Objective—To identify preoperative variables associated with postoperative hypocalcemia in dogs with primary hyperparathyroidism undergoing parathyroidectomy.
Design—Retrospective case series.
Procedures—Medical records of dogs undergoing parathyroidectomy for treatment of primary hyperparathyroidism between January 2004 and January 2009 at 4 institutions were reviewed; data regarding various preoperative variables and postoperative serum total and ionized calcium concentrations were recorded. Preoperative ultrasonographic and surgical findings were compared regarding laterality (right, left, or bilateral) of parathyroid gland lesions. Data were analyzed via ANOVA, simple linear regression, and multiple linear regression to identify associations between preoperative variables and postoperative serum total and ionized calcium nadir concentrations.
Results—Preoperative variables significantly associated with low postoperative serum total calcium nadir concentrations included old age, history of weakness, lack of gastrointestinal tract signs, high serum parathyroid hormone concentration, and low serum calcium-phosphorus concentration product value. Preoperative variables significantly associated with low postoperative serum ionized calcium nadir concentrations included sexually intact status, low body weight, high serum urea nitrogen concentration, and lack of polyuria and polydipsia in the history. Age, body weight, serum calcium-phosphorus concentration product, and serum concentrations of parathyroid hormone and urea nitrogen were included in the final multiple linear regression model for prediction of postoperative serum calcium concentrations. Ultrasonography was performed in 58 dogs; results for 44 (75.9%) dogs agreed with surgical findings regarding laterality of parathyroid gland lesions.
Conclusions and Clinical Relevance—Prediction of postoperative hypocalcemia in dogs in this study with primary hyperparathyroidism that underwent parathyroidectomy was difficult and depended on multiple (history, physical examination, and clinicopathologic) factors.
OBJECTIVE To assess dimensions and attenuation of sternal lymph nodes (SLNs) observed by means of CT in healthy dogs.
ANIMALS 12 healthy adult research dogs.
PROCEDURES Precontrast and postcontrast enhanced CT of the thorax was performed on each dog. Objective and subjective contrast-enhanced CT measurements were obtained.
RESULTS By use of CT, 2 SLNs were identified in 10 of the 12 dogs and 1 SLN was identified in 2. Median SLN length, height, and width were 8.5 mm (range, 4 to 22 mm), 6.0 mm (range, 3 to 10 mm), and 5.0 mm (range, 3 to 10 mm), respectively. Median SLN length-to-T4 ratio, height-to-T4 ratio, and width-to-T4 ratio were 0.64 (range, 0.24 to 1.22), 0.37 (range, 0.25 to 0.53), and 0.29 (range, 0.19 to 0.67), respectively. Median SLN volume was 123 mm3 (range, 38 to 484 mm3). Median height-to-length ratio, width-to-length ratio, and height-to-width ratio were 0.57 (range, 0.27 to 1.75), 0.51 (range, 0.31 to 1.25), and 1.27 (range, 0.50 to 2.50), respectively. All SLNs had homogenous contrast enhancement with median precontrast and postcontrast attenuation values of 18.3 Hounsfield units (HU; range, 4.4 to 36.9 HU) and 41.3 HU (range, 24.0 to 77.4 HU), respectively. All SLNs had a visible hilus, which was fat attenuating in 8 dogs and hypoattenuating in 4 dogs.
CONCLUSIONS AND CLINICAL RELEVANCE CT imaging characteristics described in this study may provide a reference for dimensions and appearance of SLNs of healthy dogs and serve as a basis for comparison with results for diseased dogs.
OBJECTIVE To evaluate the usefulness of injection of indocyanine green (ICG) solution with near-infrared (NIR) fluorescence imaging for transcutaneous detection of sentinel lymph nodes (SLNs) and their associated lymphatic vessels in the oral mucosa of healthy dogs.
ANIMALS 6 adult purpose-bred research hounds.
PROCEDURES Each dog was sedated, and 1 mL of ICG solution was injected into the gingival mucosa dorsal to the right maxillary canine tooth. Subsequently, NIR fluorescence imaging was used to transcutaneously detect the lymphatic vessels and SLNs. The distance between the injection site and each SLN was measured. Time to first evidence of node fluorescence was recorded, and velocity of ICG movement was calculated. A slide preparation of a fine-needle aspiration sample of the fluorescing structure underwent cytologic examination (to confirm presence of lymphatic tissue) and NIR fluorescence imaging (to confirm presence of ICG).
