Objective—To describe clinical, laboratory, and surgical findings in dogs with confirmed gallbladder rupture and in which serum total bilirubin concentration was within reference limits.
Design—Retrospective case series.
Procedures—Medical records were searched to identify dogs with gallbladder rupture that underwent treatment at the Kansas State University Veterinary Health Center from November 2007 through November 2013. Dogs were included if they had undergone abdominal ultrasonography, serum total bilirubin concentration was ≤ 0.4 mg/dL, and abdominal exploratory surgery confirmed the presence of gallbladder upture.
Results—An exploratory celotomy was performed in all dogs because of ultrasonographic findings of mild to marked abdominal effusion and either an unidentifiable gallbladder (n = 1 dog) or a distended gallbladder with a suspected gallbladder mucocele (4 dogs). Serum total bilirubin concentration was within reference limits (median, 0.2 mg/dL; range, 0.1 to 0.4 mg/dL; reference range, 0.1 to 0.4 mg/dL) in all dogs before surgery. In 1 dog, bile acids concentrations in serum and in peritoneal fluid were compared and the results (48 μmol/L and 1,070 μmol/L, respectively) were supportive of the diagnosis of gallbladder rupture.
Conclusions and Clinical Relevance—Results indicated that even when serum total bilirubin concentration is within reference limits, gallbladder rupture should be considered in dogs with acute signs of abdominal pain when a mucocele is suspected on abdominal imaging and free abdominal fluid is present. Results suggested that a comparison of serum to peritoneal fluid bile acids concentrations may provide additional support for a diagnosis of gallbladder rupture.
Objective—To describe echocardiographic findings in dogs with dysautonomia.
Design—Prospective case series.
Animals—20 dogs with dysautonomia (13 confirmed during necropsy and 7 with results of antemortem testing [tear production, pilocarpine response test, atropine response test, and ID histamine response] supportive of the diagnosis).
Procedures—Dogs with dysautonomia were evaluated by use of echocardiography, and M-mode measurements were obtained on all dogs. A dobutamine response test was performed on 1 dog, starting at a rate of 1 μg/kg/min and doubling the rate every 15 minutes until fractional shortening (FS) increased to > 2 times the baseline value.
Results—Evidence of systolic dysfunction was detected in 17 of 20 dogs with dysautonomia, as determined on the basis of FS (median, 17.9%; range, 4.0% to 31.1%). Left ventricular internal dimension during diastole or left ventricular internal dimension during systole was enlarged in 4 of 20 and 14 of 20 dogs, respectively. Enlargement of the left atrium or aorta was identified in 3 of 15 and 1 of 15 dogs in which it was measured, respectively. Administration of dobutamine at a rate of 4 μg/kg/min resulted in dramatic improvement in FS (increase from 4% to 17%) in the 1 dog tested.
Conclusions and Clinical Relevance—Results suggested that echocardiographic evidence of diminished systolic function was common in dogs with dysautonomia. Whether the diminished function was a result of sympathetic denervation or myocardial hibernation was unclear, although myocardial hibernation was more likely.
Objective—To identify common errors in film and digital radiographs provided by referring veterinarians and determine the effect of such errors on the perceived diagnostic quality of image sets.
Sample—135 sets of radiographic images acquired by referring veterinarians for client-owned small animals evaluated at a university hospital.
Procedures—Sets of radiographs were prospectively collected and evaluated for proper performance of various radiographic technical variables including exposure, collimation, positioning, inclusion of all appropriate views, presence of artifacts, radiation safety, and labeling. Sets of radiographs were subjectively determined to be of diagnostic or nondiagnostic quality by 2 evaluators.
Results—The variables exposure, correct positioning, absence of artifacts, and acquisition of all appropriate views were significantly associated with a determination of diagnostic quality for radiograph sets. Correct patient labeling, radiation safety, and x-ray beam centering and collimation were not associated with a determination of diagnostic quality for radiograph sets. The number of categories with errors was significantly associated with identification of radiograph sets as having diagnostic or nondiagnostic quality. Digital radiographs had a significantly lower number of image artifacts and significantly higher frequency of proper labeling versus film radiographs.
Conclusions and Clinical Relevance—Results of this study suggested the technical variables proper exposure, proper positioning, absence of artifacts, and acquisition of all appropriate views were important for acquisition of sets of radiographs of high diagnostic quality. Identification of these errors and adjustment of radiographic technique to eliminate such errors would aid veterinarians in obtaining radiographs of high diagnostic quality and may reduce misinterpretation.