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Biomedical subjects

D S Biller

Publications and source records attributed to D S Biller.

At least 19 recordsLinked to original sources

Comparison of radiographic arthritic changes associated with two variations of tibial plateau leveling osteotomy.

Osteoarthritis (OA) progresses in the canine cranial cruciate ligament (CCL) deficient stifle. Progression of OA is also documented in canine patients after various surgical repair techniques for this injury. We evaluated the radiographic arthritic changes in canine stifle joints that have sustained a CCL injury, and compared radiographic OA scores between Tibial Plateau Leveling Osteotomy (TPLO)surgery patients receiving a medial parapatellar exploratory arthrotomy for CCL remnant removal versus those receiving a limited caudal medial arthrotomy without removal of the CCL remnants. Medial/lateral and caudal/cranial stifle radiographs were obtained before surgery, immediately following TPLO surgery and at 7-38 months (mean 20.5) after surgery. Sixty-eight patients (72 stifles) were included in the study. The cases were divided into two groups. The patients in group 1 (n = 49 patients, 51 stifles) had a limited caudal medial arthrotomy, and patients in group 2 (n = 19 patients, 21 stifles) had a medial parapatellar open arthrotomy. A previously described radiographic osteoarthritis scoring system was used to quantify changes in both of the groups. The age, weight, OA scores, initial tibial plateau angle, final tibial plateau angle, and the change in angle were compared between the groups. The results showed that there was significantly less progression of OA in the group that had the limited caudal medial, arthrotomy, versus a medial parapatellar open arthrotomy. There was a significant advancement of the OA scores of patients that had TPLO surgery.

Animals↗

Hyperadrenocorticism treated with metyrapone followed by bilateral adrenalectomy in a cat.

A 6-year-old spayed female cat was evaluated for uncontrolled diabetes mellitus and poor hair coat. Clinicopathologic abnormalities included high serum activity of liver enzymes, hyperglycemia, hypercholesterolemia, glucosuria, and an exaggerated response to ACTH stimulation. Abdominal ultrasonography revealed large adrenal glands. Hyperadrenocorticism was diagnosed. Treatment for a facial abscess was instituted along with administration of metyrapone for hyperadrenocorticism. After stabilization, bilateral adrenalectomy was performed. The cat recovered without complications and has remained clinically normal for 5 months with treatment of desoxycorticosterone pivalate and prednisone. Treatment with metyrapone appeared to stabilize the cat metabolically and clinically prior to surgery.

Adrenalectomy↗

Use of abdominal ultrasonography in the diagnosis of primary hyperaldosteronism in a cat.

A 13-year-old castrated male cat was examined because of a 2-week history of weakness, cervical ventroflexion, and dysphagia. Clinicopathologic abnormalities included hypokalemia and high serum creatine kinase activity. Abdominal ultrasonography revealed a 15-mm spherical mass in the area of the left adrenal gland. Plasma aldosterone concentration was high, and plasma renin activity was low. Findings were diagnostic of primary hyperaldosteronism. The cat responded well to intravenous and oral potassium supplementation while in the hospital. The owner declined surgery; therefore, repeated follow-up abdominal ultrasonography was recommended. The cat did well clinically with medical management alone until day 334, when it was lost to follow-up.

Adrenal Gland Neoplasms↗

Dental imaging.

Radiography continues to be the initial test of choice in equine dental imaging for reasons of availability and ability to detect bone and tooth changes. Contrast radiography may be useful to characterize dental involvement in cases with draining tracts. For radiographically occult lesions, other modalities are useful. CT is better than plain radiography due to the inherent avoidance of superimposition of the opposite dental arcade, excellent bone density characterization, and good spatial resolution. Nuclear medicine may be useful to verify bone involvement in the dental region in cases in which the signs are particularly vague or not readily localized. Ultrasonography is an excellent test for soft tissue characterization and may assist with the characterization of suspected bone lysis, pathologic fractures, and abscesses.

Animals↗

Ultrasonographic identification of Dirofilaria immitis in the aorta and liver of a dog.