RESULTS The ipsilateral mandibular lymphocentrum was the SLN in all dogs. The time to visually detectable fluorescence ranged from 4 to 15 minutes (mean ± SD, 8.8 ± 3.76 minutes). The mean velocity was 1.94 ± 0.93 cm/min. Fluorescence was not observed in the contralateral lymph nodes. Each fluorescing structure was confirmed to be lymphatic tissue, and NIR fluorescence imaging revealed that ICG was present in the sampled SLN.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that injection of ICG solution with NIR fluorescence imaging can be used to transcutaneously identify SLNs along with associated lymphatic vessels in the oral mucosa of healthy dogs. Time from injection to identification of fluorescence was rapid with prolonged retention of material within the SLN, indicating that this procedure could be performed during surgery.
Objective—To assess perioperative findings and postoperative complications and outcomes in dogs that had ectopic thyroid carcinomas with invasion into the hyoid apparatus and underwent tumor excision with partial hyoidectomy.
Design—Retrospective case series.
Animals—5 client-owned dogs.
Procedures—Medical records of dogs that had an ectopic neuroendocrine tumor with invasion into the hyoid apparatus and underwent tumor excision with partial hyoidectomy were reviewed for information regarding perioperative and postoperative findings and outcome. During surgery in each case, the thyrohyoid and ceratohyoid or epihyoid bones (depending on degree of hyoid apparatus involvement) were sharply transected, allowing en bloc removal of the tumor. The ipsilateral cut ends of the thyrohyoid and ceratohyoid or epihyoid bones (depending on which was cut) were sutured together with polypropylene suture in a simple interrupted pattern.
Results—All partial hyoidectomy procedures were completed without surgical or anesthetic complications. All 5 dogs were able to eat and drink between 7 and 24 hours after surgery, with no signs of dysphagia, ptyalism, or abnormal tongue carriage. Follow-up information was obtained over a period of 173 to 587 days after surgery for all 5 dogs; 4 dogs were still alive at last follow-up. One dog was euthanized 587 days after surgery because of lethargy, inappetence, and hypercalcemia.
Conclusions and Clinical Relevance—From this limited series of cases, results suggested that partial resection of the hyoid apparatus during removal of ectopic thyroid carcinoma may be tolerated well and be associated with very good functional outcomes in dogs. (J Am Vet Med Assoc 2014;245:1319–1324)
Objective—To construct and optimize a fiducial marker suitable for both CT and MRI.
Sample—Fiducial markers containing serial dilutions of iopamidol mixed with water.
Procedures—IV tubing sets were infused with serial dilutions (0% to 100%; increments of 10%) of iopamidol. Tubing ends were sealed; additional seals were added to create an equilateral triangle. A reference point was created by placing a crimp in 1 side. Markers were fixed to a gelatin soft tissue–attenuating phantom and evaluated by use of CT and MRI. For CT, simple linear regression analysis was used to assess the relationship between the percentage of marker contrast medium and quantitative variables, including marker attenuation, attenuation changes in the phantom, and beam-hardening artifact length. A subjective grading scheme for artifact creation on CT images and marker visibility on MRI images was used. Measurements were obtained by investigators who were unaware of the contents of each marker.
Results—Percentage of contrast medium in each marker was strongly correlated with marker attenuation (r2 = 0.96), artifact length (r2 = 0.765), and mean attenuation changes within the phantom (r2 = 0.826) for CT. Subjective CT scores indicated that concentrations of contrast medium > 50% resulted in excessive artifacts. Markers with concentrations of iopamidol > 50% had poor subjective MRI visibility scores. No artifacts were seen on MRI.
Conclusions and Clinical Relevance—A marker containing a 10% solution of iodinated contrast medium mixed with water provided ideal contrast for both CT and MRI.
Objective—To characterize historical, clinicopathologic, ultrasonographic, microbiological, surgical, and histopathologic features of bacterial cholecystitis and bactibilia in dogs and evaluate response to treatment and outcomes in these patients.
Design—Retrospective case-control study.
