Physical examination and CT to assess thoracic injury in 137 cats presented to UK referral hospitals after trauma.

OBJECTIVES: The aim of the study was to describe clinical examination and thoracic CT (TCT) findings in cats after trauma, and to identify physical examination findings associated with both abnormalities on TCT and the need for therapeutic interventions. METHODS: A multicentre, retrospective, observational study was conducted. Cats admitted to the participating hospitals with a history of blunt trauma and that underwent TCT were eligible. Data were collected on signalment, history, physical examination, TCT findings and subsequent interventions. RESULTS: In total, 137 cats were included. Road traffic accidents (RTAs) were the most frequently reported cause of trauma (69%). Tachypnoea (32%), pale mucous membranes (22%) and dyspnoea (20%) were the most common abnormal findings on thoracic examination. The most frequently identified thoracic pathologies on TCT were atelectasis (34%), pulmonary contusions (33%), pneumothorax (29%) and pleural effusion (20%). Thoracocentesis was the most commonly performed intervention (12%), followed by chest drain placement (7%). A total of 45 (33%) cats had no physical examination abnormalities but did have abnormalities detected on TCT; six of these cats required interventions. Increasing numbers of thoracic abnormalities on clinical examination were associated with increasing likelihood of having abnormal findings on TCT (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.21-3.44, P = 0.008) and of requiring an intervention (OR 1.82, 95% CI 1.32-2.51, P <0.001). CONCLUSIONS AND RELEVANCE: RTAs were the most common reported cause of blunt trauma. Atelectasis, pulmonary contusions and pneumothorax were the most common abnormalities identified on TCT, and thoracic drainage was the most utilised intervention. TCT may be useful in identifying cats with normal thoracic physical examination findings that have significant thoracic pathology, and a high number of abnormal findings on thoracic examination should raise suspicion for both minor and major thoracic pathology. The results of this study can be used to assist in selecting appropriate cases for TCT after blunt trauma.

Radiographic and computed tomographic characteristics of intraluminal tracheal adenoma in a cat.

A 13-year-old spayed female Persian cat presented with dyspnea and nasal discharge. Thoracic radiography revealed a dome-shaped soft-tissue opacity in the carina. Computed tomography confirmed a soft tissue-attenuating mass in the carina and the left and right proximal main bronchi that appeared to arise from the tracheal wall. Tracheoscopy revealed an intraluminal broad-based mass with multilobulated borders at the same location. Histopathological evaluation revealed a benign neoplastic process of the glandular epithelial lineage, which was considered an adenoma. Tracheal adenomas should be included in the differential diagnosis of tracheal masses.

Performance of a commercially available artificial intelligence software for the detection of confirmed pulmonary nodules and masses in canine thoracic radiography.

Advancements in the field of artificial intelligence (AI) are modest in veterinary medicine relative to their substantial growth in human medicine. However, interest in this field is increasing, and commercially available veterinary AI products are already on the market. In this retrospective, diagnostic accuracy study, the accuracy of a commercially available convolutional neural network AI product (Vetology AI®) is assessed on 56 thoracic radiographic studies of pulmonary nodules and masses, as well as 32 control cases. Positive cases were confirmed to have pulmonary pathology consistent with a nodule/mass either by CT, cytology, or histopathology. The AI software detected pulmonary nodules/masses in 31 of 56 confirmed cases and correctly classified 30 of 32 control cases. The AI model accuracy is 69.3%, balanced accuracy 74.6%, F1-score 0.7, sensitivity 55.4%, and specificity 93.75%. Building on these results, both the current clinical relevance of AI and how veterinarians can be expected to use available commercial products are discussed.

Bilateral thoracic radiographs increase lesion detection in horses with pneumonia or pulmonary neoplasia but do not bring any additional benefit for inflammatory or diffuse pulmonary disease.

Published studies describing the effects of bilateral radiographic projections on the detection of equine pulmonary lesions are currently lacking. The objectives of this retrospective, single center, observational study were to compare unilateral and bilateral thoracic radiographic projections for the detection of pulmonary lesions in a group of horses. Based on their clinical diagnosis, 167 adults and foals with bilateral thoracic radiographs were classified as having pneumonia (n = 88), inflammatory or diffuse pulmonary disease (n = 72), and pulmonary masses (n = 7). After an initial interrater repeatability test, right-to-left and left-to-right projections were anonymized and independently interpreted by a radiologist blinded to the clinical diagnosis. Scores were attributed for each pattern/lesion (alveolar, interstitial, bronchial, nodules/masses, cavitary lesions) and each quadrant. Agreement between scores from each projection was evaluated with Bland-Altman plots. Lesions identified on one side but not on the contralateral projection were considered discordant. There was no preferential lateralization of pulmonary lesions. The prevalence of discordance was 14.4%, 9.0%, and 4.2% for alveolar pattern, nodules/masses, and cavitary lesions, respectively. Up to nine horses (10.2%) with pneumonia could have been misdiagnosed. A pulmonary mass would have been missed in one case. For inflammatory or diffuse disease, discordance was slight, and the addition of contralateral projections had no impact on radiographic interpretation. In conclusion, in horses with pneumonia or neoplasia, bilateral projections, or adding at least one contralateral caudoventral view, increased the probability of identifying pulmonary lesions. In horses with inflammatory or diffuse disease, bilateral thoracic radiography provided no additional benefit.

