Receiver operating characteristics of computed tomography (CT) compared to cystoscopy in diagnosis of canine ectopic ureters: Thirty-five cases.

OBJECTIVE: The aim of the study was to determine receiver operating characteristics (ROC) of computed tomographic excretory urography (CTEU) in predicting cystoscopic findings of ureteral anatomy. STUDY DESIGN: Retrospective cohort study. ANIMALS: Thirty-five client-owned dogs. METHODS: The medical records of dogs referred for suspected ectopic ureters were reviewed. Inclusion criteria included CTEU findings reported by board-certified radiologists, followed by rigid cystoscopy with or without ureteral cystoscopic laser ablation (CLA). Data included signalment, urinary incontinence degree, body condition score, weight, degree of colon distension, CTEU and cystoscopy findings. ROC analysis was used to compare CT-predicted ureteral orthotopia/ectopia to cystoscopy findings. Additionally, ROC of CT predicted ureteral orifice locations was analyzed. Regression covariate analysis was performed to identify factors that may have influenced accuracy of diagnosis. RESULTS: The ability of CT to identify a normal and intra-or extramural ectopic ureters conclusively and correctly was 13/26 (50%) and 32/41(78%), respectively. Sensitivity and specificity of identifying extramural versus intramural ureters was 2/7 versus 30/46 (29 vs. 65%) and 61/63 versus 17/24 (97 vs. 71%), respectively. Ectopic orifice determination sensitivity and specificity varied widely depending on location from 0% to 76% and 67% to 97%, respectively. Covariate analysis failed to identify interfering factors. CONCLUSIONS: CT did not accurately predict anatomy of ureters; CT findings may need confirmation by cystoscopy and possibly intraoperative fluoroscopy prior to determining if CLA is indicated or not. CLINICAL SIGNIFICANCE: Our results may be of importance for surgeons interpreting the CTEU findings. CTEU prediction of the location of the ureteral orifice shows low sensitivity especially in or close to the urethral sphincter area.

MRI and CT characteristics of a grade I meningioma with concurrent cribriform plate lysis in a dog.

A 6-year-old female spayed German Shepherd mixed-breed dog was presented for treatment of a frontal lobe mass diagnosed on MRI, after an acute onset of generalized seizures and behavior changes. Computed tomography of the head was performed for radiation therapy planning and revealed concurrent cribriform plate lysis without nasal sinus invasion, and focal lysis of the left ventrolateral cranial fossa. Histopathology of the mass obtained via surgical excision was consistent with a grade I fibrous meningioma. The dog had a good outcome following surgery and radiation therapy.

Evaluation of a New Surgical Treatment for Equine Hind Limb Proximal Suspensory Desmitis.

OBJECTIVE: To evaluate the effects of a new microfracture and ligament splitting procedure on ligament healing and to examine the usefulness of magnetic resonance (MR) imaging for monitoring ligament healing over time using a collagenase model of hind limb proximal suspensory desmitis. STUDY DESIGN: Experimental in vivo study. ANIMALS: Healthy adult horses (n=6). METHODS: Horses were free of lameness with normal hind limb proximal suspensory ligaments (PSL). The origin of both hind limb PSL was injected with collagenase and underwent MR imaging 2 weeks later, followed by the microfracture and ligament splitting procedure on 1 limb, with the opposite limb serving as the sham-operated control. Serial lameness and MR examinations were performed. Horses were euthanatized 210 days after surgery, the PSL harvested, and histology, biochemistry, and gene expression performed on both PSL. RESULTS: Collagenase lesions viewed on MR images appeared similar to those seen clinically. Serial MR images demonstrated resolution of abnormal signal intensity and tissue formation in the microfracture sites within the third metatarsal bone. Treated limbs had histologic evidence of connective tissue appearing to originate from the small perforations and blending into the ligament but no statistical differences were identified. Gene expression for cartilage oligomeric matrix protein and decorin were significantly increased in treated compared to control limbs. CONCLUSION: The microfracture and ligament splitting procedure did incite a tissue response but further clinical investigation is necessary to determine if this tissue remodeling at the bone-ligament interface translates to improved clinical outcome. MR imaging may be useful to follow healing in horses with hind limb proximal suspensory desmitis.

Comparison of Pneumoperitoneum Volumes in Lift Laparoscopy With Variable Lift Locations and Tensile Forces.

OBJECTIVE: Evaluate the effect of peritoneal lift location and tensile force on peritoneal volume. STUDY DESIGN: Complete randomized block design. ANIMALS: Eleven fresh canine cadavers. METHODS: Cadavers underwent abdominal computed tomography (CT) scans after each treatment; 1) no lift, 2) umbilical lift with 15% body weight (BW) tension, 3) umbilical lift with 20% BW, 4) umbilical lift with 25% BW, 5) caudal lift with 15% BW, and 6) both umbilical and caudal lift with 15% BW shared equally between devices (dual lift). Isobaric pneumoperitoneal volume, instrument working distances, and transverse measures were calculated and normalized for each dog and compared across treatments. RESULTS: Increasing tensile force created a correspondingly larger pneumoperitoneal volume for the umbilical lift (0.34-0.40 total abdominal volume). Dual lifting created a larger pneumoperitoneal volume than either location alone at the same tension (0.39 total abdominal volume). Increasing lift tensions increased working distances, except to caudal abdominal structures. Increasing lift tensions at the umbilical location reduced the transverse diameter of the abdomen at the level of the kidney (0.92-0.86 total abdominal volume) and increased the transverse diameter at the midperitoneum (1.0-1.05 total abdominal volume). CONCLUSIONS: Larger isobaric penumoperitoneal volumes are produced with increased tensile force, or with dual lifting at lower force. A caudal lift leads to a small pneumoperitoneal volume but equivalent working space to caudal abdominal structures. Using an umbilical lift with moderate tensile force is preferable, providing good visualization and working space. Caudal lifting may be utilized to access caudal abdominal structures.