Extruded gallbladder mucoceles have characteristic ultrasonographic features and extensive migratory capacity in dogs.

Limited information is available on the ultrasonographic characteristics of extruded gallbladder mucoceles. The objective of this retrospective case series study was to describe the ultrasonographic features of extruded gallbladder mucoceles in a group of dogs. Medical records of four veterinary centers were searched between June 2010 and January 2018 for all dogs with a suspected extruded gallbladder mucocele based on abdominal ultrasound. Seven client-owned dogs met the inclusion criteria. All seven dogs had a discrete, heteroechoic, multilayered, stellate, or striated mass within the peritoneal cavity. Blood flow was not present in these structures. Four of these structures were identified in the caudal abdomen. In five cases, the gallbladder lumen was filled with material similar in appearance to the free-floating peritoneal mass. Four cases were confirmed surgically and one case was confirmed at necropsy. Histopathology of the gallbladder wall was evaluated in all surgical cases and analysis of the free-floating material was performed in one of the four cases. Extruded gallbladder mucoceles have common imaging characteristics that may be helpful in establishing a presumptive diagnosis. Additionally, these structures may have extensive migratory capacity. The results of the study justify the recommendation for exploration of the entire abdomen during cholecystectomy for gallbladder mucocele removal.

Granulomatous Inflammatory Response to a Microchip Implanted in a Dog for Eight Years.

An 8 yr old neutered male springer spaniel dog was referred to Texas A&M University, College of Veterinary Medicine for a large, firm, fixed mass, located in the dorsal cervical tissue. The dog was otherwise healthy and had undergone microchip implantation approximately 8 yr prior. Radiographs, ultrasound, and microchip scanner confirmed the presence of a microchip within the mass. The microchip and associated mass were surgically excised, and histopathologic examination revealed granulomatous inflammation surrounding a cracked microchip. This case represents the first report of a granulomatous inflammatory response to a microchip 8 yr after implantation in a dog and highlights an important differential diagnosis.

[Subcutaneous ureteral bypass devices as a treatment option for bilateral ureteral obstruction in a cat with ureterolithiasis]. / Beidseitiger Einsatz eines subkutanen Ureter-Bypass bei einer Katze mit bilateraler Harnleiterobstruktion.

A 6-year-old female spayed Domestic Shorthair cat was presented with acute lethargy, dehydration, marked azotemia, metabolic acidosis, left-sided renomegaly, and bilateral hydronephrosis. Ureterolithiasis and ureteral obstruction were suspected based on further diagnostics including abdominal sonography. Medical treatment was not successful. Fluoroscopically guided antegrade pyelography confirmed the diagnosis of bilateral ureteral obstruction due to ureterolithiasis. Subcutaneous ureteral bypass (SUB) devices were placed bilaterally, followed by close patient monitoring. Frequent reassessment of patient parameters and blood work served to adjust the fluid needs of the patient and to ensure proper hydration, correction of azotemia at an appropriate rate, and cardiovascular stability. After significant improvement of all patient parameters within 5 days, the patient was discharged from the hospital. Treatment included a dietary change to reduce the risk of stone formation as well as a phosphorus binder. Clinical and clinicopathologic parameters were unchanged at the 1- and 4- and 7-month rechecks (consistent with IRIS CKD stage II-NP-AP0), and both SUB devices continued to provide unobstructed urine flow. Bilateral placement of subcutaneous ureteral bypass devices may be a safe and potentially effective treatment option for acute bilateral ureteral obstruction in cats with ureterolithiasis. Strict patient monitoring and patient-centered postoperative treatment decisions are crucial to successful treatment outcomes.

Imaging diagnosis--disseminated peritoneal leiomyomatosis in a dog.

A 17-month-old male Labrador retriever presented for evaluation of an abdominal mass felt during abdominal palpation. Multiple variably sized cystic masses were identified on sonographic and radiographic images. Exploratory laparotomy revealed multiple peritoneal masses that exhibited atypical contractions and lacked an identifiable organ of origin. Histology and immunohistochemistry of multiple surgically excised masses was consistent with benign tumors of smooth muscle origin (leiomyomas). The presence of multiple peritoneal leiomyomas in this dog is consistent with disseminated peritoneal leiomyomatosis. Two years after diagnosis and multiple surgical interventions, continual insidious enlargement of leiomyomas was identified on ultrasound and CT.

Clinical findings in dogs with incidental adrenal gland lesions determined by ultrasonography: 151 cases (2007-2010).