Achados radiográficos e ultrassonográficos de fibrossarcoma em membro torácico de gatos: relato de três casos / Radiographic and ultrasound findings of fibrosarcoma in the cats: reports of three cases / Hallazgos radiográficos y ultrasonidos de fibrosarcoma en la extremidad torácica de gatos: informe de tres casos

O fibrossarcoma é uma neoplasia mesenquimal maligna originada dos fibroblastos que localiza-se especificamente em tecido cutâneo, subcutâneo e cavidade oral. A ressecção cirúrgica do tumor com margem de segurança é conhecida como a principal forma de tratamento. A principal forma de metástase é a via hematógena, atingindo pulmões, e menos comum em linfonodos regionais. A análise histopatológica é o exame diagnóstico de eleição para definição do tipo de tumor e sua graduação. Os exames de imagem são fundamentais no estadiamento das neoplasias e planejamento cirúrgico. A ultrassonografia e radiografia são os métodos mais utilizados e oferecem um grande apoio a oncologia médica veterinária. O exame radiográfico possibilita o achado de neoformações ósseas ou demais alterações como o aumento de volume de tecidos moles, infiltração gordurosa, e cavitações com gás ou fluído. O exame ultrassonográfico permite o conhecimento sobre a ecotextura, organização, e localização da lesão em tecidos moles. Em três gatos com fibrosssarcoma em membro torácico, foram realizadas radiografia e ultrassonografia específica da lesão. Os achados radiográficos foram aumento de volume, radiopacidade dos tecidos moles, sem acometimento ósseo. Os achados ultrassonográficos foram lesões de ecotextura grosseira, altamente heterogêneas. Os exames citológicos e histopatológicos revelaram tratar-se de fibrossarcoma. O presente relato tem como objetivo descrever os achados radiográficos e ultrassonográficos de fibrossarcoma em membro torácico de três gatos.

Fibrosarcoma is a malignant mesenchymal neoplasm originating from fibroblasts, which is specifically located in the skin tissue, subcutaneous tissue and oral cavity. Surgical resection of the tumor with a safety margin is known as the main form of treatment. The main form of metastasis is the hematogenous route, reaching the lungs, and less common in regional lymph nodes. histopathological analysis is the diagnostic test of choice for defining the type of tumor and its graduation. Imaging exams are essential in the staging of neoplasms and surgical planning. Ultrasonography and radiography are the most used methods and offer great support to veterinary medical oncology. The radiographic exam allows the finding of bone neoformations or other alterations such as the increase in soft tissue volume, fatty infiltration, and cavitations with gas or fluid. The ultrasound examination allows knowledge about the echotexture, organization, and location of the soft tissue lesion. Three cats with fibrosarcoma in the thoracic limb underwent lesion-specific radiography and ultrasound. The radiographic findings of fibrosarcomas were increased soft tissue radiopacity volume, without bone involvement. And the ultrasonographic findings were gross echotexture lesions, highly heterogeneous. Cytological and histopathological examinations were performed for definitive diagnosis. The present report aims to describe the radiographic and ultrasonographic findings of fibrosarcoma in the thoracic limb of three cats.

RESUMEN El fibrosarcoma es una neoplasia mesenquimatosa maligna que se origina a partir de fibroblastos, que se localiza específicamente en el tejido cutáneo, tejido subcutáneo y cavidad oral. La resección quirúrgica del tumor con un margen de seguridad se conoce como la forma principal de tratamiento. La principal forma de metástasis es la vía hematógena, que llega a los pulmones y es menos común en los ganglios linfáticos regionales. El análisis histopatológico es la prueba diagnóstica de elección para definir el tipo de tumor y su graduación. Los exámenes por imágenes son esenciales en la estadificación de las neoplasias y la planificación quirúrgica. La ecografía y la radiografía son los métodos más utilizados y ofrecen un gran apoyo a la oncología médica veterinaria. El examen radiográfico permite encontrar neoformaciones óseas u otras alteraciones como aumento de volumen de tejidos blandos, infiltración grasa y cavitaciones con gas o líquido. El examen ecográfico permite conocer la ecotextura, organización y ubicación de la lesión de tejidos blandos. A tres gatos con fibrosarcoma en la extremidad torácica se les realizó una radiografía y una ecografía específicas de la lesión. Los hallazgos radiográficos de los fibrosarcomas fueron un aumento del volumen de radiopacidad de los tejidos blandos, sin afectación ósea. Y los hallazgos ecográficos fueron lesiones macroscópicas de ecotextura, muy heterogéneas. Se realizaron exámenes citológicos e histopatológicos para el diagnóstico definitivo. El presente informe tiene como objetivo describir los hallazgos radiográficos y ecográficos del fibrosarcoma en la extremidad torácica de tres gatos.

Comparison of electrocardiographic parameters in dogs with different stages of myxomatous mitral valve disease.

