A transconjunctival surgical technique for dacryocystotomy in dogs with foreign body-induced dacryocystitis.

PURPOSE: The purpose of this study is to describe a simplified, less invasive dacryocystotomy technique that allows for complete inspection of the canine lacrimal sac and to retrospectively evaluate this surgical technique in a larger series of dogs. The anatomical background of the canine nasolacrimal system is described as a basis for the surgical technique. METHODS: Records of dogs from 2003 to 2023 which were diagnosed with dacryocystitis due to presumed foreign body and underwent surgical exploration and removal of foreign bodies within the lacrimal sac using this technique were reviewed. Postoperative treatment and outcome were evaluated. RESULTS: Records of 48 dogs were included. A foreign body was discovered during the surgery or upon retrieval of the catheter in 85% of cases (41/48). An indwelling catheter was placed in 83% of cases (40/48) for a median of 21 days. At the last recheck, the nasolacrimal duct was patent in 87% of the cases (41/47). The median follow-up time was 34 days (3-1255 days). The most commonly affected breeds were Golden retrievers (11) and dachshunds (8). The following complications occurred: two dogs removed or partly removed the catheter themselves (day 7, day 14), and one dog showed marked irritation at the catheter site which had to be removed by day 10. CONCLUSIONS: The transconjunctival dacryocystotomy technique is simple and less invasive than other described techniques with a successful long-term outcome in the majority of cases.

Ultrasonographic findings may be useful for differentiating interdigital abscesses secondary to migrating grass awns and interdigital furunculosis in dogs.

Grass awn migration and furunculosis are common diseases in dogs that can lead to interdigital subcutaneous lesions with a similar clinical presentation, and occasionally similar ultrasonographic images, but different treatments are required. This retrospective, multicentric, analytical study aimed to determine whether epidemiological, clinical, and ultrasonographic features could be used to differentiate interdigital furunculosis and abscesses secondary to migrating grass awns. Fifty-nine dogs that underwent interdigital ultrasonography were included (interdigital furunculosis [IDF], n = 27; interdigital abscess secondary to a migrating grass awn [IAGA], n = 32). Ultrasonographic images were reviewed by two observers blinded to the diagnosis, who graded nine qualitative and four quantitative parameters for each patient. In both groups, pruritus/licking (IDF 74%, IAGA 70%), a discharging interdigital wound (63% for each group), and thoracic limb involvement (IDF 88%, IAGA 75%) were common features. On ultrasound, a subcutaneous multilinear hyperechoic main element was identified in most dogs (IDF 85%, IAGA 100%). The ability to display this element in a single plane (P < 0.01), the absence of additional hyperechoic linear elements in different planes (P < 0.01), and a surrounding hypoechoic halo (P < 0.05) were significantly more common in dogs with interdigital abscesses secondary to migrating grass awns. A cut-off value of 0.83 cm for the length of the main multilinear element provided a sensitivity of 91% and a specificity of 87% in the diagnosis of a migrating grass awn. Findings supported prioritizing a differential diagnosis of interdigital abscesses secondary to grass awns in dogs with these ultrasonographic characteristics.

CT can identify characteristic features of hypaxial muscle abscesses in dogs due to presumed migrating vegetal foreign material as well as additional changes along the migratory tract in other anatomic regions.

Hypaxial muscle abscess is an important differential in dogs presenting for abdominal or back pain, lameness, and nonspecific signs like fever, lethargy, and hyporexia. It can occur concurrently with intrathoracic disease such as pyothorax secondary to migrating vegetal foreign material. Twelve dogs that underwent CT of the lumbar spine or abdomen and had a diagnosed hypaxial abscess on surgical and/or microbiological examination were included in this retrospective, descriptive case series. Computed tomography findings and findings from other imaging modalities employed were described. Eleven dogs were hunting breeds. Clinical signs included lethargy, fever, increased respiratory effort, and abdominal or back pain. Radiography and/or ultrasonography were employed during preliminary work up at clinician discretion and respectively revealed changes consistent with osteomyelitis in the cranial lumbar vertebrae and heterogenous, hypoechoic areas in the hypaxial musculature consistent with abscesses. Computed tomography findings included enlargement of hypaxial muscles with well-defined fluid attenuating noncontrast enhancing areas with a contrast-enhancing rim consistent with abscesses, periosteal reaction and lysis of vertebrae, and retroperitoneal effusion. Four of the 12 cases in this series had material identified and removed at surgery. The other eight cases were presumed to be the same disease process based on compatible signalment, imaging findings, and microbiological results. Migrating vegetal foreign bodies are a common problem at the authors' institution. Computed tomography provided expedient, thorough visualization of the relevant hypaxial lesions for diagnostic and surgical planning purposes and also characterized intrathoracic components of this disease.

