Bronchial Stent Placement for Palliative Treatment of Pulmonary Carcinoma with Bronchial Obstruction in a Cat.

A feral, domestic shorthair was evaluated for palliative treatment of a pulmonary mass with secondary pneumonia. Because of the patient's temperament and extent of the mass, tracheobronchoscopy, bronchial stenting, and biopsy were elected, followed by adjuvant radiation therapy. Stent placement across the malignantly obstructed bronchus permitted drainage and recruitment of the infected lung lobe. Uncomplicated radiation therapy, stent extension, and debulking due to tissue ingrowth were subsequently performed. Successful palliation was achieved for 323 days with subsequent progressive pulmonary and liver metastases.

Limitation of Computed Tomography in Identifying Intranasal Porcupine Quills in a Dog (Canis lupus familiaris).

A 6 yr old, spayed female, Rhodesian ridgeback was presented for a 6-8 wk history of serous nasal discharge after being quilled by a porcupine. Physical exam revealed mid dorsal maxilla sensitivity. Computed tomography showed a normal nasal cavity. Rhinoscopy revealed three porcupine quills which were removed from the nasal cavities. The patient's clinical signs had improved dramatically at 1 wk follow-up. This case demonstrates the limitations of computed tomography for diagnosing intranasal porcupine quills and the importance of pursuing rhinoscopy in patients with clinical signs of nasal disease.

Preoperative parameters (signalment, digital radiography, urinalysis, urine microbiological culture) and novel algorithm improve prediction of canine urocystolith composition.

OBJECTIVE: To determine the accuracy of 4 preoperative parameters (signalment, urinalysis, urine microbiological culture, and digital radiography) in predicting urocystolith composition, compare accuracy between evaluators of varying clinical experience and a mobile application, and propose a novel algorithm to improve accuracy. ANIMALS: 175 client-owned dogs with quantitative analyses of urocystoliths between January 1, 2012, and July 31, 2020. METHODS: Prospective experimental study. Canine urocystolith cases were randomly presented to 6 blinded "stone evaluators" (rotating interns, radiologists, internists) in 3 rounds, each separated by 2 weeks: case data alone, case data with a urolith teaching lecture, and case data with a novel algorithm. Case data were also entered into the Minnesota Urolith Center mobile application. Prediction accuracy was determined by comparison to quantitative laboratory stone analysis results. RESULTS: Prediction accuracy of evaluators varied with experience when shown case data alone (accuracy, 57% to 82%) but improved with a teaching lecture (accuracy, 76% to 89%) and further improved with a novel algorithm (accuracy, 93% to 96%). Mixed stone compositions were the most incorrectly predicted type. Mobile application accuracy was 74%. CLINICAL RELEVANCE: Use of the 4 preoperative parameters resulted in variable accuracy of urocystolith composition predictions among evaluators. The proposed novel algorithm improves accuracy for all clinicians, surpassing accuracy of the mobile application, and may help guide patient management.

Comparison of autograft and allograft fixation in Pemberton osteotomy.

UNLABELLED: This retrospective study compared the results of autograft and allograft fixation in 29 children (36 hips) who underwent Pemberton osteotomy. Autograft fixation was used in 21 hips and allograft fixation was used in 15 hips. In the autograft group, 76% of patients had a successful result; 4 of 8 of patients with a neuromuscular disorder in this group had a successful result. In the allograft group, 93% of patients had a successful result; 6 of 7 of patients with a neuromuscular disorder in this group had a successful result. Pemberton osteotomy performed with allograft fixation provided similar or better results than autograft, especially in children with neuromuscular disorders. LEVEL OF EVIDENCE: diagnostic study, Level III-2 (retrospective cohort study).

Interventional treatment of benign nasopharyngeal stenosis and imperforate nasopharynx in dogs and cats: 46 cases (2005-2013).

OBJECTIVE To determine outcome for dogs and cats with benign nasopharyngeal stenosis or an imperforate nasopharynx that underwent balloon dilatation or metallic stent placement. DESIGN Retrospective case series. ANIMALS 15 dogs and 31 cats. PROCEDURES Medical records were retrospectively reviewed, and data on signalment, history, clinical signs, lesion location, treatment, and outcome were obtained. Patients were excluded if < 6 months of follow-up information was available. RESULTS 5 dogs and 22 cats underwent balloon dilatation, and results were successful in 11 (0 dogs and 11 cats) of the 27 (41%). Stents were placed in 34 patients (including 15 in which balloon dilatation had been unsuccessful). Uncovered stents were placed in 30 patients, and results were successful in 20 (67%). Covered stents were placed in 11 patients (including 7 in which uncovered stent placement was unsuccessful), and results were successful in all 11. Twenty-three of the 34 (68%) patients in which stents were placed developed complications. The most common complications were tissue ingrowth (n = 10), chronic infection (7), and stent fracture (5) for the 30 patients with uncovered stents and chronic infection (8) and oronasal fistula (3) for the 11 patients with covered stents. Overall, outcome was successful in 36 of the 46 (78%) patients (median follow-up time, 24 months; range, 2 to 109 months). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that in dogs and cats, nasopharyngeal stenosis and imperforate nasopharynx can be successfully treated with balloon dilatation or stent placement, but that there was a high risk of failure with balloon dilatation alone and a high risk of complications regardless of procedure.

Eosinophilic Esophagitis in a Kitten.

