Change over time and agreement between clinical markers of disease resolution in dogs with aspiration-induced lung injury.

BACKGROUND: There is a lack of consensus regarding which markers of disease resolution to prioritise when assessing treatment response in client-owned dogs with aspiration-induced lung injury. This study describes the change over time and the agreement between the clinical markers used to determine disease resolution. METHODS: Physical examination (PE), owner-reported clinical signs (CS-O), thoracic radiographs (TXR) scores and C-reactive protein (CRP) concentrations were determined at enrolment, after 24, 48 and 72 hours, and after 7, 14 and 28 days. RESULTS: PE scores were significantly improved at 48 hours, while CRP initially increased (24 hours) and then decreased (48 hours). PE, CS-O and CRP significantly improved earlier (7 days) than TXR (14 days). The median number of days to marker normalisation was 7, 9 and 14 for PE, CRP and CS-O, respectively. Marker agreement was excellent/very good at enrolment and fair/poor during disease recovery. LIMITATIONS: Analysis did not control for differences aetiology of aspiration or the lack of standardisation in treatment approach. CONCLUSIONS: PE was the earliest and most consistent marker indicating disease resolution. Serial CRP monitoring (72 hours) may provide an objective marker of early treatment response. Alongside PE normalisation, improvement in CS-O, CRP and TRX may assist in determining disease resolution and guide treatments, including limiting antibiotic exposure in dogs with aspiration-induced lung injury.

Reverse sneezing as a clinical manifestation of nasopharyngeal-oropharyngeal fistula in a dog.

A 6-year-old spayed female Labrador retriever was evaluated for a 3-month history of intermittent reverse sneezing and gagging episodes. Pertinent findings at evaluation included frequent reverse sneezing and non-productive retching. No pathology was visible on sedated oral examination. Contrast-enhanced computed tomography of the skull revealed a gas-filled defect within the left ventral aspect of the soft palate. A non-eroded defect was present in the left caudoventral nasopharyngeal wall on nasopharyngoscopy. Surgical exploration revealed a nasopharyngeal-oropharyngeal fistula within the left palatine tonsillar fossa. The dog had a witnessed oropharyngeal stick injury (OSI) 3 months previous in the location of the fistula. The OSI had been allowed to heal by secondary intention and was treated with an oral antibiotic and NSAID. However, the dog lacked characteristic signs of a chronic OSI such as nasal discharge or abscess formation. The defect in the soft palate was surgically debrided and closed, and the left palatine tonsil was excised. The dog recovered completely with cessation of reverse sneezing and retching episodes.

Éternuements inversés comme manifestation clinique d'une fistule oropharyngée-nasopharyngée chez un chien. Une femelle Labrador stérilisée âgée de 6 ans a été évaluée pour une histoire de 3 mois d'épisodes intermittents d'éternuements inversés et d'étouffements. Les résultats pertinents lors de l'évaluation comprenaient des éternuements inversés fréquents et des haut-le-coeur non productifs. Aucune pathologie n'était visible à l'examen oral sous sédation. La tomodensitométrie à contraste amélioré du crâne a révélé une imperfection remplie de gaz dans la face ventrale gauche du palais mou. Une imperfection non érodée était présente dans la paroi nasopharyngée caudo-ventrale gauche à la nasopharyngoscopie. L'exploration chirurgicale a révélé une fistule nasopharyngée-oropharyngée au sein de la fosse amygdalienne palatine gauche. Le chien a eu une blessure oropharyngée par une branche (OSI) il y a 3 mois à l'emplacement de la fistule. L'OSI avait été laissée à guérir par seconde intention et a été traitée avec un antibiotique oral et un AINS. Cependant, le chien ne présentait pas de signes caractéristiques d'une OSI chronique comme un écoulement nasal ou la formation d'abcès. Le défaut du palais mou a été chirurgicalement débridé et fermé, et l'amygdale palatine gauche a été excisée. Le chien s'est complètement rétabli avec l'arrêt des épisodes d'éternuements inversés et de haut-le-coeur.(Traduit par Dr Serge Messier).

A retrospective review of canine benign prostatic hyperplasia with and without prostatitis.