The localization of a conjunctivoscleral foreign body via high-resolution microscopy coil magnetic resonance imaging in a dog.

A 3-year-old French bulldog was presented to the ophthalmology service of the Vetsuisse Faculty, University of Zurich with a 3-day history of conjunctival swelling of the left eye (OS). Ophthalmologic examination revealed a moderate conjunctival hyperemia and chemosis. A migrating foreign body having entered the conjunctival fornix behind the nictitating membrane was suspected. Within the first 24 hours of medical management, OS developed a panuveitis and a scleral perforation was highly suspected. Ocular and orbital ultrasound as well as conventional magnetic resonance imaging (MRI) examinations failed to confirm the presence of a perforating foreign body. A High-Resolution MRI (HR-MRI) using a microscopy coil was then performed with findings consistent with a perforating and migrating foreign body. A grass awn of 12 mm length was surgically retrieved "ab externo" from its' point of entry into the sclera. To the best of our knowledge, HR-MRI has not yet been used to examine canine eyes. This case report supports the idea that orbital imaging can be greatly enhanced with the introduction of HR-MRI using microscopy coils with clinically relevant implications.

IMAGING DIAGNOSIS-URETHROVAGINAL FISTULA CAUSED BY A MIGRATING GRASS AWN IN THE VAGINA.

A young intact female dog was presented with urinary incontinence. Abdominal ultrasound revealed the presence of hyperechoic linear structures within the cranial vagina suggestive of foreign material. A computed tomography (CT) retrograde vaginourethrogram demonstrated the presence of a fistulous tract between the urethra and vagina. A presumptive diagnosis of urethrovaginal fistula due to migration of foreign material was made. The grass awn was removed with vaginoscopic-guided retrieval. Fourteen days later, surgical repair of the fistula and an ovariohysterectomy were done. This case report emphasizes the usefulness of CT for diagnosis and precise anatomical localization of genitourinary tract fistulas.

Imaging diagnosis--transesophageal ultrasound-guided removal of a migrating grass awn foreign body in a dog.

A 3-year-old English Setter dog was presented for an acute onset of coughing. Tracheobronchoscopic examination allowed localization and removal of one grass awn foreign body. A second migrated grass awn was suspected to be present in the left caudal lung lobe. Transesophageal ultrasound revealed an area of pulmonary consolidation in the dorsomedial portion of left caudal lobe and a linear hyperechoic structure consistent with a grass awn foreign body within the area of consolidation. Transesophageal ultrasonography was also used to provide anatomical landmarks that facilitated successful thoracoscopic removal of the foreign body.

Imaging diagnosis--extrahepatic biliary tract obstruction secondary to a biliary foreign body in a cat.

An 11-year-old, neutered female British Shorthair cat was referred with a 4-week history of abdominal pain and vomiting. Abdominal ultrasonography revealed a dilated common bile duct containing a spindle-shaped structure with several reflecting interfaces. Differentials that were considered included an intraluminal foreign body, or helminth parasites within the common bile duct. Surgical exploration of the abdominal cavity demonstrated the presence of two grass awns obstructing the common bile duct. Anomalies of the portal vasculature were noted during surgery and were considered an incidental finding. The clinical signs resolved following surgical removal of the grass awns.

Ionised hypercalcaemia in a cat with extrahepatic biliary tract obstruction secondary to a bile duct vegetal foreign body.

