Computed tomographic findings in 205 dogs with clinical signs compatible with middle ear disease: a retrospective study.

BACKGROUND: Computed tomography (CT) is considered to be the reference method to evaluate middle ear structures. OBJECTIVES: To evaluate the presence and severity of CT changes in the middle ear and establish if any specific clinical presentations are associated with otitis media. ANIMALS: Medical records of animals referred for CT with history and clinical signs consistent with middle ear disease. METHODS: Retrospective evaluation of CT examinations of tympanic bullae performed over a six year period. Medical records were reviewed for signalment, clinical signs and cytological evaluation of the external ear canal. Dogs were divided into three clinical groups: chronic otitis externa (Group 1), peripheral vestibular disorder (Group 2) and other clinical presentations (Group 3). RESULTS: Group 1 - Of 214 ears, 87 (40.7%) had CT abnormalities: 38 of 87 (17.7%) had material-filled bullae, 42 of 87 (19.6%) had thickened bullae walls and seven of 87 (3.2%) had lysis of the bulla. Abnormalities were significantly more frequent in dogs with suppurative otitis than in erythemato-ceruminous otitis (57% and 23%, respectively; P = 0.003). Proliferative otitis, particularly in French bulldogs, was associated with severe otitis media. Group 2 - Of the 106 ears, 91 (85.8%) had normal tympanic bullae. Group 3 - Of the 26 ears from deaf dogs, 17 had filled bullae; all nine affected dogs were Cavalier King Charles spaniels. All dogs with Claude Bernard Horner syndrome or head tilt had normal tympanic bullae. CLINICAL SIGNIFICANCE: CT is useful for canine chronic otitis externa, particularly in suppurative or proliferative otitis, even in the absence of associated neurological signs.

Bone scintigraphy for the diagnosis of an abnormal medial coronoid process in dogs.

Few reports have been published regarding the use of scintigraphy in the diagnosis of elbow joint lameness in dogs. Some authors have speculated about the potential use of bone scintigraphy and its suspected high sensitivity for the early diagnosis of abnormalities of the medial coronoid process (MCP) in dogs. Scintigraphy is used routinely in our institution in dogs presented for thoracic limb lameness and/or suspected of abnormalities of the MCP when radiographic findings were equivocal. Radiographic, scintigraphic, and surgical findings of the elbow joints of 17 dogs with elbow joint lameness were compared with radiographic, scintigraphic, and necropsy findings of the elbow joints of 12 clinically healthy Labrador Retrievers. Quantitative evaluation of scintigraphic images was performed to determine relative radiopharmaceutical uptake in the region of the MCP. Maximum relative uptake of the coronoid process in the normal dogs was taken as a threshold value to classify elbows as positive or negative for an abnormal MCP after all 24 elbows of the 12 healthy dogs were confirmed as being normal at necropsy. All 17 elbows from lame dogs were positive on scintigraphy and confirmed as having chondromalacia, a fissure, or fragmentation of the MCP. Based on our results, bone scintigraphy may be a valuable diagnostic tool for the diagnosis of abnormalities of the MCP in dogs, and particularly in older dogs where clinical and radiographic changes may be ambiguous.

Computed tomography and low-field magnetic resonance imaging of the pituitary gland in dogs with pituitary-dependent hyperadrenocorticism: 11 cases (2001-2003).

OBJECTIVE: To compare the results of computed tomography (CT) and magnetic resonance imaging (MRI) of the pituitary gland in dogs with pituitary-dependent hyperadrenocorticism (PDH) caused by histologically confirmed pituitary adenoma. DESIGN: Retrospective case series. ANIMALS: 11 dogs with PDH that underwent transsphenoidal hypophysectomy. PROCEDURES: Medical records of dogs examined between January 2001 and March 2003 were reviewed. Dogs were included in this study if they had clinical signs of hypercortisolism at the time of admission (for which PDH was diagnosed) and underwent transsphenoidal hypophysectomy. Pre- and postcontrast CT and low-field MRI (0.2-Tesla magnet) were performed on the same day as surgery for each dog. RESULTS: An abnormal pituitary gland was found in 7 dogs by use of MRI and in the same 7 dogs by use of CT. Significant differences were found between postcontrast CT and MR images for height, width, and length of the pituitary gland; brain area; and thickness of the sphenoid bone. However, the pituitary gland height-to-brain area ratio determined from postcontrast CT and MR images was not significantly different. The signal-to-noise ratio and contrast-to-noise ratio of pre- and postcontrast MR images were significantly higher than those of the CT images. CONCLUSIONS AND CLINICAL RELEVANCE: Low-field MRI and dynamic CT imaging of the pituitary gland provided comparable information on the presence of pituitary adenomas in dogs with PDH.