Benign prostatic hyperplasia (BPH) is the most common prostatic disorder in older intact male dogs, but despite its prevalence, there are inconsistencies in clinical diagnosis and treatment. Although prostate size was historically considered the hallmark feature of BPH in men, currently, there is only a weak correlation between prostate size and clinical severity. We performed a retrospective cohort study with the primary objective of assessing clinical signs, ultrasonographic findings, treatments, and outcomes in dogs diagnosed with BPH, with and without concurrent prostatitis. We reviewed medical records and obtained data on presenting signs, prostatic imaging, and prevalence of concurrent bacteriuria. Prostate size was determined by ultrasonography and compared to the calculated expected size based on patient age and weight. Treatment and outcome were described for the cases with a minimum 2 months follow-up. Median age of dogs diagnosed with BPH was 8 years. Clinical signs were present in 16/25 dogs and scored as mild to moderate (median Zambelli's Symptom Index for BPH score 12). The median prostatic volume to body mass ratio was 1.60 mm3/kg. Prostate size did not correlate with the symptom severity. Concurrent bacteriuria was confirmed in 4/25 cases via bacterial culture and/or cytology. Treatments pursued and responses were only available in a subpopulation of dogs (n = 9) and were highly variable. Studies are needed to determine if current treatment options for BPH in dogs resolve associated clinical signs in addition to reducing prostate size.

Computed tomographic assessment of brain tissue disruption and skull damage in equine cadaveric heads caused by various firearm-ammunition combinations applied as potential gunshot methods for euthanasia of horses.

OBJECTIVE: To evaluate with CT the characteristics of brain tissue disruption and skull damage in cadaveric heads of adult horses caused by each of 6 firearm-ammunition combinations applied at a novel anatomic aiming point. SAMPLE: 53 equine cadaveric heads. PROCEDURES: Heads placed to simulate that of a standing horse were shot with 1 of 6 firearm-ammunition combinations applied at an aiming point along the external sagittal crest of the head where the 2 temporalis muscles form an inverted V. Firearm-ammunition combinations investigated included a .22-caliber long rifle pistol firing a 40-grain, plated lead, solid-core or hollow-point bullet (HPB); a semiautomatic 9-mm pistol firing a 115-grain, jacketed HPB; a semiautomatic .223-caliber carbine firing a 55-grain, jacketed HPB; a semiautomatic .45-caliber automatic Colt pistol firing a 230-grain, jacketed HPB; and a 12-gauge shotgun firing a 1-oz rifled slug. Additional heads placed in a simulated laterally recumbent position were shot with the semiautomatic 9-mm pistol-HPB combination. All heads underwent CT before and after being shot, and images were evaluated for projectile fragmentation, skull fracture, and cerebrum, cerebellum, and brainstem disruption. RESULTS: Computed tomography revealed that all firearm-ammunition combinations caused disruption of the cerebrum, cerebellum, and brainstem that appeared sufficient to result in instantaneous death of a live horse. Hollow-point ammunition was as effective as solid-core ammunition with regard to brain tissue disruption. Brain tissue disruption was not affected by head positioning. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the examined firearm-ammunition combinations, when applied at a novel aiming point, appear to be reasonable options for euthanasia of horses.

Biological Behavior of Canine Acanthomatous Ameloblastoma Assessed With Computed Tomography and Histopathology: A Comparative Study.

Canine acanthomatous ameloblastoma (CAA) appears to have variable biological behavior with some tumors presenting with slow growth and minimal bone loss while others grow rapidly and cause severe cancellous and cortical bone destruction. The primary aim of the study is to elucidate if variations (grades) of CAA can be identified based on both histological and diagnostic imaging indices, and to compare markers of more aggressive behavior between these 2 commonly used diagnostic tools. This study evaluated 45 cases of CAA and confirmed that there is high degree of variability in tumor invasiveness as measured with computed tomography, with predominantly intraosseous tumors being significantly associated with more invasive behavior. However, the analysis also identified that there was very little correlation between computed tomographic and histological appearance of the tumor. CAA tends to have a highly uniform and predictable histological pattern, with tumors that aggressively invade bone (as seen on CT) not showing features of atypia that might be helpful in predicting the biological behavior of the neoplastic cells. Thus, reliance on diagnostic imaging as a measure of biological behavior is recommended for treatment planning as well as possible creation of a variant/grading scheme. Prospective studies are required to evaluate if differing variants of CAA as based on diagnostic imaging should be treated differently, and how this would affect long term clinical outcome.

DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS WITH SECONDARY DYSPHAGIA IN A BLACK-HANDED SPIDER MONKEY (ATELES GEOFFROYI).