Case summary: A 10-year-old neutered female domestic shorthair cat was presented to our hospital with a 2-day history of anorexia, vomiting and lethargy. The biochemistry panel revealed increased hepatic enzyme activity and serum amyloid A concentration. Haematological values were within reference intervals. An abdominal ultrasound identified a hyperechoic spindle-shaped structure within the common bile duct and a suspected secondary subobstruction, associated with signs of intra- and extrahepatic biliary tract inflammation. During hospitalisation, the cat developed severe and sustained ionised hypercalcaemia. Exploratory surgery was elected as a result of the lack of clinical improvement, despite supportive treatment and suspected retrograde migration of the spindle-shaped structure. Two grass awns were extracted at the junction of an extrahepatic duct and the common bile duct via choledochotomy using intraoperative ultrasound guidance. A stent was then placed in the bile duct to prevent subsequent bile leakage. Histopathology of the liver revealed a moderate neutrophilic and lymphoplasmacytic inflammation with rare bacterial colonies. Escherichia coli was cultured from a bile sample. No specific cause of hypercalcaemia was identified. The cat recovered uneventfully from surgery. Hepatic enzyme activities and hypercalcaemia progressively decreased within a few weeks after surgery and remained within the reference intervals without treatment. Therefore, hypercalcaemia was suspected to be secondary to a foreign body-related granulomatous reaction. Relevance and novel information: To our knowledge, only one other feline case report of biliary tract obstruction secondary to a biliary foreign body has been described in the literature. This is also the first case reporting the use of intraoperative ultrasound to localise a vegetal foreign body within the biliary tract of a cat. This case is also unique because of the onset of hypercalcaemia suspected to be secondary to a foreign body-related granulomatous reaction.

Application of Ultrasound in Detecting and Removing Migrating Grass Awns in Dogs and Cats: A Systematic Review.

Migrating grass awns are an important cause of disease in dogs and cats. Plant awns can migrate into several body tissues and cavities because of their fusiform shape and backward-pointing barbs. Their migration causes inflammatory tissue reaction and clinical signs depend upon their localization. Ultrasound has been described as a useful, noninvasive, and readily available tool to identify and guide vegetal foreign bodies removal in animals. The aim of this systematic review was to summarize current knowledge on the application of ultrasonography in the identification and removal of grass awns from various anatomic locations in dogs and cats. We selected and analyzed 46 papers on the application of ultrasonography in dogs and cats affected by migrating grass awns. The ultrasonographic appearance of grass awns is characteristic, although their size and location can influence the visualization and the attempt of removal. In some cases, migrating grass awns are not directly visualized by ultrasonography, but the lesions caused by their migration can be easily seen. Ultrasonography can be considered a useful diagnostic tool to localize and remove migrating grass awns; however, when the migration occurs in less accessible locations or discrete foreign bodies are present, this diagnostic tool should be considered as a part of a multidisciplinary approach with advanced diagnostic imaging modalities.

Sublumbar grass awns in two cats: ultrasonographic features and ultrasound-guided retrieval.

CASE SERIES SUMMARY: Two adult cats were evaluated because of recurrent abscesses of the right lateral thoracoabdominal wall. The abscesses receded with antibiotics but relapsed shortly after therapy interruption. Ultrasonography identified fluid-filled lesions containing linear, hyperechoic material with distal acoustic shadowing in the sublumbar region of both cats. Ultrasound-guided retrieval of grass awns was performed in both cases, which resulted in complete clinical resolution. RELEVANCE AND NOVEL INFORMATION: While sublumbar abscesses in dogs are a relatively common disease, their occurrence in cats is much less common. To our knowledge, this is the first report describing the ultrasonographic features of sublumbar abscessation induced by foreign bodies and their ultrasound-guided retrieval in cats.

A specific laryngeal finding in dogs with bronchial vegetal foreign bodies: a retrospective study of 63 cases.

