A 17-year-old 6-kg (13.2-lb) castrated male domestic shorthair cat was admitted to the emergency department because of a 3-day history of anorexia and dysphagia. One month previously, the patient had received a diagnosis of a fungal ear infection and was being treated with florfenicol, terbinafine, and mometasone furoate otic solution. Ingestion of the solution had been witnessed by the owner and was suspected to be the cause of the dysphagia.
On physical examination, heart rate, respiratory rate, and rectal temperature were within reference limits. A grade 4/6 holosystolic murmur was auscultated over the left parasternal region, but no gallop
Case Description—A 12-month-old castrated male Boxer was examined because of signs of acute, progressive intracranial disease.
Clinical Findings—Cytologic and histologic findings were consistent with an intracranial fungal granuloma in the right cerebral hemisphere. Fungal culture yielded a Cladophialophora sp.
Treatment and Outcome—The granuloma was surgically debulked to remove infected brain tissue and the avascular purulent core. Postoperatively, the patient was treated with fluconazole (2.3 mg/kg [1 mg/lb], PO, q 12 h) for 4 months, followed by voriconazole (3.4 mg/kg [1.5 mg/lb], PO, q 12 h) for a further 10 months. The outcome was considered excellent on the basis of resolution of neurologic signs and a lack of evidence of recurrence of the granuloma during magnetic resonance imaging and CSF analysis 8 months after surgery. Magnetic resonance imaging and CSF analysis 9 weeks after administration of antifungal medications was discontinued (16 months after surgery) confirmed resolution.
Clinical Relevance—Intracranial phaeohyphomycosis in small animals is rare and is most commonly associated with Cladophialophora infection. Phaeohyphomycosis frequently causes a focal granuloma, whereas other fungal infections typically cause diffuse meningoencephalitis. In all previous reports of phaeohyphomycosis of the CNS in dogs, treatment has been limited to medical management with conventional antifungal drugs and had failed to prevent death. The present report suggested that combined management of granulomas with surgery and newer triazole medications such as voriconazole may represent a novel strategy that improves the prognosis for this disease.
Objective—To determine whether subcutaneous fat thickness measured on thoracic radiographs was associated with body condition score (BCS) in dogs.
Animals—87 client-owned dogs (41 males and 46 females) with a median age of 10.0 years (range, 1 to 16 years) and median weight of 20.3 kg (range, 3.1 to 58.0 kg).
Procedures—Age, sex, body weight, and breed were recorded. Body condition scores (scale from 1 to 9) and muscle condition scores were assigned by a single investigator. Subcutaneous fat thickness was measured at the level of the eighth rib head on a dorsoventral or ventrodorsal radiographic view of the thorax by a single investigator. Ratios of subcutaneous fat thickness to the width of the midbody of T8 on the ventrodorsal or dorsoventral radiographic view (T8 ratio) and to the length of the midbody of T4 on a right lateral radiographic view (T4 ratio) were calculated and compared with BCS by means of the Spearman correlation method.
Results—Median BCS was 6 (range, 1 to 9), and all muscle condition scores were represented. There were significant correlations between BCS and T4 ratio (r = 0.86) and between BCS and T8 ratio (r = 0.84).
Conclusions and Clinical Relevance—Results indicated that in this population, there was a significant association between BCS and subcutaneous fat thickness measured on thoracic radiographs. Findings suggested that measuring subcutaneous fat thickness could aid in the retrospective assignment of BCS in studies involving dogs in which BCS was not recorded in the medical record.
OBJECTIVE To determine whether the degree of CT attenuation of muscle would differ between healthy old and young dogs.
ANIMALS 10 healthy old (> 8 years old) and 9 healthy young (1 to 5 years old) Labrador Retrievers with a body condition score of 5 or 6 on a 9-point scale.
PROCEDURES CT was performed with the dogs mildly sedated. A freehand closed polygon tool was used to define the outer margin of the left epaxial muscles on each transverse image obtained from the cranial to caudal endplates of T13. The CT attenuation values from every voxel from within these regions of interest were exported from DICOM software as a single dataset in an extensible markup language file. From these data, mean CT attenuation values were calculated for each dog and these mean values were compared between age groups.
RESULTS Mean CT attenuation values for the epaxial muscles were significantly lower in old dogs than in young dogs. A significant negative correlation (r = –0.74) was identified between mean CT attenuation values and dog age.
CONCLUSIONS AND CLINICAL RELEVANCE In addition to loss of skeletal muscle mass, low muscle CT attenuation values suggested that the old dogs in this study also had greater muscle fat content than did young dogs. Additional studies are warranted to evaluate qualitative and quantitative muscle changes in old dogs.
Objective—To evaluate clinically applicable methods of assessing lean body mass in dogs and compare muscle mass and inflammatory markers in healthy young and old dogs.
Animals—9 healthy young (1 to 5 years old) and 10 old (> 8 years old) Labrador Retrievers with a body condition score of 5 to 6 of 9.
Procedures—Radiography of the thoracolumbar region was performed for measurement of epaxial muscle height at the level of T13–L1. Computed tomographic images were obtained for the measurement of the epaxial and temporal muscles. Ultrasonography also was performed for regional muscle measurements at these same sites and the quadriceps muscle. Serum C-reactive protein, insulin-like growth factor-1, and tumor necrosis factor-α concentrations also were measured, and dogs' activity for 14 days was assessed with an activity monitor.
