Accuracy of the modified vertebral heart score and the cardio-vertebral ratio for radiographic evaluation of cardiomegaly in ferrets.

Thoracic radiography is commonly used to assess the size of the heart and diagnose cardiac disease in ferrets. Several standardized radiographic heart size indicators have been introduced in this species and values in healthy ferrets have been reported. To date, none of these indicators has been tested in ferrets with cardiac disease. The aim of this prospective and retrospective, analytical observational design study was to assess the accuracy of the modified vertebral heart score (mVHS) and the cardio-vertebral ratio (CVR) in the radiographic detection of cardiomegaly in ferrets. Thoracic radiographs of 24 ferrets with confirmed heart diseases, 22 ferrets with non-cardiac diseases and normal-sized hearts on echocardiogram, and 24 healthy ferrets were mixed and examined by three independent and blinded radiologists who measured mVHS and CVR in right lateral (RL) and ventrodorsal (VD) radiographs. For all readers, ferrets with cardiac disease had significantly higher mVHS and CVR than ferrets without cardiac disease on echocardiography. Optimal cut-points for predicting cardiac enlargement were 6.25 vertebrae and 7.25 vertebrae for RL-mVHS and VD-mVHS, and 1.58 and 1.80 for RL-CVR and VD-CVR, respectively. Using these cut-points, the accuracy was good for indicators measured in RL radiographs (92.9% for RL-mVHS; 91.4% for RL-CVR) and moderate for indicators measured in VD radiographs (88.6% for VD-mVHS; 85.7% for VD-CVR). Findings supported the use of mVHS and CVR for evaluating the size of the heart in diseased ferrets, with caution in values interpretation when pericardial fat prevents precise delineation of the cardiac silhouette contour especially on VD radiographs.

Analysis of a Laxity Index Database and Comparison with the Fédération Cynologique Internationale Grades of This Population.

OBJECTIVE: This study aimed to analyse the distribution of the laxity indices (LI) in a dog population, to compare the LI with the Fédération Cynologique Internationale (FCI) grades and to search for differences of LI between breeds. STUDY DESIGN: The database was composed of all dogs presented to the University Hospital of the Faculty of Veterinary Medicine in Ghent for obligatory hip screening between January 2016 and February 2019, and all patients presented to orthopaedic consultation between January 2017 and January 2019 for a complaint of hindlimb lameness, which underwent both a standard extended ventrodorsal radiograph of the hips and a stress radiograph revealing hip joint laxity. The latter was obtained by means of the Vezzoni-modified Badertscher distension device and the LI was calculated. For each dog of the population, the LI was then compared with the FCI grade. RESULTS: The LI values ranged between 0.15 and 1.04, with a mean of 0.46. The LI and the FCI grade increased together, and showed a moderate-to-good correlation. There was a highly significant overall difference in the mean value of LI per FCI grade group (p < 0.001). The mean LI of the Labrador Retrievers was slightly but significantly lower than the mean LI of the Golden Retrievers (p < 0.01). CONCLUSION: The LI calculated on a stress radiograph taken with the Vezzoni-modified Badertscher distension device shows a good correlation with the FCI grade assigned on a standard extended ventrodorsal projection. A wide range of passive hip joint laxity exists in dogs considered to be phenotypically normal based on the FCI grading method.

Technical Repeatability and Reproducibility of the Stress Radiographs Performed with the Vezzoni-Modified Badertscher Hip Distension Device.

OBJECTIVE: The aim of this study was to evaluate the repeatability and reproducibility of the radiographical stress technique using the Vezzoni-modified Badertscher distension device (VMBDD). MATERIALS AND METHODS: Stress radiographs of 10 dogs obtained with the VMBDD were performed consecutively by two different operators and then measured twice by a third veterinarian. The technical repeatability was first assessed individually for the two operators who took the stress radiographs, followed by the technical reproducibility. The obtained variances were used to calculate the 95% limits of agreement for the measurement repeatability, the technical repeatability and the technical reproducibility. RESULTS: Both the technical repeatability and reproducibility of the VMBDD technique were good, with the 95% limits of agreement of the measurement repeatability and technical repeatability equalling ± 0.07 overall, and the 95% limits of agreement of the technical reproducibility being ± 0.09. CLINICAL SIGNIFICANCE: These results, in combination with the previous results for the measurement of the laxity index, support the use of the VMBDD as a reliable in-house evaluation method to assess the hip joint by trained clinicians. For screening purposes, however, we suggest to limit the number of evaluators, to limit the variability.

Intra- and Inter-observer Variability of Measurements of the Laxity Index on Stress Radiographs Performed with the Vezzoni-Modified Badertscher Hip Distension Device.

