RESUMO
OBJECTIVE: To describe the finding of the lung ultrasound (LUS) "wedge sign" in dogs with presumptive pulmonary thromboembolism (PTE). CASE SERIES SUMMARY: This case series describes 2 dogs with predisposing risk factors of (1) right transvenous pacemaker terminating in its right ventricle, severe protein-losing nephropathy, and glucocorticoid therapy, and (2) caval syndrome, each having the LUS "wedge sign" in upper lung regions, a sign consistent with pulmonary infarction and peripheral PTE. NEW OR UNIQUE INFORMATION PROVIDED: Historically, the diagnosis of canine PTE has been made through supportive findings because the gold standard test, computed tomography pulmonary angiography (CTPA), poses limitations. The use of LUS has shown promise in people for detecting PTE, with the advantages of availability, being radiation- and contrast medium-sparing, rapid (<90 s), point-of-care, real-time information. Our cases suggest a possible new first-line approach for suspecting canine PTE by using LUS and the finding of the "wedge sign" in nongravity-dependent caudodorsal and perihilar lung regions.
Assuntos
Doenças do Cão , Embolia Pulmonar , Animais , Angiografia por Tomografia Computadorizada/métodos , Doenças do Cão/diagnóstico por imagem , Cães , Glucocorticoides , Humanos , Pulmão/diagnóstico por imagem , Embolia Pulmonar/diagnóstico por imagem , Embolia Pulmonar/veterinária , Ultrassonografia/métodos , Ultrassonografia/veterináriaRESUMO
Objectives Subclinical bacteriuria (SB) is bacterial colonization of the urinary tract in the absence of clinical signs. The purposes of this study were to determine the prevalence of SB in cats and to describe results of the contemporaneous urinalysis. Secondarily, patient characteristics associated with SB were compared with those for cats without SB. Methods An electronic search identified all urine cultures performed on cats at a teaching hospital between 2009 and 2015. Results were subcategorized based on the presence or absence of lower urinary tract disease (LUTD) and SB-positive cases identified. The first control population was from samples without LUTD. The second control population was from all samples not identified as a SB-positive sample, including subclinical negative samples and those with LUTD. Five controls for each SB-positive sample were selected for both control groups. Medical records for all groups were reviewed. Results In all, 31/500 (6.2%) subclinical samples were positive. Most infections were a single organism (n = 27); four contained multiple organisms. Escherichia coli was the most common species (58%) followed by Enterococcus species (25%). Positive specimens were more likely to be from female cats (n = 24) vs male (n = 7; P = 0.0054). SB was strongly associated with bacteriuria (60% vs 6%; P <0.0001) and pyuria (67% vs 19%; P <0.0001). Positive specimens were significantly more likely to have an abnormal sediment examination (odds ratio 13.5, P <0.0001). When compared with all specimens including those with LUTD, SB was significantly associated with a lower urine specific gravity (1.022 vs 1.030; P = 0.0256) and presence of chronic kidney disease (68% vs 46%; P = 0.0168). Conclusions and relevance In this study, SB appears to be uncommon in cats and, in most cases, is associated with an abnormal urine sediment examination. Based on this study, there is little indication to perform a culture in a cat with no clinical signs of LUTD and an unremarkable sediment examination.