Attempted ultrasound-guided ethanol ablation of a suspected pancreatic pseudocyst in a dog.

A 9-year-old, spayed female toy poodle dog developed refractory anorexia after pancreatitis. Abdominal imaging showed a cystic structure compressing the stomach. Appetite improved after percutaneous drainage of the structure, but the structure refilled within 48 h. Percutaneous ethanol ablation of the structure was attempted. Afterwards, the patient developed fatal hypotensive shock.

Tentative d'ablation à l'éthanol par échographie guidée pour un pseudokyste pancréatique suspecté chez un chien. Une chienne caniche stérilisée âgée de 9 ans a développé une anorexie réfractaire après une pancréatite. L'imagerie abdominale a montré une structure kystique comprimant l'estomac. L'appétit s'est amélioré après un drainage percutané de la structure, mais la structure s'est remplie de nouveau dans un délai de 48 heures. On a réalisé une tentative d'ablation à l'éthanol percutanée de la structure. Après l'intervention, le patient a développé un choc hypotensif mortel.(Traduit par Isabelle Vallières).

Optimization of contrast-enhanced multidetector abdominal computed tomography in sedated canine patients.

A major disadvantage of computed tomography for abdominal screening in dogs has been the need for general anesthesia to prevent motion artifacts. With multidetector helical CT, it is possible to decrease examination time, allowing patients to be scanned under sedation. It is also desirable to decrease tube loading to prolong x-ray tube life. To develop a protocol that will allow for examination of sedated patients with minimal image artifacts, milliamperage (mA) and helical pitch were varied, providing 16 experimental scan protocols. A standard clinical protocol was also tested, providing 17 protocols for evaluation. These protocols were tested, using a standard CT phantom, canine tissues in a water bath, and a canine cadaver. The cadaver images were scored semiquantitatively by three reviewers to determine the protocol with the best combination of speed and minimal image artifact. The optimized protocol was then applied to 27 sedated canine patients of three body weight categories. The images obtained were compared to the standard protocol by two reviewers for presence of motion, streak, and quantum mottle artifacts. There was significantly more streak artifact noted by one observer using the optimized study protocol, but no significant difference in any other category. Scanning under sedation was well tolerated in all patients, and sedated CT examination is a promising tool for screening abdominal disease in dogs.

Comparison of abdominal computed tomography and abdominal ultrasound in sedated dogs.

Abdominal ultrasound (US) is used frequently as a first-line screening tool for abdominal disease. Although computed tomography (CT) is superior to US in the diagnosis of some abdominal diseases, a major impediment is the requirement of general anesthesia to prevent motion and for safe restraint. With multidetector helical CT, faster examinations allow general anesthesia to be avoided, while producing diagnostic-quality images. Abdominal US and CT were compared for lesion detection in 27 sedated dogs, divided into three even groups based on body weight. Lesions were categorized further as to subjective clinical relevance. In dogs less than 25 kg, there is no significant difference in lesion detection between CT and US. In dogs weighing greater than 25 kg, more lesions were detected with CT than with US (P = 0.0001), including clinically relevant lesions (P = 0.0277). From these results, it appears that CT has an advantage in lesion detection in dogs greater than 25 kg, making it a better screening test for abdominal disease in these patients.