Hypersensitivity pneumonitis associated with inhalation of Lycoperdon spores (lycoperdonosis) in a 3-month-old English setter dog in Quebec.

A 3-month-old female English setter dog was presented to the Faculty of Veterinary Medicine of the Université de Montréal (Quebec) with acute respiratory distress. The dog had moderately increased C-reactive protein concentrations, and thoracic radiographs revealed a moderate, caudodorsal, nodular-to-miliary alveolo-interstitial pulmonary pattern that was worse in the perihilar region. Initial differential diagnoses included a fungal pneumonia (e.g., blastomycosis or histoplasmosis). Cytology of the bronchoalveolar lavage revealed several round, green structures ~2 µm in diameter, consistent with fungal spores. The dog was hospitalized, but within 24 h the respiratory condition deteriorated and euthanasia was elected. Post-mortem panfungal PCR and sequencing tests identified the spores as Lycoperdon sp. Retrospectively, the owners recalled that the dog had played in a wood pile with mushrooms and had sneezed in a cloud of spores, implying inhalation of Lycoperdon spores. This is the first report of a confirmed case of canine lycoperdonosis in eastern Canada (Quebec), and the radiographic features in this case differed slightly from previous reports. Diagnosis before bronchoalveolar lavage analysis was challenging, as spore inhalation was not initially reported. Although the disease is infrequently reported in dogs, this case report reminds veterinarians to consider lycoperdonosis as a differential diagnosis when addressing animals presented with acute dyspnea with similar radiographic lesions, and highlights the importance of history and cytology in diagnosing this condition. Key clinical message: Hypersensitivity pneumonitis secondary to inhalation of Lycoperdon spores must be included in differential diagnoses for a dog with acute onset of respiratory signs and a nodular-to-miliary interstitial pulmonary pattern coalescing in patchy perihilar alveolar pulmonary lesions, and should prompt clinicians to question owners regarding inhalation of mushroom spores.Although cytological examination of a bronchoalveolar lavage reveals the presence of fungal spores, panfungal PCR and sequencing tests are needed to pinpoint the species involved.

Pneumopathie d'hypersensibilité associée à l'inhalation de spores de Lycoperdon (lycoperdonose) chez un chien setter anglais de 3 mois au Québec. Une chienne setter anglais âgée de 3 mois a été présentée à la Faculté de médecine vétérinaire de l'Université de Montréal (Québec) avec une détresse respiratoire aiguë. Le chien présentait des concentrations de protéine C-réactive modérément augmentées et les radiographies thoraciques ont révélé un schéma pulmonaire alvéolo-interstitiel modéré, caudodorsal, nodulaire à miliaire, pire dans la région périhilaire. Les diagnostics différentiels initiaux incluaient une pneumonie fongique (par exemple, blastomycose ou histoplasmose). La cytologie du lavage broncho-alvéolaire a révélé plusieurs structures rondes et vertes d'environ 2 µm de diamètre, compatibles avec des spores fongiques. Le chien a été hospitalisé, mais en 24 heures, l'état respiratoire s'est détérioré et l'euthanasie a été décidée. Les tests panfongiques PCR et de séquençage post-mortem ont identifié les spores comme étant Lycoperdon sp. Rétrospectivement, les propriétaires ont mentionné que le chien avait joué dans un tas de bois avec des champignons et avait éternué dans un nuage de spores, ce qui implique une inhalation de spores de Lycoperdon. Il s'agit du premier rapport d'un cas confirmé de lycoperdonose canine dans l'est du Canada (Québec), et les caractéristiques radiographiques de ce cas différaient légèrement des rapports précédents. Le diagnostic avant l'analyse du lavage broncho-alvéolaire était difficile, car l'inhalation de spores n'avait pas été initialement signalée. Bien que la maladie soit rarement rapportée chez les chiens, ce rapport de cas rappelle aux vétérinaires de considérer la lycoperdonose comme un diagnostic différentiel lorsqu'ils traitent des animaux présentant une dyspnée aiguë avec des lésions radiographiques similaires, et souligne l'importance de l'anamnèse et de la cytologie dans le diagnostic de cette affection.Message clinique clé : La pneumopathie d'hypersensibilité secondaire à l'inhalation de spores de Lycoperdon doit être incluse dans les diagnostics différentiels chez un chien présentant un début aigu de signes respiratoires et un schéma pulmonaire interstitiel nodulaire à miliaire fusionnant dans des lésions pulmonaires alvéolaires périhilaires inégales, et devrait inciter les cliniciens à interroger les propriétaires concernant l'inhalation de spores de champignons.Bien que l'examen cytologique d'un lavage broncho-alvéolaire révèle la présence de spores fongiques, des tests panfongiques PCR et de séquençage sont nécessaires pour identifier les espèces impliquées.(Traduit par Dr Serge Messier).

