COMPARISON OF THORACIC ULTRASONOGRAPHY AND RADIOGRAPHY FOR THE DETECTION OF INDUCED SMALL VOLUME PNEUMOTHORAX IN THE HORSE.

Small volume pneumothorax can be challenging to diagnose in horses. The current standard method for diagnosis is standing thoracic radiography. We hypothesized that thoracic ultrasonography would be more sensitive. Objectives of this prospective, experimental study were to describe a thoracic ultrasound method for detection of small volume pneumothorax in horses and to compare results of radiography and ultrasound in a sample of horses with induced small volume pneumothorax. Six mature healthy horses were recruited for this study. For each horse, five 50 ml air boluses were sequentially introduced via a teat cannula into the pleural space. Lateral thoracic radiographs and standardized ultrasound (2D and M-mode) examinations of both hemithoraces were performed following administration of each 50 ml air bolus. Radiographs and ultrasound images/videos were analyzed for detection of pneumothorax by four independent investigators who were unaware of treatment status. Sensitivity, specificity, positive predictive values, negative predictive values, and agreement among investigators (Kappa test, κ) were calculated for radiography, 2D and M-mode ultrasound. Comparisons were made using a chi-squared exact test with significance set at P < 0.05. Two-dimensional (84%) and M-mode (80%) ultrasound were more sensitive than radiography (48%) for pneumothorax detection (P = 0.02 and P = 0.04, respectively). Specificity and positive predictive values were similar for all three imaging modalities (P = 1). Agreement between investigators for pneumothorax detection was excellent for 2D ultrasound (κ = 1), very good for M-mode ultrasound (κ = 0.87), and good for radiography (κ = 0.79). Findings from this experimental study supported the use of thoracic ultrasonography as a diagnostic method for detecting pneumothorax in horses.

An optimized protocol for multislice computed tomography of the canine brain.

Computed tomography (CT) is commonly used in veterinary practice to evaluate dogs with suspected brain disease, however contrast resolution limitations and artifacts may reduce visualization of clinically important anatomic features. The purpose of this study was to develop an optimized CT protocol for evaluating the canine brain. The head of a 5-year-old Springer Spaniel with no neurological signs was imaged immediately following euthanasia using a 4-slice CT scanner and 282 protocols. Each protocol used a fixed tube voltage of 120 kVp and 10 cm display field of view. Other acquisition and reconstruction parameters were varied. For each protocol, four selected images of the brain were reconstructed, anonymized and saved in DICOM format. Three board-certified veterinary radiologists independently reviewed each of the four images for each protocol and recorded a numerical quality score for each image. The protocol yielding the lowest total numerical score was defined as the optimal protocol. There was overall agreement that the optimal protocol was the one with the following parameters: sequential mode, 300 mAs, 1 mm slice thickness, 1 s tube rotation time, medium image reconstruction algorithm and applied beam hardening correction. Sequential imaging provided optimal image resolution. The thin-sliced images provided a small blur due to partial volume artifacts. A high tube current resulted in a relatively low noise level. Use of a medium frequency image reconstruction algorithm provided optimal contrast resolution for brain tissue. Use of a proprietary beam hardening correction filter (Posterior Fossa Optimization) markedly reduced beam-hardening artifact.

Computed tomographic features of Morel-Lavallée lesions in 3 cats.

OBJECTIVE: To describe the CT features of Morel-Lavallée lesions (MLLs) and their association with trauma in cats. This study aimed to investigate whether MLL fluid in cats accumulates between the dermis and deep fascia near superficial trauma, exhibits a vertical attenuation gradient, and shows no or only mild contrast enhancement on CT images. ANIMALS: 3 young cats: a 1-year-old neutered male domestic shorthair cat, a 2-year-old neutered male domestic shorthair cat, and a 3-year-old neutered female British Shorthair cat. CLINICAL PRESENTATION: The clinical presentation of the 3 cats in the study involved recurrent swelling and fluid accumulation affecting at least 1 pelvic limb following trauma. RESULTS: In all cases, there was a fluid-filled space deep to the skin and superficial subcutaneous layer but superficial to the deep fascial plane overlying the muscular component of the pelvic limbs. The MLL fluid had a vertical attenuation gradient and no or only mild contrast enhancement. CLINICAL RELEVANCE: Morel-Lavallée lesions are often initially overlooked, likely due to distraction by concomitant significant bone injuries, and can be mistaken for hematomas, seromas, subcutaneous edema, contusions, or cellulitis, leading to less aggressive treatment. If left untreated, MLLs present a significant risk of extensive skin necrosis compared to other types of subcutaneous swelling.

Bacterial cholangiohepatitis in a dog.

A 9-year-old female Yorkshire terrier was presented for vomiting and diarrhea. Blood chemistry tests revealed hepatic dysfunction, cholestasis, and inflammation. Liver ultrasonography and liver biopsy were consistent with cholangiohepatitis. Fine-needle aspiration of the gallbladder revealed the presence of bacteria later identified as Clostridium spp. The cholangiohepatitis was successfully treated.

