Ultrasound-guided caudal cervical articular process arthrocentesis is accurate in live horses with and without arthropathy.

BACKGROUND: Cervical articular process joint (CAPJ) therapy is advocated for horses with neck disorders. Several ultrasound-guided CAPJ techniques have been described in cadaver studies with 72%-89% intra-articular injection accuracy; however, the CAPJ injection accuracy in clinical equine practice has not been extensively reported. OBJECTIVES: To describe a modified cranial approach for ultrasound-guided caudal CAPJ injections, to investigate the accuracy of this CAPJ injection technique in live horses, and to assess the effect of CAPJ injection location, laterality, operator, and radiographic CAPJ enlargement on injection accuracy. STUDY DESIGN: Retrospective case study. METHODS: Medical records of adult horses in which ultrasound-guided caudal (C4-T1) CAPJ injections were performed using a modified cranial approach between November 2006 and December 2020 were reviewed. Radiographic images of caudal cervical vertebrae were assessed by a blinded radiologist and the degree of CAPJ enlargement was graded using a previously described grading system (Rgrade 1-5b). Ultrasound-guided caudal CAPJ injection accuracy was determined by synovial fluid retrieval during an individual CAPJ injection. Statistical analysis was performed using mixed-effects multivariable logistic model to evaluate the association of CAPJ injection accuracy and the CAPJ injection location, Rgrade, laterality (right, left), and operator. RESULTS: The study included 149 horses with 177 hospital admissions. Synovial fluid was obtained from 586/658 (89.1%) caudal CAPJs using modified cranial ultrasound-guided approach for CAPJ injections. C6-C7 CAPJ injections had 7-fold higher likelihood (OR = 6.78, 95% CI: 1.67-27.52; p = 0.007) of synovial fluid retrieval compared with C4-C5 CAPJ injections. Operator, CAPJ injection side (left, right), and degree of radiographic CAPJ enlargement did not have significant effects on the success of synovial fluid retrieval from ultrasound-guided caudal CAPJ injections. MAIN LIMITATIONS: Retrospective study design. CONCLUSIONS: Intra-articular ultrasound-guided caudal CAPJ injections using a modified cranial approach can be performed accurately in live horses with and without CAPJ arthropathy.

Computed tomographic diagnosis of a common bile duct abscess and secondary extrahepatic biliary duct obstruction in a potbelly pig.

A potbelly pig was evaluated for anorexia and icterus. Clinicopathologic abnormalities suggested an active inflammatory hepatobiliary process. Ultrasound and CT of the abdomen revealed an extrahepatic biliary obstruction of the common bile duct (CBD). Surgical exploration and choledochotomy revealed a markedly dilated CBD containing a large volume of intraluminal inspissated biliary material. This case report describes the imaging findings of an extrahepatic biliary obstruction secondary to abscessation within the CBD in a pig.

Incidence and risk factors for complications associated with equine general anaesthesia for elective magnetic resonance imaging.

BACKGROUND: Complications are a practical consideration for elective magnetic resonance imaging (MRI) studies performed under general anaesthesia but relatively little is known about their distribution and risk factors. OBJECTIVES: To describe the incidence of complications associated with MRI performed under general anaesthesia at a large referral facility and evaluate potential risk factors for these complications. STUDY DESIGN: Retrospective case-control study. METHODS: Patient information and details of the MRI procedure were collected retrospectively from medical records of all horses that had undergone an MRI under general anaesthesia at the University of Pennsylvania, New Bolton Center, between September 2005 and April 2012. Complications and categorical variables were examined by chi-squared or Fisher's exact tests as appropriate. A mixed-effects logistic regression approach was used to evaluate associations between explanatory variables and the outcome variable (complications or pyrexia). A univariable screen was used to select variables (likelihood ratio test p < 0.2) for inclusion in the multivariable analysis. Statistical significance was inferred when p ≤ 0.05. RESULTS: Complications were noted after MRI in 51 (17.4%) of 293 events eligible for inclusion. Complications included pyrexia (n = 35), pneumonia (n = 14), colic (n = 10), facial/nerve paralysis (n = 6), diarrhoea (n = 4), and other (n = 3). The odds of developing a post-anaesthetic complication were significantly decreased in horses that received peri-anaesthetic antimicrobials (OR 0.29, 95% CI 0.14-0.63, p = 0.002). Increased age (OR 0.87, 95% CI, 0.76-0.99, p = 0.03) and peri-anaesthetic antimicrobial administration (OR 0.23, 95% CI 0.08-0.65, p = 0.005) were associated with a decreased odds of developing pyrexia. MAIN LIMITATIONS: Single centre retrospective design. CONCLUSIONS: Potential complications including pyrexia, pneumonia and colic should be recognised when pursuing MRI under general anaesthesia. The administration of peri-anaesthetic antimicrobials decreased the odds of a complication and warrants consideration, particularly in horses that might be classified as high risk.