Radiographic analysis in Thoroughbreds reveals morphological changes in healthy maturing stifle joints and possible association between subchondral lesions and femoral condyle width.

OBJECTIVE: Assess femorotibial features in foals with and without medial femoral condyle (MFC) subchondral radiolucencies (SR+ and SR-). METHODS: 3 independent, sequential radiographic studies were performed. Study 1 retrospectively measured femorotibial morphological parameters in repository radiographs (SR- and SR+). Study 2 qualitatively compared drawings of intercondylar notch shape in postmortem radiographs (SR-). Study 3 prospectively measured femorotibial parameters in 1-month-old foals (SR-). In studies 1 and 3, 13 morphologic parameters were measured. Limb directional asymmetry was assessed in 2 age groups (< 7 or ≥ 7 months). RESULTS: Study 1 (SR- group; n = 183 radiographs) showed increased femoral measurements with maturation, except the distal femoral intercondylar notch width (FINwal), which decreased. In contrast, in SR+ stifles (53 radiographs), 3 femoral parameters (MFC width [MFCwpf], MFC height, or FINwal) showed no changes. Tibial plateau width alone increased with maturation in both groups. Interobserver reliability was good to excellent. Study 2 (n = 53 radiographs) confirmed a distal FINw decrease in SR- foals. In study 1, left SR- stifles in greater than or equal to 7-month-old fillies had significantly larger femoral bicondylar width and FINw, while right SR+ stifles in fillies greater than or equal to 7 months had a significantly larger MFCw. In study 3 of 1-month-old foals (n = 94 SR- radiographs), the MFCw, femoral condyle bicondylar width, and lateral femoral condyle height were all greater on the left, whereas the intercondylar intereminence space width was larger on the right. CLINICAL RELEVANCE: In SR+ stifles, the distal femur exhibited divergent maturation, indicating a wider MFC in the right stifle in older foals. As SR lesions are more common on the right, this suggests a potential association with MFC morphology.

Residual volume of extruded disc material and residual spinal cord compression measured on postoperative MRI do not predict neurological outcomes in dogs following decompressive surgery for thoracolumbar intervertebral disc extrusion.

Published studies on the validity of using quantitative MRI measures of pre- and postoperative spinal cord (SC) compression as prognostic indicators for dogs undergoing surgery for intervertebral disc extrusion (IVDE) are currently limited. The aim of this retrospective analytical study was to describe the volume of postoperative residual extradural material (VREM) and the ratio of the cross-sectional area (CSA) of maximum SC compression to the CSA of SC in a compression-free intervertebral space as MRI measures of preoperative and postoperative compression (residual spinal cord compression, RSCC), and to compare these measures between the neurological outcome in a group of dogs. Inclusion criteria were dogs that underwent surgery for thoracolumbar IVDE, were imaged pre- and immediately postoperatively by MRI, and had a neurological follow-up examination 2 to 5 weeks postoperatively. Two blinded observers independently performed measurements in pre- and postoperative MRI studies. Dogs were classified into positive outcome (PO) and negative outcome (NO) groups based on follow-up neurologic examination scores. Seventeen dogs were included (12 PO, 5 NO). Interobserver agreement for MRI measurements was good to excellent (ICCs: 0.76-0.97). The prevalence of residual extradural material in postoperative MRI studies was 100%. No significant differences in mean preoperative SC compression, mean RSCC, mean SC decompression, or VREM were found between outcome groups (P = .25; P = .28; P = .91, P = .98). In conclusion, neither postoperative VREM nor RSCC could predict successful neurological outcomes.

Iatrogenic adrenal atrophy following oral corticotherapy is not reliably identified ultrasonographically in cats.

Background: In dogs, corticosteroid administration is known to decrease adrenal gland height when measured ultrasonographically. However, comparable information is lacking in cats. Objectives: i) Validate that the adrenal height of our control population without corticosteroid administration was similar to previous data, ii) determine effects of dose and duration of oral corticosteroid therapy on adrenal height, and iii) determine an adrenal size threshold to differentiate cats receiving corticosteroids or not. Animals and procedures: Adult cats (N = 308) that received abdominal ultrasonographic examination(s) were retrospectively recruited and allocated into 2 groups: those with and without oral corticosteroid use. Cats receiving corticosteroids were subdivided into 6 subgroups by dose (supraphysiologic, anti-inflammatory, or immunosuppressive) and duration of therapy (≤ 1 mo or > 1 mo). Results: Adrenal height in cats without corticosteroid therapy was comparable to previous studies. An anti-inflammatory corticosteroid dose for > 1 mo caused a 21.4% decrease in adrenal height (mean difference of 0.8 mm; P = 0.009). However, no difference in adrenal height was noted in the other subgroups (P > 0.21), and no useful adrenal height threshold was established. Conclusion and clinical relevance: Feline iatrogenic adrenal atrophy may be difficult to establish with ultrasonography, as only cats receiving anti-inflammatory corticosteroid doses for > 1 mo had a modest (< 1 mm) decrease in adrenal height.

