Erector spinae plane block in dogs undergoing hemilaminectomy: A prospective randomized clinical trial.

OBJECTIVE: To compare the perioperative cumulative opioid consumption and the incidence of cardiovascular complications in dogs undergoing hemilaminectomy in which either an erector spinae plane (ESP) block or systemic opioids were administered. STUDY DESIGN: Prospective randomized clinical trial. ANIMALS: A total of 60 client-owned dogs. METHODS: Dogs were randomized to one of three groups: an ESP block (group ESP), a constant rate infusion of fentanyl (group FNT, positive control) or a single dose of methadone as premedication (group MTD, negative control). Intraoperative nociceptive response was treated with fentanyl [1 µg kg-1, intravenously (IV)] boli. Before closure of the surgical site, morphine (0.1 mg kg-1) was applied to the dura mater. The cumulative dose of opioids was recorded and compared between groups. The incidence of intraoperative bradycardia and/or hypotension and the time to extubation were compared between groups. The short form of the Glasgow Composite Pain Scale (SF-GCPS) was used to score nociception before anaesthetic induction and 1, 2, 6, 12,18 and 24 hours postoperatively. Methadone 0.2 mg kg-1 was administered IV if the SF-GCPS score was ≥ 5. RESULTS: Group MTD required more intraoperative rescue analgesia than groups ESP (p = 0.008) and FNT (p = 0.001). The total cumulative intraoperative dose of fentanyl was higher in groups FNT (p < 0.0001) and MTD (p = 0.002) than in group ESP. The incidence of cardiovascular complications was similar between groups. Extubation time was longer in group MTD (p = 0.03). Postoperatively, the time to first rescue analgesia was longer in group ESP than in group MTD (p = 0.03). The cumulative postoperative opioid consumption and pain scores were similar between groups. CONCLUSIONS AND CLINICAL RELEVANCE: The ESP block resulted in a reduced intraoperative opioid consumption compared with the control positive and negative groups.

Angiostrongylus vasorum infection in dogs from a cardiopulmonary dirofilariosis endemic area of Northwestern Italy: a case study and a retrospective data analysis.

BACKGROUND: In Italy, Angiostrongylus vasorum, an emergent parasite, is being diagnosed in dogs from areas considered free of infection so far. As clinical signs are multiple and common to other diseases, its diagnosis can be challenging. In particular, in areas where angiostrongylosis and dirofilariosis overlap, a misleading diagnosis of cardiopulmonary dirofilariosis might occur even on the basis of possible misleading outcomes from diagnostic kits. CASE PRESENTATION: Two Cavalier King Charles spaniel dogs from an Italian breeding in the Northwest were referred to a private veterinary hospital with respiratory signs. A cardiopulmonary dirofilariosis was diagnosed and the dogs treated with ivermectin, but one of them died. At necropsy, pulmonary oedema, enlargement of tracheo-bronchial lymphnodes and of cardiac right side were detected. Within the right ventricle lumen, adults of A. vasorum were found. All dogs from the same kennel were subjected to faecal examination by FLOTAC and Baermann's techniques to detect A. vasorum first stage larvae; blood analysis by Knott's for Dirofilaria immitis microfilariae, and antigenic tests for both A. vasorum (Angio Detect™) and D.immitis (DiroCHEK® Heartworm, Witness®Dirofilaria). The surviving dog with respiratory signs resulted positive for A. vasorum both at serum antigens and larval detection. Its Witness® test was low positive similarly to other four dogs from the same kennel, but false positive results due to cross reactions with A. vasorum were also considered. No dogs were found infected by A. vasorum. Eventually, the investigation was deepened by browsing the pathological database of Veterinary Pathology Laboratories at Veterinary School of Milan University through 1998-2016, where 11 cases of angiostrongylosis were described. Two out of 11 dogs had a mixed infection with Crenosoma vulpis. CONCLUSION: The study demonstrates the need for accurate surveys to acquire proper epidemiological data on A. vasorum infection in Northwestern Italy and for appropriate diagnostic methods. Veterinary clinicians should be warned about the occurrence of this canine parasite and the connected risk of a misleading diagnosis, particularly in areas endemic for cardiopulmonary dirofilariosis.

Endolymphatic sac tumor in an 8-month-old cat.