Magnetic resonance imaging of the canine optic nerve.

We describe the magnetic resonance (MR) imaging aspects of normal canine optic nerve, the diameter of the optic nerve as measured on MR images, and optimal MR sequences for the evaluation of the optic nerve using a 0.2T MR unit. Three millimeter contiguous slides of the normal canine orbital region were acquired in transverse and dorsal oblique planes using a variety of tissue weighting sequences. It was apparent that detailed anatomic assessment of the optic nerve can be performed with low-field MR imaging, but none of the sequences provided unequivocal superior image quality of the optic nerve. The mean diameter of the optic nerve sheath complex was 3.7mm and of the optic nerve 1.7 mm. The intraorbital and intracanalicular parts of the optic nerve are consistently visible and differentiation between the optic nerve and optic nerve sheath complex is possible using low-field MR systems.

Validation of renal oxidative metabolism measurement by positron-emission tomography.

Either in research or in clinical practice, the exploration of renal oxidative metabolism is limited by the lack of noninvasive measurement. Positron-emission tomography using carbon-11 acetate may estimate tissue oxidative metabolism by measuring acetate turnover in the Krebs cycle. Although extensively studied in cardiology, this method has never been validated for renal oxidative metabolism measurement. The aim of this study is the validation of acetate turnover compared with the invasive renal oxygen consumption measurement. Renal oxygen consumption and tubular sodium reabsorption were measured invasively in 10 anesthetized pigs. Simultaneously, acetate turnover was estimated by the clearance of carbon-11 acetate in the renal cortex, after a 166-MBq injection of carbon-11 acetate. Renal oxidative metabolism was measured under various conditions induced by mechanical and pharmacological interventions. Renal oxygen consumption and acetate turnover varied on a wide range from 0.05 to 0.29 mmol min(-1) (>5-fold) and from 0.025 to 0.188 minutes(-1) (>7-fold), respectively. Acetate turnover was very significantly correlated with renal oxygen consumption (P<0.0001; R=0.82) and tubular sodium reabsorption (P=0.001; R=0.67). This study demonstrates that acetate turnover measures renal oxidative metabolism noninvasively and quantitatively, consistent with changes in tubular sodium reabsorption. This method may be applied to assess oxidative metabolism in animal models and in humans.

Assessment of ultrasonography and computed tomography for the evaluation of unilateral orbital disease in dogs.

OBJECTIVE: To describe clinical, ultrasonographic, and computed tomographic (CT) features of confirmed neoplastic and nonneoplastic disease in dogs with unilateral orbital diseases, determine criteria to differentiate between the 2 conditions, and assess the relative value of ultrasonography and CT for the differential diagnosis of these 2 conditions. DESIGN: Prospective study. ANIMALS: 29 dogs with unilateral neoplastic orbital disease and 16 dogs with unilateral nonneoplastic orbital disease. PROCEDURES: Clinical history and results of physical and ophthalmologic examinations were recorded. Ultrasonographic and CT images were evaluated, and discriminating factors were identified to differentiate neoplastic from nonneoplastic diseases. Diagnostic value of ultrasonography and CT was assessed. RESULTS: Dogs with neoplastic disease were significantly older; had clinical signs for a longer time before initial examination; had more progressive onset of clinical signs; and more frequently had protrusion of the nictitating membrane, fever, and anorexia. The most discriminating factor for both imaging modalities was delineation of the margins (odds ratio was 41.7 for ultrasonography and 45 for CT), with neoplastic lesions clearly delineated more often. Ultrasonographically, neoplastic lesions were more frequently hypoechoic and homogeneous, with indentation of the globe and bone involvement evident more frequently than for nonneoplastic lesions. Mineralization was detected only with neoplasia. Fluctuant fluid was seen more frequently in dogs with nonneoplastic disease. Computed tomography more frequently revealed extraorbital involvement. Diagnostic value was similar for both imaging modalities. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasonography and CT are valuable imaging modalities to assist in differentiating neoplastic from nonneoplastic unilateral orbital disease in dogs.

Effect of four sedative and anesthetic protocols on quantitative thyroid scintigraphy in euthyroid cats.