A 32-yr-old male black-handed spider monkey (Ateles geoffroyi) with marked kyphosis and reduced spinal range of motion developed intermittent regurgitation, which was managed with an acid reducer. Diffuse idiopathic skeletal hyperostosis (DISH) was suspected in this animal due to radiographically evident ossification of the anterior longitudinal ligament. At repeat radiographic evaluation 1.5 yr later, due to weight loss and increased frequency of regurgitation, the cervical spine was deviated ventrally and appeared to be impinging on the thoracic inlet. The spider monkey was humanely euthanized due to poor prognosis, and the presumptive diagnosis of DISH was confirmed via postmortem computed tomography and necropsy. DISH has not been reported in black-handed spider monkeys, and secondary dysphagia, an uncommon but recognized consequence in humans, has not been reported in a nonhuman primate. Earlier recognition of this possibly underreported disease process may increase treatment options and effectiveness of intervention.

Comparison of T1wFLAIR and T1wTSE sequences in imaging the brain of small animals using high-field MRI.

BACKGROUND: T1w turbo spin echo (TSE) represents a fundamental sequence in magnetic resonance imaging (MRI) protocols investigating the brain. Recent human literature has reported T1w Fluid Attenuated Inversion Recovery's (FLAIR's), superiority to T1wTSE in relation to tissue contrast for grey-to-white matter (GM-WM) and lesion-to-WM, although conflicting results are reported concerning lesion detection.To the author's knowledge, T1wFLAIR has not been investigated in veterinary medicine. The aim of this prospective study was to determine quantitatively and qualitatively which sequence provides better overall better image quality both pre- and post-gadolinium. RESULTS: Twenty-eight animals underwent MRI of the brain with T1wTSE and T1wFLAIR sequences performed with equivalent mean acquisition times. Quantitative assessment of the sequences was undertaken using contrast-to-noise (CNR) and signal-to-noise (SNR) ratios from predefined locations. T1wFLAIR provided a better CNR compared to T1wTSE, while T1wTSE provided better SNR due to the higher noise levels of T1wFLAIR images. Qualitative assessment of the sequences was performed using Visual Grading Analysis Scoring (VGAS) for a number of criteria by three observers on two separate occasions. T1wFLAIR performed better for cerebrospinal fluid (CSF) suppression, white-to-grey matter (WM-GM) and white matter-to-CSF (WM-to-CSF) definition in both pre- and post-contrast images whereas the T1wTSE sequence was less affected by noise levels. The individual parameter for overall image quality found no significant difference between the two sequences. However, the composite VGAS favored T1wFLAIR as the preferred sequence. Although case numbers were insufficient for statistical analysis, comparison of the sequences indicates that lesion definition and margination was better in T1wFLAIR pre-contrast images, however post-contrast lesion detection was almost equivalent between sequences with slightly better margination in the T1wTSE sequence. CONCLUSIONS: T1wFLAIR provides better CNR with better WM-GM and WM-CSF definition both pre- and post-contrast compared to T1wTSE albeit with a higher degree of noise; this was confirmed both quantitatively and qualitatively. Our results also suggest that T1wFLAIR is better for lesion detection and margination pre-contrast administration and sequences are relatively equivocal post-gadolinium administration although further research is required to determine the benefit that inversion recovery sequences make when investigating brain lesions in small animal MRI.

Catheter occlusion of the dorsal sagittal sinus-confluens sinuum to enable resection of lateral occipital multilobular osteochondrosarcoma in two dogs.

CASE DESCRIPTION: A 6-year-old neutered male mixed-breed dog (dog 1) and 5-year-old neutered male Boston Terrier (dog 2) were evaluated because of lateralized multilobular osteochondrosarcoma (MLO) of the occiput. CLINICAL FINDINGS: Diagnostic imaging revealed proliferative bony occipital masses in both dogs and a nodule in the right caudal lung lobe of dog 1. For both dogs, MRI revealed intact flow through the dorsal sagittal sinus (DSS) into 1 transverse sinus. TREATMENT AND OUTCOME: In dog 1, a 4F balloon catheter was introduced into the DSS to the confluens sinuum (CS) and inflated over 16 hours to occlude venous flow. The mass with the CS was removed 24 hours later, and the skull was reconstructed. The dog was discharged from the hospital 2 days after surgery and survived 17 months before euthanasia because of metastasis. In dog 2, balloon catheter insertion into the DSS failed, and a 3.5F rubber catheter was placed up to the CS to occlude flow. The occiput with MLO was removed 48 hours after catheterization, and the skull was reconstructed. Dog 2 was discharged from the hospital after 3 days and was doing well 15 months later. CLINICAL RELEVANCE: Findings for these 2 dogs suggested that deliberate preoperative occlusion of the DSS and CS allows successful resection of occipital neoplasms across the midline. Without prior occlusion of the DSS, development of lethal cerebral edema would have been likely. Gradual balloon catheter occlusion of the CS may facilitate challenging occipital mass excisions.

