Case report: Sarcocystis speeri, Aspergillus fumigatus, and novel Treponema sp. infections in an adult Atlantic spotted dolphin (Stenella frontalis).

A complete postmortem examination, including a computed tomography scan "virtopsy" (virtual necropsy), gross necropsy, cytology, histology, and molecular diagnostics were performed to investigate the cause of death of a deceased adult male Atlantic spotted dolphin (Stenella frontalis) that stranded on Pensacola Beach, Florida, USA in February 2020. Significant findings included chronic inflammation of the meninges, brain, and spinal cord with intralesional protozoa (identified as Sarcocystis speeri via 18S rRNA and ITS-1 sequences), suppurative fungal tracheitis and bronchopneumonia (identified as Aspergillus fumigatus via ITS-2 gene sequence) and ulcerative bacterial glossitis (associated with a novel Treponema species, Candidatus Treponema stenella, identified via 23S rRNA gene sequence). This is the first reported case of S. speeri in a marine mammal. Little is understood about the epidemiology of S. speeri, including the identity of its intermediate hosts. The findings of this case suggest that S. frontalis may be a capable aberrant host and experience morbidity and mortality from this parasite. It is suspected that the novel Treponema and Aspergillus fumigatus infections were opportunistic or secondary to immunosuppression, either due to S. speeri infection or other co-morbidities.

What Is Your Diagnosis?

In collaboration with the American College of Veterinary Radiology.

Case-based intensive veterinary radiology clerkship improves students' radiographic interpretation skills and overall course satisfaction scores.

The variability in diagnostic imaging caseload, increasing class sizes, high hospital workloads, and the progressive departure of veterinary radiologists from academia can lead to inconsistent and reduced teaching opportunities. This one group pretest, posttest study aimed to compare the learning outcomes of students enrolled in two veterinary radiology clerkship models. Our hypothesis was that the learning and satisfaction scores of students in a case-based veterinary radiology clerkship would be higher than those in a clinical veterinary radiology clerkship. During the spring and summer semesters of 2019, students were assigned to a clinical (CRC) or case-based (CBRC) radiology clerkship model, respectively. Prior to starting the clerkship and at the conclusion thereof, all students took identical radiographic interpretation quizzes. Four major areas of learning were assessed: knowledge base (KB), diagnostic test interpretation (DTI), problem prioritization and differential diagnosis (PPDDX), and critical thinking (CrT). A total of 41 of 48 (CRC) and 130 of 151 (CBRC) students enrolled in this study; 15 and 34, respectively, were off-shore students, while the remainder were in-house students. In-house students improved their scores with CRC and CBRC, but achieved better scores in the four areas with CBRC. Off-shore students only improved their scores with CBRC. In both groups, there was a negative effect of CRC on DTI. Course satisfaction score was 3.21 on CRC and 4.38 on CBRC (range 1-5). An intensive, case-based, discussion-focused veterinary radiology clerkship can improve students' radiographic interpretation skills and overall course satisfaction scores.

Evaluation of the efficacy of a cannabidiol and cannabidiolic acid rich hemp extract for pain in dogs following a tibial plateau leveling osteotomy.

Objective: To determine the impact of a cannabidiol (CBD) and cannabidiolic acid (CBDA) rich hemp product on acute post-operative pain in dogs following a tibial plateau leveling osteotomy (TPLO), and to evaluate for changes in early bone healing, serum chemistry profiles, and complete blood counts. Methods: In this randomized, placebo controlled, blinded clinical trial, 44 client-owned dogs were assigned to receive either a CBD/CBDA product dosed at 2-2.5 mg/kg PO every 12 h or a placebo for 4 weeks following a TPLO. Variables evaluated before (week 0), and at 2 and 4 weeks post-operatively included standardized veterinary assessments for pain score, weight-bearing, and lameness, the Canine Brief Pain Inventory (pain interference score-PIS, pain severity score-PSS), and serum biochemistry. Complete blood counts were performed at weeks 0 and 4. Additionally, orthogonal radiographs evaluating the degree of healing were taken at week 4. A mixed model analysis, analyzing changes of variables of interest from enrollment baseline to all other time points was utilized, with a p-value ≤ 0.05 considered significant. Results: Of the 44 enrolled patients, 3 were lost to follow up and excluded from analysis. No significant differences were noted between placebo (n = 19) and CBD/CBDA (n = 22) groups at any point in pain score, degree of lameness, degree of weight-bearing, PIS, PSS, or radiographic healing of the osteotomy. A significant finding of elevation of ALP above normal reference range in the treatment group was identified (p = 0.02) and eosinophil count was affected by treatment (p = 0.01), increasing from baseline in placebo and decreasing in treatment groups. Finally, a significant difference (p = 0.03) was noted at 2 weeks post-operatively where 4 patients in the placebo group and no treatment patients received trazodone to facilitate activity restrictions. Clinical significance: Use of a CBD/CBDA rich hemp product dosed at 2-2.5 mg/kg PO every 12 h did not have a significant impact on pain or delay early bone healing. A statistically significant increase in ALP, decrease in eosinophils, and reduced use of trazodone was identified in the treatment group.