OBJECTIVES: To describe and evaluate the accuracy, intra- and inter-observer variability of the laxity index (LI), used to quantify hip laxity on stress radiographs obtained with the Vezzoni-modified Badertscher distension device (VMBDD). METHODS: Stress radiographs of 10 dogs obtained with the VMBDD were measured three times by an experienced observer. Six participants with different backgrounds (two ECVDI residents, two PhD students, two veterinary assistants) followed a short presentation and performed subsequently the measurements four times in two separate sessions. The effect of self-learning, feedback and specialization on the accuracy of the measurements was assessed. RESULTS: While the intra- and inter-observer variability were in agreement with other studies, the results of the experienced observer indicated that the variability can be very low. Neither feedback nor self-learning improved the results. A high degree of experience in radiographic assessment was not necessary to perform the measurements correctly. CLINICAL SIGNIFICANCE: As the LI measurements were acceptable after a short presentation, they support the use of VMBDD for a complete and correct in-house evaluation of the hip joint by trained clinicians. However, we propose that, in the context of screening, measurements should be performed by a limited number of experienced examiners, to limit the impact of the inter-observer variability.

Intraobserver and interobserver agreement on the radiographical diagnosis of canine cranial cruciate ligament rupture.

Even though radiography is one of the most frequently used imaging techniques for orthopaedic disorders, it has been demonstrated that the interpretation can vary between assessors. As such, the purpose of this study was to examine the intraobserver and interobserver agreement and the influence of level of expertise on the interpretation of radiographs of the stifle in dogs with and without cranial cruciate ligament rupture (CCLR). Sixteen observers, divided in four groups according to their level of experience, evaluated 30 radiographs (15 cases with CCLR and 15 control stifles) twice. Each observer was asked to evaluate joint effusion, presence and location of degenerative joint disease, joint instability and whether CCLR was present or absent. Overall, intraobserver and interobserver agreement ranged from fair to almost perfect with a trend towards increased agreement for more experienced observers. Additionally, it was found that stifles that were classified with high agreement have either overt disease characteristics or no disease characteristics at all, in comparison to the ones that are classified with a low agreement. Overall, the agreement on radiographic interpretation of CCLR was high, which is important, as it is the basis of a correct diagnosis and treatment.

Comparison of Three Methods to Quantify Laxity in the Canine Hip Joint.

OBJECTIVES: Comparison of PennHIP and a novel method to diagnose hip laxity, called the Vezzoni modified Badertscher distension device technique. METHODS: In a total of 10 dogs, it was first assessed whether the distraction index (DI) from the PennHIP evaluation center could be reproduced by two individual observers. In the next two steps, the DI measurements made by the individual observers and the PennHIP evaluation center were compared with the laxity index (LI) measured on the Vezzoni modified Badertscher distension device view. Finally, the interobserver agreement of the DI, LI and Norberg angle was assessed and compared with classification criteria. RESULTS: The results were similar for the first three comparisons: there was no evidence for bias, the relation between DI and LI was linear and the variability was small. A comparison of the interobserver agreement showed that the measurement variability for the NA was substantial, while the reproducibility for the DI and LI was equal. CLINICAL SIGNIFICANCE: While the standard ventrodorsal hip extended radiograph is most commonly used for diagnosis and screening of canine hip dysplasia, it lacks sensitivity to diagnose laxity. To improve the identification of hip joint laxity, distraction-based radiographic techniques are helpful. The Vezzoni modified Badertscher distension device technique allows for a reliable in-house evaluation of canine hip joint laxity.

Association between ultrasonographic appearance of splenic parenchyma and cytology in cats.

Objectives The purpose of this study was to determine whether the presence of a splenic mass or a diffusely moth-eaten parenchyma on ultrasonographic scans could represent potential criteria of malignancy in the feline spleen. Methods Feline patients with ultrasonographic images and cytological analysis of the spleen obtained by fine-needle aspiration were retrospectively included in a multicentre study. Results One hundred and ninety-five cats met our inclusion criteria. There was a lack of agreement between the moth-eaten ultrasonographic appearance of the spleen and the presence of a malignant neoplasia on cytological analysis. The sensitivity and specificity of a moth-eaten parenchyma for predicting malignant neoplastic disease were 13.2% and 84.8%, respectively. The sensitivity and specificity of a splenic mass >1 cm for predicting malignant neoplastic disease were 21.0% and 94.7%, respectively. A marbled appearance of the splenic parenchyma was significantly more frequent among patients examined with a high-frequency transducer (11-18 MHz) than among those examined with a low-frequency transducer (6.6-10 MHz) (27.6% vs 11.1%, respectively; P = 0.004). Similarly, although not statistically significant, a moth-eaten parenchyma was more frequent in the high-frequency transducer group than in the low-frequency group (17.1% vs 8.9%, respectively; P = 0.09). Conclusions and relevance Based on our findings, a moth-eaten ultrasonographic appearance of the spleen in cats does not necessarily reflect a lymphoma or another malignant neoplastic process on cytological analysis. The presence of a splenic mass >1 cm on ultrasound is suggestive of malignancy in cats. Finally, the transducer frequency must be taken into account when assessing the splenic parenchyma, as a high-frequency transducer seems to improve the detection of a marbled or moth-eaten parenchyma.