Avascular necrosis of the femoral head in a cynomolgus macaque (Macaca fascicularis).

A cynomolgus macaque presented with right hindlimb lameness as well as crepitus and decreased passive range of motion of the right coxal joint. Radiography and histopathology were consistent with avascular necrosis of the femoral head. This case is the first published report of this condition in a cynomolgus macaque.

Identification of a previously unreported site of subchondral bone injury in the dorsodistolateral calcaneus in Thoroughbred racehorses.

BACKGROUND: Increasing accessibility and advancements in computed tomographic (CT) imaging improve understanding of the contributors to poor performance in the Thoroughbred racehorse. OBJECTIVES: To characterise an unreported site of tarsal subchondral bone injury (SBI) in Thoroughbred racehorses. STUDY DESIGN: Retrospective, cross-sectional analytical study. METHODS: Tarsal CT scans of 108 horses were reviewed for evidence of SBI in the dorsodistolateral calcaneus (DDLC). Signalment, including age, breed, sex, and discipline of horses, was recorded. The association of DDLC SBI with Thoroughbred racehorse compared to other breeds/disciplines was calculated. Nuclear scintigraphic scans of the hindlimbs of Thoroughbreds between 2007 and 2022 were also reviewed for increased radiopharmaceutical uptake (IRU) suggestive of DDLC SBI. RESULTS: Tarsal CT scans of 108 horses were analysed and lesion location and type were recorded. DDLC SBI was identified in 8/108 (7.3%) horses. All lesions were found in racing Thoroughbreds (Fischer's exact test p = 0.002) and in 20% (8/40) of racing Thoroughbreds that underwent tarsal CT. DDLC SBI was determined to be the primary cause of lameness in 3/8. Third tarsal bone fracture was considered the primary cause of lameness in 3/8 horses. A total of 1663 nuclear scintigraphic scans of 1603 Thoroughbred horses were reviewed. Increased IRU in the DDLC was present in 13 horses (0.9%). MAIN LIMITATIONS: Study limitations include the retrospective nature of the study, incomplete medical records, lack of sensitivity/specificity data for lesion identification on various imaging modalities or comparison to histopathology, and limited substantive follow-up information. CONCLUSIONS: The DDLC is a previously unreported site of SBI in the Thoroughbred racehorse. The lesion can be the primary source of lameness but may also be found in horses with other clinically relevant osseous injuries. This lesion may be underestimated in the Thoroughbred population. Further investigation is required to determine the true prevalence, clinical relevance, and prognosis in Thoroughbred racehorses with this injury.

