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Associations between physical examination, laboratory, and radiographic findings and outcome and subsequent racing performance of foals with Rhodococcus equi infection: 115 cases (1984-1992).

OBJECTIVE: To determine whether physical examination, laboratory, or radiographic abnormalities in foals with Rhodococcus equi infection were associated with survival, ability to race at least once after recovery, or, for foals that survived and went on to race, subsequent racing performance. DESIGN: Retrospective study. ANIMALS: 49 Thoroughbreds and 66 Standardbreds admitted to 1 of 6 veterinary teaching hospitals between 1984 and 1992 in which R equi infection was positively diagnosed. PROCEDURE: Results of physical examination, laboratory testing, and thoracic radiography were reviewed. Indices of racing performance were obtained for foals that recovered and eventually raced and compared with values for the US racing population. RESULTS: 83 (72%) foals survived. Foals that did not survive were more likely to have extreme tachycardia (heart rate > 100 beats/min), be in respiratory distress, and have severe radiographic abnormalities on thoracic radiographs at the time of initial examination than were foals that survived. Clinicopathologic abnormalities were not associated with whether foals did or did not survive. Forty-five of the 83 surviving foals (54%) eventually raced at least once, but none of the factors examined was associated with whether foals went on to race. Racing performance of foals that raced as adults was not significantly different from that of the US racing population. CLINICAL IMPLICATIONS: R equi infection in foals is associated with a decreased chance of racing as an adult; however, foals that eventually go on to race perform comparably to the US racing population.

Actinomycetales Infections↗

[The thorax of patients in diving accidents. Radiologic study].

On the basis of a series including 185 files on diving accidents gathered between 1981 and 1988, the authors carry out a radiological study of the thoracic signs observed after drowning and lung overpressure. The typical radiological form and the various clinical forms of drowning and lung overpressure are described in this article. Emergency plain thoracic radiography in bed in the method of choice. However, the existence of many false-negative findings leads to proposing a study with computed tomography (CT) after initial treatment in order to better assess the lesions and to characterize the accident. The utility of radiology is also demonstrated for the follow-up of evolution. Lastly, the authors lay stress on the necessity to prevent such accidents, to which radiologists can contribute by detecting thoracic lesions (dystrophy and other evolutive lesions) for which diving is contraindicated.

Decompression Sickness↗

Correlation of cardiac enlargement as assessed by vertebral heart size and echocardiographic and electrocardiographic findings in dogs with evolving cardiomegaly due to rapid ventricular pacing.

Vertebral heart size (VHS) has been proposed as a method for quantifying cardiomegaly in dogs. This study was designed to determine how well echocardiographic and electrocardiographic findings correlated with VHS. Dogs were rapid-paced into varying degrees of cardiomegaly and were monitored by thoracic radiography, echocardiography, and electrocardiography during development of cardiomegaly. Echocardiographic and electrocardiographic parameters were compared with VHS. VHS increased with increased duration or rate of pacing or both, and left atrium-to-aorta ratio, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, P wave duration, and QRS duration correlated significantly with VHS. VHS (a score obtained from routine thoracic radiographs) seems to correlate well with both echocardiographic and electrocardiographic parameters. When 9 veterinarians, experienced in interpretation of cardiac silhouettes on radiographs, measured VHS from 1 normal dog and 1 dog with severe cardiomegaly, coefficients of variation (ratio of standard deviation to the mean) for their measurements were 2.7% and 2.8%, respectively. Thus, VHS could be established with great uniformity by experienced interpreters.

Animals↗

Blastomycosis in a ferret.

An 18-month-old female ferret with an ulcerated metacarpal pad and signs of respiratory illness was diagnosed as having blastomycosis by visualization of organisms on a tissue imprint, an agarose gel immunodiffusion test, and thoracic radiography. The ferret was treated intravenously with amphotercin B at 0.4 to 0.8 mg/kg and orally with ketoconazole at 8 mg/kg for approximately 1 month, during which time clinical and radiographic improvement was noted. A change to SC amphoterocin B therapy resulted in relapse of clinical signs despite continuation of ketoconazole therapy, and necessitated euthanasia. Necropsy revealed granulomatous lesions typical of Blastomyces dermatitidis infection in the lungs, thoracic pleura, spleen, meninges, and brain. Comparisons between this case and canine blastomycosis cases are made and alternative treatment regimes for mustelid blastomycosis are suggested.

Amphotericin B↗

Left aortic arch and right ligamentum arteriosum causing esophageal obstruction in a dog.

A 10-week-old, mixed-breed dog was examined because of persistent regurgitation. Results of thoracic radiography and fluoroscopy of the esophagus, using a liquid suspension of barium sulfate, were suggestive of a vascular ring anomaly. During left lateral thoracotomy, a left aortic arch was identified, but the cause of the esophageal obstruction could not be determined. Results of endoscopic examination of the esophagus suggested a compressive lesion originating from the right side of the esophagus. An anomalous artery could not be identified on an aortogram. Post-mortem examination revealed a left aortic arch and right ligamentum arteriosum that were causing the esophageal obstruction.

Animals↗

Inflammatory mammary carcinoma in dogs: 33 cases (1995-1999).

