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  • Author or Editor: Ana V. Caceres x
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Case Description—An 11-year-old spayed female Collie was evaluated because of regurgitation, dysphagia, severe ptyalism, coughing, and weight loss of approximately 12 weeks’ duration. Esophageal squamous cell carcinoma had been diagnosed prior to referral on the basis of results of radiographic and endoscopic examination and histologic evaluation of biopsy samples. A percutaneous endoscopically placed gastrostomy (PEG) tube had been inserted 2 weeks prior to referral, and the dog was being treated for infection at the gastrostomy site.

Clinical Findings—Physical examination findings included marked ptyalism, stertor, and inflammation and discharge at the gastrostomy site.

Treatment and Outcome—Surgical options were declined by the owner, and palliative treatment was chosen to alleviate clinical signs and facilitate PEG tube removal. With fluoroscopic guidance, a self-expanding metallic stent was placed in the esophageal lumen at the site of obstruction. Botulinum toxin A was injected into the mandibular salivary glands under ultrasonographic guidance as treatment for severe ptyalism. Following discharge, clinical improvement was reported until euthanasia for unrelated disease 12 weeks after stent placement. Necropsy revealed that the stent had not migrated and had remained patent with some tumor ingrowth but no evidence of stricture or obstruction.

Clinical Relevance—Esophageal stenting effectively treated obstruction and improved clinical signs and may be beneficial for palliative treatment in other animals with malignant esophageal tumors. Although the degree to which botulinum toxin A injection into salivary glands improved clinical signs could not be determined, it may potentially be useful as adjunctive treatment to reduce severe ptyalism.

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in Journal of the American Veterinary Medical Association


Objective—To determine the sensitivity, positive predictive value, and interobserver variability of CT in the detection of bullae associated with spontaneous pneumothorax in dogs.

Design—Retrospective case series.

Animals—19 dogs with spontaneous pneumothorax caused by rupture of bullae.

Procedures—Dogs that had CT for spontaneous pneumothorax caused by rupture of bullae confirmed at surgery (median sternotomy) or necropsy were included. Patient signalment, CT protocols, and bulla location, size, and number were obtained from the medical records. Computed tomographic images were reviewed by 3 board-certified radiologists who reported on the location, size, and number of bullae as well as the subjective severity of pneumothorax.

Results—Sensitivities of the 3 readers for bulla detection were 42.3%, 57.7%, and 57.7%, with positive predictive values of 52.4%, 14.2%, and 8.4%, respectively, with the latter 2 readers having a high rate of false-positive diagnoses. There was good interobserver agreement (κ = 0.640) for correct identification of bullae. Increasing size of the bulla was significantly associated with a correct CT diagnosis in 1 reader but not in the other 2 readers. Correct diagnosis was not associated with slice thickness, ventilation protocol, or degree of pneumothorax.

Conclusions and Clinical Relevance—Sensitivity and positive predictive value of CT for bulla detection were low. Results suggested that CT is potentially an ineffective preoperative diagnostic technique in dogs with spontaneous pneumothorax caused by bulla rupture because lesions can be missed or incorrectly diagnosed. Bulla size may affect visibility on CT.

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in Journal of the American Veterinary Medical Association