This study evaluated changes in electrocardiographic (ECG) parameters according to the stage of myxomatous mitral valve disease (MMVD) in dogs, as well as the utility of ECG parameters as prognostic indicators for congestive heart failure (CHF). Medical records of dogs with MMVD were retrospectively searched. Dogs with MMVD (N = 101) were classified into stages B [B1 (n = 52) and B2 (n = 23)] and C (n = 26) according to the American College of Veterinary Internal Medicine guidelines. Baseline variables were collected; these included signalment, radiographic, echocardiographic, and ECG parameters. Corrected QT intervals (QTc) were calculated using the logarithmic (QTc1) and Fridericia (QTc2) formulas. The P wave duration, QTc1, and QTc2 were significantly longer in stage C than in stage B. The P wave duration cutoff of 43.5 ms had a diagnostic accuracy of 65% for differentiating CHF, with a sensitivity of 63% and a specificity of 90%. A cutoff value of 307.8 ms for QTc1 yielded a sensitivity of 62%, a specificity of 76%, and a diagnostic accuracy of 78%, and a cutoff value of 239.2 ms for QTc2 yielded a sensitivity of 62%, a specificity of 83%, and a diagnostic accuracy of 77% for diagnosing CHF. Therefore, prolonged P wave and QTc in dogs with MMVD may facilitate the prediction of CHF. Electrocardiography could provide clinicians with a readily available and cost-effective screening tool for predicting CHF, if the usefulness of ECG parameters can be verified.

Cette étude a évalué les changements des paramètres électrocardiographiques (ECG) en fonction du stade de la maladie de la valve mitrale myxomateuse (MMVD) chez le chien, ainsi que l'utilité des paramètres ECG en tant qu'indicateurs pronostiques de l'insuffisance cardiaque congestive (ICC). Les dossiers médicaux des chiens atteints de MMVD ont été consultés rétrospectivement. Les chiens atteints de MMVD (N = 101) ont été classés en stades B [B1 (n = 52) et B2 (n = 23)] et C (n = 26) selon les directives de l'American College of Veterinary Internal Medicine. Les variables de base ont été collectées; celles-ci comprenaient le signalement, ainsi que les paramètres radiographiques, échocardiographiques et ECG. Les intervalles QT corrigés (QTc) ont été calculés à l'aide des formules logarithmiques (QTc1) et Fridericia (QTc2). La durée de l'onde P, QTc1 et QTc2 étaient significativement plus longues au stade C qu'au stade B. Le seuil de durée de l'onde P de 43,5 ms avait une précision diagnostique de 65 % pour différencier l'ICC, avec une sensibilité de 63 % et une spécificité de 90 %. Une valeur seuil de 307,8 ms pour QTc1 a donné une sensibilité de 62 %, une spécificité de 76 % et une précision diagnostique de 78 %, et une valeur seuil de 239,2 ms pour QTc2 a donné une sensibilité de 62 %, une spécificité de 83 %, et une précision diagnostique de 77 % pour le diagnostic d'ICC. Par conséquent, une onde P et un QTc prolongés chez les chiens atteints de MMVD peuvent faciliter la prédiction de l'ICC. L'électrocardiographie pourrait fournir aux cliniciens un outil de dépistage facilement disponible et rentable pour prédire l'ICC, si l'utilité des paramètres ECG peut être vérifiée.(Traduit par Docteur Serge Messier).

Echocardiographic parameters and indices in 23 healthy Maltese dogs.

BACKGROUND: Echocardiography is a primary tool used by veterinarians to evaluate heart diseases. In recent years, various studies have targeted standard echocardiographic values for different breeds. Reference data are currently lacking in Maltese dogs and it is important to fill this gap as this breed is predisposed to myxomatous mitral valve disease, which is a volume overload disease. OBJECTIVES: To establish the normal echocardiographic parameters for Maltese dogs. METHODS: In total, 23 healthy Maltese dogs were involved in this study. Blood pressure measurements, thoracic radiography, and complete transthoracic echocardiography were performed. The effects of body weight, age and sex were evaluated, and the correlations between weight and linear and volumetric dimensions were calculated by regression analysis. RESULTS: The mean vertebral heart size was 9.1 ± 0.4. Aside from the ejection fraction, fractional shortening, and the left atrial to aorta root ratio, all the other echocardiographic parameters were significantly correlated with weight. CONCLUSION: This study describes normal echocardiographic parameters that may be useful in the echocardiographic evaluation of Maltese dogs.

Lung ultrasound nodule sign for detection of pulmonary nodule lesions in dogs: Comparison to thoracic radiography using computed tomography as the criterion standard.

Thoracic radiography (TR), the most common screening test for pulmonary metastases in dogs, can fail to detect small lesions <3 mm. Lung ultrasonography (LUS) is a widely available imaging modality capable of detecting peripheral nodules but is underutilized for this purpose. Thoracic computed tomography (CT) is the criterion standard for diagnosis of lung metastases and nodular disease but is less practical for a variety of reasons. We hypothesized that LUS would be more sensitive but less specific at detecting nodules consistent with metastatic pulmonary disease in dogs compared to TR, using CT as the criterion standard. This was a masked, single-center prospective study of 62 client-owned dogs evaluated for respiratory signs or pulmonary metastatic neoplasia screening using TR, LUS and CT. Dogs were included if metastatic pulmonary disease was a differential. All imaging modalities were scored as having nodules (yes/no) and other types of pathologic lesions were recorded. Sensitivity (Se), specificity (Sp) and positive (LR+) and negative likelihood ratios (LR-) were determined for TR and LUS. For TR, Se and Sp were 64% and 73%, and LR+ and LR- were 2.37 and 0.49, respectively. For LUS, Se and Sp were 60% and 65% and LR+ and LR- were 1.71 and 0.62, respectively. The results of the study indicate that LUS had a similar Se to TR, with both modalities missing nodules when used for screening. The low Sp and LR- suggests caution should be used when assuming TR and LUS rule out the presence of nodules.