Syndrome of inappropriate antidiuretic hormone secretion associated with congenital hydrocephalus in a dog.

A 13-month-old, male bichon frise was examined for the investigation of intermittent seizures, ataxia, abnormal behavior, polyuria, and polydipsia. At presentation, clinical and neurological examinations were unremarkable with the exception of mild truncal ataxia and a domed skull. Severe hyponatremia and hypoosmolality were identified, and following diagnostic testing a diagnosis of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was made. Magnetic resonance imaging revealed changes consistent with severe hydrocephalus. Water restriction resulted in increased serum osmolality and a reduction in severity of clinical signs. The current case report documents SIADH associated with hydrocephalus in a dog. Structural brain disease should be excluded before a diagnosis of idiopathic SIADH is made.

Prevalence of diabetes in Murcia (Spain): a Mediterranean area characterised by obesity.

The aim of this cross-sectional study was to describe the prevalence of total, known and unknown diabetes mellitus and impaired fasting glucose (IFG) in the population of Murcia (SE Spain), a Mediterranean area with a high prevalence of obesity. Therefore, 2562 subjects (>or=20 years) were selected by stratified random sampling and a survey was carried out by telephone, together with a physical examination and biochemical determinations. The ADA-1997 diagnostic criteria were used. The crude prevalence of total diabetes was 11% (9.5-12.6%), known diabetes 7.8% (6.5-9.2%), unknown diabetes 3.2% (2.4-4.2%) and IFG 4.9% (3.9-6.1%). Both total diabetes and IFG were higher in men than in women, with prevalence rates increasing with age. People with diabetes and IFG had higher BMI, blood pressure, total cholesterol, LDL-cholesterol and triglyceride values than the rest of the population. No difference in the prevalence of diabetes was observed between the rural and urban populations. The prevalence of diabetes in Murcia is high compared to the rest of Spain and the world, suggesting that the possible benefits attributed to some characteristics of the diet of this Mediterranean population are not sufficient to counteract the risk factors associated with the disease.

Oesophageal foreign bodies in dogs: factors affecting success of endoscopic retrieval.

Oesophageal foreign bodies are common in dogs. Endoscopic removal is a viable treatment option but few studies have assessed the clinical and radiographic features that would be useful in decision-making and prognosis.Dogs (n = 44) with oesophageal foreign bodies presented to the University Veterinary Hospital were assessed. Terriers and West Highland White Terriers were significantly overrepresented (p < 0.0001) and in those breeds the foreign body was significantly (p < 0.0001) more likely to be located caudal to the heart base. The majority (88.6%) of foreign bodies were bones or bone fragments.Group 1 (n = 30) included animals where endoscopic removal was successful and Group 2 (n = 14) animals where it was unsuccessful or not attempted because of evidence of oesophageal rupture. There was no statistically significant difference in age, sex, body weight, type, location and size of foreign body, recovery rate, short-term complications and long-term outcome between the two groups. Duration of signs prior to presentation and time to spontaneous oral feeding were significantly longer (p < 0.01 in each case) in Group 2 (five days and 120 hours, respectively) compared to Group 1 (2 days and 24 hours, respectively). Mortality was 11.1%. Long-term follow-up of 29 dogs suggested oesophageal stricture formation manageable by feeding alone in seven (24.1%) cases.Terriers appear predisposed to oesophageal foreign bodies. Success of endoscopic removal is adversely affected by duration of signs prior to presentation. Surgical removal negatively influences time to recovery. Stricture formation appears to be a relatively common complication and alternate measures for its prevention should be sought.

Quantitative thyroid scintigraphy in greyhounds suspected of primary hypothyroidism.

The existence of hypothyroidism in greyhounds remains controversial and its investigation is complicated by the low circulating thyroid hormone concentrations typically found in healthy dogs of this breed. Quantitative measurement of thyroidal technetium-99m pertechnetate ((99m)TcO4-) uptake is known to be useful in assessing thyroid function in other breeds. The aim of this study was to evaluate thyroid scintigraphy as a method of assessing thyroid function in greyhounds suspected of primary hypothyroidism. Twenty greyhounds (eight females, 12 males) were studied. Thirteen had bald thigh syndrome and seven poor performance and low total T4. Total T4 concentrations were decreased in 18 (90%), and free T4 in two (10%) dogs. All canine thyroid stimulating hormone concentrations were within the reference interval. Thyroidal (99m)TcO4- uptake values (mean +/- SD, 0.76 +/- 0.26%) were within the reference limits published for euthyroid dogs (0.39-1.86%) making hypothyroidism highly unlikely. There were no significant differences (P < 0.05) when comparing data between dogs with bald thigh syndrome (13 dogs) and the remaining dogs (seven dogs). Seventeen (85%) dogs had higher uptake in the left thyroid gland than in the right that might reflect an anatomic feature of the greyhound breed. Calculation of percent thyroidal uptake of (99m)TcO4- is more accurate than thyroid: salivary gland ratios because of high variability in salivary gland uptake. Percent thyroidal uptake of (99m)TcO4- should be used when assessing thyroid function scintigraphically in the greyhound breed.