Comparison of the distraction index and Norberg angle with radiographic grading of canine hip dysplasia.

The Orthopedic Foundation for Animals (OFA) radiographic grading system stands as a well-established benchmark for categorizing hip dysplasia in canines. Although more objective techniques to quantify early hip laxity in young dogs, such as the Norberg angle (NA) and distraction index (DI), have been documented, there is a scarcity of published studies that directly compare these radiographic measures. The primary objectives of this prospective, analytical study were to assess and compare the NA and DI measures with OFA grades within a cohort of dogs. Thirty dogs (57 hip joints) were evaluated, with a mean age of 5.4 ± 2.9 years and a mean body weight of 34.3 ± 7.1 kg. The discriminative power of hip dysplasia for DI and NA used OFA as a reference were compared by multivariate discriminant analysis test. Using the DI (≤0.3) 12 joints were classified as normal, using NA (≥105°) 24 joints and using OFA (≤3) 29. When comparing the discriminant power of NA with OFA resulting similar (P = .8324) with correct classifications of 81% using cross validation, however, the discriminant power of dysplasia of the DI resulted significantly greater (P = .0034) than OFA with correct classifications of only 59% using cross-validation, consequently it was possible determined that of 29 patients with OFA ≤ 3, 20 had DI > 0.3. These findings demonstrated that phenotypic healthy dogs according to OFA grading can present passive hip joint laxity, as demonstrated by radiographic evaluation with distraction. Furthermore, DI can contribute to the screening of CHD when evaluated in conjunction with OFA grading.

B-mode ultrasonography and ARFI elastography of articular and peri-articular structures of the hip joint in non-dysplastic and dysplastic dogs as confirmed by radiographic examination.

BACKGROUND: Canine hip dysplasia is a common orthopedic disease in veterinary practice. The diagnosis is made by radiographic examinations that evaluate bone alterations associated with hip dysplasia. Although radiographic examination is the gold standard for diagnosis, it does not allow a detailed evaluation of soft tissues such as the joint capsule and periarticular muscles. This study aimed to evaluate the accuracy of B-mode ultrasonography and acoustic radiation force impulse (ARFI) elastography in assessing the joint capsule and periarticular muscles of dogs using the Orthopedic Foundation of Animals (OFA) classification and the distraction index (DI) in the early and late diagnosis of hip dysplasia. This study sought to propose a protocol for the ultrasonographic evaluation of the structures involved in canine hip dysplasia. METHODS: Radiographic and ultrasonographic evaluations were performed on 108 hip joints of 54 dogs. Thirty dogs were older than 2 years and 24 were aged between 4 and 10 months. RESULTS: It was verified that an increase in pectineus muscle stiffness (cutoff value > 2.77 m/s) by elastography in some dysplastic dogs and an increase in the thickness of the joint capsule (cutoff value > 0.9 mm) in B-mode ultrasonography, were associated with a distraction index > 0.5, with both having a positive correlation. In B-mode ultrasonographic evaluation, the presence of signs of degenerative joint disease, such as irregularities of the cranial edge of the acetabulum and femoral head, were associated with a distraction index > 0.5 in canines, with a specificity of 94%. In adult dogs, the findings of degenerative joint disease on ultrasound were associated with a diseased OFA classification (P < 0.05). Measurement of the joint capsule > 1.10 mm was diagnostic for dysplasia in unhealthy dogs by OFA. CONCLUSIONS: ARFI elastography has shown that the pectineus muscle may experience changes in stiffness in dysplastic animals. Additionally, changes in joint capsule thickness can be identified in B-mode in young and adult dogs with dysplastic joints, which contributes to the diagnosis of hip dysplasia.

Ultrasonographic assessment of renal perfusion in bitches with mammary carcinoma treated with long-term carprofen.

