INTRATHORACIC MENINGOCELE NOT ASSOCIATED WITH NEUROFIBROMATOSIS.
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Diagnosis, Differential↗
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Hypervitaminosis A in a cat.
A 10-year-old cat that was kept on a diet consisting largely of raw liver was evaluated because of lethargy, partial anorexia, and weight loss of several months' duration. The cat's head and neck were rigidly extended, and a hard mass was palpable in the ventral cervical region. Cervical and thoracic radiography revealed proliferative bony lesions of the cervical and thoracic vertebrae as well as of the sternum and costal cartilages. Serum vitamin A concentration was 4 times normal. For reasons unrelated to hypervitaminosis A, euthanasia and necropsy were performed 6 months after evaluation. The skull and the cervical and first few thoracic vertebrae were rigidly fused, and the vertebral architecture was altered by deposition of new bone. The sternum and costal cartilages were similarly affected. The historical, physical, radiographic, laboratory, and postmortem findings were consistent with the diagnosis of hypervitaminosis A. On the basis of findings in this cat, hypervitaminosis A should be suspected in any sick cat fed a diet consisting partly or completely of raw liver.
Animal Feed↗
Nontuberculous mycobacterial infection attributable to Mycobacterium intracellulare serotype 10 in two rhesus monkeys.
Infection with Mycobacterium intracellulare serotype 10 was diagnosed in 2 rhesus monkeys (Macaca mulatta) in a closed colony of 90 animals. The clinicopathologic presentation in 1 animal with advanced disease was characterized by a precipitous weight loss, therapeutically unresponsive diarrhea, anemia, weakness, prostration, refractory tuberculin tests (using mammalian old tuberculin and M bovis purified protein derivative tuberculin), and disseminated granulomas in the lungs, spleen, liver, kidneys, lymph nodes, salivary glands, and intestines. The lamina propria throughout the large and small intestines was infiltrated with mycobacteria-laden macrophages. Severe hypoproteinemia, hypoalbuminemia, hypoglobulinemia, mild hypocalcemia, and edema were compatible with a malabsorption-like syndrome. The 2nd animal was clinically normal, but a weak positive tuberculin reaction to M bovis purified protein derivative at 72 hours necessitated euthanasia. This animal's disease was characterized by microgranulomas in the lungs, bronchial lymph nodes, liver, and pancreas, without involvement of the gastrointestinal tract. There was no evidence of M intracellulare infection in the remaining 88 animals in the colony, as determined by mycobacterial cultures of tracheobronchial washings, additional tuberculin testing, thoracic radiography, and mycobacterial culture of the drinking water. Tuberculin testing and thoracic radiographs of personnel working with the nonhuman primates were also negative. These cases were considered to be important because both animals were infected with the same serotype and because there has been an increasing number of isolations of this organism in human infections throughout Massachusetts. Drug-sensitivity testing revealed the organism to be sensitive to cycloserine and resistant to isoniazid, rifampin, ethambutol, streptomycin, kanamycin, and pyrazinamide.
Animals↗
Subcutaneous emphysema in a neonatal foal.
A 16-hour-old foal was examined because of subcutaneous emphysema, which began developing 3 hours after a routine delivery. Physical examination did not reveal soft-tissue or musculoskeletal trauma, and there were no skin injuries to explain the subcutaneous accumulation of air. Results of CBC and serum biochemical analysis were within reference limits, and findings on endoscopy of the pharyngeal area, trachea, and esophagus were within normal limits other than observation of dorsal pharyngeal compression. A pulmonary bulla, pneumomediastinum, and pneumothorax were detected on thoracic radiography. Because of the apparent association of the subcutaneous emphysema and thoracic abnormalities, a diagnosis of primary subcutaneous emphysema was made. A tracheostomy tube was placed to facilitate ventilation and to provide an exit point for the trapped air. Supportive care was provided. The foal's condition resolved over the subsequent 8 days.
Airway Obstruction↗
Hypertrophic osteopathy associated with Mycobacterium fortuitum pneumonia in a dog.