Prevalence, risk factors and survival in dogs with myxomatous valve degeneration / [Prevalência, fatores de risco e sobrevivência em cães com degeneração mixomatosa valvar]

The objective of this study was to describe the prevalence, survival time, and risk factors of myxomatous mitral valve disease (MMVD) in dogs by a retrospective observational cohort study design of a Brazilian veterinary center, admitted from 2012 to 2018 (2.585 days). Considering the 105 dog files confirmed as MMVD, the prevalence of the disease was higher in small-breed dogs with ages from 10 to 19 years (30.3%). The survival time of the dogs at B1 stage (1.854 ± 145 days) was higher than the B2 (1.508+209) and C/D (930 ± 209). Higher risks of death (hazard ratio) were detected in the presence of syncope (2.5), pulmonary crackling (2.0), dyspnea (1.9), and higher values of vertebral heart scale (1.7), radiographic left atrium dimension (1.8), the ACVIM staging (1.7), and the duration of QRS complex (1.05). The results achieved demonstrated higher prevalence of MMVD in old small-breed dogs, associated with longer survival time in the B1 stage of the disease, and higher risk of death related to the presence of clinical signs, such as dyspnea, syncope, and pulmonary crackling, beyond some radiographic, echocardiographic, and electrocardiographic variables of heart or atrial enlargement.(AU)

O objetivo deste estudo foi descrever a prevalência, o tempo de sobrevivência e os fatores de risco da doença mixomatosa valvar mitral (DMVM) em cães, por meio de estudo de coorte observacional retrospectivo, os quais foram atendidos em um centro veterinário de 2012 a 2018 (2.585 dias). Considerando os 105 arquivos de cães com confirmação da DMVM, maior prevalência foi observada em raças pequenas com idades entre 10 e 19 anos (30,3%). O tempo de sobrevivência de cães em estágio B1 (1.854+145 dias) foi superior ao B2 (1.508+209) e ao C/D (930+209). Maior risco de morte (hazard ratio) foi observado na presença de síncope (2,5), crepitação pulmonar (2,0), dispneia (1,9), bem como de valores superiores de VHS (1,7), dimensão radiográfica do átrio esquerdo (1,8), estadiamento ACVIM (1,7) e duração do complexo QRS (1,05). Os resultados obtidos demonstraram maior prevalência de DMVM em cães idosos de raças pequenas, associada a maior tempo de sobrevida no estágio B1 da doença e a maior risco de morte relacionado à presença de sinais clínicos como dispneia, síncope e crepitação pulmonar, além de algumas variáveis radiográficas, ecocardiográficas e eletrocardiográficas de cardiomegalia ou aumento atrial esquerdo.(AU)

The evaluation of non-anesthetic computed tomography for detection of pulmonary parenchyma in feline mammary gland carcinoma: a preliminary study.

BACKGROUND: Thoracic radiography in awake cats is a common procedure for the evaluation of pulmonary metastasis in feline mammary gland carcinoma (MGC). However, due to poor sensitivity, computed tomography (CT) is progressively taking its place. To perform CT in animals, general anesthesia is normally preferred but can cause lung atelectasis, affecting lung interpretation. Besides, MGC is often found in senile cats that are concurrently affected with other diseases, increasing anesthetic risk. Therefore, this study was aimed at comparing the effect of anesthesia on lung atelectasis observed through CT in clinically healthy cats and comparing the feasibility of non-anesthetic CT with non-anesthetic radiography in the detection of lung lesions in feline MGC. Thoracic CTs from anesthetized, clinically healthy cats and non-anesthetized either clinically healthy cats or MGC-affected cats were reviewed. In clinically healthy cats, motion artifacts and characteristics of lung atelectasis were observed and compared. In MGC-affected cats, motion artifacts were observed and compared to clinically healthy cats, and the number of MGC-affected cats, the number and characteristics of lung lesions were compared between non-anesthetic thoracic CT and radiography. RESULTS: Anesthesia significantly increased lung CT attenuation (P = 0.0047) and was significantly correlated with lung atelectasis (OR = 15; CI 2.02-111.18; P = 0.0081), particularly of the cranial lung lobe. Nonetheless, significantly higher motion artifacts in the caudal thoracic area were found in non-anesthetized healthy cats (P = 0.0146), but comparable low motion artifacts were observed in anesthetized healthy and MGC-affected cats. Non-anesthetic CT revealed higher numbers of MGC-affected cats and pulmonary nodules with a significantly lower nodular diameter (P = 0.0041) than those observed on radiographs. The smallest nodular diameters detected on radiographs and CT were 2.5 and 1.0 mm, respectively. Furthermore, CT showed additional information such as intra-thoracic lymphadenopathy, that could not be seen on radiographs. CONCLUSIONS: Despite the motion artifacts, CT without anesthesia is a sensitive technique as it provides better lung inflation. Furthermore, compared to non-anesthetic radiography, non-anesthetic CT provided more information such as higher number of pulmonary nodules of a smaller size, including more distinct intra-thoracic lesions, such as lymphadenopathy, in MGC-affected cats.