The aim of this study was to evaluate renal hemodynamics, routine clinical and laboratory parameters used to estimate renal function, and clinical evolution during six months in bitches with mammary carcinomas that underwent mastectomy and were treated (TG) or not (CG) with carprofen for three months after surgery. Twenty-six bitches with mammary carcinoma were equally distributed into TG that received carprofen 4.4 mg/kg/day for 90 days and CG that did not receive anti-inflammatory medication. Renal artery Doppler flowmetry, contrast-enhanced ultrasound (CEUS) of renal parenchyma, haematological, biochemical and clinical analyses were obtained once a month. These data were compared between groups and time via analysis of variance (ANOVA) in a completely randomized design with repeated measures (P < 0.05). On B-mode ultrasound, the area of the renal artery was greater (P = 0.0003) in the TG. Regarding laboratory findings, haematocrit and haemoglobin were similar in both groups, showing a significant and gradual increase after three months of treatment; MCV, MHC, and MCHC were increased (P < 0.05) and lymphocyte and band counts decreased (P < 0.05) in the TG. Regarding biochemical tests, ALT was the only parameter with a significant difference, being higher (P = 0.0272) in the treated group. It can be concluded that the use of carprofen for 90 days causes minimal changes in renal perfusion, erythrocyte parameters and ALT activity, and reduces the proportion of blood inflammatory cells. Therefore, use of this medication can be carried out safely in patients who require auxiliary cancer treatment.

High-definition ultrasonography in the evaluation of the reproductive tract of bitches during the follicular phase of the estrous cycle.

The aim was to sonographically evaluate the reproductive tract of bitches during the follicular phase of the estrous cycle using High Density (HD) ultrasonic techniques. Females (n = 8) were evaluated at five different times throughout the follicular phase, as determined by vaginal cytology and blood progesterone concentrations. Ultrasonic exams were performed using the ACUSON S2000/SIEMENS device utilizing a multifrequency HD transducer (5.5-18 MHz). Videos of the ovaries were obtained and recordings were evaluated using a DICOM viewer software for counting and measuring the ovarian structures, which were assigned to groups based on diameter in mm: G1: ≤ 1; G2: from 1.01 to 3.5; G3 from 3.51 to 5.5; G4: from 5.51 to 10. There was a greater uterine thickness with the progression of the follicular phase (P < 0.05). Six distinct regions were identified in the uterine wall. The ovarian dimensions increased (P < 0.05) as stage of the follicular phase advanced. There was fluid detected around the ovaries after ovulation. There was a characteristic fat tissue hyperechogenicity around the ovaries at all timepoints. There was a difference in the number of ovarian structures of each dimension group at each time there were assessments (P < 0.05). There was a difference in diameter of the largest ovarian structure and in average value of wall thickness at all timepoints when there were evaluations (P < 0.05). The HD ultrasonography technique provides for excellent image resolution, allowing for a more precise characterization of the bitch's reproductive structures and changes occurring during the follicular phase of the estrous cycle.

Applicability of B-mode ultrasonography, ARFI elastography and contrast-enhanced ultrasound in the evaluation of chronic kidney disease in dogs / Aplicabilidade da ultrassonografia modo-B, elastografia ARFI e ultrassonografia contrastada na avaliação da doença renal crônica em cães

The objective of this study was to verify the applicability of B-mode ultrasonography, ARFI elastography and CEUS in the diagnosis of chronic kidney disease and its Stages in dogs. 24 healthy dogs and 28 with CKD were included. In B-mode, the echogenicity, echotexture and cortico-medullary ratio of the kidneys were verified. By elastography, the shear-wave velocity of the cortical (SWVcort) and medullary (SWVmed) regions were determined and tissue deformity was evaluated. Wash-in, wash-out and peak enhancement (TPic) of the contrast in the renal parenchyma were calculated and homogeneity, presence of filling gaps and distinction of filling phases were evaluated by CEUS. Changes in echogenicity, echotexture and cortico-medullary ratio were observed only in sick patients. There was an increase in SWVcort in CKD, with a cutoff point >2.91m/s. Healthy kidneys were non-deformable and 25% had changes in gray scales. There was an increase in wash-in and TPic, changes in filling characteristics, filling failures and difficulty in distinguishing between the Stages in CEUS in CKD. It was found that dogs with CKD 2, 3 and 4 had greater SWVcort and wash-in values than CKD 1. Elastographic and CEUS changes were observed in dogs with CKD, demonstrating the applicability of ultrasonographic techniques in their diagnosis.(AU)