A 4 mo old intact male kitten was presented for chronic regurgitation and failure to thrive after weaning to dry food. Esophageal dilatation and severe diffuse proliferative lesions of the esophageal mucosa were found via radiography and esophagoscopy, respectively. Histopathologic examination revealed severe, chronic, diffuse, hyperplastic eosinophilic and mastocytic esophagitis. Eosinophilic infiltrates were prominent, with a mean of 29.8 eosinophils per high power field, supportive of eosinophilic esophagitis (EoE). Significant clinical improvement was seen with dietary modification using a hydrolyzed diet. The addition of glucocorticoids did not result in further improvement in clinical signs. Repeat histopathology showed near resolution of eosinophilic infiltration. EoE is an uncommon and rarely reported condition in dogs and cats. Diagnosis involves histopathologic confirmation and exclusion of other causes of eosinophilic infiltration within the esophagus. This case report demonstrates the importance of biopsy in identification of EoE and the efficacy of dietary modification in the treatment of this disease in a kitten.

Canine struvite urolithiasis.

Struvite calculi, composed of magnesium ammonium phosphate, have existed for thousands of years in human medicine and are a leading cause of calculi in companion animals. Struvite stones have also been called urease, infection-induced, phosphatic, and triple phosphate stones. They are the most common uroliths in dogs, in which most cases of struvite urolithiasis are associated with infection. Management of struvite urolithiasis requires a multimodal approach that addresses the presence of the urolith(s) and associated infection while identifying risk factors that predispose to the development of infection.

Preliminary evaluation of the utility of comparing SpO2 /FiO2 and PaO2 /FiO2 ratios in dogs.

OBJECTIVE: To determine whether the ratio of pulse oximetry saturation/fraction of inspired oxygen (SpO2 /FiO2 , [SF]) correlates with the ratio of partial pressure of oxygen in arterial blood/FiO2 (PaO2 /FiO2 , [PF]) in dogs. DESIGN: Prospective, observational pilot study. SETTING: Urban tertiary veterinary referral center. ANIMALS: Thirty-eight client-owned dogs requiring assessment of oxygenation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Arterial blood gas analysis with co-oximetry was performed on samples obtained from the dorsal pedal artery. Median SpO2 was 91.5% (range 80-97%) and median PaO2 was 70.1 mmHg (range 44.5-103.8 mmHg). Hypoventilation was uncommon and venous admixture was the predominant cause of hypoxemia in this population. Median SF was 435.7 (range 381.0-461.9) and median PF was 334.0 (range 211.9-494.3). Nine dogs (23.6%) had PF <300; no dogs had PF below 200. SF and PF were correlated (ρ = 0.618, P < 0.01). CONCLUSIONS: SF and PF in dogs spontaneously breathing room air have good correlation, suggesting that SF may be a useful, noninvasive surrogate for PF when assessing oxygenation in canine patients. Further studies are warranted to confirm and validate this relationship in spontaneously breathing and mechanically ventilated dogs on varying levels of FiO2 and to assess the ability of SF to predict outcome.

Methods of urolith removal.

Multiple techniques exist to remove uroliths from each section of the urinary tract. Minimally invasive methods for removing lower urinary tract stones include voiding urohydropropulsion, retrograde urohydropropulsion followed by dissolution or removal, catheter retrieval, cystoscopic removal, and cystoscopy-assisted laser lithotripsy and surgery. Laparoscopic cystotomy is less invasive than surgical cystotomy. Extracorporeal shock wave lithotripsy can be used for nephroliths and ureteroliths. Nephrotomy, pyelotomy, or urethrotomy may be recommended in certain situations. This article discusses each technique and gives guidance for selecting the most appropriate technique for an individual patient.

Urate urolithiasis.

Urate uroliths belong to the purine family of uroliths and are the third most common urolith type in dogs and cats. In dalmatians, an autosomal recessive trait is responsible for hyperuricosuria and a predisposition to urate urolithiasis. In other dog breeds and in cats, urate uroliths are predominantly associated with liver disease, specifically portosystemic vascular anomalies. Idiopathic urate uroliths may occur in animals without liver disease. Ammonium urate uroliths are most common. Urate uroliths are amenable to medical dissolution. This article reviews the pathogenesis and management of urate urolithiasis.

Calcium oxalate urolithiasis.

Calcium oxalate (CaOx) uroliths are one of the most common urolith types in dogs, cats, and humans. Many factors predispose animals to CaOx uroliths, including breed, old age, obesity, male sex, being neutered, and certain diseases. Because there are no effective strategies for medical dissolution of these uroliths, management should focus on physical removal (by surgical or nonsurgical methods) and prevention, especially in patients with recurring uroliths, high-risk breeds, and animals with predisposing diseases. Prevention focuses on diet modification, primarily to increase water intake, and the appropriate use or avoidance of specific medications.

Feline struvite urolithiasis.

Feline urolithiasis represents 15% of all cases of nonobstructive lower urinary tract disease in cats. Approximately 50% of feline uroliths are composed of struvite. Struvite urolithiasis commonly recurs, but optimal management may decrease its frequency. The pathophysiology and management of struvite urolithiasis are different in cats and dogs. This article focuses on struvite urolithiasis in cats, highlighting important aspects of pathophysiology, treatment, and prevention.

Diagnosis of urolithiasis.

Diagnostic imaging is usually required to determine the presence of urolithiasis. Double-contrast cystography is more accurate than survey radiography and approximately as accurate as ultrasonography. Knowledge of the mineral composition of calculi helps direct appropriate management of urolithiasis, and signalment can help predict composition with about 70% accuracy. In cats, about half of cystic calculi are struvite and half are calcium oxalate; most nephroliths and ureteroliths are calcium oxalate. In female dogs, struvite uroliths are the predominant type found in the bladder. In male dogs, breed plays a strong role in prediction of bladder urolith type. It is difficult to predict the composition of nephroliths and ureteroliths based on signalment alone in dogs. Urinalysis and imaging findings can help in predicting urolith composition, although chemical analysis is necessary for definitive diagnosis.