OBJECTIVE: To determine epidemiologic, clinical, and pathologic characteristics of inflammatory mammary carcinoma (IC) in dogs. DESIGN: Retrospective study. ANIMALS: 33 dogs with IC and 153 dogs with malignant mammary tumors other than IC. PROCEDURES: Medical records were reviewed, and signalment, history, physical examination findings, and results of thoracic radiography and necropsy were obtained. RESULTS: 33 of 436 (7.6%) dogs examined at a veterinary teaching hospital because of dysplasia or tumors of the mammary glands and 33 of 186 (17.7%) dogs with at least 1 malignant tumor had IC. Thirty-two of the 33 dogs were sexually intact. Dogs with IC were significantly older than were dogs with other malignant mammary tumors, and in dogs with IC, the tumor was initially noticed a mean of 52 days after the beginning of the last observed estrus, whereas in dogs with other mammary tumors, the tumor was initially noticed a mean of 137 days after the beginning of the last observed estrus. Dogs with IC were more likely to be anorectic and to have generalized weakness, weight loss, and thoracic metastases. Dogs with IC survived a mean of 25 days with palliative treatment. Histologically, involvement of dermal lymphatic vessels was identified in 14 of 19 (74%) dogs with IC. Two clinical forms of IC (primary and secondary) were identified. Dogs with primary IC had a worse clinical condition. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that IC is an uncommon but distinct entity in dogs. A histologic finding of dermal lymphatic involvement should be considered a hallmark for the pathologic diagnosis of IC in dogs.

Age Factors↗

Thorax ultrasound in the management of pediatric pneumonias complicated with empyema.

The aim of this work is to prospectively study the value of thoracic ultrasound (US) before pleural drainage in children with parapneumonic effusion (PPE). All children hospitalized for PPE, identified by thoracic radiography, underwent US to assess pleural loculation, echogenicity, and pleural fluid quantity. From August 2001 to July 2003, 52 children were examined. US was performed on 48 of these children, of whom 35 received chest tube drainage and 13 only received clinical treatment. US identified 38 patients with free flowing and 10 with loculated pleural fluid. About 25 of the free flowing (65.8%) and 10 (100%) of the loculated patients received chest tube drainage. Echogenicity was anechoic in 13, echoic without septations in 17 and echoic with septations in 18. Chest tube drainage was required in 6 anechoic (46.15%), 14 echoic without septations (82.35%), and 15 echoic with septations (83.33%). Quantity of fluid estimated by US varied from 20 to 860 ml. Effusion volume was higher in patients that were echoic with septations and loculated effusions. Pleural glucose and pH were lower, and LDH was higher in loculated PPE patients. In conclusion, US is an auxiliary exam for determining whether thoracic drainage is needed in parapneumonic effusion; loculated or echoic effusion should be drained, and free anechoic fluid needs further investigation.

Adolescent↗

Safety and efficacy of a technique for thoracoscopically guided pulmonary wedge resection in horses.

OBJECTIVE: To evaluate the safety and efficacy of thoracoscopically guided pulmonary wedge resection in horses. ANIMALS: 10 horses (5 control horses and 5 horses affected with recurrent airway obstruction [ie, heaves]). PROCEDURE: Each horse underwent a thoracoscopically guided pulmonary wedge resection. Before, during, and after surgery, heart rate, respiratory rate, arterial blood gases, and systemic and pulmonary arterial pressures were measured. Physical examination, CBC, and thoracic radiography and ultrasonography were performed 24 hours before and 2 and 48 hours after surgery. Pulmonary specimens were assessed by histologic examination. A second thoracoscopic procedure 14 days later was used to evaluate the resection site. RESULTS: The technique provided excellent specimens for histologic evaluation of the lung. Heart and respiratory rates decreased significantly after horses were administered sedatives. A significant transient decrease in Pao2 was detected immediately after pulmonary wedge resection, but we did not detect significant effects on arterial pH, Paco2, or mean arterial and pulmonary arterial pressures. All horses except 1 were clinically normal after thoracoscopic surgery; that horse developed hemothorax attributable to iatrogenic injury to the diaphragm. The second thoracoscopy revealed minimal inflammation, and there were no adhesions. CONCLUSIONS AND CLINICAL RELEVANCE: Thoracoscopically guided pulmonary wedge resection provides a minimally invasive method for use in obtaining specimens of lung tissues from healthy horses and those with lung disease. This technique may be useful for the diagnosis of diseases of the lungs and thoracic cavity.

Animals↗

Ancillary testing for the ruminant respiratory system.

With greater use of a wide variety of diagnostic tools, such as transtracheal washing, respiratory endoscopy, chest radiography, thoracic ultrasonography, blood gas analysis, and lung biopsy, veterinarians are gaining tremendous insight into pathogenic mechanisms of the ruminant respiratory system. We have available many diagnostic aids; some fairly simple and inexpensive, others highly sophisticated and presently at far greater cost than justifiable on most individual food animals. Some methods recently developed, such as same-day viral particle detection in BAL samples,6 have tremendous potential for rapid and accurate diagnosis in ruminant pulmonary medicine. Undoubtedly, future research in this area will provide an ever widening array of powerful and rapid diagnostic aids to deal with respiratory disease of ruminants.

Animals↗