OBJECTIVES: To determine the effect of sedation and anesthesia on thyroid and salivary gland uptake of technetium Tc 99m pertechnetate ((99m)TcO(4)) in euthyroid cats. ANIMALS: 6 euthyroid cats. PROCEDURES: Thyroid scintigraphy was performed by use of a high-resolution low-energy parallel-hole collimator after IV injection of 117 to 133 MBq (3.16 to 3.59 mCi) of (99m)TcO(4)(-). The procedure was performed 4 times on each cat during different sedative and anesthetic protocols in a rotating schedule as follows: propofol, ketamine-midazolam-atropine, ketaminemidazolam, and medetomidine. Regions of interest were drawn around thyroid and salivary glands and counts corrected for background and decay. Percentage of (99m)TcO(4)(-) uptake in salivary and thyroid glands and thyroid-to-salivary gland (99m)TcO(4)(-) uptake ratio were calculated at 20 and 40 minutes. Relative effects of anesthesia and sedation on salivary and thyroid gland (99m)TcO(4)(-) uptake were compared. RESULTS: Significant differences among sedativeanesthetic protocols were found for thyroid gland (99m)TcO(4)(-) uptake, salivary gland (99m)TcO(4)(-) uptake, and thyroid-to-salivary gland (99m)TcO(4)(-) uptake ratio. Thyroid gland (99m)TcO(4)(-) uptake for the ketamine-midazolam protocol at 20 and 40 minutes after (99m)TcO(4)(-) administration was significantly higher than for the propofol protocol. A significant difference in salivary gland(99m) TcO(4)(-) uptake was found between ketamine-midazolam and ketamine-midazolam-atropine protocols at 40 minutes. The thyroid-to-salivary gland (99m)TcO(4)(-) uptake ratio for the ketamine-midazolam protocol was significantly higher at 40 minutes than for propofol or ketamine-midazolam-atropine protocols. CONCLUSIONS AND CLINICAL RELEVANCE: Sedation and anesthesia have a significant effect on thyroid and salivary gland (99m)TcO(4) uptake in euthyroid cats that may interfere with thyroid scintigraphic image interpretation.

Iohexol plasma clearance in healthy dogs and cats.

Iohexol plasma clearance as a measure of glomerular filtration was determined in 31 dogs and 19 cats after an intravenous (i.v.) bolus injection. All animals were healthy and privately owned. Serial blood samples were taken before and up to 4 h after tracer injection. Iohexol plasma concentration was determined using X-ray fluorescence. A plasma tracer elimination curve was generated and clearance was calculated by dividing the injected dose by the area under the curve estimated using a two-compartment pharmacological model. Clearance was normalized to body weight (BW), body surface area (BSA), and extracellular fluid volume (ECFV). Mean, SD, and coefficient of variation of plasma clearance, before and after normalization, were calculated. Linear regression analyses were performed between body size and normalized plasma clearances. No significant linear relation was found between BSA and clearance normalized to BSA in dogs, and between BSA, BW, ECFV and clearance normalized to BSA, BW, and ECFV in cats. The optimal method for normalization of iohexol plasma clearance in dogs was by using BSA. In cats, all three methods tested were considered satisfactory. Normalization to BSA appears to be superior to normalization to BW and ECFV in dogs, and can be recommended for clinical use.

Simplified methods for estimation of plasma clearance of iohexol in dogs and cats.

The purpose of this study was to evaluate simplified methods for iohexol plasma clearance estimation in dogs and cats. Serial blood samples were taken before and 5, 20, 40, 60, 80, 100, 120, 150, 180, and 240 minutes after a bolus injection of iohexol in 51 dogs and 25 cats. Iohexol plasma concentration was determined with X-ray fluorescence. Clearance was calculated by dividing the injected dose by the area under the plasma tracer elimination curve estimated with a 2-compartment pharmacologic model. Clearance was normalized to body surface area (BSA). The 10-point clearance was used as a reference for the evaluation of simplified methods. A 2-sample method based on a single exponential fit and a single-sample method based on a linear quadratic model were investigated. Simplified methods were evaluated by calculating the standard deviation of the difference (SDD) between the clearances obtained with the simplified methods and the 10-point reference method. All combinations of sampling times were evaluated. The best sampling times were chosen for dogs and cats as the ones yielding the lowest SDD. Linear regression analysis was performed between the reference method and the optimized simplified methods. The best combination of time for the 2-sample method was 5 and 120 minutes in dogs and 20 and 180 minutes in cats. The best time for sampling in the single-sample method was 120 minutes in dogs and 80 minutes in cats. Plasma clearance of iohexol can be estimated in dogs and cats from 1 or 2 blood samples with a reasonable margin of error.

Determination of extrarenal plasma clearance and hepatic uptake of technetium-99m-mercaptoacetyltriglycine in cats.

