Neurological signs and MRI findings in 12 dogs with multiple myeloma.

Vertebral lesions and associated neurological signs occur in dogs with multiple myeloma, however, veterinary literature describing MRI findings is currently lacking. The objective of this multicenter, retrospective, case series study was to describe neurological signs and MRI findings in a group of dogs that presented for spinal pain or other neurological deficits and had multiple myeloma. Electronic records of four veterinary referral hospitals were reviewed. Dogs were included if they had a pathologically confirmed diagnosis of multiple myeloma, had presented for spinal pain or other neurological signs, and had undergone MRI of the vertebral column. The MRI studies were evaluated and the anatomical location of lesion(s), signal intensity, presence of extra-dural material, degree of spinal cord compression, extent of vertebral lesions, and contrast enhancement were recorded. Twelve dogs met inclusion criteria. Most dogs (n = 8) had a chronic progressive history, with varying degrees of proprioceptive ataxia and paresis (n = 11), and spinal pain was a feature in all dogs. The MRI findings were variable but more consistent features included the presence of multiple expansile vertebral lesions without extension beyond the outer cortical limits of affected vertebrae, and associated extradural material causing spinal cord compression. The majority of lesions were hyper- to isointense on T2 (n = 12) and T1-weighted (n = 8) sequences, with variable but homogeneous contrast-enhancement (n = 12). These described MRI characteristics of multiple myeloma may be used to aid early identification and guide subsequent confirmatory diagnostic steps, to ultimately improve therapeutic approach and long-term outcome.

Ultrasonographic and histopathological features in 8 cats with fibrotic small intestinal stricture.

Benign stricture is an uncommon cause of chronic small intestinal obstruction in the cat. The purpose of this retrospective case series was to describe the ultrasonographic features, histopathological findings, and clinical presentation in a group of cats with benign small intestinal stricture. Inclusion criteria were cats presenting during the period 2010-2017, and that had ultrasonography and small intestinal stricture confirmed at surgery. For each cat, clinical data and ultrasonographic findings were retrieved from the medical record, and histopathology, where available, was reviewed. Eight cats met the inclusion criteria. The location of strictures was duodenum (1/8), mid- to distal jejunum (4/8), and ileum (3/8). Ultrasonographic findings included gastric distension (8/8) and generalized (3/8) or segmental (5/8) intestinal dilation consistent with mechanical obstruction. Ingesta did not propagate beyond the strictured segment. Wall thickening was mild to moderate (3-6 mm). Normal wall layering was disrupted in all cats. Strictures were predominantly hypoechoic (7/8) and associated with hyperechoic peri-intestinal mesentery (6/8). Annular strictures (5/8) were less than 15 mm in length whereas long-segment strictures (3/8) were greater than 15 mm in length. Histopathology showed transmural disease with fibrosis and inflammation (8/8), often (6/8) extending into the bordering mesentery. The mucosa was the most severely affected layer and epithelial injury accompanied the mucosal fibrosis/inflammation. Clinical presentation reflected delayed diagnosis of chronic bowel obstruction with debilitation (8/8), marked weight loss (8/8), and prerenal azotemia (5/8). Benign fibrostenotic stricture should be considered a differential diagnosis in debilitated young cats presenting with chronic bowel disease and ultrasonographic features of intestinal obstruction.

Rapid vascular uptake of contrast during a retrograde urethro-cystogram in a cat with chronic lower urinary tract disease.

CASE SUMMARY: A 9-year male neutered domestic longhair cat was referred to our hospital for investigation of recurrent urinary tract obstruction. The clinical signs had started 12 months earlier and the cat had been catheterised on multiple occasions. Clinical examination and abdominal ultrasound of the abdomen was unremarkable but examination of the penis revealed it to be prolapsed and extremely erythematous and friable. A retrograde contrast urethrocystogram was performed, showing extravasation of the contrast medium and establishing the presence of partial leakage or a tear of the urethra. In subsequent radiographs, the contrast was seen being rapidly absorbed into the pelvic and systemic vasculature via the penile veins, internal and external pudendal veins, internal and external iliac veins, and, ultimately, the caudal vena cava. Later, the contrast medium was seen within the renal pelves. Retrograde urethrocystography revealed stenosis and irregularities of the caudal urethral mucosa consistent with strictures. A routine perineal urethrostomy was performed and the cat recovered well. CONCLUSIONS AND RELEVANCE: Rapid vascular absorption of extravasated contrast medium has not been reported before. In this case, the increased blood supply to the distal urethra and penis is likely secondary to (chronic) inflammation, as demonstrated by the urethral strictures and the friable, oedematous nature of the penis. Whether the inflammation was caused by chronic obstruction or repeated iatrogenic trauma, or a combination of these factors, will remain debatable. Nonetheless, this case demonstrates that when a retrograde contrast urethrocystogram is considered, it is imperative that a contrast medium (or other intraurethral medication such as local anaesthesia) is chosen that is safe for intravascular use. Equally, an absolute aseptic technique is essential considering the potential for contaminants to be absorbed quite rapidly into the systemic circulation. Multiple catheterisations should be avoided when there is chronic inflammation, and alternative options should be considered when chronic disease is suspected.