Imaging the Equine Foot.

Over the past 5 years, advancements in diagnostic imaging technology have led to improvement of radiographic technique and development of standing computed tomography (CT) and PET-CT scanners. Although these modalities are in their initial stages of development and clinical applications, they are meant to revolutionize the diagnosis and management of diseases of the foot in the standing patient, in particular detecting subclinical lesions, and the establishment of computer-assisted surgical suits. This article also reviews the improved radiographic projections of the equine foot and benefits of high-field and contrast magnetic resonance imaging (MRI) in diagnosis of cartilage and ligamentous pathologies.

Obstipation in pet pigs: 24 cases.

Clinical features and patient outcomes for pet pigs with obstipation are poorly defined. This retrospective study reports the clinical findings from 24 pet (non-production) pigs with obstipation presented to 2 veterinary teaching hospitals. Clinical features of obstipated pet pigs included anorexia or hyporexia in 24 pigs (100%), pain on abdominal palpation in 22 (90%), lethargy in 21 (88%), tachypnea in 19 (79%), vomiting in 14 (58%), and tachycardia in 13 (54%). Frequently observed hematologic and biochemical abnormalities included leukopenia in 36% (8/22) of the pigs, lymphopenia in 75% (17/22), toxic changes in neutrophils in 63% (14/22), hypokalemia in 50% (9/18), and hypoglycemia in 28% (5/18). Diagnostic imaging via radiography and/or computed tomography frequently identified gastric distention and accumulation of ingesta and gas throughout the gastrointestinal tract. Medical treatments included fluid therapy, anti-emetics, oral administration of carbonated beverages, non-steroidal anti-inflammatory drugs, and systemic antimicrobials. Surgical intervention was performed in 7/29% of pigs. In this study, obstipation in pet pigs carried a fair to favorable prognosis for survival, with 70% of patients surviving to discharge.

Obstipation chez les porcs de compagnie : 24 cas. Les caractéristiques cliniques et l'issue des porcs de compagnie souffrant d'obstipation sont mal définis. Cette étude rétrospective rapporte les résultats cliniques de 24 porcs de compagnie (hors production) souffrant d'obstipation présentés à deux hôpitaux d'enseignement vétérinaire. Les caractéristiques cliniques des porcs de compagnie avec obstipation comprenaient l'anorexie ou l'hyporexie chez 24 porcs (100 %), des douleurs à la palpation abdominale chez 22 (90 %), une léthargie chez 21 (88 %), une tachypnée chez 19 (79 %), des vomissements chez 14 (58 %), et tachycardie dans 13 cas (54 %). Les anomalies hématologiques et biochimiques fréquemment observées comprenaient une leucopénie chez 36 % (8/22) des porcs, une lymphopénie chez 75 % (17/22), des modifications toxiques des neutrophiles chez 63 % (14/22), une hypokaliémie chez 50 % (9/18), et une hypoglycémie dans 28 % (5/18). L'imagerie diagnostique par radiographie et/ou tomodensitométrie a fréquemment identifié une distension gastrique et une accumulation d'ingesta et de gaz dans le tractus gastro-intestinal. Les traitements médicaux comprenaient la fluidothérapie, les antiémétiques, l'administration orale de boissons gazeuses, les anti-inflammatoires non stéroïdiens et les antimicrobiens systémiques. Une intervention chirurgicale a été réalisée chez sept (29 %) des porcs. Dans cette étude, l'obstipation chez les porcs de compagnie avait un pronostic de survie allant de passable à favorable, avec 70 % des patients survivant jusqu'à leur congé.(Traduit par Dr Serge Messier).