Grass awns commonly cause respiratory disease in dogs; when located in the trachea or bronchi, they cause severe bronchial inflammation and sepsis. The interplay of cough, bronchoconstriction, and mucus secretion can result in a less effective expulsive cough phase, especially when the causal factor persists. The bronchial exudate could consequently become trapped in the upper respiratory tracts of dogs with bronchial vegetal foreign bodies. We retrospectively reviewed endoscopic findings of the upper respiratory tract in dogs that underwent bronchoscopy in our hospital and correlated these findings with the presence of bronchial grass awns. Muco-purulent exudate in the ventral larynx region, between the vocal cords and laryngeal ventricles, was frequently associated with the presence of bronchial grass awns. This laryngeal finding could be secondary to an altered response to grass awn localization in the bronchi. These results should be carefully considered, particularly in countries where grass awns are commonly found.

Retroperitoneal Abscess Associated With a Migrating Grass Awn in a Cat: Treatment With Omentalization and Grass Awn Removal.

An 18-month-old domestic short hair male castrated cat presented with a history of fever of unknown origin of 1-year duration. Abdominal ultrasound revealed a mixed echogenicity mass. Cytological examination of the fluid obtained through fine needle aspiration was consistent with a retroperitoneal abscess. The cat underwent a midline celiotomy and the abscess was opened, lavaged, and omentalized. Antibiotics were also administered. Two months after surgery, the cat represented with a fluctuant swelling in the right flank region at the lumbodorsal triangle. Abdominal and mass ultrasound showed a mixed echogenicity swelling in the right flank. Under gas anesthesia, the swelling was surgically explored and a 0.4 cm long grass awn was found and removed. Telephone communication with the owners 6 months after surgery found the cat to be free of clinical signs.

Preoperative and intraoperative ultrasound aids removal of migrating plant material causing iliopsoas myositis via ventral midline laparotomy: a study of 22 dogs.

BACKGROUND: Migrating plant material is often suspected clinically to be the underlying cause of iliopsoas myositis in the dog, but cannot always be found pre- or intraoperatively. In most cases, recurrence of clinical signs is related to failure to remove the plant material. Preoperative ultrasonography can be useful to visualize migrating plant material and to determine anatomical landmarks that can assist in planning a surgical approach. The purpose of the present study was to report the role of intraoperative (intra-abdominal) ultrasonography for visualizing and removing the plant material from iliopsoas abscesses using a ventral midline laparotomy approach. RESULTS: A retrospective case series of 22 dogs with iliopsoas muscle abnormalities and suspected plant material was reported. Preoperative visualization and subsequent retrieval of the plant material was performed during a single hospitalization. In all 22 dogs, the plant material (including complete grass awns, grass awn fragments and a bramble twig) was successfully removed via ventral midline laparotomy in which intraoperative ultrasonography was used to direct the grasping forceps tips to the foreign body and guide its removal. In 11 of these 22 dogs, the plant material was not completely removed during prior surgery performed by the referring veterinarians without pre- or intraoperative ultrasonography. Clinical signs resolved in all dogs and all dogs resumed normal activity after successful surgical removal of the plant material. CONCLUSION: Intraoperative ultrasonography is a safe and readily available tool that improves success of surgical removal of plant material within the iliopsoas abscesses via ventral midline laparotomy. Moreover, ultrasonographic findings of unusual plant material can be useful in planning and guiding surgical removal, by providing information about the size and shape of the foreign body.

Penetrating palpebral grass awn in a dog: Unusual case of a penetrating grass awn in an eyelid.

An unusual case of a penetrating grass awn in an eyelid of a dog is reported. A 6-month-old mixed breed dog was referred to the Ophthalmology Unit of the Veterinary Teaching Hospital of Camerino University for anorexia, lethargy, left monolateral ocular swelling and pain to the left eye, present from 1 month. Ophthalmic examination of the left eye showed copious and purulent discharge, and ultrasonography revealed the presence of an abscess containing a grass foreign body. The grass awn was surgically removed. Three days after surgery, the dog showed a marked improvement, with a total resolution obtained in 7 days. To the authors' knowledge, penetrating foreign bodies such as the one of this paper have never been described before in literature.