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- Author or Editor: Laurent Blond x
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Abstract
OBJECTIVES
To evaluate blood and cerebrospinal fluid (CSF) concentrations of C-reactive protein (CRP) in dogs with meningoencephalitis of unknown origin (MUO); to evaluate whether blood CRP concentration is associated with epidemiological, clinicopathologic, and MRI findings; and to investigate blood CRP predictive power in survival.
ANIMALS
30 client-owned dogs with MUO, 15 client-owned dogs with steroid-responsive meningitis arteritis (SRMA; positive control group), and 15 healthy dogs (negative control group).
METHODS
Blood CRP concentration was measured in each group, while it was performed in CSF only in the MUO and SRMA groups. The analysis of epidemiological data included breed, age, sex, duration of clinical signs, and history of seizures. Blinded analysis of MRI was performed based on a classification grid, and traditional CSF analysis parameters were assessed. The predictive power of blood CRP concentration regarding survival at 6 months was investigated.
RESULTS
Of the 30 dogs with MUO, 9 (30%) had an increased CRP concentration in blood, and 3 (10%) showed a measurable CRP in CSF. Median blood CRP concentration in dogs with MUO was 0.1 mg/L (range, 0.1 to 102 mg/L), which was not statistically different from the healthy dog group but significantly lower than the SRMA control group. Only the duration of clinical signs was positively associated with an increased blood CRP level. Blood CRP concentration was not associated with survival at 6 months.
CLINICAL RELEVANCE
Blood CRP concentration is of limited value for the diagnosis and prognosis of dogs with MUO. Chronicity of the disease may be associated with an increased concentration of blood CRP.
Abstract
OBJECTIVE
To describe and compare the results of preoperative CT and surgical findings in dogs with sublumbar abscesses and investigate potential associations between these variables and the outcome of abscess recurrence.
ANIMALS
51 client-owned dogs.
PROCEDURES
A retrospective, records-based study was performed of dogs undergoing surgery for treatment of sublumbar abscesses diagnosed by use of CT between January 2010 and December 2018. Signalment, clinical signs, clinicopathologic data, CT findings, surgical techniques and findings, duration of hospitalization, postoperative treatment, and complications were recorded. Long-term follow-up was performed through telephone interviews. Logistic regression analysis was used to investigate associations between the variables of interest and abscess recurrence.
RESULTS
51 dogs met the study inclusion criteria; 48 were included in outcome analysis. The CT findings agreed with surgical findings for identification of a migrating vegetal foreign body for 39 of 51 (77%) dogs. All dogs survived to hospital discharge; 1 dog died of hemoabdomen 3 days after surgery, and 6 had minor (surgical wound) complications reported. Abscess recurrence developed in 12 of 48 (25%) dogs with a median time to recurrence of 6 months. Identification of diskospondylitis on CT examination was the only investigated factor significantly associated with recurrence; odds of recurrence in dogs with this finding were 8.4 times those for dogs without this finding.
CONCLUSIONS AND CLINICAL RELEVANCE
Our results suggested dogs with sublumbar abscesses have a good prognosis after surgery, although recurrence can develop. Preoperative identification of diskospondylitis was significantly associated with abscess recurrence in this study sample.
Abstract
OBJECTIVE
To evaluate the feasibility and reliability of early ultrasound diagnosis for postsurgical bowel dehiscence and find the most reliable ultrasound criteria for dehiscence identification. Additionally, to determine the impact of early ultrasound detection of leakage in terms of survival and duration of hospitalization. Finally, to assess the need for systematized screening or checkup of the population at risk of dehiscence only.
ANIMALS
31 cats and 83 dogs.
METHODS
A retrospective, records-based study was performed on 83 dogs and 31 cats (114 total) undergoing small intestinal surgery. Epidemiologic data, clinical signs, surgical procedures, pre- and postoperative ultrasound findings at 48 to 96 hours, hospitalization duration, complications, and general outcomes were recorded. Univariate and multivariate analyses were used to identify ultrasound findings associated with dehiscence.