A 5-year-old sexually intact male mixed-breed dog was evaluated because of suspected vena caval syndrome secondary to heartworm disease. On physical examination, the dog was thin, icteric, and weak and had tachycardia and a cardiac murmur. Serum biochemical and hematologic abnormalities included hyperbilirubinemia, high serum alkaline phosphatase and alanine transferase activities, hypoalbuminemia, leukocytosis, and normocytic normochromic anemia. Dirofilaria immitis microfilariae were seen in a blood smear. Echocardiography was used to confirm the diagnosis of vena caval syndrome. Multiple aberrant adult heartworms were evident ultrasonographically in the abdominal aorta and its branches and within hypoechoic nodules in the left caudal lobe of the liver. The dog's condition deteriorated despite supportive treatment and retrieval of 58 adult heartworms from the right side of the heart and vena cava, and the dog was euthanatized. At necropsy, adult heartworms were found in the aorta and inflammatory hepatic nodules. To our knowledge, ultrasonographic identification of heartworms within the systemic arterial system and liver of a dog has not been described previously.

Animals↗

Field imaging of the respiratory tract. Radiology and ultrasonography.

This article addresses the current status and clinical opportunities for portable radiography and ultrasonography. Radiology is indicated for imaging the nasal cavity, larynx, pharynx and thin portions of the neck. In young foals, adequate radiographs of the entire respiratory tract may be possible. Ultrasonography is indicated in superficial parts of the head and neck, the pleural space and diseased parts of the lungfields.

Ambulatory Care↗

Autosomal dominant polycystic kidney disease in Persian and Persian-cross cats.

A form of autosomal dominant polycystic kidney disease (ADPKD) similar in clinical features to human ADPKD occurs in the Persian cat. We characterized the morphologic and immunohistochemical features of this disease in a colony of affected cats. Complete postmortem examinations were performed on 11 normal and 22 affected cats ranging in age from 3 months to 10 years. Kidneys were evaluated by gross and histologic examinations, ultrastructure, lectin staining, bromodeoxyuridine immunochemistry for labeling index and immunochemistry for distribution of Na/K ATPase. Feline ADPKD was characterized by variable numbers of cysts in the renal cortex and medullar. Ultrastructural examination and lectin staining suggested that cysts arose from proximal and distal nephron segments. Bromodeoxyuridine labeling demonstrated increased proliferation of epithelium lining some cysts in young cats. Immunohistochemical staining showed variable translocation of Na/K ATPase from the basolateral membranes of cyst-lining cells to the cytoplasm or luminal membranes. Cystic renal disease commonly was associated with chronic tubulointerstitial nephritis and hepatobiliary hyperplasia and fibrosis. Focal hyperplasia of renal tubular epithelium, hepatic cysts, and cardiac lesions were present in some cats. Feline ADPKD shares many morphologic and pathogenetic features with human ADPKD.

Animals↗

Clinical applications of radiography and ancillary imaging.

Radiography will remain the most popular imaging modality in the near future for many reasons. It is economical, portable, and familiar to large animal practitioners. Contrast radiography allows evaluation of vascular and tract lesions. Other modalities may offer various advantages. Diagnostic sonography has the advantage of being able to evaluate soft tissue structure damage, fluid pockets, and lucent foreign bodies. Xeroradiography and CR use conventional, high-powered x-ray units for the production of images on nontraditional ionized film plate-cassette systems. Both systems provide superior bone-soft tissue contrast, by virtue of edge enhancement, than does conventional radiography. CT and MR imaging provide cross-sectional imaging of bones and adjacent structures, avoiding structures that may be superimposed on the area of interest with conventional radiography. The major limitation is the demand for a custom-engineered couch able to withstand the weight of an adult bovine. Scintigraphy provides important functional information for the clinical evaluation of orthopedic disease. It may be the most useful imaging tool to localize the cause of lameness.

Animals↗

Metacarpal fracture associated with lymphosarcoma-induced osteolysis in a horse.

A 19-year-old Appaloosa gelding was reluctant to move. Radiography revealed diffuse, permeative lysis of the cortex and subchondral bone of the phalanges, third metacarpal bones, proximal sesamoid bones, radius, carpal bones, tibia, mandible, and nasal bones of the skull. A comminuted fracture of the distal aspect of the left third metacarpal bone was identified on a lateral to medial radiographic view of the left metacarpophalangeal joint. Histologic examination of the first phalanx, third metacarpal bone, and sternum revealed multifocal infiltrates of nodular lymphosarcoma in cortical and subchondral bone. Osteoclastic cavities were apparent in bone trabeculae contiguous with nodular foci of lymphosarcoma. Osteoclastic osteolysis was not evident at bone surfaces that were not directly adjacent to neoplastic cells. Although lymphosarcoma is the most frequent malignant neoplasia encountered in horses, diffuse neoplastic infiltration of cortical and subchondral bone of the appendicular and axial skeleton represents an unusual presentation of lymphosarcoma.