Use of a platelet-rich plasma-collagen scaffold as a bioenhanced repair treatment for management of partial cruciate ligament rupture in dogs.

Dogs are commonly affected with cruciate ligament rupture (CR) and associated osteoarthritis (OA), and frequently develop a second contralateral CR. Platelet rich plasma (PRP) is a component of whole blood that contains numerous growth factors, which in combination with a collagen scaffold may act to promote bioenhanced primary repair of ligament. This study tested the hypothesis that treatment of partial stable CR stifles with an intra-articular collagen scaffold and PRP would decrease the disease progression, synovitis and risk of complete CR over a 12-month study period. We conducted a prospective cohort study of 29 client-owned dogs with an unstable stifle due to complete CR and stable contralateral stifle with partial CR. All dogs were treated with tibial plateau leveling osteotomy (TPLO) on the unstable stifle and a single intra-articular application of PRP-collagen in the stable partial CR stifle. Dogs were evaluated at the time of diagnosis, and at 10-weeks and 12-months after treatment. We evaluated correlation between both development of complete CR and time to complete CR with diagnostic tests including bilateral stifle radiographs, 3.0 Tesla magnetic resonance (MR) imaging, and bilateral stifle arthroscopy. Additionally, histologic evaluation of synovial biopsies, C-reactive protein (CRP) concentrations in serum and synovial fluid, and synovial total nucleated cell count, were determined. Results indicated that a single application of PRP-collagen in partial CR stifles of client owned dogs is not an effective disease-modifying therapy for the prevention of progression to complete CR. Radiographic effusion, arthroscopic evaluation of cranial cruciate ligament (CrCL) damage, and MR assessment of ligament fiber tearing in partial CR stifles correlated with progression to complete CR over the 12-month follow-up period. We determined that the best predictive model for development of complete CR in PRP-collagen treated partial CR stifles included variables from multiple diagnostic modalities.

Accuracy of 3 Tesla magnetic resonance imaging using detection of fiber loss and a visual analog scale for diagnosing partial and complete cranial cruciate ligament ruptures in dogs.

Canine cranial cruciate ligament rupture is often bilateral and asymmetrical, ranging from partial to complete rupture. The purpose of our diagnostic accuracy study was to assess the accuracy of 3 Tesla magnetic resonance imaging (MRI) detection of fiber loss and use of a visual analog scale in the diagnosis of complete versus partial cranial cruciate ligament rupture in 28 clinical dogs with unilateral complete rupture and contralateral partial rupture. Three Tesla MRI was performed on 56 stifles using sagittal sequences (T2-weighted fast spin echo with fat saturation, proton density fast spin echo, and T2-weighted 3D fast spin echo CUBE). Two MRI observers assessed the cranial cruciate ligament for fiber loss and completed a visual analog scale. The MRI data were compared to arthroscopy and clinical status. Accuracy classifying partial or complete rupture was assessed using receiver operating characteristic analysis. Compared to arthroscopy, for complete cranial cruciate ligament rupture, sensitivity, specificity, and accuracy of MRI detection of fiber loss were 0.78, 0.50-0.60, and 0.68-0.71, respectively, and, for partial tears, specificity was 1.00. An MRI visual analog scale score ≥79 was indicative of complete cranial cruciate ligament rupture (sensitivity 0.72-0.94 and specificity 0.71-0.84). Using a visual analog scale cut-point ≥79, observers achieved good accuracy discriminating clinical status of partial or complete cranial cruciate ligament rupture (area under the curve 0.87-0.93). MRI evaluation for fiber loss and use of a visual analog scale are specific in stifles with clinically stable partial cranial cruciate ligament rupture. In stifles with clinically unstable complete cranial cruciate ligament rupture, both MRI tests are sensitive though not specific compared to arthroscopy. As a diagnostic imaging method, MRI may help guide treatment in patients with cranial cruciate ligament damage, particularly for stable partial rupture.