Radiographic characteristics of alveolar microlithiasis and pulmonary ossification following chronic corticosteroid therapy in a dog.

A 10-year-old, neutered female, Australian Shepherd was referred for acute respiratory distress and a history of chronic exogenous steroid administration. On thoracic radiographs, a severe increase in mineral opacity characterized as a generalized unstructured interstitial pulmonary pattern, diffuse calcinosis cutis, and moderate hepatomegaly were noted. Cor pulmonale was identified on echocardiography. The patient developed a pneumothorax following sampling and had a cardiac arrest. Postmortem histopathology of the lungs revealed pulmonary interstitial mineralization and alveolar microlithiasis. This report supports including generalized pulmonary mineralization due to chronic exogenous steroid administration as a differential diagnosis for dogs with these clinical and imaging findings.

Radiographic Reference Intervals of the Cardiac Silhouette Width in the Bald Eagle (Haliaeetus leucocephalus).

Radiograph imaging is an important diagnostic tool for assessing cardiac size in avian patients. The bald eagle (Haliaeetus leucocephalis), once on the United States Federal List of Endangered and Threatened Wildlife and Plants, is now a thriving species in the United States. However, there is surprisingly little information regarding bald eagle cardiac reference values obtained through radiographic imaging for use in assessment of cardiac disease in this species. This study was performed to establish reference values of cardiac size in the bald eagle. Ventrodorsal radiographic images were taken from 9 healthy birds obtained from a raptor rehabilitation facility. Cardiac silhouette width to thorax width, cardiac silhouette width to sternum width, cardiac silhouette width to hepatic silhouette width, and cardiac silhouette width to coracoid width were obtained. Ratios were calculated between the respective areas measured. The results showed that the cardiac silhouette averages 44%-52% of the thoracic width, 71%-86% of the sternal width, 94%-117% of the width of the hepatic silhouette, and 500%-920% of the coracoid width. In the individuals studied there was a strong correlation between cardiac silhouette width to thoracic and sternal width whereas cardiac width with hepatic and coracoid widths had a moderate to weak correlation respectively. The values obtained in this study can be used to radiographically assess the cardiac size of bald eagles, thus aiding in the diagnosis of cardiomegaly in this species.

Diagnosis of pulmonary contusions with point-of-care lung ultrasonography and thoracic radiography compared to thoracic computed tomography in dogs with motor vehicle trauma: 29 cases (2017-2018).

OBJECTIVE: To determine the accuracy of lung ultrasound (LUS) using the Veterinary Bedside Lung Ultrasound Examination (VetBLUE) protocol and 3-view thoracic radiographs (TXR) compared to thoracic computed tomography (TCT) for diagnosing the presence and quantification of pulmonary contusions (PC). DESIGN: Prospective cohort study conducted from February 2017 to June 2018. SETTING: Private emergency and referral center. ANIMALS: Thirty-two dogs having sustained motor vehicle trauma were consecutively enrolled. Three dogs were excluded from statistical analysis. All dogs survived to hospital discharge. INTERVENTIONS: Within 24 hours of sustaining trauma, dogs had LUS, TXR, and TCT performed. Using the VetBLUE protocol, LUS PC were scored according to the presence and number of B-lines and C-lines, indicating extravascular lung water. Thoracic radiographs and TCT were scored for PC in a similar topographical pattern to the VetBLUE protocol. Lung ultrasound and TXR were compared to "gold standard" TCT for the presence and quantification of PC. MEASUREMENTS AND MAIN RESULTS: On TCT, 21 of 29 (72.4%) dogs were positive and 8 of 29 (27.6%) dogs were negative for PC. When LUS was compared to TCT, 19 of 21 dogs were positive for PC (90.5% sensitivity) and 7 of 8 dogs were negative (87.5% specificity) for PC. LUS PC score correlated strongly with TCT PC score (R = 0.8, P < 0.001). When TXR was compared to TCT, 14 of 21 dogs were positive for PC (66.7% sensitivity) and 7 of 8 dogs were negative (87.5% specificity) for PC. TXR PC score correlated strongly with TCT PC score (R = 0.74, P < 0.001). CONCLUSIONS: In this population of dogs with motor vehicle trauma, LUS had high sensitivity for diagnosis of PC when compared to "gold standard" TCT. LUS provides reliable diagnosis of PC after trauma. More patients with PC were identified with LUS than with TXR, and additional studies are warranted to determine whether this increased sensitivity is statistically significant.

Pilot study: Application of artificial intelligence for detecting left atrial enlargement on canine thoracic radiographs.