Successful Treatment of Congenital Lobar Emphysema in Multiple Lung Lobes in an English Bulldog Puppy.

A 5 mo old male intact English bulldog was evaluated at a veterinary referral hospital for acute respiratory distress and chronic difficulty breathing. Thoracic radiographs revealed multifocal pulmonary hyperinflation and hyperlucency suspected in the left caudal and accessory lung lobes. A thoracic computed tomography scan identified severe diffuse enlargement of the caudal subsegment of the left cranial lung lobe and the dorsal process of the accessory lung lobe, with parenchymal hypoattenuation, rounded margins, and thin pulmonary vessels. Based on clinical signs and imaging findings, he was diagnosed with suspect congenital lobar emphysema in multiple lung lobes. A median sternotomy was performed, which revealed a hyperinflated, emphysematous left cranial lung lobe (caudal subsegment) and accessory lung lobe for which two lung lobectomies were performed. The remaining lung lobes were small and atelectatic. Histopathology revealed bronchial cartilage hypoplasia and aplasia and findings consistent with congenital lobar emphysema. The puppy recovered well from surgical treatment of congenital lobar emphysema, requiring multiple lung lobectomies, with subsequent computed tomography-evidenced re-expansion of the remaining lung lobes 3 mo after surgery. The patient is still alive 1 yr after surgery with a normal activity level and no evidence of respiratory compromise.

Laparoscopic gonadectomy in a dog with 78,XX/78,XY chimerism and underdeveloped reproductive organs.

CASE DESCRIPTION: A 1-year-old externally sexually intact female Great Dane was referred for further evaluation of abnormal and underdeveloped internal reproductive organs. CLINICAL FINDINGS: Physical examination findings included a cranioventrally displaced vulva and a grade 2/6 left apical systolic heart murmur. No uterus or ovaries were identified during abdominal ultrasonography. Computed tomography with retrograde vaginourethrography revealed an underdeveloped uterus and possible left intra-abdominal gonad. Karyotyping revealed mixed sex chromosomes (70% XY and 30% XX). Analysis of a serum sample yielded positive results for anti-Müllerian hormone; other findings included mid range estradiol concentration (48.2 pg/mL [within reference intervals for sexually intact and neutered males and females]), low progesterone concentration (< 0.2 ng/mL [within reference intervals for anestrous females]), and low testosterone concentration (< 20 ng/dL [similar to the expected concentration in neutered males]). Overall, the results of the sex hormone analyses were consistent with findings for either a sexually intact female or a neutered male dog. The dog's cardiac structure and function were echocardiographically normal. TREATMENT AND OUTCOME: The dog was anesthetized and underwent laparoscopic gonadectomy. The gonads, although abnormal and underdeveloped, were readily identified intraoperatively and successfully removed. On the basis of histologic findings, the removed gonads were confirmed to be rudimentary testicles. The dog recovered from anesthesia and surgery without complications. CLINICAL RELEVANCE: Laparoscopic surgery was effective for visualization of abnormal and hypoplastic reproductive organs when abdominal ultrasonography and CT were of limited diagnostic usefulness, and laparoscopic surgery allowed straightforward gonadectomy in a 78,XX/78,XY chimeric dog.

A novel ultrasound-guided lateral quadratus lumborum block in dogs: a comparative cadaveric study of two approaches.