Results—Mean epaxial muscle area measured by ultrasonography was significantly lower in the old group, compared with the young group, whereas epaxial muscle area measured by CT was only significantly lower in the old group after normalization for vertebral height. Neither temporal and quadriceps muscle measurements nor serum C-reactive protein or insulin-like growth factor-1 concentrations were significantly different between age groups. Tumor necrosis factor-α concentrations were undetectable in all dogs.
Conclusions and Clinical Relevance—This study documented reduced epaxial muscle area in healthy old Labrador Retrievers, consistent with the syndrome of sarcopenia. Ultrasonography and CT were feasible methods of measuring epaxial muscle area, but much additional research is required to assess this method. A better understanding of underlying mechanisms of sarcopenia as well as methods for slowing progression is needed.
OBJECTIVE To describe the ultrasonographic appearance of the urinary bladder incision site in dogs that underwent cystotomy for treatment of urolithiasis.
DESIGN Prospective, longitudinal study.
ANIMALS 18 client-owned dogs.
PROCEDURES Dogs underwent urinary bladder ultrasonography at baseline (≤ 1 day before surgery) and at 1 day and approximately 2, 6, and 12 weeks after cystotomy for urocystolith removal. A baseline ratio between ventral (cystotomy site) and corresponding dorsal midline wall thickness was calculated and used to account for measurement variations attributable to bladder distension at subsequent visits. Patient signalment, weight, medications administered, urocystolith composition, and culture results were recorded. Clinical signs, reoccurrence of hyperechoic foci, and suture visualization were recorded at follow-up examinations. Variables were evaluated for association with cystotomy site thickening and resolution of thickening.
RESULTS Median wall thickness at the ventral aspect of the bladder was significantly greater than that of the corresponding dorsal aspect at baseline. Cystotomy site thickening peaked 1 day after surgery and decreased at subsequent visits in a linear manner. Twelve weeks after surgery, 5 of 10 clinically normal dogs evaluated had persistent cystotomy site thickening. Eleven of 18 dogs had reoccurrence of hyperechoic foci within the bladder at some time during the study (median time to first detection, 17 days after surgery).
CONCLUSIONS AND CLINICAL RELEVANCE Persistent cystotomy site thickening can be present up to 3 months after cystotomy for urolithiasis in dogs without lower urinary tract signs. Reoccurrence of hyperechoic foci in the bladder, although subclinical, was detected earlier and at a higher rate than anticipated.
OBJECTIVE To evaluate use of an ultrasonographically and radiographically determined value, the vertebral epaxial muscle score (VEMS), for assessing muscle mass in cats.
ANIMALS 30 healthy neutered cats of various body weights and between 1 and 6 years of age.
PROCEDURES Mean epaxial muscle height was calculated from 3 transverse ultrasonographic images obtained at the level of T13. Length of T4 was measured on thoracic radiographs, and the VEMS (ratio of epaxial muscle height to T4 length) was calculated and compared with body weight. Ratios of epaxial muscle height to various anatomic measurements also were compared with body weight as potential alternatives to use of T4 length.
RESULTS 1 cat was excluded because of a heart murmur. For the remaining 29 cats, mean ± SD body weight was 5.05 ± 1.40 kg. Mean epaxial muscle height was 1.27 ± 0.13 cm, which was significantly correlated (r = 0.65) with body weight. The VEMS and value for epaxial muscle height/(0.1 × forelimb circumference) were not significantly correlated (r = −0.18 and −0.06, respectively) with body weight, which is important for measures used for animals of various sizes.
CONCLUSIONS AND CLINICAL RELEVANCE The VEMS and value for epaxial muscle height/(0.1 × forelimb circumference) can both be used to normalize muscle size among cats of various body weights. Studies are warranted to determine whether these values can be used to accurately assess muscle mass in cats with various adiposity and in those with muscle loss.
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.
Case Description—An 8-month-old male Saint Bernard developed tetanic seizures and hyperthermia during evaluation of bilateral osteochondritis dissecans of the shoulder joints. Further investigation revealed that the dog was receiving an unbalanced homemade diet.
Clinical Findings—Preliminary evaluation of the dog revealed bilateral signs of pain and mild muscle wasting in the shoulder joint areas. Serum biochemical analysis revealed severe hypocalcemia, hyponatremia, hypochloremia, hyperphosphatemia, vitamin D deficiency, and taurine deficiency. Diffuse osteopenia was identified on radiographs of the mandible and long bones, confirming bone demineralization. Analysis of the homemade diet revealed that the dog's diet was severely deficient in a variety of nutrients.
Treatment and Outcome—The dog responded positively to treatment for hypocalcemia, hyperthermia, and seizures. The dog's diet was changed to a complete and balanced canine diet formulated for growth. Body weight and body condition were monitored, and dietary intake was adjusted to achieve optimal body condition during growth. After initial evaluation, serial monitoring of serum calcium and taurine concentrations revealed that values were within reference limits and the dog had no further clinical signs associated with dietary deficiency.
Clinical Relevance—Findings in this puppy highlight the risks associated with feeding an unbalanced homemade diet during growth and the importance of obtaining a thorough dietary history from all patients. For owners who elect to feed a homemade diet, it is critical to have the homemade diet carefully formulated by a veterinary nutritionist to avoid severe nutrient imbalances, especially in young, growing dogs.