OBJECTIVE: To determine the prevalence of and clinical features associated with incidental adrenal gland lesions (IAGLs) discovered during abdominal ultrasonography in dogs. DESIGN: Retrospective case series. ANIMALS: 151 dogs with an IAGL and 400 control dogs. PROCEDURES: Reports of ultrasonographic examinations of the abdomen of dogs performed during a 3.5-year period were reviewed. Adrenal glands were classified as having an IAGL if a nodule or mass was described or the width of either gland was ≥ 10 mm. For dogs with an IAGL, information regarding signalment, concurrent disorders, and outcome was obtained from the medical record. Findings were compared with those in a control population of 400 dogs examined during the same period. RESULTS: An IAGL was detected in 151 of 3,748 (4%) dogs. Dogs with an IAGL were significantly older (median age, 11.25 years) and heavier (median body weight, 21 kg [46.2 lb]) than the control population (median age, 9.5 years; median body weight, 14 kg [30.8 lb]). Malignant tumors were reported in 6 of 20 (30%) dogs that underwent adrenal glandectomy or necropsy and had a maximum IAGL dimension that ranged from 20 to 46 mm; benign lesions all had a maximum dimension < 20 mm. Various coincidental conditions were reported in dogs with an IAGL, including nonadrenal gland malignant neoplasia in 43 (28.5%) dogs. CONCLUSIONS AND CLINICAL RELEVANCE: IAGLs were more likely in dogs ≥ 9 years of age. On the basis of this small data set, malignancy should be suspected for IAGLs ≥ 20 mm in maximum dimension.

Ultrasonographic characteristics of lipiduria in clinically normal cats.

Echoes are frequently seen in the urinary bladder of cats during abdominal ultrasound. These have been attributed to hematuria, pyuria, crystalluria, and lipid. However, sonographic findings have not been previously correlated with urinalysis. We prospectively evaluated 40 clinically normal cats via ultrasound, serum chemistry, and urinalysis. Thin layer chromatography was performed on the urine to determine the amount (mg) of lipid subfractions including diacylglycerol, triglyceride, phospholipid, free fatty acid, cholesterol, and cholesterol ester. Ninety percent (36/40) of the cats in our population had sonographic echoes suspended in the urinary bladder, with most having a subjective score of mild echoes (n = 20). None of the sonographic echoes were gravity dependent or caused distal acoustic shadowing, reverberation, or twinkle artifact. Of the cats with sonographic echoes in the urine, 66% (24/36) had no significant findings on urinalysis other than the presence of lipid. The total amount of subjective sonographic echoes was not significantly related to the total amount of fat measured on thin layer chromatography or the number of lipid droplets seen on urinalysis. An increased amount of urine diacylglycerol was significantly associated with clumping of echoes (P = 0.02) and the amount of lipid droplets seen on urinalysis (P = 0.04). An association between increased amounts of urine diacylglycerol and the amount of echoes seen on ultrasound approached significance (P = 0.05). Findings from this study support previously published theories that sonographic echoes within the urinary bladder of clinically normal cats may be due to urine lipid.

Ultrasonographic appearance of histoplasmosis identified in the spleen in 15 cats.

Histoplasmosis is the second most common fungal infection reported in the cat. The disseminated form involving lung, liver, lymph nodes, spleen, and bone marrow is a frequent manifestation of the disease. Limited information is available in the literature regarding the ultrasonographic appearance of the spleen in cats with disseminated or splenic histoplasmosis. A retrospective review of splenic ultrasound images from 15 cats confirmed to have histoplasmosis by splenic aspirates was performed. Size, echotexture, echogenicity, margin appearance, presence of nodules, and the overall shape of the spleen were reported in each case. Splenomegaly was documented in all cases (15/15) and a hypoechoic appearance of the spleen was documented in 14/15 of cases. The spleen was diffusely and uniformly affected in 14/15 (six homogenous and eight with a subtle mottled appearance) and had discrete nodules in 1/15 cats. Histoplasmosis should be included in the differential list for an enlarged and hypoechoic spleen in cats with consistent clinical findings. Additionally, ultrasound guided splenic aspirate may be a useful method to obtain a cytology sample for diagnosis.

Formulation of a standardized protocol and determination of the size and appearance of the spleen in healthy cats.

