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Biomedical subjects

T W Fossum

Publications and source records attributed to T W Fossum.

At least 19 recordsLinked to original sources

Severe bilateral fibrosing pleuritis associated with chronic chylothorax in five cats and two dogs.

Severe bilateral fibrosing pleuritis was diagnosed in 5 cats and 2 dogs with chronic chylothorax. All animals were dyspneic on initial examination and remained moderately to severely dyspneic after thoracentesis. Radiographic evidence of fibrosing pleuritis included rounded lung lobes and failure of the lungs to reexpand following effective pleural drainage. Fibrosing pleuritis was also suggested in several animals with radiographic evidence of pleural fluid, in which pleural fluid could not be retrieved. Macroscopically, the lung lobes of all animals were compressed and atelectatic to various degrees, and the pleura appeared to be diffusely thickened and roughened. In several animals, fibrous adhesions were found between the parietal and visceral pleura of some lobes. Lung lobes were markedly constricted and appeared as small, smooth, rounded hilar masses in 4 animals. Mild to moderate pulmonary edema was evident in 3 animals at necropsy. Six of the 7 animals died (2) or were euthanatized (4) within 72 hours after the diagnosis of fibrosing pleuritis. The fibrosing pleuritis developed in 1 animal with lymphoblastic lymphosarcoma and chylothorax after treatment via passive pleuroperitoneal drainage; this animal was euthanatized because of underlying neoplasia. One cat, in which decortication was performed and resulted in marked reexpansion of the lung lobes, died 4 hours after surgery with signs compatible with pulmonary edema. On the basis of our findings, we suggest that animals with chronic chylothorax are at risk to develop fibrosing pleuritis. Furthermore, animals with severe bilateral fibrosing pleuritis should be given extremely guarded prognoses.

Animals

Pneumothorax in a dog with a pulmonary abscess and suspected infective endocarditis.

Nontraumatic pneumothorax was diagnosed in a dog with a pulmonary abscess and evidence of infectious endocarditis, including fever, mitral murmur, and vegetative lesion of mitral valve leaflets. Pneumothorax persisted after 4 days of continuous thoracic drainage. At exploratory thoracotomy, the diaphragmatic lung lobe was identified as the source of air leakage and was excised. Results of culturing of blood and lung tissue for aerobic and anaerobic bacteria were negative. Antibiotics were administered because of suspected bacterial endocarditis. Pneumothorax and fever resolved after surgical and medical treatments.

Animals

Chylous ascites in three dogs.

Chylous ascites was diagnosed in 3 dogs. Mesenteric lymphangiography was performed in 2 dogs and helped delineate abnormalities of the lymphatic system. The cause of chylous ascites in each dog appeared to be different. In 1 dog, a ruptured mesenteric lymphatic was identified at surgery. Evidence of abdominal lymphatic obstruction was found in another dog. Chylous ascites in the third dog appeared to be a complication of mesenteric lymphangiography for chylothorax.

Animals

Osteomyelitis.

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Animals

Lymphoscintigraphy in healthy dogs and dogs with experimentally created thoracic duct abnormalities.

Lymphoscintigraphic evaluation of the thoracic duct (TD) was performed in 10 healthy and 12 dogs with experimentally created TD abnormalities (6 dogs with TD lacerations and 6 dogs with cranial vena ligations). Complete imaging took 4 hours and caused no adverse effects or complications. Lymphoscintigraphy of healthy dogs failed to image the TD; however, background activity in the abdomen and thorax, and radioactivity in the kidneys, bladder, liver, and heart were noticed. Lacerations and transections of the TD were experimentally created in 6 dogs to ascertain whether TD rupture could be detected with lymphoscintigraphy. Lymphoscintigraphy was performed within 48 hours of creating the TD defect. There was no significant difference in the scintigraphic pattern of healthy dogs and those with experimentally created TD defects. Ligation of the cranial vena cava was performed in 6 dogs; 3 dogs developed chylothorax. In those 3 dogs, diffuse radioactivity was imaged in the thorax and was compatible with thoracic lymphangiectasia. In one of these dogs, linear activity consistent with the TD and localized regions of radioactivity cranial to the heart (compatible with the mediastinal lymph nodes) were noticed. Lymphoscintigraphic findings in these dogs correlated with lymphangiographic findings.

Animals

Hyponatremia and hyperkalemia associated with idiopathic or experimentally induced chylothorax in four dogs.