Radiographic and magnetic resonance imaging predicts severity of cruciate ligament fiber damage and synovitis in dogs with cranial cruciate ligament rupture.

Cruciate ligament rupture (CR) and associated osteoarthritis (OA) is a common condition in dogs. Dogs frequently develop a second contralateral CR. This study tested the hypothesis that the degree of stifle synovitis and cranial cruciate ligament (CrCL) matrix damage in dogs with CR is correlated with non-invasive diagnostic tests, including magnetic resonance (MR) imaging. We conducted a prospective cohort study of 29 client-owned dogs with an unstable stifle due to complete CR and stable contralateral stifle with partial CR. We evaluated correlation of stifle synovitis and CrCL fiber damage with diagnostic tests including bilateral stifle radiographs, 3.0 Tesla MR imaging, and bilateral stifle arthroscopy. Histologic grading and immunohistochemical staining for CD3+ T lymphocytes, TRAP+ activated macrophages and Factor VIII+ blood vessels in bilateral stifle synovial biopsies were also performed. Serum and synovial fluid concentrations of C-reactive protein (CRP) and carboxy-terminal telopeptide of type I collagen (ICTP), and synovial total nucleated cell count were determined. Synovitis was increased in complete CR stifles relative to partial CR stifles (P<0.0001), although total nucleated cell count in synovial fluid was increased in partial CR stifles (P<0.01). In partial CR stifles, we found that 3D Fast Spin Echo Cube CrCL signal intensity was correlated with histologic synovitis (SR = 0.50, P<0.01) and that radiographic OA was correlated with CrCL fiber damage assessed arthroscopically (SR = 0.61, P<0.001). Taken together, results of this study show that clinical diagnostic tests predict severity of stifle synovitis and cruciate ligament matrix damage in stable partial CR stifles. These data support use of client-owned dogs with unilateral complete CR and contralateral partial CR as a clinical trial model for investigation of disease-modifying therapy for partial CR.

COMPARISON OF TRANSVERSE COMPUTED TOMOGRAPHIC EXCRETORY UROGRAPHY IMAGES AND MAXIMUM INTENSITY PROJECTION IMAGES FOR DIAGNOSING ECTOPIC URETERS IN DOGS.

Computed tomographic maximum intensity projection (MIP) images have been shown to improve reader confidence in their diagnoses and to improve detection of vascular structures and pulmonary nodules. The objectives of this method comparison study were to compare transverse source computed tomographic excretory urography (CTEU) images to two, five, and 10 slab thick MIP images for diagnosing canine ectopic ureters, compare reader confidence, and evaluate interobserver agreement. Two board-certified veterinary radiologists and a board-certified small animal internist blindly reviewed transverse source CTEU and two, five, and 10 slab thick MIP images of 24 dogs enrolled in the study. Inclusion criteria included a diagnostic CTEU and either cystoscopic or surgical confirmation of the presence or absence of ureteral ectopia. Eleven dogs were confirmed to have 17 ectopic ureters at surgery and/or cystoscopically. There was no significant difference in reader diagnoses between viewing methods or between viewing methods and the surgical/cystoscopic findings (P < 0.001). Reader confidence was significantly greater on two (P = 0.0080) and five (P = 0.0009) slab thick MIP images with significant interobserver agreement between readers for all viewing methods (P values ranging between 0.0363 and <0.001). In addition, the diagnostic accuracy of MIP images was similar to or better than transverse source CTEU images, when assessed by a radiologist. The study results suggest that CTEU is a reliable imaging technique for diagnosing canine ectopic ureters among specialists of varied experience. In addition, thin slice reconstructed MIP images improve reader confidence and potentially diagnostic accuracy, and thus their use should be considered, especially in more challenging cases.

3D FSE Cube and VIPR-aTR 3.0 Tesla magnetic resonance imaging predicts canine cranial cruciate ligament structural properties.