O objetivo deste estudo foi verificar a aplicabilidade da ultrassonografia modo-B, elastografia ARFI e CEUS no diagnóstico da doença renal crônica e seus estágios em cães. Foram incluídos 24 cães saudáveis e 28 com DRC. Pelo modo-B, verificou-se ecogenicidade, ecotextura e relação córtico-medular dos rins. Pela elastografia, foram determinadas as velocidades de cisalhamento das regiões cortical (SWVcort) e medular (SWVmed) e foi avaliada a deformidade tecidual. Calculou-se os temos de wash-in, wash-out e pico de intensidade (TPic) do parênquima renal e avaliou-se homogeneidade, presença de falhas e distinção das fases de preenchimento por contraste por meio de CEUS. Alterações em ecogenicidade, ecotextura e relação córtico-medular foram observadas somente em pacientes doentes. Houve aumento da SWVcort na DRC, com ponto de corte >2.91m/s. Rins saudáveis foram não-deformáveis e 25% apresentou alterações nas escalas de cinza. Houve aumento do wash-in e TPic, alterações nas características de preenchimento, falhas e dificuldade para distinguir as fases de preenchimento do contraste nos rins com DRC. Verificou-se que cães com DRC graus 2, 3 e 4 tiveram valores de SWVcort e wash-in maiores que cães com DRC grau 1. Foram obsrervadas alterações elastográfica e de CEUS em cães com DRC, demonstrando a aplicabilidade destas técnicas ultrassonográficas no seu diagnóstico.(AU)

Applicability of B-mode ultrasonography, ARFI elastography and contrast-enhanced ultrasound in the evaluation of chronic kidney disease in dogs

ABSTRACT: The objective of this study was to verify the applicability of B-mode ultrasonography, ARFI elastography and CEUS in the diagnosis of chronic kidney disease and its Stages in dogs. 24 healthy dogs and 28 with CKD were included. In B-mode, the echogenicity, echotexture and cortico-medullary ratio of the kidneys were verified. By elastography, the shear-wave velocity of the cortical (SWVcort) and medullary (SWVmed) regions were determined and tissue deformity was evaluated. Wash-in, wash-out and peak enhancement (TPic) of the contrast in the renal parenchyma were calculated and homogeneity, presence of filling gaps and distinction of filling phases were evaluated by CEUS. Changes in echogenicity, echotexture and cortico-medullary ratio were observed only in sick patients. There was an increase in SWVcort in CKD, with a cutoff point >2.91m/s. Healthy kidneys were non-deformable and 25% had changes in gray scales. There was an increase in wash-in and TPic, changes in filling characteristics, filling failures and difficulty in distinguishing between the Stages in CEUS in CKD. It was found that dogs with CKD 2, 3 and 4 had greater SWVcort and wash-in values than CKD 1. Elastographic and CEUS changes were observed in dogs with CKD, demonstrating the applicability of ultrasonographic techniques in their diagnosis.

RESUMO: O objetivo deste estudo foi verificar a aplicabilidade da ultrassonografia modo-B, elastografia ARFI e CEUS no diagnóstico da doença renal crônica e seus estágios em cães. Foram incluídos 24 cães saudáveis e 28 com DRC. Pelo modo-B, verificou-se ecogenicidade, ecotextura e relação córtico-medular dos rins. Pela elastografia, foram determinadas as velocidades de cisalhamento das regiões cortical (SWVcort) e medular (SWVmed) e foi avaliada a deformidade tecidual. Calculou-se os temos de wash-in, wash-out e pico de intensidade (TPic) do parênquima renal e avaliou-se homogeneidade, presença de falhas e distinção das fases de preenchimento por contraste por meio de CEUS. Alterações em ecogenicidade, ecotextura e relação córtico-medular foram observadas somente em pacientes doentes. Houve aumento da SWVcort na DRC, com ponto de corte >2.91m/s. Rins saudáveis foram não-deformáveis e 25% apresentou alterações nas escalas de cinza. Houve aumento do wash-in e TPic, alterações nas características de preenchimento, falhas e dificuldade para distinguir as fases de preenchimento do contraste nos rins com DRC. Verificou-se que cães com DRC graus 2, 3 e 4 tiveram valores de SWVcort e wash-in maiores que cães com DRC grau 1. Foram obsrervadas alterações elastográfica e de CEUS em cães com DRC, demonstrando a aplicabilidade destas técnicas ultrassonográficas no seu diagnóstico.

Quantitative ultrasound elastography and biometry of the bitch uterus in the early puerperium after vaginal delivery and caesarean section.