CONTEXTO: A maior acessibilidade à tomografia computadorizada (TC) está aprimorando o conhecimento de fatores contribuintes à baixa performance de cavalos puro sangue inglês (PSI) de corrida. OBJETIVOS: Caracterizar um local não previamente descrito de lesão óssea subcondral (LOS) no tarso de cavalos PSI de corrida. DELINEAMENTO DO ESTUDO: Estudo analítico transversal retrospectivo. METODOLOGIA: TC do tarso de 108 cavalos foram revisadas para detectar evidência de LOS na região dorso-distal-lateral do calcâneo (DDLC). Informações de idade, raça, sexo e modalidade esportiva dos cavalos foram revisados. A presença de LOS na região DDLC em cavalos PSI de corrida foi comparada com a presença da mesma lesão em outras raças e modalidades esportivas. Cintilografia nuclear dos membros pélvicos de cavalos PSI de corrida entre 2007 e 2020 também foram revisadas para a presença de evidência de aumento de captação radiofarmacêutica (CRF) sugestiva de LOS na região DDLC. RESULTADOS: LOS na região DDLC for identificada em 8/108 (7.3%) dos equinos. Todas as lesões foram encontradas em PSI de corrida (teste exato de Fischer p = 0.002), e em 20% (8/40) dos PSI de corrida que tiveram o exame de TC feito. LOS na região DDLC foi determinada como a causa primária da claudicação em 3/8 dos casos. Fratura do terceiro osso do tarso foi considerada a causa primária de claudicação em 3/8 dos cavalos. 1663 exames de cintilografia de 1603 cavalos PSI de corrida foram revisados. Aumento da CRF na região DDLC estava presente em 13 equinos (0.9%). PRINCIPAIS LIMITAÇÕES: As limitações deste estudo incluem a natureza retrospectiva do mesmo, prontuários médicos incompletos, falta de dados de sensibilidade e especificidade da lesão nos métodos diagnósticos e comparação histológica, e informação de acompanhamento dos casos limitada. CONCLUSÕES: A região DDLC é um local de LOS não previamente descrito em cavalos PSI de corrida. A lesão pode ser a causa primária de claudicação, mas também pode ser encontrada em casos que apresentam outras lesões relevantes. Essa lesão pode ser subestimada em cavalos PSI de corrida. Mais investigações são necessárias para determinar a prevalência real, a relevância clínica e o prognóstico dessas lesões em cavalos PSI de corrida.

Small Animal Teleultrasound.

Teleradiology is well established in many small animal practices, whereas teleultrasound is slowly gaining prominence. The demand for teleultrasound services in the veterinary profession has increased substantially because access to ultrasound to general practitioners increases faster than the number of imaging specialists and Point of Care Ultrasound (POCUS) becomes part of the standard of care. Two main methods of teleultrasound currently exist: asynchronous (eg, "store-and-forward") and synchronous (eg, real-time) interpretations. Few standardized protocols for teleultrasound in small animals are available. Similarly, there are no standardized training programs for sonographic examination acquisition and interpretation outside of the traditional diagnostic imaging residency under the purview of the American College of Veterinary Radiology. The success of a telesonographic evaluation largely depends on the relationship between the veterinarian requesting remote assistance and the expert providing support.

What Is Your Diagnosis?

In collaboration with the American College of Veterinary Radiology.

Utility of radiographic measurements to predict echocardiographic left heart enlargement in dogs with preclinical myxomatous mitral valve disease.

BACKGROUND: Evaluation of left heart size helps determine disease severity in dogs with myxomatous mitral valve disease (MMVD). HYPOTHESIS/OBJECTIVES: Determine the ability of radiographic vertebral heart size (VHS) and vertebral left atrial size (VLAS) to predict LHEECHO in dogs with preclinical MMVD. ANIMALS: Seventy client-owned dogs with MMVD and no historical or present clinical or radiographic evidence of congestive heart failure (CHF). METHODS: Retrospective cross-sectional study of dogs with same-day echocardiography and thoracic radiography. Receiver-operating characteristic (ROC) curves were used to assess the ability of VHS, VLAS, and VHS + VLAS to discern dogs with and without LHEECHO , and clinically relevant cutpoints for these radiographic measurements were selected. RESULTS: The ability of VHS and VHS + VLAS to predict LHEECHO was moderate (area under the curve [AUC]VHS = 0.851; 95% CI, 0.762-0.941; AUCVHS + VLAS = 0.865; 0.783-0.947), and performance of VLAS and VHS + VLAS was not different from that of VHS alone. A VHS cutpoint of >10.8 had sensitivity = 91.1% (76.3%-98.1%) and specificity = 69.4% (51.9%-83.7%) for predicting LHEECHO . A cutpoint of >11.7 had sensitivity = 32.4% (17.4%-50.5%) and specificity = 97.2% (85.5%-99.9%) for predicting LHEECHO . Thirty (43%) of the 70 dogs had a VHS value of 10.9 to 11.7. CONCLUSIONS AND CLINICAL IMPORTANCE: Vertebral heart size >11.7 identified dogs with LHEECHO and VHS ≤ 10.8 excluded dogs with LHEECHO . A large percentage of dogs had VHS values intermediate to these cutpoints.