Estimation of cranial cruciate ligament (CrCL) structural properties in client-owned dogs with incipient cruciate rupture would be advantageous. The objective of this study was to determine whether magnetic resonance imaging (MRI) measurement of normal CrCL volume in an ex-vivo canine model predicts structural properties. Stifles from eight dogs underwent 3.0 Tesla 3D MRI. CrCL volume and normalized median grayscale values were determined using 3D Fast Spin Echo (FSE) Cube and Vastly under-sampled Isotropic PRojection (VIPR)-alternative repetition time (aTR) sequences. Stifles were then mechanically tested. After joint laxity testing, CrCL structural properties were determined, including displacement at yield, yield load, load to failure, and stiffness. Yield load and load to failure (R(2)=0.56, P <0.01) were correlated with CrCL volume determined by VIPR-aTR. Yield load was also correlated with CrCL volume determined by 3D FSE Cube (R(2)=0.32, P <0.05). Structural properties were not related to median grayscale values. Joint laxity and CrCL stiffness were not related to MRI parameters, but displacement at yield load was related to CrCL volume for both sequences during testing (R(2)>0.57, P <0.005). In conclusion, 3D MRI offers a predictive method for estimating canine CrCL structural properties. 3D MRI may be useful for monitoring CrCL properties in clinical trials.

Use of computed tomography for measurement of kidneys in dogs without renal disease.

OBJECTIVE To determine the size of the left and right kidneys by use of CT in dogs of various breeds without evidence of renal disease. DESIGN Retrospective, observational study. ANIMALS 21 client-owned dogs. PROCEDURES Renal length, diameter of the abdominal aorta, and length of the L2 vertebral body were measured independently on multiplanar reformatted non-contrast-enhanced CT images by 3 observers at 3 time points. Intraobserver and interobserver agreement for renal length were determined. Associations of renal length with body weight, aorta diameter, and L2 vertebral body length were assessed by calculation of Pearson correlation coefficients and 95% confidence intervals. Renal measurements were normalized to patient size by calculating renal length-to-aorta diameter and renal length-to-L2 vertebral body length ratios for comparison with previously published radiographic and ultrasonographic measurements. RESULTS All kidneys were identified and measured on CT images by all observers. Intraobserver and interobserver agreement were excellent. Body weight, aorta diameter, and length of the L2 vertebral body were significantly correlated with renal length. Renal length-to-aorta diameter and renal length-to-L2 vertebral body length ratios (7.4 and 2.7, respectively) fell within the ranges of previously published values for these measurements. CONCLUSIONS AND CLINICAL RELEVANCE As CT becomes more widely available in general practice, knowledge of typical renal measurements and anatomic ratios obtained with this modality in dogs may be useful. A prospective study with a larger population of dogs, ideally including formulation of a reference range, is needed.

Acute resolution of pulmonary alveolar infiltrates in 10 dogs with pulmonary hypertension treated with sildenafil citrate: 2005-2014.

OBJECTIVE: To describe clinical canine patients with naturally occurring pulmonary hypertension and radiographic pulmonary alveolar infiltrates before and after treatment with sildenafil. ANIMALS: Ten client-owned dogs. METHODS: A retrospective analysis of dogs with echocardiographically-determined pulmonary hypertension and pulmonary alveolar infiltrates on thoracic radiographs was performed before (PRE) and after (POST) sildenafil therapy. Clinical scores, pulmonary alveolar infiltrate scores and tricuspid regurgitation gradients were analyzed PRE and POST sildenafil. RESULTS: Pulmonary alveolar infiltrates associated with pulmonary hypertension developed in a diffusely patchy distribution (10/10). Sixty percent of dogs had a suspected diagnosis of interstitial pulmonary fibrosis as the etiology of pulmonary hypertension. Median PRE clinical score was 4 (range: 3-4) compared to POST score of 0 (0-2) (p = 0.005). Median alveolar infiltrate score PRE was 10 (5-12) compared to POST score of 4 (0-6) (p = 0.006). Median tricuspid regurgitation gradient PRE was 83 mmHg (57-196) compared to 55 mmHg POST (33-151) (p = 0.002). CONCLUSIONS: A subset of dogs with moderate to severe pulmonary hypertension present with diffuse, patchy alveolar infiltrates consistent with non-cardiogenic pulmonary edema. The typical clinical presentation is acute dyspnea and syncope, often in conjunction with heart murmurs suggestive of valvular insufficiency. This constellation of signs may lead to an initial misdiagnosis of congestive heart failure or pneumonia; however, these dogs clinically and radiographically improve with the initiation of sildenafil.

Osseous-associated cervical spondylomyelopathy in dogs: 27 cases (2000-2012).