OBJECTIVE: To determine maximum extrarenal plasma clearance of technetium-99m-mercaptoacetyltriglycine (99mTc-MAG3) and maximum extrarenal hepatic uptake of 99mTc-MAG3 in cats. ANIMALS: 6 clinically normal adult cats. PROCEDURES: Simultaneously, baseline plasma clearance and camera-based uptake of 99mTc-MAG3 were determined in anesthetized cats. Double exponential curves were fitted to plasma clearance data. Injected dose was divided by area under the curve and body weight to determine 99mTc-MAG3 clearance. Regions of interest were drawn around kidneys and liver, and percentage dose uptake was determined 1 to 3 minutes after injection. After bilateral nephrectomy, simultaneous extrarenal plasma clearance and camera-based hepatic uptake of 99mTc-MAG3 were evaluated in each cat. RESULTS: Mean +/- SD baseline plasma clearance and extrarenal clearance were 5.29 +/- 0.77 and 0.84 +/- 0.47 mL/min/kg, respectively. Mean extrarenal clearance (as a percentage of baseline plasma clearance) was 16.06 +/- 7.64%. For right, left, and both kidneys, mean percentage dose uptake was 9.42 +/- 2.58, 9.37 +/- 0.86, and 18.79 +/- 2.47%, respectively. Mean hepatic percentage dose uptake before and after nephrectomy was 12.95 +/- 0.93 and 21.47 +/- 2.00%, respectively. Mean percentage change of hepatic uptake after nephrectomy was 166.89 +/- 23.19%. CONCLUSIONS AND CLINICAL RELEVANCE: In cats, extrarenal clearance of 99mTc-MAG3 is higher than that of other species; therefore, 99mTc-MAG3 is not useful for estimation of renal function in felids. Evaluation of renal function in cats may be more accurate via camera-based versus plasma clearance-based methods because camera-based studies can discriminate specific organs.

Ureteral fibroepithelial polyps in four dogs.

Four dogs with ureteral fibroepithelial polyps, ranging from 9-12 years of age, are presented in this report. The patients presented with urinary incontinence, urinary tract infection, and/or polydypsia and pollakiuria. All dogs were intact at the time of diagnosis or for the majority of their lives and three were male. Various diagnostic procedures were performed including ultrasonography, contrast radiography, and nuclear scintigraphy. Not all procedures were performed in all patients. Findings included ureteral dilation proximal to the level of an intraluminal mass and ipsilateral hydronephrosis. Unilateral ureteronephrectomy was performed in three dogs with masses in the proximal ureter; ureteral resection and anastamosis was performed in the remaining patient with a mass located in the distal ureter. The same pathologist (RAP) reviewed all four lesions. The lesions appeared polypoid and were attached to the ureteral wall by a thin stalk. Histopathologically, they contained a superficial layer of well-differentiated transitional epithelial cells overlying a prominent fibrovascular stroma with a mild (three dogs) or marked (one dog) degree of lymphoplasmacytic inflammation. This disease may represent a benign neoplasm or a chronic inflammatory reaction and has a good prognosis with surgical removal. Its histopathological characteristics, higher incidence in males, and location more commonly within the upper third of the ureter is remarkably similar to the disease in humans.

Dynamic renal blood flow measurement by positron emission tomography in patients with CRF.

BACKGROUND: Positron emission tomography (PET) is a functional imaging device that allows dynamic regional blood flow measurements. We performed a study to test whether PET could detect acute changes in renal blood flow (RBF) in patients with chronic renal failure (CRF). METHODS: RBF was measured by means of PET (PET-RBF) using oxygen 15-labeled water (H2(15)O) in eight men with hypertension and moderate CRF before and 5, 40, 80, and 120 minutes after the injection of quinaprilat (10 mg intravenously). Effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) were measured simultaneously by para-aminohippuric acid (PAH-ERPF) and inulin clearances before and 20, 60, 100, and 140 minutes after quinaprilat injection. RESULTS: Baseline RBF and ERPF were decreased in all patients (221 +/- 20 mL/min/100 g and 225 +/- 38 mL/min/1.73 m2, respectively). PET-RBF increased significantly after quinaprilat injection (+15%, +26%, +19%, and +23% versus baseline; P < 0.003). PAH-ERPF did not increase significantly (-6%, +12%, +20%, and +15% versus baseline; P = 0.15). GFR (50.1 +/- 8.9 mL/min/1.73 m2 at baseline) did not change significantly after quinaprilat injection; however, filtration fraction (GFR-ERPF ratio) decreased significantly from 0.23% +/- 0.02% to 0.20% +/- 0.02% (P = 0.0004). Mean arterial pressure decreased significantly after quinaprilat injection (P < 0.005). CONCLUSION: This study dynamically measured RBF by means of PET in patients with CRF for the first time. It showed that RBF rapidly increased after quinaprilat injection. PET using H2(15)O is a powerful method for the noninvasive measurement of dynamic changes in RBF that remain undetected by PAH clearance.