CASE DESCRIPTION 2 dogs with chylothorax were identified to have cardiac mass lesions obstructing the return of venous blood from the cranial vena cava. Chylous effusion was presumed to have been a result of an increase in cranial vena cava pressure affecting flow of chyle through the thoracic duct.
CLINICAL FINDINGS Both dogs had tachypnea and pleural effusion requiring therapeutic thoracocentesis. Fluid analysis confirmed chylothorax. A heart-base mass was identified via echocardiography in each dog, and CT-angiographic findings confirmed obstruction to venous return in the cranial vena cava in both dogs and compression of the pulmonary artery in 1 dog.
TREATMENT AND OUTCOME Each dog was anesthetized, and self-expanding endovascular stents were placed with fluoroscopic guidance. In both dogs, the site of stent placement was the cranial vena cava, and in 1 dog, an additional stent was positioned in the pulmonary artery. Chylous effusion resolved successfully in both dogs after surgery, with postoperative survival times exceeding 6 months. Complications included periprocedural arrhythmias in both dogs and eventual obstruction of the stent with tumor extension and fluid reaccumulation in 1 dog.
CLINICAL RELEVANCE Endovascular stent placement may provide a useful palliative treatment for chylothorax secondary to vascular compression by a heart-base mass in dogs.
OBJECTIVE To evaluate the knowledge of various veterinary specialists regarding various radiation safety matters and determine the availability of radiation safety training.
DESIGN Cross-sectional study.
SAMPLE 164 radiology, 81 internal medicine, and 108 emergency and critical care (ECC) specialists.
PROCEDURES An online survey was developed regarding knowledge of and training in radiation safety, and invitations were sent via email through the email lists of the veterinary internal medicine, ECC, and radiology specialty colleges. Responses were summarized, and comparisons were made between radiologists and internal medicine and ECC clinicians.
RESULTS 65.5% (38 /58) of respondents from academic institutions and 30.0% (33/110) of respondents from private practices indicated that radiation safety training was mandatory at their institution for personnel who work with ionizing radiation–emitting equipment, and 80.2% (85/106) and 56.6% (77/136), respectively, had received some radiation safety training. Low proportions of radiologists and internal medicine and ECC clinicians correctly identified the effective dose of ionizing radiation associated with 3-phase esophagography and 3-phase abdominal CT. Many radiologists (92/153 [60.1%]) and nonradiologists (92/179 [51.4%]) believed that the effective doses used in veterinary practice pose no increased risk of fatal cancer to their patients.
CONCLUSIONS AND CLINICAL RELEVANCE Radiation safety training, although more common in academia, was not universally available and may not meet radiography equipment license requirements for some institutions. Most radiologists, internal medicine clinicians, and ECC clinicians had a poor understanding of the amount of ionizing radiation associated with medical imaging procedures and the potential hazards to their patients.