Elastography is an actual imaging method used to qualitatively and quantitatively evaluate the elastic properties of tissues. The aim of this study was to evaluate and compare uterine tissue biometry and stiffness during post-partum period in brachycephalic bitches (n = 12) after c-section (GCS; n = 8) or normal delivery (GNB; n = 4). These animals were evaluated daily by abdominal ultrasound from the day of delivery until the 10th day post-partum; measuring uterine diameter, myometrial and endometrial thickness (mm) and shear wave velocity (SWV; m/s), by B-mode and ARFI (acoustic radiation force impulse) elastography, respectively. Uterine diameter was higher (p = .012) in animals submitted to c-section (15.26 ± 4.73 mm) than in normal birth (12.53 ± 2.64 mm) during the first 7 days post-partum. Uterine thickness gradually involuted in both groups (p < .0001), the myometrium during the first 9 days (p = .005) and the endometrium during the first 6 days (p = .003). The myometrial and endometrial SWVs were similar between types of delivery (p = .7846 and .8273) and presented a gradual increase (p = .411; .0043, respectively), during the first 10 days post-partum. It was concluded that bitches with normal delivery had smaller uterine thickness and faster puerperal involution than submitted to c-section, while uterine tissue stiffness was similar between delivery types and increased gradually during post-partum.

Ultrasonography for lymph nodes metastasis identification in bitches with mammary neoplasms.

The aim of this study was to evaluate and compare the diagnostic accuracy of B-mode, Doppler ultrasonography and Acoustic Radiation Force Impulse (ARFI) elastography in the identification of axillary and inguinal lymph nodes metastasis in bitches with mammary neoplasms. The axillary (n = 96) and inguinal (n = 100) lymph nodes of 100 bitches were evaluated using B-Mode, Colour Doppler and ARFI-elastography. After this evaluation, mastectomy and lymph nodes excision were performed and these structures were histologically classified as free, reactive or metastatic. Ultrasonographic parameters were compared by Chi-Square or ANOVA tests and if they are significant, discriminative power analysis according to histopathological classification was performed (ROC analysis). The ARFI-elastography shear wave velocity (SWV) enabled metastasis identification in inguinal (sensitivity 95% specificity 87%) and axillary lymph nodes (sensitivity 100% specificity 94%). While B-Mode ultrasound Short/Long axis ratio evaluation of inguinal and axillary lymph nodes only resulted in a sensitivity around of 71% and specificity of 55%. In conclusion, B-Mode ultrasonography may contribute to diagnosis of metastasis in axillary and inguinal lymph nodes of bitches affected by mammary neoplasm with limited accuracy, while SWV evaluation proved to be an excellent diagnosis tool, which allows differentiation between free, reactive and tumour metastatic lymph nodes.

Accuracy of four ultrasonography techniques in predicting histopathological classification of canine mammary carcinomas.

Due to the importance of presurgical, noninvasive, and accurate diagnostic tools in mammary carcinoma characterization, this prospective secondary observational cohort study was designed to evaluate and compare the diagnostic accuracy of B-mode, Doppler, contrast enhancement ultrasonography, or acoustic radiation force impulse-elastography in identifying mammary carcinomas types with high degree of malignancy. A total of 246 mammary carcinomas from 141 female dogs were analyzed using B-mode, Doppler, contrast enhancement ultrasonography, and acoustic radiation force impulse ultrasonography prior to their histopathological classification according to types (simple, complex, or special) and grade (I, II, or III). Qualitative and quantitative variables were compared between carcinoma types and grades by Fisher's or analysis of variance. Diagnostic performance was estimated by receiver-operating characteristic analysis, using histopathological classification as a reference. Deformability (acoustic radiation force impulse) had a diagnostic specificity of 100% and sensitivity of 12% in identifying special carcinomas. A width:length ratio greater than 0.53 can be suggestive of special carcinoma, with 80% sensitivity and 76% specificity. Contrast wash-in and peak enhancement times lower than 7.5 and 13.5 s, respectively, were indicative of complex carcinoma at 62% sensitivity and 60% specificity. Contrast wash-in, peak enhancement, and wash-out times greater than 6.5, 12.5, and 64.5 s, respectively; were indicative of grade II and III carcinoma at 68% sensitivity and 62% specificity. In conclusion, B-mode ultrasonography, contrast enhancement ultrasonography, and acoustic radiation force impulse-elastography enabled the identification of some of the characteristics of high-grade mammary carcinoma types and grades in female dogs with limited accuracy. The findings from this study may contribute to oncology research and clinical management canine patients.

