Objective—To determine the respective associations between ureteral obstruction and renomegaly, urine specific gravity (USG), and serum creatinine concentration and to assess the reliability of abdominal palpation for detection of renomegaly in cats.
Design—Retrospective case series.
Animals—89 client-owned cats with (n = 29) or without ureteral obstruction and with (30) or without (30) kidney disease.
Procedures—Medical records of cats that underwent abdominal ultrasonography at a veterinary teaching hospital from January 2006 through April 2013 were reviewed. Cats were categorized as having ureteral obstruction (obstructed group) or no ureteral obstruction with (KD group) or without kidney disease (NKD group). Renomegaly and renal asymmetry were defined on the basis of mean renal length for NKD cats. Prevalence of renomegaly and renal asymmetry, mean USG and serum creatinine concentration, and abdominal palpation and ultrasonographic findings were compared among the groups.
Results—Renomegaly was identified in 2 obstructed cats and 1 KD cat and was not associated with ureteral obstruction. Renal asymmetry was detected in 18 obstructed cats and 11 KD cats. For obstructed and KD cats, the mean USG was significantly lower and the mean serum creatinine concentration was significantly greater than those for NKD cats. Twenty-eight of 29 cats with ureteral obstruction had hypercreatininemia. Abdominal palpation was not a reliable method for detection of renomegaly.
Conclusions and Clinical Relevance—Results indicated renomegaly was not associated with ureteral obstruction in cats, and abdominal palpation was an unreliable method for detection of renomegaly. The most consistent abnormal finding for cats with ureteral obstruction was hypercreatininemia. (J Am Vet Med Assoc 2015;247:518–524)
OBJECTIVE To evaluate interobserver agreement for features used in presumptive diagnosis of acute noncompressive nucleus pulposus extrusion (ANNPE) or ischemic myelopathy by MRI, compare findings on postcontrast T1-weighted (T1W) MRI sequences with fat saturation (FS) for the 2 conditions, and determine whether length and directional patterns of hyperintensity of the intramedullary spinal cord on T2-weighted (T2W) fast spin echo (FSE) MRI sequences differ between dogs with these diseases.
DESIGN Retrospective, observational study.
ANIMALS 20 dogs with clinical signs compatible with ANNPE (n = 14) or ischemic myelopathy (6).
PROCEDURES 3 observers evaluated MRI data (including T2W FSE, T2W single-shot FSE, and T1W FS sequences) for dogs with a presumptive diagnosis of ischemic myelopathy or ANNPE. Interobserver agreement for variables of interest including presumptive diagnosis was assessed by κ statistic calculations. Associations between diagnosis and variables of interest were assessed with Fisher exact or Cochran-Mantel-Haenszel tests.
RESULTS Perfect interobserver agreement (κ = 1 for all comparisons) was found for the presumptive diagnosis of ischemic myelopathy versus ANNPE. Meningeal enhancement on postcontrast T1W FS MRI images and nonlongitudinal directional pattern of intramedullary hyperintensity on T2W FSE images were significantly associated with a diagnosis of ANNPE. Greater length of intramedullary hyperintensity was significantly associated with a diagnosis of ischemic myelopathy.
CONCLUSIONS AND CLINICAL RELEVANCE Directional pattern and length of intramedullary hyperintensity on T2W FSE MRI images and enhancement patterns in postcontrast T1W FS sequences may provide important contributions to the criteria currently used in the presumptive diagnosis of ischemic myelopathy versus ANNPE.
Objective—To determine radiographic vertebral ratio values representing vertebral canal stenosis in Doberman Pinschers with and without clinical signs of caudal cervical spondylomyelopathy (CCSM).
Animals—Doberman Pinschers with (n = 81) and without (39) signs of CCSM.
Procedures—All dogs underwent lateral survey radiography of the cervical vertebral column. Five specific measurements were made at C3 through C7, and from those data, 3 ratios were calculated and analyzed for use in diagnosis of CSSM: canal height-to-vertebral body height ratio (CBHR), canal height-to-vertebral body length ratio (CBLR), and caudal vertebral canal height-to-cranial vertebral canal height ratio (CCHR). The CBHR and CBLR were considered indicators of vertebral canal stenosis, and CCHR described vertebral canal shape.
Results—Compared with Doberman Pinschers without CCSM, mean CBHR and CBLR values were significantly smaller for Doberman Pinschers with CCSM; for CBHR, this difference was evident at each assessed vertebra. The CCHR value for C7 was significantly larger in dogs with CCSM. Receiver operating characteristic statistics did not identify a threshold point that had combined high sensitivity and specificity sufficient to differentiate between Doberman Pinschers with and without CCSM.
Conclusions and Clinical Relevance—Doberman Pinschers with CCSM had vertebral canal stenosis combined with a funnel-shaped vertebral canal at C7 significantly more often than did Doberman Pinschers without CCSM. Despite these significant differences, no reliable threshold ratio values were identified to differentiate groups of dogs.
