Objective—To document computed tomography (CT) features in dogs with masticatory myositis.
Design—Retrospective case series.
Animals—7 dogs with an immunologic diagnosis of masticatory myositis and an absence of clinical abnormalities of any skeletal muscles other than the masticatory muscles.
Procedures—History; clinical, hematologic, biochemical, immunologic, cytologic, and histologic findings; and pre- and postcontrast CT imaging features of masticatory muscles and head and neck lymph nodes were extracted from medical records.
Results—On CT images, changes in size (atrophy or swelling) were common for all masticatory muscles except the digastricus muscles, which were involved only in 1 dog. Pre-contrast attenuation changes, most often hypoattenuation with varied distribution patterns, were seen in masticatory muscles of 4 dogs. Contrast enhancement with a predominantly inhomogeneous distribution pattern was seen in the temporalis, masseter, and pterygoid muscles of all dogs. Head and neck lymph nodes were enlarged in all but 1 dog and had contrast enhancement with predominantly central or homogeneous distribution patterns. Muscle biopsy was performed in 6 dogs, with biopsy specimens obtained from areas that had the most obvious contrast enhancement on CT images. For all 6 dogs, biopsy speci-mens had histologic features indicative of masticatory myositis.
Conclusions and Clinical Relevance—Results suggested that CT may be a useful adjunct in the diagnosis of masticatory myositis in dogs, including selection of sites for diagnostic muscle biopsy.
Objective—To evaluate long-term response of cats with stomatitis to tooth extraction.
Design—Retrospective case series.
Animals—95 cats with stomatitis.
Procedures—Medical records of cats with stomatitis that was treated with tooth extraction during a 14-year period were reviewed. Demographic information and diagnostic results were recorded as well as surgical procedure, including full-mouth extraction (FME) versus partial-mouth extraction (PME), and specifics of medical management. Patients were categorized according to response to treatment.
Results—Median postoperative follow-up time was 231 days (range, 33 to 2,655 days). Of 95 cats, 6 (6.3%) had no improvement and 25 (26.3%) had little improvement in stomatitis following tooth extraction and extended medical management (EMM). Following tooth extraction, 37 (39.0%) cats had substantial clinical improvement and 27 (28.4%) cats had complete resolution of stomatitis; of these 64 cats, 44 (68.8%) required EMM for a finite period to achieve positive outcomes. Extent of tooth extraction (PME vs FME) was not associated with overall response to treatment. At initial recheck examination, a better long-term response to tooth extraction was observed in patients with resolution of abnormal behavior (OR, 7.2), decrease in oral inflammation (OR, 3.5), and lack of need for follow-up medical management with antimicrobials (OR, 3.7).
Conclusions and Clinical Relevance—Extraction of teeth in areas of oral inflammation provided substantial improvement or complete resolution of stomatitis in more than two-thirds of affected cats. Full-mouth extraction did not appear to provide additional benefit over PME. Most cats with stomatitis may require EMM to achieve substantial clinical improvement or complete resolution. (J Am Vet Med Assoc 2015;246:654–660)
Case Description—A 6-year-old German Shorthaired Pointer was evaluated for possible reconstruction of a mandibular defect resulting from gunshot trauma.
Clinical Findings—A 5-cm defect of the right mandibular body was evident. A segment of the mandibular body was removed 9 weeks earlier because of severe contamination and comminution associated with gunshot trauma. Subsequent right-sided mandibular drift resulted in malocclusion in which the left mandibular canine tooth caused trauma to mucosa of the hard palate medial to the left maxillary canine tooth. The right maxillary canine tooth caused trauma to gingiva lingual to the right mandibular canine tooth.