Animals↗

Hepatic imaging with radiology and ultrasound.

Radiographically, the diseased liver may change in size, shape, position, or opacity. Contrast studies such as peritoneography, cholecystography, portography, and arteriography may be performed to increase the specificity of the radiographic diagnosis. Ultrasound can be used to detect the changes in liver echogenicity associated with disease, identify focal verses diffuse disease processes, detect vascular and biliary abnormalities noninvasively, and direct needle aspirates and biopsies for culture, cytology, and histopathology.

Animals↗

Evaluation of mesenteric lymphangiography and thoracic duct ligation in cats with chylothorax: 19 cases (1987-1992).

Mesenteric lymphangiography and thoracic duct ligation were performed on 19 cats with chylothorax between 1987 to 1992. Chylothorax was diagnosed on the basis of detection of chylomicrons in the pleural effusion or determination of a cholesterol concentration:triglyceride concentration ratio of < 1 in the pleural fluid. Preoperative medical treatment consisted of thoracentesis (19 of 19 cats) and feeding a fat-restricted diet (14 of 19 cats). Positive-contrast mesenteric lymphangiography was performed before thoracic duct ligation to identify an underlying cause for the effusion. Lymphangiectasia was diagnosed by use of radiography in 17 cats, none of which had evidence of a thoracic duct rupture. Thoracic duct ligation was performed via an incision made through the left 10th intercostal space. Lymphangiography was repeated immediately after ligation of the thoracic duct to document occlusion of all branches. Follow-up monitoring was done for 12 to 47 months (median, 28 months) and consisted of physical examination, evaluation for clinical signs related to pleural effusion, and thoracic radiography. Ten of 19 (53%) cats had complete resolution of pleural effusion. Nonchylous effusion, localized in the right hemithorax, was detected in 1 cat 2 months after thoracic duct ligation, but resolved after thoracotomy, breakdown of thoracic adhesions, and expansion of the right cranial lung lobe. Chylous effusion resolved 3 to 7 days (mean, 5.4 days) after surgery in the 10 cats that survived > 12 months after surgery. Four cats died between 2 and 13 days after thoracic duct ligation, but pleural effusion had resolved in 3 of these 4 cats at the time of death.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Ultrasonographic diagnosis of pyelonephritis in a cow.

A 2-year-old Holstein cow was examined because of a 2-month history of anorexia, decreased milk production, and a white vaginal discharge. Results of physical, laboratory, and ultrasound examinations were consistent with pyelonephritis. Through ultrasound examination, the right kidney and ureter were identified as structurally involved. Right nephrectomy was performed. Eight months after nephrectomy, the cow was clinically normal. In this cow, ultrasonography helped to determine disease severity, to direct the course of treatment, and to improve the accuracy of diagnosis and prognosis.

Animals↗

Enchondroma in a rhesus monkey.

A 2.5-year-old rhesus monkey was examined because of a bony enlargement of the distal portion of the right tibia. On the basis of radiographic and histologic findings, enchondroma was diagnosed. The tumor enlarged over the next 2 years, but the monkey continued to have normal use of its limb.

Animals↗

Effect of phenylephrine on hemodynamics and splenic dimensions in horses.

Pharmacologically induced splenic contraction might be useful during certain medical or surgical procedures in horses. The effects of phenylephrine, an alpha 1-adrenergic receptor agonist, on hemodynamic function and splenic dimensions were examined in 6 healthy adult horses. Phenylephrine infusion (1, 3, or 6 micrograms/kg of body weight/min for 15 minutes) resulted in a dose-related increase in mean pulmonary artery pressure; right atrial pressure; systolic, mean, and diastolic arterial pressures; and packed cell volume (P = 0.0001). Concurrent decreases in heart rate and specific cardiac output (P = 0.0001) were detected, but stroke volume did not vary significantly. The rate-pressure product was increased only at the highest phenylephrine dosage (P = 0.012). Bradycardia was observed at all dosages during drug infusion, and second-degree atrioventricular block was detected in 88% of horses during infusion. Phenylephrine administration caused dose-dependent splenic contraction, as detected by ultrasonographic measurements of splenic area and thickness (P = 0.0001). At the 3- and 6-micrograms/kg/min infusion rates, splenic area was reduced to 28 and 17% of baseline measurement, respectively. Splenic dimensions had returned to baseline values by 35 minutes after the end of infusion. Infusion of phenylephrine at a dosage of 3 micrograms/kg/min for 15 minutes can be used to induce splenic contraction in horses.

Animals↗