Two dogs with idiopathic chylothorax and 2 dogs with experimentally induced (ie, ligation of the cranial vena cava) chylothorax were treated by intermittent thoracic drainage. Of these 4 dogs, 3 that did not have evidence of renal failure had normal or near-normal serum sodium and potassium concentrations before thoracic drainage began, and all 3 developed repeatedly marked hyponatremia and hyperkalemia during thoracic drainage. Another dog became weak and depressed, ostensibly because of hyperkalemia. Serum sodium and potassium concentrations in 1 dog with spontaneous chylothorax returned to normal after chylothorax resolved and thoracic drainage was stopped. The other 3 dogs died or were euthanatized, and the effect of stopping thoracic drainage could not be evaluated. In 3 dogs in which it was measured, normal-to-high plasma cortisol concentration was observed before and after adrenocorticotropin administration, and 2 dogs also had hyperaldosteronemia. Hyponatremia was hypothesized to be caused by sodium loss via thoracic drainage whereas hyperkalemia may have been multifactorial in origin, but probably was attributable, at least, in part to decreased renal potassium clearance.

Animals

Chylothorax in cats: 37 cases (1969-1989).

Case records of 37 cats with chylothorax examined at 2 institutions were retrospectively evaluated. Dyspnea and coughing were the most common abnormalities noticed by the owners, and most cats were dyspneic on initial examination. There was no statistically significant difference in the gender distribution of cats studied when compared with reference populations; however, purebred cats appeared to be overrepresented in the study population. Four of the cats had unilateral pleural effusion (2 left side, 2 right side) and 9 cats had effusions that were primarily, but not exclusively, on the right side. Surgery was performed on 20 cats. Fifteen cats underwent thoracic duct or cisterna chyli ligation; 20% had complete resolution of pleural fluid. There was no significant difference in the survival rate of cats that underwent thoracic duct ligation and those that were treated by other means. Six cats had mesenteric lymphangiography performed; 2 cats had normal results, and the remainder had various degrees of thoracic lymphangiectasia. Two cats in which pleuroperitoneal shunts were placed and 2 of 3 cats that underwent pleurodesis were euthanatized or died after surgery.

Age Factors

Diagnosis and treatment of chylothorax associated with lymphoblastic lymphosarcoma in four cats.

Chylothorax was diagnosed in 4 cats with lymphoblastic lymphosarcoma. Clinical findings included dyspnea, muffled heart sounds, and noncompressibility of the cranial portion of the thorax. All cats had high pleural fluid triglyceride concentration. Lymphosarcoma was diagnosed by cytologic evaluation of pleural fluid in 3 cats and by histologic evaluation of a cranial cervical lymph node in 1 cat. Two cats were euthanatized prior to any treatment, and the other 2 cats were managed by thoracic drainage, chemotherapy, and/or irradiation.

Animals

Generalized lymphangiectasis in a dog with subcutaneous chyle and lymphangioma.

A 2 1/2-year-old spayed Great Dane was evaluated for large, fluctuant, chyle-containing swellings on the ventral portion of the left side of the abdomen. Multiple abnormalities of the lymphatic system were diagnosed, including thoracic duct obstruction, lymphangioma, subcutaneous chyle reflux, intestinal lymphangiectasia, and dilatation of hepatic, mesenteric, and pleural lymphatic vessels. Mesenteric lymphangiography revealed leakage of contrast medium into the subcutaneous tissues adjacent and to the left of the second lumbar vertebral body. Dietary and surgical management to control the chylous reflux were unsuccessful, and the dog died approximately one year after the skin lesions were first observed.

Animals

Surgical correction of pectus excavatum, using external splintage in two dogs and a cat.

Two 4-week-old pups and a 7-week-old kitten with respiratory distress and pectus excavatum were treated by external application of a coaptation splint to the ventral aspect of the thorax. Sutures were placed percutaneously around the sternum and through predrilled holes in a piece of moldable splint material that had been contoured to fit a normal-shaped thorax. Correction of the sternal deformity and alleviation of respiratory distress were achieved in all 3 animals. Frontosagittal index and vertebral index were assessed before and after surgery. In all 3 animals, both indices were abnormal before surgery, but were within the normal range after surgery.

Animals

Cisplatin for treatment of transitional cell and squamous cell carcinomas in dogs.

Thirteen dogs with tumors were treated with monthly infusions of cisplatin. Complete responses were not observed. Of 8 dogs with urinary tract transitional cell carcinomas, 1 (12.5%) had a partial response of 31 weeks' duration, and 4 (50%) had stable disease for 12, 30, 32, and 34 weeks. Three (60%) of 5 dogs with head and neck squamous cell carcinomas had partial responses for 2, 10, and 15 weeks. All 13 dogs were evaluated for signs of toxicosis. Transient episodes of vomiting were recorded for 7 dogs (54%), and 2 dogs (15%) had mild thrombocytopenia. Although renal function gradually decreased in 2 dogs (15%), none of the dogs had an episode of acute renal failure attributable to cisplatin. These findings suggest that cisplatin may be a safe and potentially effective agent for treatment of transitional cell and squamous cell carcinomas in dogs.