Mycobacterium fortuitum was isolated from the lung of a dog that had new periosteal bone formation consistent with hypertrophic osteopathy. Fever, weight loss, and bilateral hind limb lameness were the initial clinical signs. The tarsi were swollen and a pain response was elicited on palpation of the hind limb. Radiography revealed periosteal new bone formation on the metatarsi, femurs, and ischii. Thoracic radiography revealed pulmonary mass lesions in the right middle and left caudal lung lobes. After right middle and left caudal lung lobectomy, M fortuitum was isolated from the excised tissues. Amoxicillin trihydrate/clavulanic acid and amikacin were administered, on the basis of susceptibility test results.
Animals↗
Hepatic abscesses in dogs: 14 cases (1982-1994).
OBJECTIVES: To determine typical clinical signs and clinicopathologic findings in dogs with hepatic abscesses, to assess outcome of treatment, and to evaluate the role that abdominal ultrasonography has in the diagnosis of hepatic abscesses in dogs and in monitoring response to treatment. DESIGN: Retrospective case series. ANIMALS: 14 dogs with hepatic abscesses. RESULTS: Anorexia and lethargy were the most common historical complaints, followed by vomiting and diarrhea. Physical abnormalities included fever, dehydration, signs of abdominal pain, hepatomegaly, and mucosal bleeding. Hematologic abnormalities included leukocytosis with neutrophilia, mild to moderate thrombocytopenia, and mild anemia. Serum biochemical abnormalities included high alkaline phosphatase and alanine aminotransferase activities and high bilirubin concentration; hypoalbuminemia and prolonged coagulation values were also reported. Abdominal radiography revealed hepatomegaly, poor abdominal detail, a hepatic mass, or splenomegaly in 9 dogs. Thoracic radiography revealed alveolar consolidation or mixed bronchial/interstitial pulmonary patterns in 6 dogs. Hypoechoic, heteroechoic, or hyperechoic masses were identified in all dogs in which ultrasonography was performed. Escherichia coli, Clostridium sp, Klebsiella pneumoniae, Enterococcus sp, Staphylococcus epidermidis, and S intermedius were the most common bacteria isolated from hepatic abscesses. Concurrent infections were identified in the biliary tract, spleen, blood, endocardium, lung, prostate gland, peritoneum, lymph nodes, salivary gland, or brain of several dogs. Seven dogs died or were euthanatized before definitive treatment could be initiated. One dog was successfully treated with antibiotics and was alive 12 months after medical treatment. Six dogs were treated surgically (ie, full or partial liver lobectomy, drainage, abdominal lavage) and medically (ie, antibiotic administration). Five of these dogs survived and were alive 12 months after surgery. Ultrasonography was used to monitor response to treatment in several dogs. CLINICAL IMPLICATIONS: Hepatic abscesses are rare in dogs, but the clinical signs and clinicopathologic findings are similar to other inflammatory hepatic disease. Ultrasonography revealed abnormalities in all animals in which imaging studies were performed, and was successfully used to monitor response to treatment in several dogs. Medical and surgical treatments were used successfully to treat hepatic abscesses in dogs.
Animals↗
Computed tomography in the diagnosis of aortic aneurysm dissection or traumatic injury.
Thirty patients thought to have an atherosclerotic thoracic aneurysm or chronic aortic dissection were evaluated by computed tomography (CT) and the findings compared with those from conventional radiography, thoracic aortography, and surgery. In all cases, CT defined the lesion and correlated well with angiography. Staging of atherosclerotic aneurysms was possible, and CT also demonstrated the relationship between true and false lumina in aortic dissections; however, aortography was often necessary to differentiate a dissection from an aneurysm or for staging. The relative value of CT and aortography is discussed.
Adult↗
Cardiovascular changes after bone marrow transplantation in dogs with mucopolysaccharidosis I.