OBJECTIVE: To describe an ultrasound-guided lateral quadratus lumborum (LQL) block technique and the spread characteristics of lidocaine-dye injected in the LQL plane using a transversal (LQL-T) or a longitudinal (LQL-L) approach. STUDY DESIGN: Experimental anatomic study. ANIMALS: A total of eight canine cadavers. METHODS: Bilateral ultrasound-guided injections in the fascial plane lateral to the quadratus lumborum muscle and medial to the thoracolumbar fascia (LQL plane) with the needle directed at the first lumbar (L1) transverse process were performed using lidocaine-dye (0.3 mL kg-1). Anatomical dissection determined the dye distribution, sympathetic trunk staining and number of spinal nerves stained circumferentially >1 cm. RESULTS: The LQL fascial plane was ultrasonographically recognized in all cadavers and filled with lidocaine-dye in all eight cadavers with the LQL-T approach and in six with LQL-L. The injectate spread ventral to the lumbar transverse processes, around the quadratus lumborum muscle and dorsal to the transversalis fascia, affecting the ventral branches of the spinal nerves and the sympathetic trunk. A median (range) of 4 (3-5) and 3 (0-4) ventral branches of the thoracolumbar nerves were dyed with LQL-T and LQL-L approaches, respectively (p = 0.04). The most cranial nerve stained was the twelfth thoracic (T12) with the LQL-T approach and T13 with LQL-L, and the most caudal was L3 with both approaches. The incidence of sympathetic trunk staining was significantly higher using LQL-T (six injections) compared with LQL-L (one injection; p = 0.04). Dye was not observed in the lumbar plexus, epidural space or abdominal cavity. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasound-guided LQL-T approach resulted in a more consistent spread toward the spinal nerves and sympathetic trunk compared with LQL-L approach. Further studies are necessary to assess the LQL block effectiveness and success rate in live dogs.

Description of ultrasound-guided quadratus lumborum block technique and evaluation of injectate spread in canine cadavers.

OBJECTIVE: To describe a quadratus lumborum (QL) block technique in canine cadavers and the spread of injectate. STUDY DESIGN: Prospective, randomized, descriptive, experimental anatomic study. ANIMALS: A group of 12 adult canine cadavers. METHODS: Gross and ultrasound anatomy of the sublumbar musculature and the relationship with the spinal nerves was studied in two cadavers. Bilateral ultrasound-guided injections were performed in eight cadavers in the fascial plane between the QL and psoas muscle using a dye-lidocaine solution [low volume (LV) 0.15 mL kg-1 or high volume (HV) 0.3 mL kg-1]. The ultrasound transducer was positioned caudal and parallel to the proximal aspect of the last rib, and an insulated needle was introduced in-plane using a ventrolateral to dorsomedial approach. Dissections were performed to determine the number of spinal nerves successfully stained (>1 cm) and the presence of injectate in the epidural space or abdominal cavity. Additionally, two cadavers were transversally cryosectioned after QL injection. RESULTS: Ventral branches of the last thoracic and first three lumbar spinal nerves ran between the bundles of the QL muscle and between the QL and psoas muscles. The target fascial plane was ultrasonographically identified and filled with the dye solution following all injections. Ventral branches of the thirteenth thoracic and first, second and third lumbar nerves were stained by 0.0%, 71.4%, 100%, 100%, and 25%, 100%, 100%, 100% using LV and HV, respectively. Multisegmental spread stained the lumbar sympathetic trunk on 0 (0-3) and 3 (0-4) vertebral levels with LV and HV, respectively. No abdominal or epidural spread was identified. CONCLUSION AND CLINICAL RELEVANCE: Although no significant differences were found, HV resulted in a higher percentage of stain on spinal nerves and sympathetic trunk than LV. Further studies are warranted to determine if the QL block provides somatic and visceral abdominal analgesia in dogs.

Ultrasound-guided erector spinae plane block in canine cadavers: relevant anatomy and injectate distribution.