Animals—40 client-owned dogs (10 with bacterial cholecystitis on histologic analysis or bactibilia on cytologic examination [case dogs] and 30 without bactibilia [controls]) evaluated at a veterinary teaching hospital between 2010 and 2014.
Procedures—Signalment, history, clinicopathologic findings, ultrasonographic features, microbiological results, surgical findings, histopathologic changes, treatments, and outcomes of case dogs were derived from medical records and summarized. Demographic and clinicopathologic data and ultrasonographic findings were compared between case and control dogs. Relationships among prior antimicrobial treatment, sediment formation in the gallbladder, presence of immobile biliary sludge, and presence of bactibilia or bacterial cholecystitis were assessed.
Results—No finding was pathognomonic for bactibilia or bacterial cholecystitis in dogs. Case dogs were significantly more likely to have immobile biliary sludge and had a greater degree of biliary sediment formation than did control dogs. All case dogs for which gallbladders were examined histologically (6/6) had bacterial cholecystitis. Five of 10 case dogs were Dachshunds. Medical or surgical treatment resulted in good outcomes.
Conclusions and Clinical Relevance—Bactibilia and bacterial cholecystitis were important differential diagnoses in dogs with signs referable to biliary tract disease. Dachshunds were overrepresented, which may suggest a breed predisposition. Cytologic evaluation of bile should be considered in the routine assessment of dogs with hepatobiliary disease if immobile biliary sludge is present. (J Am Vet Med Assoc 2015;246:982–989)
OBJECTIVE To evaluate changes in the dimension and volume of feline injection-site sarcomas (FISSs) before (in vivo) and after surgical excision and formalin fixation (ex vivo) as determined by measurements obtained from 2-D and 3-D CT images.
SAMPLE 10 excised FISSs.
PROCEDURES The maximum length, width, and depth of each FISS were measured on contrast-enhanced 2-D CT images of the tumor obtained in vivo and ex vivo. Those measurements were used to estimate tumor volume with the standard ellipsoid formula. Tumor volume was also calculated from 3-D CT images with software that used a volume-rendering algorithm. Student paired t tests were used for comparisons between the in vivo and ex vivo assessments.
RESULTS Small decreases were detected in maximum tumor length, width, and depth between the in vivo and ex vivo assessments; however, tumor length was the only dimension that decreased significantly between the 2 assessments. Median tumor volume decreased significantly between the in vivo and ex vivo assessments regardless of the method used to estimate it. Tumor volume estimated by the ellipsoid formula was significantly lower than that estimated by the 3-D CT software at both assessments.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that shrinkage of FISSs following excision and formalin fixation was small and may be less than that of grossly normal tissue. Tumor volume estimated by the ellipsoid formula was consistently less than that estimated by 3-D CT software and should not be used when accuracy of tumor volume is of particular concern and advanced CT imaging is available.
OBJECTIVE To determine complication rates associated with sutureless scrotal castration (SLSC) performed in a large number of pediatric and juvenile dogs and investigate whether procedure duration differed from that of traditional prescrotal castration (TPSC).
DESIGN Prospective case series and clinical trial.
ANIMALS 400 shelter-owned dogs that underwent SLSC and 18 shelter-owned dogs that underwent TPSC between 2 and 5 months of age.
PROCEDURES In the first phase of the study, SLSC was performed for 400 dogs, which were monitored for ≥ 24 hours after surgery to identify surgery-related complications such as hemorrhage, signs of pain, self-trauma, swelling, and dermatitis at the incision site. In the second phase, the durations of 18 SLSC and 18 TPSC procedures were measured and compared.
RESULTS No hemorrhage-related complications were identified in any dog during SLSC in the first phase. Complications were all minor and self-limiting and included peri-incisional dermatitis (9/400 [2.3%]), skin bruising (4/400 [1.0%]), and swelling (1/400 [0.3%]). No self-trauma was observed for any dog, nor did any dog require additional analgesic treatment after surgery. Procedure duration was significantly briefer for SLSC (mean ± SD, 1.0 ± 0.2 minutes) than for TPSC (3.5 ± 0.4 minutes).
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that SLSC as evaluated was safe and significantly faster than TPSC when performed in healthy 2- to 5-month-old dogs. The SLSC technique has the potential to improve morbidity and mortality rates as well as financial costs associated with castration, particularly in high-quality, high-volume spay and neuter programs.