Animals

Treatment of hemangiopericytoma in a dog, using surgical excision, radiation, and a thoracic pedicle skin graft.

A dog with hemangiopericytoma of the left forelimb underwent surgical excision followed by radiation therapy and thoracic pedicle skin grafting. Recurrence of the neoplasm was not observed 3.5 years after surgery. Hemangiopericytoma is an uncommon neoplasm that seldom metastasizes but has a high recurrence rate. In this dog, complete surgical excision was not possible because of the location and invasiveness of the neoplasm. The combination of surgery, radiotherapy, and skin grafting was a viable alternative to limb amputation.

Animals

Results of thoracic duct ligation in dogs with chylothorax.

Thoracic duct lymphangiography and ligation were done on 15 dogs with idiopathic chylothorax. Lymphangiography revealed thoracic lymphangiectasia in all dogs; none had a thoracic duct rupture. Lymphangiography immediately after ligation demonstrated missed branches of the thoracic duct in 4 of the 15 dogs. Eleven of the 15 dogs are alive and doing well. Eight of the 11 had no radiographic or clinical signs of pleural effusion (mean follow-up, 31.5 months; range, 4 to 75 months). The other 3 living dogs had persistent effusion; 2 were successfully managed with a pleuroperitoneal shunt (follow-up, 15 months) or pleurodesis (follow-up, 5 months), respectively, and 1 was not treated because the effusion was mild and the dog did not have clinical signs of disease (follow-up, 14 months). Four of the 15 dogs died or were euthanatized because of persistent effusion (mean follow-up, 11.5 months; range, 3 to 24 months). Considering the lack of treatment alternatives for dogs with idiopathic chylothorax, these results support thoracic duct ligation as a treatment method for dogs.

Animals

Use of cisplatin for treatment of appendicular osteosarcoma in dogs.

Nineteen dogs were treated for osteosarcoma of the appendicular skeleton. Eleven dogs treated by amputation and adjunctive cisplatin chemotherapy had a significantly longer (P less than 0.003) median survival time of 43 weeks (range, 20 to 108 weeks) than did 8 dogs whose median survival time was 14.5 weeks (range, 8 to 46 weeks) after amputation alone. All 11 dogs given cisplatin were evaluated for signs of drug toxicosis. Transient episodes of vomiting were recorded in 9 of 11 dogs. Additional toxic effects included gradual decreases in endogenous creatinine clearance in 3 dogs and thrombocytopenia in 1 dog. On the basis of prolonged survival times and minimal adverse effects, we concluded that cisplatin has promise as an effective and relatively nontoxic agent, when combined with amputation, for treatment of dogs with osteosarcoma of the appendicular skeleton.

Amputation, Surgical

Ultrastructural morphology of the canine thoracic duct and cisterna chyli.

The ultrastructural morphology of the thoracic duct and cisterna chyli of the dog was examined using scanning and transmission electron microscopy. Examination of the cisterna chyli, reservoir of the lymphatic system, featured a number of afferent lymphatics draining into the cisterna: valves were however absent. The luminal surface of the endothelial lining of both the thoracic duct and cisterna demonstrated ovoid endothelial nuclei with numerous cellular ridges. Considerable variation existed in the number of smooth muscle cells lining the duct and cisterna in the contracted and distended state. Organelles and inclusions characteristic of endothelium and smooth muscle were identified. Reflux of lymph into the thoracic duct was prevented by a mono- and bicuspid valve situated at the lymphaticovenous junction.

Animals

Late-onset regurgitation associated with persistent right aortic arch in two dogs.

Congenital persistent right aortic arch was diagnosed as the cause of weight loss and regurgitation in 2 dogs, aged 2.5 and 8 years, respectively. The first dog had 2 brief episodes of regurgitation that resolved spontaneously before the most recent onset of signs and diagnosis. The second dog had no clinical signs attributed to persistent right aortic arch until 2 months before the diagnosis was made. Dogs born with persistent right aortic arch typically have clinical signs of esophageal stenosis around the time of weaning. Evidence from the 2 dogs in this report indicate that clinical signs associated with vascular ring anomalies may not become evident until later in life. Veterinarians should consider the diagnosis of persistent right aortic arch in any age dog that is admitted because of regurgitation, weight loss, and dilatation of the cranial portion of the esophagus.

Animals