreds had a greater right-left disparity (67.5 percent R, 27.1 per cent L). Fractures were classified according to their size and anatomical location within the third carpal bone: incomplete fractures of the radial facet (type 1, N = 39), large proximal chip fractures of the radial facet (type 2, N = 140), small proximal chip fractures of the radial facet (type 3, N = 18), medial corner fractures (type 4, N = 13), frontal plane slab fractures of the radial facet (type 5, N = 93), large frontal plane slab fractures involving both the radial and intermediate facets (type 6, N = 35), fractures of the intermediate facet (type 7 N = 13), and sagittal slab fractures (type 8, N = 20). The incidence of each fracture type was significantly different between Standardbreds and Thoroughbreds. Type 1 and 2 fracture were more common in Standardbreds; type 5 and 6 fractures were more common in Thoroughbreds. Differences between these two breeds are related to the different gaits at which they race. The classification more accurately describes the extent of injury and the variation in fractures observed in this study than the traditional division as chips or slabs. A high quality skyline projection is important in correctly identifying these fractures; over 10 percent of the fractures were detected only on this view.