Standard protocol for splenic measurement is warranted to aid in interpretation when sonographically imaging the spleen of cats. The purpose of this study was to describe the appearance and size of healthy cat spleens, and to develop a standard method of evaluation. Data were obtained from 31 clinically healthy non-sedated cats with no sonographic abnormalities. The sonographic appearance of the spleen's relative echogenicity compared to the left renal cortex and the hepatic parenchyma was recorded. Splenic height was measured at three sites. Three measurements were determined at each site, and the mean value of these three measurements was determined and used for data analysis. A significance level of P <0.05 was used for analysis, which was performed using S-PLUS software (version 8.1). The mean proximal height of the spleen was 7.1 mm. The mean body sagittal height was 9.3 mm. The mean height of the tail of the spleen was 8.7 mm (95% confidence interval). The splenic parenchymal echogenicity was less than the left renal cortex echogenicity and greater than the liver in 17/31cats; less than the left kidney cortex and equal to the liver in 5/31cats; equal to the cortex of the left kidney and greater than the liver in 5/31 cats; equal to the liver and renal cortex in 2/31 cats; and less than the liver and kidney with the renal cortex less than the liver in 2/31 cats. The protocol recommended for consistent evaluation of the spleen in the cat includes three specific measurements.

Imaging diagnosis--pulmonary alveolar proteinosis in a dog.

A young dog was presented for cyanosis and right heart failure. Radiographic and CT characteristics included right heart/pulmonary artery enlargement, hepatomegaly, abdominal effusion, and severe, generalized air-space filling. Focal increased opacities were present in the peripheral lung, as were multiple pulmonary blebs and bullae. Echocardiographic findings were consistent with cor pulmonale and pulmonary hypertension. Bronchoscopic findings were consistent with chronic inflammation. Pulmonary alveolar proteinosis (PAP) was confirmed at necropsy. Pulmonary alveolar proteinosis is an interstitial lung disease that results in accumulation of phospholipoproteinaceous material and should be included as a differential diagnosis for dogs with these clinical and imaging characteristics.

Multi-organ involvement of Heterobilharzia americana infection in a dog presented for systemic mineralization.

Canine schistosomiasis due to Heterobilharzia americana is a clinically underdiagnosed disease in dogs, which is found primarily in the Gulf Coast and south Atlantic region of the United States. A 3-year-old dog from Texas with a clinical diagnosis of systemic mineralization of unknown origin in the absence of evidence of hypercalcemia was found at necropsy to have severe disseminated H. americana infection involving the liver, pancreas, small and large intestine, lungs, and kidneys. Calcification of many of the large number of H. americana eggs gave the false impression of soft-tissue mineralization on radiographic and ultrasonographic images. Polymerase chain reaction amplification and sequencing of DNA derived from formalin-fixed sections of small intestine and liver, using primers specific for a 487-base pair segment of the H. americana small subunit ribosomal RNA gene, confirmed the presence of H. americana.

Imaging diagnosis--gastric pneumatosis in a cat.

Gastrointestinal foreign bodies were removed surgically from a 9-year-old Siamese cat. Two days later the cat became lethargic and started regurgitating. A degenerative leukocytosis and drop in packed cell volume were present. Gastric wall thickening with intramural gastric air was detected radiographically and sonographically. Gastric ulceration with a focal necrotic area was seen endoscopically. At surgery, the stomach wall was emphysematous. Clinical signs resolved following partial gastrectomy and medical management. Intramural gastric air with declining clinical course was a significant impetus to return to surgery.

Imaging diagnosis-heterobilharzia americana infection in a dog.

An approximately three-year-old mixed breed female dog was evaluated for peritoneal effusion, anorexia, intermittent vomiting, and diarrhea. Radiographically, there was mineralization of the wall of small intestinal segments. Sonographic findings were consistent with multisystemic mineralization of liver, small intestinal wall, and pancreas. Multifocal granulomas containing schistosome eggs (Heterobilharzia americana) were identified histologically. The mineralization pattern described herein is an uncommon presentation of severe diffuse heterobilharziasis in a dog.

Imaging diagnosis-synovial myxoma of lumbar vertebrae articular process joint.

Magnetic resonance (MR) imaging and histopathology were used to diagnose an articular process synovial myxoma in a dog. On MR images, the tumor was characterized by distortion of the left L1-L2 articular process, widening of the articular process joint, and the presence of a mass contiguous with the synovium of the articular process that displaced the spinal cord. The tumor was T2-hyperintense, T1-hypointense, relative to muscle, and had mild contrast enhancement. The MR features of articular process synovial myxoma may be distinct from other diseases of the articular process joint.

Imaging diagnosis--tracheobronchial zygomycosis in a cat.