Five dogs with mucopolysaccharidosis I, 3 of which had been treated with bone marrow transplantation (BMT), were evaluated for 20 months with electrocardiography, thoracic radiography, and M-mode and 2-dimensional echocardiography. Treated and untreated (control) dogs had widened P waves on ECG. Thoracic radiographs remained normal for all dogs throughout the study. Thickening of the mitral valve was observed on echocardiograms of dogs in both groups, but the untreated dogs appeared to have thicker valves. Concentrations of glycosaminoglycans in the mitral valves and myocardium were higher in control dogs than in treated dogs. Markedly large aortic root diameters were observed on echocardiograms in both untreated dogs, but aortic root diameters remained normal in treated dogs. Echocardiography, but not electrocardiography, was useful in monitoring heart enlargement in each dog. Dogs treated with BMT generally had less severe cardiac changes and slower disease progression than control dogs.
Animals↗
Surgical correction of concomitant cranioventral abdominal wall, caudal sternal, diaphragmatic, and pericardial defects in young dogs.
Seven puppies with concomitant congenital cranioventral abdominal wall, caudal sternal, diaphragmatic, and pericardial defects were treated surgically when they were between 10 and 12 weeks old. Three pups had ventricular septal defects that were not corrected. Diaphragmatic herniorrhaphy without extension of the diaphragmatic defect was performed in 6 pups. In one pup, paracostal extension of the diaphragmatic defect was necessary to decrease tension on the diaphragmatic closure. All pups were healthy at 6-month follow-up examinations, but 2 of 3 pups with ventricular septal defects had moderate generalized cardiomegaly evident on thoracic radiography. Early surgical correction of the congenital defects in these pups was usually simple because there were few or no thoracic adhesions, the dogs were small, the defects were small in 6 of 7 dogs, and the costal arch was pliable in each dog.
Abdominal Muscles↗
[Dyspnea through compression of mediastinal structures due to pericardial cyst].
A case of a 65-year-old patient, showing dyspnea to strains and right side pain as main symptoms of an approximately 8 cm cyst in the pericardium. The physical, biochemical and electrocardiographic examinations did not evince any changes. The results from the thoracic radiography, CT scan and echocardiogram suggested pericardial cyst. Based on those clinical evidences, the patient was submitted to a thoracotomy in the right side thoracic region and a complete excision of the mediastinal mass was performed, with complete remission of the symptoms.
Aged↗
Chronic pneumonia caused by Mycobacterium thermoresistibile in a cat.
Mycobacterium thermoresistibile was isolated in pure culture from ultrasound-guided pulmonary aspirates taken from a young cat with severe, chronic, pyogranulomatous pneumonia. Thoracic radiography and ultrasonography before therapy demonstrated severe diffuse alveolar disease. Twelve months combination therapy with doxycycline, rifampicin and clarithromycin resolved the infection. Thoracic radiographs taken at the completion of therapy showed multifocal pulmonary mineralisation. M thermoresistibile has been infrequently reported as a human or animal pathogen. This is the first reported pulmonary infection by M thermoresistibile in a cat and documents the successful treatment of the organism in a feline patient.
Animals↗
Effects of age and allergen-induced airway inflammation in cats: radiographic and cytologic correlation.
Thoracic radiography is an important diagnostic tool for feline respiratory medicine. The aim of this study was (1) to assess age-related changes of thoracic radiographic views in healthy young cats and (2) to test if experimentally-induced bronchial inflammation by inhaling Ascaris suum (AS) allergens leads to radiographic changes after single or repeated exposures. Healthy cats (n=15-30) aged between 6 and 30 months were evaluated. Eight healthy cats and eight AS-sensitised cats, respectively, inhaled sterile saline or allergen. Radiographs were taken 24h before, and 6, 24 and 48 h after the challenge. Bronchoalveolar lavage (BAL) was performed after the last radiographic examination. AS-sensitised cats underwent three further allergen challenges at 3-month intervals. The radiographic evaluation was based on a scoring system considering bronchial, interstitial and alveolar patterns. A significant age-related increase in interstitial and total radiographic score was detected in healthy cats older than 18 months and in healthy cats older than 24 months. Whilst saline inhalation did not affect radiographic scores, a single AS challenge induced significant changes of all scores within 6-24h. A significant positive correlation between radiographic scores and BAL neutrophils and eosinophils was found. Repeated AS challenges did not induce irreversible changes in radiographic scores.