OBJECTIVE: To investigate the distribution and nerve staining of two volumes of lidocaine-dye solution after ultrasound-guided erector spinae plane (ESP) injections in canine cadavers. STUDY DESIGN: Experimental cadaveric study. ANIMALS: A total of nine canine cadavers. METHODS: ESP injections were performed between the longissimus thoracis muscle and the dorsolateral edge of the ninth thoracic transverse process. Two cadavers were transversally cryosectioned after unilateral ESP injections [0.6 mL kg-1; high volume (HV)]. In seven cadavers, bilateral ESP injections with HV or low volume (0.3 mL kg-1; LV) were performed. Gadodiamide was added to the injectate for two cadavers and magnetic resonance imaging (MRI) was performed pre- and post-injection. Injectate distribution and nerve staining of the branches of the spinal nerves were recorded after gross anatomical dissection. The thoracic paravertebral and epidural spaces were examined for dye solution. RESULTS: Cryosections, MRI and gross dissections showed that the injectate spread dorsally to the transverse processes, over the ventromedial aspect of the longissimus thoracis muscle where the medial and lateral branches of the dorsal branches of the spinal nerves are located. LV and HV stained a median (range) of 4 (2-7) and 4 (3-8) medial branches, respectively (p = 0.52). LV and HV stained 4 (2-5) and 5 (4-7) lateral branches (p = 0.26), respectively. Ventral branches were not stained, and dye was not identified in the epidural or paravertebral spaces. CONCLUSIONS: and clinical relevance Medial and lateral branches were consistently stained over several spinal segments. The number of nerves stained was not different with HV or LV, and the ventral branches of the spinal nerves were not stained in any cadaver. ESP block may find a clinical application to desensitize structures innervated by the medial and lateral branches of the dorsal branches of the thoracic spinal nerves.

MRI has limited agreement with CT in the evaluation of vertebral fractures of the canine trauma patient.

Complete assessment of vertebral trauma in dogs currently requires CT and MRI for evaluation of the osseous and soft tissue structures that contribute to vertebral stability. Some studies in people have suggested that MRI may be sensitive and specific at detecting vertebral fractures making this potentially a single modality that could be used in spinal trauma evaluation. This study aimed to assess the ability for observers to evaluate vertebral fractures using MRI when compared to CT, which was used as the reference standard. Twenty-nine dogs with previously diagnosed acute vertebral fractures and four dogs with no vertebral fracture that had undergone sequential CT and MRI were included into the study. One hundred twenty-eight vertebrae were evaluated for the presence of fractures. Imaging studies were read by two observers blinded to the history. While both observers had similarly high sensitivity and specificity for simple detection of any fractured vertebrae, interobserver agreement was only moderate (κ = 0.584). When evaluations were specifically limited to detection of structurally unstable fractured vertebrae both observers showed improved specificity and interobserver agreement became substantial (κ = 0.650). Complete agreement for exact fracture location between MRI and CT results was only achieved in 14.3-32.6% of fractured vertebra with up to 79% of fractures being missed in some vertebral structures. This suggests that although MRI may be able to detect the presence of fractured vertebrae, it is not able to replace CT for the complete evaluation of the traumatized spine and documentation of fracture morphology.

Volumetric and linear measurements of lung tumor burden from non-gated micro-CT imaging correlate with histological analysis in a genetically engineered mouse model of non-small cell lung cancer.

In vivo micro-computed tomography (CT) imaging allows longitudinal studies of pulmonary neoplasms in genetically engineered mouse models. Respiratory gating increases the accuracy of lung tumor measurements but lengthens anesthesia time in animals that may be at increased risk for complications. We hypothesized that semiautomated, volumetric, and linear tumor measurements performed in micro-CT images from non-gated scans would have correlation with histological findings. Primary lung tumors were induced in eight FVB mice with two transgenes (FVB/N-Tg(tetO-Kras2)12Hev/J; FVB.Cg-Tg(Scgb1a1-rtTA)1Jaw/J). Non-gated micro-CT scans were performed and the lungs were subsequently harvested. In the acquired micro-CT scans, measurements of all identified tumors were determined using the following methods: semiautomated three-dimensional (3D) volume, ellipsoid volume, Response Evaluation Criteria in Solid Tumors (RECIST; sum of largest axial (i.e., transverse) diameter from five tumors), sum of largest axial diameters from all tumors (modified RECIST), and average axial diameter. For histological analysis, all five lung lobes were analyzed and the tumor area was summed from measurements made on five histological sections that were 300 µm apart from each other (covering a total depth of 1200 µm). All micro-CT measurement methods had very strong correlation with histological tumor burden (Pearson's correlation coefficient, 0.87 ( p = 0.0053) -0.98 ( p < 0.0001)). The only methods found to have different correlations were the semiautomated 3D method and the RECIST method (Williams' test for dependent overlapping correlations, p = 0.013). Our results suggest quantification of lung tumor burden from non-gated micro-CT imaging will reflect histological differences between mice and can therefore be used for between-group comparisons or when concerns about systemic health of research animals may limit lengthy anesthetic procedures.