Although deep learning has been explored extensively for computer-aided medical imaging diagnosis in human medicine, very little has been done in veterinary medicine. The goal of this retrospective, pilot project was to apply the deep learning artificial intelligence technique using thoracic radiographs for detection of canine left atrial enlargement and compare results with those of veterinary radiologist interpretations. Seven hundred ninety-two right lateral radiographs from canine patients with thoracic radiographs and contemporaneous echocardiograms were used to train, validate, and test a convolutional neural network algorithm. The accuracy, sensitivity, and specificity for determination of left atrial enlargement were then compared with those of board-certified veterinary radiologists as recorded on radiology reports. The accuracy, sensitivity, and specificity were 82.71%, 68.42%, and 87.09%, respectively, using an accuracy driven variant of the convolutional neural network algorithm and 79.01%, 73.68%, and 80.64%, respectively, using a sensitivity driven variant. By comparison, accuracy, sensitivity, and specificity achieved by board-certified veterinary radiologists was 82.71%, 68.42%, and 87.09%, respectively. Although overall accuracy of the accuracy driven convolutional neural network algorithm and veterinary radiologists was identical, concordance between the two approaches was 85.19%. This study documents proof-of-concept for application of deep learning techniques for computer-aided diagnosis in veterinary medicine.

Use of vertebral left atrial size for staging of dogs with myxomatous valve disease.

INTRODUCTION/OBJECTIVES: The American College of Veterinary Internal Medicine (ACVIM) guidelines suggest that pimobendan should be initiated in dogs which meet all criteria of stage B2 myxomatous mitral valve disease (MMVD): murmur intensity ≥ 3/6, left atrial-to-aortic ratio ≥ 1.6, normalized left ventricular internal diameter in diastole ≥ 1.7, and vertebral heart size > 10.5. Recently, a new radiographic index for left atrial enlargement, vertebral left atrial size (VLAS), was proposed. The objective of the present study was to evaluate whether VLAS is useful in staging MMVD and if it can distinguish between ACVIM stages B1 and B2. ANIMALS: Ninety-seven client-owned dogs with MMVD were evaluated and classified as ACVIM stage B1, B2, or C-D. MATERIALS AND METHODS: The echocardiographs and radiographs of all the dogs were retrospectively evaluated to obtain left atrial-to-aortic ratio, normalized left ventricular internal diameter in diastole, and VLAS values. The data were analyzed to assess the correlation between these measurements and VLAS, and the optimal cutoff value of VLAS was determined. RESULTS: A VLAS cutoff value of 2.6 provided the greatest diagnostic accuracy for identification of dogs with ACVIM stage B2 MMVD (area under the curve, 0.96; sensitivity, 95%; specificity, 84%). A VLAS ≥2.5 exhibited the highest sensitivity (sensitivity, 100%; specificity, 78%), and a VLAS ≥ 3.1 exhibited the highest specificity (sensitivity, 47%; specificity, 100%). CONCLUSIONS: VLAS is a helpful index for monitoring MMVD using radiography. A VLAS cutoff value of 2.5 could be used to identify dogs that may benefit from echocardiography to determine if they have reached ACVIM stage B2.

Fibroblastic osteosarcoma in a white-eared opossum (Didelphis albiventris) / Osteossarcoma fibroblástico em gambá-de-orelha-branca (Didelphis albiventris)

Osteosarcoma is characterized by the production of osteoid or woven bone, using neoplastic osteoblasts. It is the most common primary bone neoplasm in canines and humans. This neoplasm was previously reported in all vertebrate classes, including a wide variety of mammals. However, there is no case report describing this neoplasm in Didelphis albiventris. Therefore, the objective of this manuscript is to describe the clinical-pathological aspects of fibroblastic osteosarcoma in D. albiventris. A wild adult male white-eared opossum (D. albiventris) arrived at the zoological park of the "Universidade de Caxias do Sul" with a swollen left thoracic limb. After a general clinical examination, the animal was transferred to the Veterinary Clinic of "Universidade de Caxias do Sul" for radiographic examination of the left thoracic limb and thorax. Additionally, some material was collected through fine needle aspiration (FNA) for cytologic evaluation. The radiographic findings and cytologic evaluation indicated osteosarcoma. The animal was euthanized due to severe clinical conditions and guarded prognosis. During necropsy, macroscopic analysis of the viscera was performed, fragments of various organs were collected and fixed in 10% neutral buffered formalin. All fragments were processed following routine histological techniques. The histopathological evaluation confirmed osteosarcoma, which was classified as a fibroblastic subtype. Case reports are crucial for the knowledge of incidence, prevalence, and behavior of the current mentioned disease, as well as other diseases, in species with such limited information. In order to obtain a decisive diagnosis, a few different examination methods were associated. Although the observations presented are based on a single case, this neoplasm had a similar clinical presentation to that described in other species.(AU)