L'atrophie iatrogène des surrénales consécutive à une corticothérapie orale n'est pas identifiée de manière fiable par échographie chez le chat. Contexte: Chez le chien, l'administration de corticostéroïdes est connue pour diminuer la taille des glandes surrénales lorsqu'elle est mesurée par échographie. Cependant, des informations comparables manquent chez les chats. Objectifs: i) Valider que la taille des surrénales de notre population témoin sans administration de corticostéroïdes était similaire aux données précédentes, ii) déterminer les effets de la dose et de la durée de la corticothérapie orale sur la taille des surrénales, et iii) déterminer un seuil de taille des surrénales pour différencier les chats recevant des corticostéroïdes ou pas. Animaux et procédures: Des chats adultes (N = 308) qui ont subi un ou plusieurs examens échographiques abdominaux ont été recrutés rétrospectivement et répartis en 2 groupes : ceux avec et sans corticothérapie orale. Les chats recevant des corticostéroïdes ont été subdivisés en 6 sous-groupes selon la dose (supraphysiologique, anti-inflammatoire ou immunosuppresseur) et la durée du traitement (≤ 1 mois ou > 1 mois). Résultats: La taille des surrénales chez les chats sans corticothérapie était comparable à celle des études précédentes. Une dose de corticoïdes anti-inflammatoires pendant > 1 mois a entraîné une diminution de 21,4 % de la taille des surrénales (différence moyenne de 0,8 mm; P = 0,009). Cependant, aucune différence de taille surrénalienne n'a été notée dans les autres sous-groupes (P > 0,21) et aucun seuil de taille surrénalienne utile n'a été établi. Conclusion et pertinence clinique: L'atrophie surrénalienne iatrogène féline peut être difficile à établir par échographie, car seuls les chats recevant des doses de corticostéroïdes anti-inflammatoires pendant > 1 mois ont présenté une diminution modeste (< 1 mm) de la taille des surrénales.(Traduit par Dr Serge Messier).

An Anatomical, Sonographic, and Computed Tomography Study of the Transversus Abdominis Plane Block in Cat Cadavers.

This study compared the distribution of a bupivacaine-iopamidol-dye solution following ultrasound-guided in-plane TAP injection using a 1-point (TAP-L) or 2-point (TAP-SL) approach in cat cadavers. Two cadavers were used to study the TAP sonoanatomy while eight cadavers were enrolled in a randomized, prospective, blinded investigation. Each cat randomly received a TAP-L with 0.5 mL/kg in one hemiabdomen and a TAP-SL with 0.25 mL/kg/point in the contralateral hemiabdomen. After injection, computed tomography and dissection were performed to assess contrast distribution and number of stained target nerves. TAP-SL resulted in a wider contrast spread (mm) compared with TAP-L (87 ± 7 versus 71 ± 9; p = 0.002). The prevalence of nerve staining was higher using TAP-SL than TAP-L (p = 0.001). The ventral branches of T10, T11, T12, T13, L1 and L2 were stained in 2/8, 2/8, 5/8, 7/8, 4/8 and 1/8, and in 7/8, 7/8, 8/8, 8/8, 8/8 and 1/8 using TAP-L and TAP-SL approaches, respectively. Computed tomography and dissection identified minimal injectate intraperitoneally or within the falciform ligament fat following 1 TAP-L and 2 TAP-SL. Ultrasound-guided TAP-SL provided better injectate distribution around the thoracolumbar spinal nerve branches than TAP-L.

Can MRI differentiate between ring-enhancing gliomas and intra-axial abscesses?