Objective—To describe the contrast-enhanced ultrasonographic characteristics and vascular patterns of adrenal gland tumors in dogs and determine whether those features are indicative of malignancy or histologic type of tumor.
Animals—14 dogs with 16 adrenal gland lesions (10 carcinomas [8 dogs], 3 adenomas [3 dogs], and 3 pheochromocytomas [3 dogs]).
Procedures—Unsedated dogs with adrenal gland lesions underwent B-mode ultrasonography and contrast-enhanced ultrasonography ≤ 48 hours before adrenalectomy; contrast-enhanced ultrasonographic examinations were video-recorded. Macroscopic evaluation of the adrenal gland lesions and histologic examination of removed adrenal gland tissues were subsequently performed. Surgical and histopathologic findings and the ultrasonographic and contrast-enhanced ultrasonographic characteristics were recorded for the various tumor types. Time-intensity curves were generated from the contrast-enhanced ultrasonographic recordings and used to calculate regional blood volume (value proportional to area under the curve) and mean transit time (time the lesion began to enhance to the half-peak intensity).
Results—In adrenal gland carcinomas, tortuous feeding vessels were noticeable during the arterial and venous phases of contrast enhancement. Heterogeneity of contrast enhancement was evident only in malignant tumors. Compared with adenomas, adrenal gland carcinomas and pheochromocytomas had significantly less regional blood volume. Mean transit times were significantly shorter in adrenal gland carcinomas and pheochromocytomas than in adenomas.
Conclusions and Clinical Relevance—For dogs, evaluation of the vascular pattern and contrast-enhancement characteristics of adrenal gland tumors by means of contrast-enhanced ultrasonography may be useful in assessment of malignancy and tumor type.
CASE DESCRIPTION A 10-year-old spayed female Rottweiler was referred for evaluation because of a 2-month history of regurgitation and weight loss, despite no apparent change in appetite. The dog had received antiemetic and antacid treatment, without improvement.
CLINICAL FINDINGS Physical examination revealed a low body condition score (2/5), but other findings were unremarkable. Diffuse, global esophageal dilatation was noted on plain thoracic radiographs, and normal motility was confirmed through videofluoroscopic evaluation of swallowing. Transhepatic ultrasonographic and CT examination revealed a circumferential, intraparietal lesion in the distal portion of the esophagus causing distal esophageal or cardial subobstruction and no metastases. Incisional biopsy of the lesion was performed, and findings of histologic examination supported a diagnosis of esophageal leiomyoma.
TREATMENT AND OUTCOME In view of numerous possible complications associated with esophageal surgery, the decision was made to palliatively treat the dog by transcardial placement of a self-expanding, covered, nitinol esophageal stent under endoscopic guidance. Two weeks after stent placement, radiography revealed complete migration of the stent into the gastric lumen. Gastrotomy was performed, and the stent was replaced and fixed in place. Twenty-four months after initial stent placement, the dog had a healthy body condition and remained free of previous clinical signs.
CLINICAL RELEVANCE Diffuse benign muscular neoplasia should be considered as a differential diagnosis for acquired esophageal dilatation in adult and elderly dogs. In the dog of this report, transcardial stent placement resulted in resolution of the clinical signs, with no apparent adverse effect on digestive function. The described procedure could be beneficial for nonsurgical treatment of benign esophageal tumors in dogs.
Objective—To determine the incidence of adverse events within 24 hours after contrast-enhanced ultrasonography (CEUS) in dogs and cats and compare the risk of death within 24 hours after imaging for animals that underwent ultrasonography with and without injection of a contrast agent.
Design—Retrospective case-control study.
Animals—750 animals (411 case dogs, 238 control dogs, 77 case cats, and 24 control cats).
Procedures—At 11 institutions, medical records were reviewed of dogs and cats that had CEUS performed (cases) as were medical records of dogs and cats with clinical signs similar to those of case animals that had ultrasonography performed without injection of a contrast agent (controls). Information regarding signalment; preexisting disease; type, dose, and administration route of contrast agent used; immediate (within 1 hour after CEUS) and delayed (> 1 and ≤ 24 hours after CEUS) adverse events; and occurrence and cause of death (when available) was extracted from each medical record. Risk of death within 24 hours after ultrasonography was compared between case and control animals.
Results—Of the 411 case dogs, 3 had immediate adverse events (vomiting or syncope) and 1 had a delayed adverse event (vomiting). No adverse events were recorded for case cats. Twenty-three of 357 (6.4%) clinically ill case animals and 14 of 262 (5.3%) clinically ill control animals died within 24 hours after ultrasonography; risk of death did not differ between cases and controls.
Conclusions and Clinical Relevance—Results indicated that CEUS was safe in dogs and cats.