O osteossarcoma é caracterizado pela produção de osteoide ou osso imaturo, por osteoblastos neoplásicos. É a neoplasia óssea primária mais comum em caninos e humanos. Essa neoplasia já foi relatada em todas as classes de vertebrados, incluindo uma grande variedade de mamíferos. Não havendo descrição dessa neoplasia até o momento em Didelphis albiventris. O objetivo deste trabalho é descrever aspectos clínico-patológicos de um caso de osteossarcoma fibroblástico em D. albiventris. Chegou para atendimento no Zoológico da Universidade de Caxias do Sul um gambá-de-orelha-branca (D. albiventris), macho, adulto, de vida livre com aumento de volume no membro torácico esquerdo. Após avaliação clínica geral, o animal foi encaminhado para a Clínica Veterinária da Universidade de Caxias do Sul para realização de radiografia do membro torácico esquerdo e de tórax, sendo também realizada coleta de material por punção aspirativa por agulha fina (PAAF) para avaliação citológica. Os achados radiográficos e da avaliação citológica foram sugestivos de osteossarcoma. Devido ao estado clínico grave e prognóstico reservado optou-se pela eutanásia. Durante a necropsia realizou-se a análise macroscópica das vísceras, foram coletados fragmentos de diversos órgãos, fixados em formalina 10%, processados pelas técnicas histológicas de rotina. Na avaliação histopatológica confirmou-se a suspeita de osteossarcoma sendo classificado no subtipo fibroblástico. A descrição de relatos é fundamental para conhecimento da incidência, prevalência e comportamento desta e de outras doenças em espécies que as informações são limitadas. A associação de diferentes métodos de exames foram necessários para a obtenção de um diagnóstico definitivo. Embora as observações apresentadas se baseiem em um caso único, esta neoplasia possuiu apresentação clínica semelhante a descrita em outras espécies.(AU)

Determination of the value of vertebral heart size regarding the weight and body area in canines / Determinação dos valores do vertebral heart size em relação ao peso e área corporal canina

The vertebral heart size is a method used to measure the cardiac dimension in order to identify the remodeling of the chambres in heart disease. This study aims to determinate the vertebral heart size values at right lateral and ventrodorsal radiographs views relating to canines weight and body area variations. For the purpose of the study 40 healthy dogs within the age of 1 to 6 years, males and females, with deep or intermediated thorax were selected, brachycephalic dogs were not included in the study; the dogs were separated in four groups: group 1(n=9) compound of dogs up to 5 kg; group 2 (n=8) with dogs from 5,1 to 10 kg; group 3 (n=12) with dogs from 10,1 to19 kg and group 4 (n=11) with dogs weighing more than 19,1 kg. The values of body score, body mass index and the thorax configuration where previously measured, as well as the vertebral heart size and the depth width ratio from the radiographs. The results demonstrated intervals of right lateral-lateral vertebral heart size 9.9 to 10.4v and ventro-dorsal vertebral heart size of 9.8-10.3v. The study results show that the vertebral heart size numbers did not correlate with weight or body area, regardless the type of radiography view. Therefore, it can be concluded that the vertebral heart size in right lateral and ventrodorsal radiography can be used to rate the cardiac area, not suffering influence by the dog's weight or body area.

O vertebral heart size é um método utilizado para mensurar a dimensão cardíaca visando identificar os remodelamentos das câmaras nas cardiopatias. O objetivo do estudo foi determinar os valores de vertebral heart size nas projeções radiográficas latero-lateral direita e ventro-dorsal conforme as variações do peso e área corporal. Para isso, foram selecionados 40 cães hígidos com idade entre 1 e 6 anos, machos e fêmeas, com padrão torácico intermediário e profundo, com exclusão dos braquicefálicos; os cães foram divididos em quatro grupos: grupo 1 (n=9) composto por cães de até 5 kg; grupo 2 (n=8) com cães de 5,1 a 10 kg; grupo 3 (n=12) com cães de 10,1 a 19 kg e grupo 4 (n=11) com cães acima de 19,1 kg. Os valores de escore corporal, índice de massa corporal e conformação torácica foram previamente mensurados, bem como os valores dos vertebral heart size a relação profundidade/largura torácica das radiografias. Os resultados demonstraram intervalos de vertebral heart size latero-lateral 9.9 a 10.4v e vertebral heart size ventro dorsal de 9.8-10.3v. Os valores não apresentaram correlação com o peso e área corporal nos grupos estudados, independente das projeções estudas. Assim, pode-se concluir que método vertebral heart size nas projeções estudadas é aplicável na avaliação da área cardíaca, não sofrendo influências do peso e área corporal canina.

Radiographic evaluation of tracheal collapse in dogs by compressive technique / Avaliação radiográfica do colapso de traqueia em cães pela técnica compressiva

The purpose of this study was to verify the applicability of the compressive radiographic technique (pressures of 5, 10, 15 and 20mmHg) in the diagnosis of tracheal collapse in small breed dogs, in lateral cervicothoracic radiography. Out of the 50 dogs evaluated, 25 presented tracheal collapse (TG group), 23 did not present tracheal collapse (CG) and two were excluded because they did not tolerate a pressure of 20 mmHg. The TG group presented a smaller internal diameter of the trachea in the region of the fourth cervical vertebra (D4) and at the entrance of the thorax (TDE) compared to the CG group, in all the radiographic projections performed, as well as within the TG group where the compressive technique differed from conventional. Furthermore, there was a correlation between the clinical sign of coughing during cervical collar use and the presence of radiographic tracheal collapse at a pressure of 20 mmHg. It was concluded that the compressive radiographic technique was feasible and efficient in confirming the diagnosis of tracheal collapse in dogs, especially in the pressure of 20 mmHg, where it was associated with clinical signs, and can be used in isolation or complementary to the conventional technique.(AU)