Background: The endolymphatic sac is an organ devoid of sensory receptors. It is connected with the endolymphatic compartment and contains endolymph. Endolymphatic sac tumor (ELST) is a rare neoplasm involving the middle and inner ear described in humans and dogs that does not show cellular characteristics of malignancy, but can be locally invasive and involve destruction of the temporal bone and adjacent structures. Case Description: An 8-month-old female cat was referred because of sudden onset of vestibular signs starting 3 days prior to referral. On clinical examination, the patient showed depression, right head tilt, left-sided facial paralysis, and horizontal nystagmus with fast phase to the left. The magnetic resonance images showed a voluminous extra-axial lesion, with irregular morphology and well-defined margins, with intracranial extension in the region of the pons, rostral medulla oblongata, cerebellar vermis, floccule, and left cerebellar hemisphere. Due to progressive clinical deterioration, the cat was euthanized 2 weeks later. A necropsy was then performed and histological samples were taken. The necropsy revealed the presence of a voluminous dark red irregular mass extending from the tympanic bulla to the posterior cranial fossa following the left glossopharyngeal nerve. The histopathological exam of the extra-axial lesion featured a nonencapsulated, moderately cellular, rather loose, proliferation of cuboidal to columnar epithelium breaching through chunks of an otherwise normal appearing dura mater and invading some cranial nerves. Sections of the cerebellum and brainstem revealed moderate, focal, impingement of the parenchyma with a very mild extension of the proliferating cells into the ventral left side of the medulla oblongata. Based on these histological characteristics, the lesion was defined as ELST, a rare neoplasm described in human beings and with two reports in dogs. Conclusion: To our knowledge, this is the first report describing an ELST in a cat.

Ventriculomegaly in Cavalier King Charles Spaniels with Chiari-like malformation: relationship with clinical and imaging findings.

The objective of this study was to calculate lateral ventricles dimension in Cavalier King Charles Spaniel dogs with Chiari-like malformation and investigate the association between ventriculomegaly and signalment, clinical signs, ventricular asymmetry, grade of Chiari-like malformation, syringomyelia and index of medullary kinking. Retrospectively, 43 client-owned Cavalier King Charles Spaniels, older than 1 year of age, with magnetic resonance imaging diagnosis of Chiari-like malformation were enrolled. Initial and follow-up (up to 36 months) clinical status was graded. Images were reviewed to quantify the enlargement of lateral ventricles, evaluate ventricular symmetry, grade of Chiari-like malformation, grade of syringomyelia and medullary kinking index. Cases presenting epileptic seizures during the evaluation period were also recorded. The most common initial clinical signs were scratching and neck pain. Ventriculomegaly was identified in 70% of dogs, Chiari-like malformation grade 2 was observed in 77% of cases, ventricular asymmetry and syringomyelia were identified in 54% and 80% of dogs, respectively; the median medullary kinking index was 37.77%. Moreover, 28% of dogs presented epileptic seizures. No significant association was identified between dimension of lateral ventricles and signalment, clinical signs, and imaging findings; no significant association was identified between ventriculomegaly and epilepsy (P≥0.05). In conclusion, the prevalence of ventriculomegaly in Cavalier King Charles Spaniels is high but this finding does not seem related to the severity of clinical signs, presence of Chiari-like malformation, syringomyelia and craniocervical junction abnormalities such as medullary kinking.

Hypertrophic scar in a dog: histological and clinical features.

An adult male bullmastiff dog was treated for paraparesis and ataxia due to discospondylitis and disc herniation. At this time, the dog had a nonhealing ulcer between the pads of the left hindfoot. At re-evaluation, the dog had developed a large exophitic mass in the previously ulcerated area. Cytological examination revealed occasional spindle cells with mild atypia, and a soft tissue tumour was suspected. The mass was excised and submitted for histology. The lesion was characterized by superficial ulceration, an intermediate layer of granulation tissue and a deep portion containing vertically orientated capillaries and perpendicularly arranged fibroblasts and collagen. The histological features led to a diagnosis of hypertrophic scar. Eight weeks after surgery, the lesion recurred and was treated with an intralesional injection of methylprednisolone acetate. The lesion regressed in 10 days, but recurred after 3 months following severe self-trauma. Hypertrophic scars and keloids are two types of exuberant scarring reported in human beings, the pathogenesis of which is still unclear but seems to involve several cytokines, growth factors and inflammatory cells. The histological features identified in this case paralleled those reported in hypertrophic scars in humans. In this case, intralesional corticosteroid therapy was useful in the management of the lesion, but the severe self-trauma could have influenced the recurrence. Even if uncommon, hypertrophic scar should be included among the differential diagnoses of spindle cell tumours in dogs.

Middle ear cholesteatoma in 11 dogs.

Middle ear cholesteatoma is a rare condition in dogs with chronic otitis. Otorrhea, otodinia, and pain on temporomandibular joint palpation are the most common clinical signs. Neurological abnormalities are often detectable. Computed tomography reveals the presence of an expansive and invasive unvascularized lesion involving the tympanic cavity and the bulla, with little or no contrast enhancement after administration of contrast mediu. Video-otoscopy may detect pearly growth or white/yellowish scales in the middle ear cavity. Surgery is the only therapy but is associated with a high risk of recurrence.

Agreement of surgeon's perception of the effectiveness of spinal cord decompression with findings on postoperative magnetic resonance imaging for dogs surgically treated for intervertebral disk extrusion.