Gliomas of the brain may appear as expansile ring-enhancing masses in MRI studies, mimicking the appearance of intra-axial abscesses. The aims of this study were to compare the MRI features of ring-enhancing gliomas and intra-axial brain abscesses in dogs and cats and to identify the characteristics that might help differentiate them. For this multicenter, retrospective, and observational study, the inclusion criteria were as follows: (a) a definitive diagnosis of glioma or abscess based on cytological or histopathological examination following CSF collection or surgical biopsy/necropsy, respectively; (b) MRI study performed with a high- or low-field MRI scanner, including a same plane T1W pre- and postcontrast, a T2W and a T2 FLAIR sequence in at least one plane. If available, delayed T1W postcontrast, T2*W GE, DWI/ADC, and SWI sequences were also evaluated. Sixteen patients were diagnosed with ring-enhancing gliomas, and 15 were diagnosed with intra-axial abscesses. A homogenous signal on T1W (P = 0.049) and T2W (P = 0.042) sequences, a T2W (P = 0.005) or T2*W GE (P = 0.046) peripheral hypointense halo, and an even enhancing capsule (P = 0.002) were significantly associated with brain abscesses. A progressive central enhancement on delayed T1W postcontrast sequences was correlated with ring-enhancing gliomas (P = 0.009). The combination of the following features was suggestive of brain abscess: homogeneous T1W or T2W signal intensity, a T2W or T2*W GE peripheral hypointense halo and an evenly enhancing capsule. Central progression of enhancement on delayed T1W postcontrast sequences was suggestive of glioma.

Bilateral thoracic radiographs increase lesion detection in horses with pneumonia or pulmonary neoplasia but do not bring any additional benefit for inflammatory or diffuse pulmonary disease.

Published studies describing the effects of bilateral radiographic projections on the detection of equine pulmonary lesions are currently lacking. The objectives of this retrospective, single center, observational study were to compare unilateral and bilateral thoracic radiographic projections for the detection of pulmonary lesions in a group of horses. Based on their clinical diagnosis, 167 adults and foals with bilateral thoracic radiographs were classified as having pneumonia (n = 88), inflammatory or diffuse pulmonary disease (n = 72), and pulmonary masses (n = 7). After an initial interrater repeatability test, right-to-left and left-to-right projections were anonymized and independently interpreted by a radiologist blinded to the clinical diagnosis. Scores were attributed for each pattern/lesion (alveolar, interstitial, bronchial, nodules/masses, cavitary lesions) and each quadrant. Agreement between scores from each projection was evaluated with Bland-Altman plots. Lesions identified on one side but not on the contralateral projection were considered discordant. There was no preferential lateralization of pulmonary lesions. The prevalence of discordance was 14.4%, 9.0%, and 4.2% for alveolar pattern, nodules/masses, and cavitary lesions, respectively. Up to nine horses (10.2%) with pneumonia could have been misdiagnosed. A pulmonary mass would have been missed in one case. For inflammatory or diffuse disease, discordance was slight, and the addition of contralateral projections had no impact on radiographic interpretation. In conclusion, in horses with pneumonia or neoplasia, bilateral projections, or adding at least one contralateral caudoventral view, increased the probability of identifying pulmonary lesions. In horses with inflammatory or diffuse disease, bilateral thoracic radiography provided no additional benefit.

Effects of Butorphanol With Alfaxalone or Dexmedetomidine on Feline Splenic Size and Appearance on Ultrasound and Computed Tomography.

The purpose of the study was to determine the effects of intramuscular butorphanol with dexmedetomidine or alfaxalone on feline splenic size, echogenicity, and attenuation using ultrasound and computed tomography (CT). Ten healthy research cats underwent ultrasound and CT without sedation (controls), 15 min after protocol AB (alfaxalone 2 mg/kg and butorphanol 0.2 mg/kg) and 10 min after protocol DB (dexmedetomidine 7 µg/kg and butorphanol 0.2 mg/kg), with a one-week wash-out period between each sedation, using a cross-over study design. Images were randomized and anonymized for evaluation by a board-certified radiologist. On ultrasound, the sedative protocols affected splenic thickness, at the body and the tail (p = 0.002 and 0.0003, respectively). Post-hoc tests revealed that mean ± SEM thickness was greater after AB (body: 10.24 ± 0.30 mm; tail: 7.96 ± 0.33 mm) than for the control group (body: 8.71 ± 0.30 mm; tail: 6.78 ± 0.33 mm), while no significant difference was observed following DB. Splenic echogenicity was unchanged between treatments (p = 0.55). On CT, mean ± SEM splenic volume was increased after AB (37.82 ± 1.91 mL) compared to the control group (20.06 ± 1.91 mL) (p < 0.0001), but not after DB (24.04 ± 1.91 mL). Mean splenic attenuation increased after AB (p = 0.0009), but not DB. Protocol DB may be preferable for profound sedation in cats while avoiding changes in feline splenic imaging. When protocol AB is selected, splenomegaly should be expected, though mild on ultrasound. The increased splenic attenuation after AB is unlikely to be clinically relevant.

