To describe a retroesophagoscopic approach (ROSA) to nasopharyngoscopy and compare it with the conventional retroflexed endoscopic approach (REA).
36 feline cadavers and 2 client-owned cats with nasopharyngeal disorders.
36 veterinarians participated in the experimental portion of the study involving feline cadavers. Each veterinarian performed the ROSA and REA to nasopharyngoscopy on a feline cadaver once, attempting to identify and biopsy 2 landmarks (soft palate and choanae) with each approach while time was recorded. Numeric scales were used to measure perceived ease of use and image quality for both techniques. Data were compared between approaches by an independent statistician. The ROSA approach was also used as part of the diagnostic workup for the 2 client-owned cats.
35 of the 36 (97%) veterinarians were able to identify and biopsy both landmarks using the ROSA, whereas 21 (58%) veterinarians were able to visualize both landmarks using the REA and 19 (53%) successfully biopsied the landmarks. Image quality for the soft palate was scored higher with the ROSA (median score, 7.5/10) than with the REA (4.5/10). The ROSA was fast and easy to perform. This approach was also successfully performed in the 2 client-owned cats with nasopharyngeal disorders, with no complications reported.
CONCLUSIONS AND CLINICAL RELEVANCE
The ROSA was found to be a fast, effective, and easy alternative endoscopic technique for assessment of the nasopharynx in cats. This approach may allow use of various instruments that could be relevant for interventional procedures. However, the ROSA was also invasive and should be considered for diagnostic and therapeutic purposes for selected indications only when REA is unsuccessful. (Am J Vet Res 2021;82:752–759)
Case Description—A 5-year-old castrated male Toy Poodle cross was evaluated because of lethargy, inappetence, and suspected abdominal hemorrhage. The dog had been evaluated on 4 other occasions for episodes of excessive bleeding associated with trauma or surgical procedures.
Clinical Findings—At previous evaluations, results of repeated measurements of prothrombin time, partial thromboplastin time, and buccal mucosal bleeding time were unremarkable; activated clotting time, plasma von Willebrand factor concentration, results of platelet function testing, and plasma factor VII, VIII, IX, X, XI, and XII concentrations were considered normal. At this evaluation, clinicopathologic analyses revealed mild regenerative anemia that progressed over a 4-day period to moderate regenerative anemia and acute inflammation with panhypoproteinemia. Abdominal ultrasonography revealed a large mass (suspected to be a hematoma) near the urinary bladder. Rotational thromboelastometry revealed that clotting times were within reference limits, with abnormal clot formation times and clot firmness. The result of a factor XIII (FXIII) clot solubility assay confirmed FXIII deficiency.
Treatment and Outcome—The dog's bleeding diathesis resolved with inpatient care and IV fluid therapy, although plasma transfusions had been required at previous evaluations. Seven months after discharge from the hospital, the dog continued to do well clinically, although it had several additional episodes of excessive bleeding.
Clinical Relevance—To the authors’ knowledge, this is the first reported case of congenital FXIII deficiency in a dog. In addition to more common inherited coagulopathies, FXIII deficiency should be a differential diagnosis for dogs with episodes of excessive bleeding and apparently normal results of standard coagulation tests.
CASE DESCRIPTION Three 21-week-old sexually intact female sibling domestic shorthair cats were brought to an emergency clinic because of signs of sudden respiratory distress that were noted by the owner after the cats had been confined for approximately 10 hours in a room with an operating ozone-generating air purifier. No other potential toxicant exposures were reported.
CLINICAL FINDINGS On initial examination, the 3 cats were severely dyspneic and tachypneic. Pulmonary crackles were audible on thoracic auscultation. Thoracic radiography revealed a marked peribronchial, unstructured interstitial pulmonary pattern that coalesced to a patchy alveolar pattern, consistent with noncardiogenic pulmonary edema.
TREATMENT AND OUTCOME A diuretic (furosemide, 2 mg/kg [0.9 mg/lb], IV) and bronchodilator (terbutaline sulfate, 0.01 mg/kg [0.005 mg/lb], IM) were administered, and supplemental oxygen was provided by placing the cats in an oxygen cage at 80% oxygen saturation. By 24 hours after placement in the oxygen cage, all cats had unremarkable respiratory rates and thoracic auscultation findings. Complete resolution of the respiratory signs and radiographic pulmonary lesions was achieved within 48 to 72 hours after initial evaluation. At a recheck examination performed 3 months after initial evaluation, the cats remained free of respiratory signs, and no radiographic pulmonary lesions were detected.
CLINICAL RELEVANCE To the authors’ knowledge, this was the first reported case of pulmonary toxicosis believed to have been caused by ozone exposure in cats. Associated respiratory signs were successfully and rapidly reversed following oxygen supplementation and medical treatment.
To evaluate agreement of 4 methods (Tikhonov gamma variate adaptive regularization of plasma concentration-time curve fitting applied to technetium Tc 99m diethylenetriamine pentaacetic acid [99mTc-DTPA] plasma clearance [Tk-GV], plasma clearance of exogenous creatinine [CrCL], Gates gamma camera-based measurement method with 99mTc-DTPA renal clearance and dynamic scintigraphy [GTS], and iohexol renal clearance assessed with dynamic CT with Patlak plotting [CT-Pp]) for measuring glomerular filtration rates (GFR) in healthy cats.
7 healthy, laboratory-raised cats.
Each method for measuring GFR was performed twice in 7 cats at 24-day intervals. The Wilcoxon signed-rank sum test was used to compare the results obtained from the 14 studies for each method. Results from the 4 methods were assessed for agreement and correlation.
The median GFR values were 2.75, 2.83, 3.14, and 4.26 mL/min/kg, for Tk-GV, CT-Pp, plasma CrCL, and GTS, respectively. Analysis with Wilcoxon signed-rank sum tests identified significant pairwise differences between results obtained with the Tk-GV versus the plasma CrCL method, the Tk-GV versus the GTS method, and the plasma CrCL versus the GTS method. The least variable method was Tk-GV, with an SD of 1.27 (mL/min/kg).
CONCLUSIONS AND CLINICAL RELEVANCE
Findings indicated that Tk-GV yielded GFR measurements comparable with those obtained with CT-Pp, plasma CrCL, and GTS; however, the Tk-GV method yielded the tightest range of results among the methods evaluated.