OBJECTIVE: To determine the accuracy of the surgeon's perception versus postoperative MRI findings in assessing the effectiveness of spinal cord decompression achieved in dogs surgically treated for intervertebral disk extrusion (IVDE) and whether postoperative MRI findings were more likely to be associated with various outcomes. ANIMALS: 68 dogs surgically treated for cervical or thoracolumbar IVDE. PROCEDURES: Data on clinical, neurologic, pre- and postoperative MRI, and intraoperative findings as well as outcomes and recovery times (6-month follow-up period) were prospectively collected and compared between various groups. RESULTS: 54 (79%) dogs had thoracolumbar IVDE, and 14 (21%) had cervical IVDE. Median degree of spinal cord compression as assessed on transverse T2-weighted MRI images was 45.6% before surgery and 8.8% after surgery. The correlation between surgeons' perception (n = 3) and postoperative MRI findings for the degree of spinal cord decompression achieved was only fair (κ = 0.40). Unsatisfactory spinal cord decompression as assessed via postoperative MRI was associated with severity of preoperative neurologic grade and preoperative compression, thoracolumbar (vs cervical) IVDE, and ventral (vs ventrolateral or dorsolateral) circumferential distribution of extruded material. Satisfactory (vs unsatisfactory) decompression as assessed via MRI was associated with a lower postoperative neurologic grade, greater likelihood of a successful outcome, and lower mean recovery time. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that for dogs surgically treated for IVDE, the surgeon's perception of adequate spinal cord decompression may be less reliable than postoperative MRI findings. Postoperative MRI appeared particularly useful for dogs with a severe preoperative neurologic status, severe preoperative spinal cord compression, and thoracolumbar IVDE.

Spinal epidural abscess in two calves.

OBJECTIVE: To report clinical signs, diagnostic and surgical or necropsy findings, and outcome in 2 calves with spinal epidural abscess (SEA). STUDY DESIGN: Clinical report. ANIMALS: Calves (n=2). METHODS: Calves had neurologic examination, analysis and antimicrobial culture of cerebrospinal fluid (CSF), vertebral column radiographs, myelography, and in 1 calf, magnetic resonance imaging (MRI). A definitive diagnosis of SEA was confirmed by necropsy in 1 calf and during surgery and histologic examination of vertebral canal tissue in 1 calf. RESULTS: Clinical signs were difficulty in rising, ataxia, fever, apparent spinal pain, hypoesthesia, and paresis/plegia which appeared 15 days before admission. Calf 1 had pelvic limb weakness and difficulty standing and calf 2 had severe ataxia involving both thoracic and pelvic limbs. Extradural spinal cord compression was identified by myelography. SEA suspected in calf 1 with discospondylitis was confirmed at necropsy whereas calf 2 had MRI identification of the lesion and was successfully decompressed by laminectomy and SEA excision. Both calves had peripheral neutrophilia and calf 2 had neutrophilic pleocytosis in CSF. Bacteria were not isolated from CSF, from the surgical site or during necropsy. Calf 2 improved neurologically and had a good long-term outcome. CONCLUSION: Good outcome in a calf with SEA was obtained after adequate surgical decompression and antibiotic administration. CLINICAL RELEVANCE: SEA should be included in the list of possible causes of fever, apparent spinal pain, and signs of myelopathy in calves.

Computed tomography features of middle ear cholesteatoma in dogs.

We describe the computed tomography (CT) findings in 11 dogs with middle ear cholesteatoma. The cholesteatoma appeared as an expansile tympanic cavity mass with a mean attenuation value of 55.8 +/- 4.2 Hounsfield units. There was no appreciable contrast enhancement of the tympanic bulla contense but ring enhancement was seen in four dogs. Due to the slow progressive growth, the lesion causes severe bone changes at the contour of the tympanic bulla, including osteolysis, osteoproliferation and osteosclerosis, expansion of the tympanic cavity, and sclerosis or osteoproliferation of the ipsilateral temporomandibular joint and paracondylar process. Cholesteatoma can cause lysis of the petrosal part of the temporal bone, leading to intracranial complications. Although not definitive, CT provides useful information for distinguishing a middle ear cholesteatoma from otitis media and neoplasia. In otitis media, enlargement of the tympanic cavity is not routinely observed. In tumors that primarily affect the middle or inner ear, the predominant signs are lysis of the contour of the tympanic bulla or the petrosal part of the temporal bone, soft tissue swelling around the middle ear and marked contrast enhancement. In tumors that arise from the external ear, a soft tissue mass is visible within the external acusticus meatus, and the middle ear is only involved secondarily.

Congenital facial infiltrative lipoma in a calf.

The clinical and pathologic findings related to an infiltrative facial lipoma in a 5-month-old female Holstein Friesian calf are reported. The tumor was congenital, increased in size with time, and deformed the left side of the face and cranial bones. The clinical condition of the calf was good; the only detectable abnormalities were poor weight gain and decreased motility of the left upper lip. Clinical and radiologic data indicated the mass was not removable. Muscle and lymph node invasion by tumor tissue were detected histologically. Infiltrative lipoma is a rare variety of lipoma that has been reported in dogs, cats, horses, and humans. Although its cytologic characteristics are those of a benign tumor, in this patient the invasiveness of the neoplasm was associated with poor prognosis.