O objetivo deste trabalho foi verificar a aplicabilidade da técnica radiográfica compressiva no diagnóstico do colapso de traqueia em cães de raças pequenas, por meio da comparação do diâmetro da traqueia durante a radiografia cervicotorácica lateral convencional e sobre influência da compressão externa com pressões de 5, 10, 15 e 20mmHg (técnica compressiva). Dos 50 cães avaliados, 25 apresentaram colapso de traqueia (grupo TG), 23 não apresentaram o colabamento traqueal (grupo controle - CG) e dois foram excluídos por não tolerarem a pressão de 20mmHg. Os diâmetros internos da traqueia na região da quarta vértebra cervical (D4) e na entrada do tórax (DET) foram menores no grupo TG em relação ao CG, em todas as projeções radiográficas realizadas, bem como dentro do grupo TG, no qual a técnica compressiva diferiu da convencional. Houve correlação entre o sinal clínico de tosse durante o uso de coleira cervical e a presença do colapso de traqueia radiográfico, na pressão de 20mmHg. Concluiu-se que a técnica radiográfica compressiva foi exequível e eficiente na confirmação do diagnóstico do colapso de traqueia em cães, especialmente na pressão de 20mmHg, em que houve associação com sinais clínicos, podendo ser utilizada de forma isolada ou complementar à técnica convencional.(AU)

Temporal changes in clinical and radiographic variables in dogs with preclinical myxomatous mitral valve disease: The EPIC study.

BACKGROUND: The Evaluation of pimobendan in dogs with cardiomegaly caused by preclinical myxomatous mitral valve disease (EPIC) study monitored dogs with myxomatous mitral valve disease (MMVD) as they developed congestive heart failure (CHF). OBJECTIVES: To describe the changes in clinical and radiographic variables occurring as dogs with MMVD and cardiomegaly develop CHF, compared to similar dogs that do not develop CHF. ANIMALS: One hundred and thirty-five, and 73 dogs that did or did not develop CHF, respectively. MATERIALS AND METHODS: The following variables were evaluated in 2 groups of dogs (dogs that did or did not develop CHF): Heart rate (HR), clinic respiratory rate (RR), home-measured resting respiratory rate (RRR), rectal temperature (RT), body weight (BW), and vertebral heart sum (VHS). Absolute value and rate of change of each variable were calculated for each day a dog was in study. Daily means were calculated and plotted against time. The onset of CHF or last visit before leaving the study were set as reference time points. RESULTS: The most extreme values and rate of change occurred in variables immediately before onset of CHF. Vertebral heart sum increased earliest. Heart rate, RR, and RRR also increased. Rectal temperature and BW decreased. Increases in RR and RRR were most extreme and occurred immediately before CHF. CONCLUSIONS AND CLINICAL IMPORTANCE: Dogs with MMVD and cardiomegaly experience increases in HR, RR, RRR, and VHS, and decreases in BW and RT as they develop CHF. The variables with highest absolute change and rate of change were RR and RRR. These findings reinforce the value of RR and RRR as indicators of impending or incipient CHF.

Concurrent thoracic pathology identified with radiology in hyperthyroid cats referred for radioiodine therapy.

OBJECTIVES: Radioiodine (RAI) treatment for hyperthyroidism is becoming increasingly available in the UK. Pretreatment assessment is commonly performed, as patient handling is limited once RAI has been administered. The aims of this study were to determine the prevalence of thoracic pathology using thoracic radiography in hyperthyroid cats referred for RAI treatment and to determine the value of this technique pretreatment. METHODS: The hospital databases were searched for hyperthyroid cats referred for RAI treatment at the Feline Centre, Langford Vets, between January 2012 and July 2016. Radiographs were reviewed by Diplomates of the European College of Veterinary Diagnostic Imaging at the time of treatment and each set of radiographs was subsequently reviewed by one radiologist for the study. Cardiorespiratory signs were recorded, if present, and any change in treatment plan or suitability for RAI treatment was documented. RESULTS: Two hundred and fifty-two cats were included in the study. Thoracic pathology was identified in 77% (n = 194/252) of the cats, of which 59% (n = 115/194) had pulmonary abnormalities with bronchial and bronchointerstitial patterns most frequently; 57% (n = 111/194) had skeletal abnormalities and 43% (n = 84/194) had cardiac abnormalities, with mild-to-moderate cardiomegaly most prevalent. Other abnormalities included sternal lymphadenomegaly (7%; n = 13/194), mediastinal pathology (3%; n = 5/194), oesophageal pathology (2%; n = 4/194) and pleural space disease (0.5%; n = 1/194).Twelve cases (6%) had a change in their treatment plan as a result of thoracic radiographic abnormalities, of which five subsequently underwent RAI treatment. CONCLUSIONS AND RELEVANCE: A low prevalence of significant thoracic pathology was identified on radiographs in hyperthyroid cats referred for RAI treatment. Incidental thoracic abnormalities were found much more commonly; hence, results of thoracic radiology need to be combined with the clinical picture, to decide whether further investigations or alterations to the treatment plan are required pre-RAI.