Effects of repeated use and resterilization on structural and functional integrity of microwave ablation antennas.

OBJECTIVE To determine effects of repeated use and resterilization on structural and functional integrity of microwave ablation (MWA) antennas. SAMPLE 17 cooled-shaft MWA antennas (3 groups of 5 antennas/group and 2 control antennas). PROCEDURES 1, 2, and 3 ablations in the livers of bovine cadavers were performed at the maximum recommended settings. Antennas were cleaned and sterilized in hydrogen peroxide plasma, and the process was repeated (reprocessing cycle; n = 6). Control antennas were only sterilized (6 times). Aerobic and anaerobic bacterial cultures were performed, and antennas were microscopically assessed for damage. RESULTS 6 cycles were completed. Thirteen of 15 MWA antennas remained functional for up to 4 cycles, 10 were functional after 5 cycles, and only 7 were functional after 6 cycles. Progressive tearing of the silicone coating of the antennas was observed, with a negative effect of the number of cycles for silicone tearing. Size of the ablation zone decreased mildly over time after cycles 5 and 6; however, this was not considered clinically relevant. No significant changes in the shape of ablation zones were detected. All cultures yielded negative results, except for an isolated case, which was considered a contaminant. CONCLUSIONS AND CLINICAL RELEVANCE Structural and functional integrity of the microwave antennas remained acceptable during repeated use and reprocessing for up to 4 cycles. However, there was a decrease in functional integrity at cycles 5 and 6. We suggest that these microwave antennas be subjected to > 3 reprocessing cycles. Antennas should be carefully examined before reuse.

Computed tomography diagnosis of a thoracic and abdominal penetrating foreign body in a dog.

A 1.5-year-old, spayed female, mixed-breed dog was presented for hemoabdomen associated with an abdominal mass. Upon presentation bicavitary effusion was diagnosed. A penetrating intra-abdominal wooden foreign body was identified using computed tomography. This case describes a thoracic penetrating wooden foreign body causing bicavitary effusion following migration into the retroperitoneal space.

Diagnostic d'un corps étranger thoracique et abdominal pénétrant par tomodensitométrie chez un chien. Une chienne de race croisée stérilisée âgée de 1,5 ans a été présentée pour un hémoabdomen associé à une masse abdominale. Sur présentation, une effusion bicavitaire a été diagnostiquée. Un corps étranger en bois intra-abdominal pénétrant a été identifié par tomodensitométrie. Ce cas décrit un corps étranger en bois pénétrant dans le thorax et causant une effusion bicavitaire après la migration dans l'espace rétropéritonéal.(Traduit par Isabelle Vallières).

Radiographic diagnosis of mechanical obstruction in dogs based on relative small intestinal external diameters.

Mechanical obstruction is a frequent cause of acute vomiting in dogs requiring prompt diagnosis to improve patient management and prognosis. The purpose of this retrospective study was to compare small intestinal radiographic characteristics in dogs with versus without mechanical intestinal obstruction. Fifty dogs with gastrointestinal clinical signs and abdominal radiographs were recruited from hospital record archives and assigned to groups (group 1, obstructive, n = 25; group 2, nonobstructive n = 25). Abdominal radiographs were randomized and independently interpreted by three examiners who were unaware of group status. Intestinal dilation was subjectively scored based on distribution (segmental, regional or diffuse), and severity (absent, mild, moderate or severe). Small intestinal maximal diameter (SImax), L5 vertebral body height, small intestinal minimal diameter (SImin), and an estimated average of small intestinal diameters (SIave) were measured and three ratios were calculated: SImax/L5, SImax/SImin, and SImax/SIave. Segmental dilation was more prevalent in obstructed dogs for all examiners (P ≤ 0.03) and most nonobstructed dogs had no dilation (P ≤ 0.05). All ratios were higher in obstructed dogs (P < 0.002). Subjective dilation scores and ratio measurements had low interobserver agreement (absent to fair, with kappa values between -0.06 and 0.57) and reproducibility (coefficients of 0.35-0.61). Findings indicated that dogs with SImax/L5 ≤ 1.4, SImax/SImin ≤ 2, and SImax/SIave ≤ 1.3 values are very unlikely to be mechanically obstructed; dogs with SImax/L5 ≥ 2.4, SImax/SImin ≥ 3.4 and SImax/SIave ≥ 1.9 are very likely obstructed, particularly if segmental dilation (less than 25% of the small intestine) is present. Dogs with ratios falling between these thresholds may need further testing unless other signs justify surgical exploration or endoscopy.