OBJECTIVE: To evaluate the signalment, neurologic examination and imaging findings, and outcome in dogs treated medically or surgically for osseous-associated cervical spondylomyelopathy (OACSM). DESIGN: Retrospective case series. ANIMALS: 27 client-owned dogs. PROCEDURES: Medical records for dogs with OACSM (diagnosis made in 2000 through 2012) were reviewed. Collected data included signalment, neurologic examination findings (graded from 0 [normal] to 5 [tetraplegia]), imaging findings, treatment, and outcome. From MRI and CT images, measurements were obtained for subjective grading of spinal cord compression. RESULTS: Among the 27 dogs, the median age was 2 years; there were 15 Great Danes, 3 Mastiffs, 3 Newfoundlands, and 6 other large-breed dogs. For medically treated dogs (n = 7), the median initial neurologic grade was 2; for surgically treated dogs (20), the median initial neurologic grade was 3. Magnetic resonance imaging revealed dorsolateral spinal cord compression in 22 dogs and lateral spinal cord compression in 5 dogs. Dogs with more severe compressions were slightly more likely to undergo surgical than medical treatment. Median survival time of medically treated dogs was 43 months, and that of surgically treated dogs was 60 months. Fifteen of 19 dogs treated surgically had improved neurologic grades at 4 to 8 weeks after surgery and had a good to excellent long-term outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Surgical treatment of dogs with OACSM resulted in neurologic improvement and was associated with a good long-term outcome. For dogs that received medical treatment, neurologic deterioration continued but some patients did well for several years.

Surgical management of vertebral synovial cysts in a rabbit (Oryctolagus cuniculus).

CASE DESCRIPTION: An approximately 8-month-old female Miniature Lop rabbit (Oryctolagus cuniculus) was evaluated because of an acute onset of progressive paraparesis. CLINICAL FINDINGS: The rabbit was ambulatory paraparetic, and results of neurologic examination were consistent with a myelopathy localizing to the T3-L3 spinal cord segments. Evaluation with CT myelography revealed focal extradural spinal cord compression bilaterally at the level of the articular process joints of T12-L1. TREATMENT AND OUTCOME: A Funkquist type A dorsal laminectomy was performed at T12-L1, and the vertebral column was stabilized with pins and polymethylmethacrylate-based cement. Multiple vertebral synovial cysts were confirmed on histologic evaluation of the surgically excised tissues. The rabbit was nonambulatory with severe paraparesis postoperatively and was ambulatory paraparetic at a recheck examination 7 weeks after surgery. Fourteen weeks after surgery, the rabbit appeared stronger; it walked and hopped slowly but still fell and dragged its hindquarters when moving faster. Thirty-seven weeks after surgery, the neurologic status was unchanged. CLINICAL RELEVANCE: Although thoracolumbar myelopathy in rabbits is commonly secondary to vertebral fracture, vertebral synovial cysts should be considered a differential diagnosis for rabbits with slowly progressive paraparesis. Decompressive surgery and stabilization can result in a good outcome for rabbits with this condition.

Imaging diagnosis-pulmonary-tracheobronchial prolapse in a new Caledonian giant gecko (Rhacodactylus leachianus).

A 3-year-old male New Caledonian giant gecko, or Leach's gecko (Rhacodactylus leachianus) presented with acute lethargy and coelomic distention. Findings from survey radiographs and an upper gastrointestinal tract contrast study were consistent with severe aerophagia, a collapsed left lung, and hyperinflation of the right lung due to suspected bronchial obstruction. The gecko was treated with conservative medical management, but was found dead 5 days after presentation. Necropsy findings showed intussusception of the proximal left lung into the left mainstem bronchus and trachea.

Episodic blindness and ataxia in a horse with cholesterinic granulomas.

An 11-year-old Oldenburg mare presented following three episodes of acute, transient blindness, ataxia, and disorientation within the preceding 7 months. Clinical improvement, including return of vision, occurred within 1 week of initiating corticosteroid therapy for each of the three episodes. However, mild right-sided miosis was a consistent finding on ophthalmic examinations. Routine clinicopathologic testing revealed no significant abnormalities, and testing of cerebral spinal fluid for selected infectious diseases was unrewarding. Computed tomography of the brain demonstrated a hyperattenuating mass with peripheral mineralization in the rostroventral aspect of each lateral ventricle. The mare was euthanized due to a guarded to poor prognosis. On histopathology, the masses consisted of clusters of cholesterol clefts admixed with leukocytes, mineral deposits, and connective tissue. Cholesterinic granulomas of the lateral ventricles and hydrocephaly were diagnosed. Cholesterinic granulomas should be considered a differential diagnosis in horses presenting for intermittent blindness.