Tracheobronchial zygomycosis is described in a cat with acute dyspnea. Zygomycetes are an uncommon opportunistic group of pathogens, and few examples have been described in feline patients. Radiographic, ultrasonographic, and computed tomography imaging allowed identification of tracheobronchial masses, with intraluminal and peribronchial involvement. Surgical removal was impossible and antifungal chemotherapy was ineffective. Feline zygomycosis is a serious condition that should be considered when tracheobronchial masses are identified.

Bilateral testicular germ cell-sex cord-stromal tumor in a pekin duck (Anas platyrhynchos domesticus).

An intact male white pekin duck (Anas platyrhynchos domesticus) was presented for examination because of respiratory distress and 2- to 3-month history of lameness and lethargy. Results of radiography, ultrasonography, and cytologic examination revealed a large neoplastic mass in the coelom. The duck was euthanatized, and results of necropsy revealed 2 large, lobulated masses in the coelom and a small nodule on the liver. Histopathologic examination of the large masses revealed a collision pattern testicular tumor consisting of Sertoli, seminoma, and interstitial cell components. The hepatic nodule was a metastatic lesion consistent with a Sertoli cell testicular tumor. This is the first reported case of a mixed germ cell-sex cord-stromal tumor in a duck.

Bilateral renal agenesis in an alpaca cria.

A 3-day-old male alpaca cria was presented for lack of vigor and failure to urinate since birth. Based on the history, laboratory data, ultrasonographs, surgical findings, and postmortem examination, the cria was diagnosed with bilateral renal agenesis and hypoplastic bladder, a congenital condition rarely seen in veterinary medicine.

Doppler ultrasonographic evaluation of gastrointestinal hemodynamics in food hypersensitivities: a canine model.

Chronic enteropathy due to food hypersensitivity is a common complaint in dogs and humans, and definitive diagnosis and identification of offending allergens remains challenging. Doppler waveform analysis of the celiac artery (CA) and the cranial mesenteric artery (CMA) of 8 dogs with proven food hypersensitivity was performed in the fasting state and at 20, 40, 60, and 90 minutes after feeding their regular daily diet, and at 2 and 4 days after feeding 4 different allergens. Resistive index (RI), pulsatility index (PI), and the percentage differences between these measurements were calculated and compared statistically. The maximal decrease in RI and PI after feeding the regular diet was reached at 40 minutes after ingestion in both vessels (CA: RI = -6%, PI = -23%; CMA: RI = -9%, PI = -30%). After this trough, the resistance in both vessels rose nearly to baseline after 90 minutes (CA: RI = -1%, PI = -13%; CMA: RI = -3%, PI = -14%). When fed an allergen-containing meal the percentage changes at the trough were significantly greater (CA: RI = -10%, PI = -32%; CMA: RI = - 14%, PI = -40 %; p < 0.05) compared to those seen after feeding the maintenance diet. Also, RI and PI values were significantly (P < .05) lower at 90 minutes on days 2 and 4 of the challenge period. During the challenge period, dogs did not show overt signs of gastrointestinal disease. Significant postprandial hemodynamic alterations in response to food allergens in dogs with food hypersensitivities can be shown noninvasively with Doppler ultrasound.

Orchitis in two dogs with Rocky Mountain spotted fever.

Two dogs with testicular swelling were sonographically diagnosed with orchitis and were subsequently diagnosed with Rocky Mountain spotted fever (RMSF). Use of both gray scale and color Doppler sonography allowed for differentiation of orchitis from neoplasia and torsion. While only experimentally induced RMSF is reported to cause orchitis in dogs, it should be considered in any dog with vascular insult to the testes, especially when other signs of systemic illness are involved.

Urinary bladder incarceration and infarction by an intra-abdominal fat pad in a Virginia opossum (Didelphis virginiana).

A 2.5-year-old, female opossum had acute stranguria. Based on radiography and ultrasonographic examination a cystic structure was identified in the caudal abdomen associated with bilateral hydroureter and hydronephrosis. This structure contained a neutrophilic fluid, determined to be urine. There was a neutrophilic leukocytosis. Serum chemistry values were within normal limits. The opossum was euthanized. An intra-abdominal fat pad incarceration of the urinary bladder above the trigone was present, resulting in complete obstruction of the urinary bladder and partial obstruction of the ureters. Vessels to the bladder were involved in the incarceration which resulted in vascular compromise and infarction of the bladder. Mild to moderate hydroureter and hydronephrosis were present.