RESULTS
Dehiscence was suspected by ultrasound for 0 of 31 cats and 7 of 83 dogs (2 of 49 for enterotomy and 5 of 34 for enterectomy). Every suspected dehiscence was confirmed during revision surgery except one enterectomy revision, which was declined by the owner. Neither this case nor those without ultrasound evidence of dehiscence developed clinical signs of intestinal leakage. Direct visibility of wall discontinuity, presence of gas bubbles, and liquid in vicinity of the intestinal surgical site were statistically associated with early dehiscence. Survival rate after the second surgery was 83%. Median hospitalization time after the second surgery for dehiscence was 2 days (minimum, 2 days; maximum, 4 days).
CLINICAL RELEVANCE
Postoperative ultrasound examination between 48 and 96 hours after intestinal surgery allows early and sensitive detection of intestinal dehiscence. Survival rate after revision surgery was significantly higher than that associated with septic peritonitis.
Abstract
Objective—To evaluate interobserver agreement and diagnostic accuracy of brain MRI in dogs.
Design—Evaluation study.
Animals—44 dogs.
Procedures—5 board-certified veterinary radiologists with variable MRI experience interpreted transverse T2-weighted (T2w), T2w fluid-attenuated inversion recovery (FLAIR), and T1-weighted-FLAIR; transverse, sagittal, and dorsal T2w; and T1-weighted-FLAIR postcontrast brain sequences (1.5 T). Several imaging parameters were scored, including the following: lesion (present or absent), lesion characteristics (axial localization, mass effect, edema, hemorrhage, and cavitation), contrast enhancement characteristics, and most likely diagnosis (normal, neoplastic, inflammatory, vascular, metabolic or toxic, or other). Magnetic resonance imaging diagnoses were determined initially without patient information and then repeated, providing history and signalment. For all cases and readers, MRI diagnoses were compared with final diagnoses established with results from histologic examination (when available) or with other pertinent clinical data (CSF analysis, clinical response to treatment, or MRI follow-up). Magnetic resonance scores were compared between examiners with κ statistics.
Results—Reading agreement was substantial to almost perfect (0.64 < κ < 0.86) when identifying a brain lesion on MRI; fair to moderate (0.14 < κ < 0.60) when interpreting hemorrhage, edema, and pattern of contrast enhancement; fair to substantial (0.22 < κ < 0.74) for dural tail sign and categorization of margins of enhancement; and moderate to substantial (0.40 < κ < 0.78) for axial localization, presence of mass effect, cavitation, intensity, and distribution of enhancement. Interobserver agreement was moderate to substantial for categories of diagnosis (0.56 < κ < 0.69), and agreement with the final diagnosis was substantial regardless of whether patient information was (0.65 < κ < 0.76) or was not (0.65 < κ < 0.68) provided.
Conclusions and Clinical Relevance—The present study found that whereas some MRI features such as edema and hemorrhage were interpreted less consistently, radiologists were reasonably constant and accurate when providing diagnoses.
Abstract
CASE DESCRIPTION A 4-hour-old 6.3-kg (13.9-lb) female alpaca cria was evaluated because of severe respiratory distress and difficulty nursing since birth.
CLINICAL FINDINGS The cria had open-mouth breathing and cyanotic membranes, with no airflow evident from either nostril. Supplemental oxygen was delivered, and the patient was anesthetized and intubated orotracheally; a CT evaluation of the head confirmed bilateral membranous obstruction of the nasal cavities, consistent with complete bilateral choanal atresia.
TREATMENT AND OUTCOME Choanal atresia was treated with an endoscopically assisted balloon-dilation technique, and temporary tracheostomy was performed. Stenosis recurred, requiring revision of the repair and intranasal stent placement 3 days after the first surgery. The tracheostomy tube was removed the next day. Complications during hospitalization included mucoid obstruction of the tracheostomy tube, granulation tissue development in the trachea near the tracheostomy site, mucoid stent obstruction, aspiration pneumonia, and presumed partial failure of passive transfer of immunity. The stents were removed 2 weeks after admission, and the cria was discharged 3 days later. The owner was advised that the animal should not be bred. At last follow-up 3 years later, the alpaca was doing well.
CLINICAL RELEVANCE Surgical treatment with a balloon-dilation technique and placement of nasal stents with endoscopic guidance were curative in this neonatal alpaca with bilateral membranous choanal atresia. Computed tomography was useful to determine the nature of the atresia and aid surgical planning. Because a genetic component is likely, owners should be advised to prevent affected animals from breeding.