Aging↗
Development and resolution of radiographic lesions in canine heartworm disease.
Thoracic radiography of 7 Beagles was performed before heartworm infection, during a 1-year heartworm infection, and for 1 year following appropriate treatment. Cardiac and vascular lesions on thoracic radiographs were compared with angiographic changes. Within 3 months of obstructed blood flow in the caudal lobar arteries, associated increased focal parenchymal densities were detected. These lesions were regarded as characteristic of heartworm disease. Although the most severe arteriographic changes were in the caudal lobar arteries, lobar arterial changes on a lateral view were best detected in the right cranial lobar artery. These arteries increased in size during infection and decreased in size after treatment. It was concluded that the dorsoventral view is best for evaluation of the caudal lobar arteries. The most marked parenchymal lesions were detected during the first 6 months following adulticide treatment. These lesions and the other radiographic alterations then decreased in severity. Persistence of the parenchymal lesions were related to persistence of heartworm infection.
Animals↗
Evaluation of the Palmaz stent in the trachea and mainstem bronchi of normal dogs.
OBJECTIVE: This study evaluates the efficacy of the Palmaz balloon expandable intraluminal stent in the trachea and mainstem bronchi of normal dogs. STUDY DESIGN: Effects of the stent were evaluated by physical examination, thoracic radiography, respiratory tract fluoroscopy and endoscopy, tracheal diameter measurement, postmortem examination, and airway histomorphometry. ANIMALS OR SAMPLE POPULATION: Ten normal beagle dogs. METHODS: Stent size was estimated from thoracic radiographs in awake dogs. Group I dogs (n = 4) had two stents placed: one in the thoracic trachea (TT) plus a randomly chosen mainstem bronchus (MB). Group II dogs (n = 3) had stents placed in the MB (one stent), TT (one stent), and mid- or proximal cervical trachea (CT) (one or two stents). Three dogs were used as sham-operated controls (group III). Temperature, pulse, respiration, and cough were measured twice daily. Dogs were evaluated at 21 and 49 to 56 days after stent placement, euthanatized, and tissues were collected for histomorphometric analysis of stent integration and epithelial pathology. RESULTS: Mean tracheal diameters of awake (10.5 +/- 1.7 mm) and anesthetized dogs before stent implantation (13.9 +/- 2.0 mm) were significantly different (P < .01). Complications associated with stent placement included acute pulmonary edema (n = 2), stent migration (n = 7), stent collapse (n = 4 CT, 2 TT, and 1 MB), and positive tracheal culture (n = 10). Group II dogs coughed more at rest, exercise, and with tracheal palpation than dogs in other groups (P < .01). Group I dogs coughed more at rest than group III dogs (P < .01). Stent integration ranged from 0 to 91.3%. Squamous metaplasia and epithelial ulceration associated with stents ranged from 0 to 57.5% and 0 to 32.7%, respectively. CONCLUSIONS: Determination of stent size should be based on measurements taken on anesthetized dogs because use of inappropriately sized stents may promote stent migration, squamous metaplasia, and/or ulceration. Epithelialization over stent struts may occur if the stent is closely associated with tracheal epithelium. CLINICAL RELEVANCE: Palmaz stents do not appear to be appropriate for placement in the CT of dogs; however, with technical modifications, application in the TT and MB may be feasible.
Animals↗
Spirocercosis-associated pyothorax in dogs.