Treatment and Outcome—The right mandible was stabilized with a 2.0-mm maxillofacial miniplate positioned along the lateral alveolar margin and a 2.4-mm locking mandibular reconstruction plate placed along the ventrolateral mandible. An absorbable compressionresistant matrix containing collagen, hydroxyapatite, and tricalcium phosphate was soaked in recombinant human bone morphogenetic protein-2 (rhBMP-2; 7.2 mL of a 0.5 mg/mL solution for a dose of 3.6 mg) and placed in the defect. By 4 weeks after surgery, an exuberant callus was evident at the site of the defect. By 7 months after surgery, the callus had remodeled, resulting in normal appearance, normal occlusion, and excellent function of the jaw.
Clinical Relevance—Mandibular defects resulting from gunshot trauma can be treated by removal of contaminated tissue and comminuted bone fragments, followed by staged reconstruction. The combination of rhBMP-2 and compression-resistant matrix was effective in a staged mandibular reconstruction in a dog with a severe traumatic mandibular defect.
Objective—To determine outcome associated with use of a balloon-expandable metallic stent for treatment of nasopharyngeal stenosis in dogs and cats.
Design—Retrospective case series.
Animals—3 dogs and 3 cats.
Procedures—All 6 animals had severe inspiratory stertor at initial examination. Two animals had no orifice present at the stenosis. Nasopharyngeal stenosis was diagnosed and stent size determined by use of computed tomography. A percutaneous transluminal angioplasty balloon premounted with a balloon-expandable metallic stent was placed over a guidewire, advanced through the stenotic lesion under fluoroscopic and rhinoscopic guidance, and dilated to restore patency.
Results—All animals had immediate resolution of clinical signs after stent placement. The procedure took a median of 38 minutes (range, 22 to 70 minutes). One animal with a stenosis located far caudally needed the tip of the stent resected because of hairball entrapment and exaggerated swallowing. Both animals without an orifice in the stenosis had tissue in-growth requiring a covered stent. All animals were reexamined 6 to 12 weeks after treatment via rhinoscopy, radiography, computed tomography, or a combination of techniques. All animals lacked signs of discomfort; 5 of 6 were breathing normally 12 to 28 months after the procedure.
Conclusions and Clinical Relevance—Transnasal balloon-expandable metallic stent placement may represent a rapid, safe, noninvasive, and effective treatment in animals with nasopharyngeal stenosis. If the stenosis is extremely caudal in the nasopharynx, serial balloon dilatation might be considered prior to stent placement. A covered stent should be considered initially if the stenosis is completely closed.
Objective—To assess associations between epidemiologic
and laboratory variables and calciotropic
hormones in cats with odontoclastic resorptive
Animals—182 client-owned cats older than 1 year of
age with oral disease.
Procedure—Information on medical history, behavior,
living environment, and feeding management was
assessed by use of a questionnaire. After induction of
general anesthesia, oral examination was performed
following standardized protocols and included dental
probing and full-mouth radiography. Laboratory analyses
included evaluation of FeLV-FIV status, serum biochemical
analyses, CBC, urinalysis, and serum concentrations
of intact parathyroid hormone (iPTH),
parathyroid hormone-related peptide (PTHrP), 25-hydroxyvitamin D (25-OHD), free thyroxine (fT4), and
ionized calcium (iCa).
Results—ORLs were identified in 72.5% of cats.
Mandibular third premolars were the most commonly
affected teeth. Cats with ORLs were significantly
older (mean, 9.2 years) than cats without ORLs
(mean, 6.6 years). Multivariate logistic regression
analysis revealed that 25-OHD, urine specific gravity,
jaw-opening reflex on probing, and missing teeth
were significant variables, even after accounting for
age. Cats with ORLs had significantly higher mean
serum concentration of 25-OHD (112.4 nmol/L) and
significantly lower mean urine specific gravity
(1.0263), compared with cats without ORLs (89.8
nmol/L and 1.0366, respectively).
Conclusions and Clinical Relevance—Results did
not indicate associations between iPTH, PTHrP, or fT4
and development of ORLs. In affected cats, the
importance of high serum 25-OHD and low urine specific
gravity has not been determined. (Am J Vet Res 2005;66:1446–1452)