Comparison between single port videolaparoscopy and miniceliotomy with snock hook ovariohysterectomy techniques in bitches / Comparação das técnicas videolaparoscópica com único portal e miniceliotomia com gancho de Snook para ovário-histerectomia em cadelas

ABSTRACT: In order to use and study minimally invasive techniques to reduce side effects of ovarian-hysterectomy (OHE) in bitches, the aim of this study was to compare time, surgical complications, pain and postoperative inflammatory response, caused by single port videolaparoscopic OHE and traditional miniceliotomy with snook hook. Twenty-four healthy bitches were randomly divided in two groups: videolaparoscopy (Video) and miniceliotomy (MiniLap). Surgical time and complications, pain, need for analgesic rescue, C-reactive protein concentration, glycaemia and voluntary food ingestion were evaluated during 24 hours following the procedure and compared statistically. Surgical time (38±7min), surgical complications (17%), postoperative pain intensity, need for analgesic rescue and C-reactive protein concentration were similar between groups (P>0.05). Glycaemia was lower in Video group (P=0.03), animals fed faster and in greater proportion (P=0.02). Thus, it is concluded that both OHE techniques result in similar complications, surgical time and inflammatory response; however, animals on Video group fed more readily and presented lower glycaemia, which point to lower stress levels. These findings validated the indication of this technique.

RESUMO: Com o intuito de utilizar e estudar técnicas minimamente invasivas que permitam reduzir os efeitos adversos da ovário-histerectomia (OVH) em cadelas objetivou-se comparar: o tempo, as complicações cirúrgicas, a dor e a resposta inflamatória pós-operatória, resultantes da OVH laparoscópica por único portal e a miniceliotomia tradicional com gancho de Snook. Vinte e quatro cadelas hígidas foram aleatoriamente divididas em dois grupos e realizadas a OVH por videolaparoscopia (Vídeo) ou miniceliotomia (MiniLap). Avaliaram-se e compararam-se estatisticamente: o tempo e intercorrências cirúrgicas, a dor, necessidade de resgate analgésico, concentração sérica de proteína C reativa, glicemia e o consumo voluntário de alimento durante as 24 horas subsequentes ao procedimento. O tempo operatório (38±7min), as intercorrências cirúrgicas (17%), a intensidade de dor pós-operatória, a necessidade de resgate analgésico e a concentração sérica de proteína C reativa foram similares entre os grupos (P>0,05). A glicemia foi menor nos animais do grupo Vídeo (P=0,03) e estes se alimentaram mais rapidamente e em maior proporção (P=0,02). Assim, conclui-se que as técnicas de OVH por videolaparoscopia, miniceliotomia resultam em complicações, tempos cirúrgicos e respostas inflamatórias similares, no entanto, os animais submetidos à videolaparoscopia se alimentam mais prontamente e apresentam menor índice glicêmico indicando um nível de estresse menor e este resultado considera-se válido para a indicação desta técnica.

Ultrasonography methods for predicting malignancy in canine mammary tumors.

The aim of this study was to evaluate and compare the efficacy of B-mode, Doppler, contrast-enhanced ultrasonography (CEUS), and Acoustic Radiation Force Impulse (ARFI) elastography in predicting malignancy in canine mammary masses. This was a prospective cohort study from 2014 to 2016, which included 153 bitches with one or more mammary masses. A total of 300 masses were evaluated by ultrasonography (B-mode, Doppler, CEUS, and ARFI) and subsequently classified as benign or malignant by histopathology. Each ultrasound parameters studied were compared between benign and malignant masses by Chi-square or Student tests and differences were considered significant when P < 0.01. For the variables that proved significant differences were estimated the cut-off point, sensitivity, specificity, accuracy, and area under curve (AUC) by receiver-operating characteristic curve (ROC) analysis in a logistic regression model using histopathological classification as reference, to assess and compare diagnostic performance of each technique. Out of 300 mammary masses evaluated 246 were classified as malignant and 54 as benign. B-mode measurements showed sensitivity 67.9%, and specificity 67.6% as malignancy predictors on canine mammary masses; Doppler indexes systolic (>21.2 m/s) and diastolic velocity (>4.8 m/s) sensitivity 79.2% and specificity 70.8%; CEUS wash-out time (<80.5 s) sensitivity 80.2% and specificity 16.7%; and ARFI elastography shear velocity (SWV > 2.57 m/s) sensitivity 94.7% and specificity 97.2% In conclusion B-mode and Doppler ultrasound evaluations may assist in malignancy prediction of canine mammary masses with moderate sensitivity and specificity, already the SWV was an great accurate predictor. Therefore, ARFI elastography exam inclusion in veterinary clinic oncology and research is highly recommended, since it allows fast, non-invasive, and complication-free malignancy prediction of canine mammary masses.