The records of five dogs diagnosed with spirocercosis-associated pyothorax were retrospectively reviewed. On admission, the most common clinical findings were weakness, anorexia, depression, dyspnoea and fever. All dogs had typical oesophageal Spirocerca lupi granulomas. Contrast thoracic radiography revealed contrast material leakage from the oesophagus into the pleural cavity in two dogs only. All dogs were medically treated with broad-spectrum antibiotics, repeated chest tube drainage and thoracic lavage, and four of the dogs were treated with doramectin. One dog was euthanased due to a concurrent non-related disease at the owners request while the remaining four survived. S. lupi infection should be included in the differential diagnoses of canine pyothorax in endemic areas. Conservative medical management of pyothorax with antihelmintic medication was shown to be effective in the treatment of S. lupi-associated pyothorax.
Animals↗
Smoke exposure in cats: 22 cases (1986-1997).
OBJECTIVE: To review clinical findings and clinical course for cats exposed to smoke in residential fires and to determine clinical variables that may have prognostic importance. DESIGN: Retrospective study. ANIMALS: 22 cats admitted to our veterinary teaching hospital between 1986 and 1997 with a history of smoke exposure during a residential fire. PROCEDURE: Medical records were reviewed for history, clinical signs, physical examination findings, changes in respiratory tract signs, initial hematologic analysis, treatment, results of thoracic radiography, and outcome. RESULTS: Fifteen of 22 (68%) cats were categorized in the uncomplicated group, 5 (23%) in the complicated group, and 2 (9%) were discharged after a short period because of financial considerations. Twenty (91%) cats survived, but 2 (9%) were euthanatized because of severe respiratory compromise or neurologic changes. Predominant thoracic radiographic changes were diffuse interstitial pattern (6 cats) and focal alveolar pattern (5). The majority (8/13) of cats that were stable or had improved by the day after admission had an uncomplicated clinical course while hospitalized, whereas cats that were worse on the day after admission tended to have a complicated clinical course. CONCLUSIONS AND CLINICAL RELEVANCE: Cats that survive a residential fire and are admitted to a hospital have a good chance to be discharged. Cats that do not have signs of respiratory tract dysfunction at admission probably will not develop severe respiratory complications. For cats with signs of respiratory dysfunction at admission, better prognostic information will be determined by monitoring progression of the respiratory condition on the day after admission.
Animals↗
Frequency of pulmonary mineralization and hypoxemia in 21 dogs with pituitary-dependent hyperadrenocorticism.
The purpose of this study was to determine the frequency of hypoxemia and pulmonary mineralization using 99mTc-methylene diphosphonate (99mTc-MDP) in dogs with pituitary-dependent hyperadrenocorticism (PDH). Twenty-one dogs with PDH were prospectively evaluated using thoracic radiography, arterial blood gas analysis, and bone phase and pulmonary perfusion scintigraphy (using 99mTc-macro-aggregated albumin [99mTc-MAA]). The radiographs and bone and perfusion studies were evaluated subjectively. An averaged quantitative count density ratio was calculated between the thorax and cranial thoraco-lumbar vertebrae from lateral thoracic 99mTc-MDP images. Thoracic:vertebral ratios were calculated using 99mTc-MDP studies from 21 control dogs. The thoracic:vertebral ratios were compared between the 2 groups (PDH and control). The mean age (+/-SD) of the 21 PDH dogs was 10.2 (+/-3) years, whereas the mean age of the control group was 9.8 (+/-3) years. Seven of the 21 dogs with PDH were hypoxemic (defined as an arterial partial pressure of oxygen [PaO2] < 80 mm Hg) with an average PaO2 (+/-SD) of 62 (+/-15) mm Hg. Of the 7 hypoxemic dogs, 2 were found to have pulmonary mineralization based on bone scintigraphic images. Pulmonary perfusion abnormalities were not identified using 99mTc-MAA in any of the 21 PDH dogs. Six PDH dogs had an abnormal interstitial pulmonary pattern and 5 of these dogs were hypoxemic. The average quantitative thoracic:vertebral ratio was not significantly different between the PDH and control dogs (0.5 +/- 0.4 versus 0.4 +/- 0.1, P = .16). Causes of hypoxemia other than pulmonary thromboembolism should be considered in dogs with PDH. Pulmonary mineralization may contribute to hypoxemia in dogs with PDH.
Adrenal Cortex Diseases↗