Daniela Aparecida Ayres Garcia

Ultrasonography of small intestinal obstructions: a contemporary approach.

OBJECTIVES To assess the accuracy of intestinal ultrasound for diagnosis of intestinal obstruction in dogs and cats. METHODS A prospective clinical study was performed. Inclusion criteria were dogs and cats with clinical signs suggestive of gastrointestinal obstruction. Animals with no obstruction detected on ultrasound were excluded if they could not be monitored for 48 hours to confirm absence of obstruction. Sonographic diagnosis of small intestinal obstruction was based on identification of at least two findings suggestive of intestinal obstruction. RESULTS Ninety-two patients suspected of having intestinal obstruction were included. Correct diagnosis of intestinal obstruction was made in 21 cases (23%), and in 68 (74%) this diagnosis was excluded. Interpretation of the images on prospective analysis had sensitivity, positive predictive, specificity and negative predictive values of 100%, 87.5%, 95.8% and 100%, respectively. CLINICAL SIGNIFICANCE Ultrasonography is an excellent method for investigation of animals with gastrointestinal disorders, and is particularly useful for excluding obstructive processes.

In utero development of the fetal intestine: Sonographic evaluation and correlation with gestational age and fetal maturity in dogs

Modern high-resolution ultrasound images enable earlier assessment of measures of fetal development, including identification of the bowel. The aim of this study was to describe the ultrasonographic development of fetal bowel and correlate this with gestational age; define whether ultrasonographic visualization of fetal intestinal peristalsis in utero is associated with fetal maturation and determine whether there is a difference in fetal intestinal peristalsis detection time between fetuses delivered by normal delivery and cesarean. A cohort study was conducted in pregnant bitches presented to a veterinary hospital, to assess fetal bowel development. Statistical analysis was used to establish the correlation of the stage of fetal bowel development, as recorded by ultrasound, with outcomes of normal delivery and cesarean section. The study was broken down into three stages: the first stage was a descriptive analysis of fetal bowel development by ultrasound; the second stage compared time (in days) of bowel development between groups (normal delivery vs. cesarean); and the third stage was correlated survival probability for fetuses born on any day after detection of intestinal peristalsis with fetal maturity. All statistical analyses were significant. It is possible to monitor pregnancy progression using ultrasonographic evaluation of bowel development and this can reliably identify the end of fetal organogenesis. However, ultrasonographic detection of bowel segments with visualization of wall layers and associated peristalsis should not be used as the sole indicator for cesarean section planning because it is not possible to determine ultrasonographically whether the bowel is functional (mature).

Use of B-mode ultrasonography for fetal sex determination in dogs.

Ultrasonographic determination of fetal sex in dogs has not previously been reported. The aim of this study was to describe a method for determination of intrauterine fetal sex using ultrasound. A cohort study was conducted in pregnant bitches to perform ultrasound examination of the fetal genitalia between the eighth and ninth week of gestation. Fetal sex was determined in utero by consensus agreement of two sonographers. Eighteen pregnant bitches were included in this study, and a total of 39 fetuses were evaluated. The accuracy of ultrasonography to determine the sex with a 95% confidence interval was 62.24% to female fetuses and 65.48% to male fetuses. The sonographic accuracy in determining fetal sex can be achieved at 100% when there are up to two fetuses in the litter; however, the accuracy of the technique reduces (66.7%) when more than three fetuses are present. This study describes the sonographic appearance of the external genitalia in canine fetuses in utero associated with a specific position of the fetus and reports that sex determination is possible between 55 and 58 days of gestation.

The use of Doppler evaluation of the canine umbilical artery in prediction of delivery time and fetal distress.

The aim of this study was to describe changes in umbilical artery blood flow in the later stages of canine pregnancy. Seventeen pregnant bitches were examined sonographically to evaluate umbilical artery blood flow at the following antepartum times: 120-96, 96-72, 72-48, 48-24, 24-12, 12-6 and 6-1h. The peak systolic velocity and end diastolic velocity were measured to calculate the resistive index (RI). Bitches were classified into two groups according to delivery method: normal delivery (Group 1, n=11) and Cesarean section, due to fetal distress, (Group 2, n=6). During the study, the RI of the umbilical artery in bitches in Group 1 significantly declined in the time periods 72-48, 24-12, 12-6 and 6-1h before delivery when compared to the reference RI (120-96h antepartum period), with values ​​below 0.7 in the 12-6 and 6-1h periods. In Group 2, the RI decreased significantly in the antepartum periods 96-72, 72-48, 48-24h with respect to the period 120-96h, and increased in the periods from 24-12, 12-6 and 6-1h (being significantly higher in this last period) until the time of Cesarean section. Therefore monitoring of changes in umbilical artery RI in the pre-partum period may provide information about time of delivery in bitches and also assist in the diagnosis of possible dystocia and fetal distress.

Errors in abdominal ultrasonography in dogs and cats.

OBJECTIVES To compare ultrasonographic diagnoses with the findings of surgical exploration to identify and classify potential diagnostic errors. METHODS A cross-sectional prospective study of surgically confirmed ultrasound findings was conducted over a period of 29 months in two veterinary hospitals. Any errors in diagnosis made by the sonographer were classified as perceptual, cognitive, equipment-related, inevitable or multifactorial. RESULTS One hundred and five ultrasound examinations were performed in 88 dogs and 17 cats. Errors in ultrasound diagnosis occurred in 17 animals (16·2%). These errors were identified as cognitive in 10 animals, inevitable in 5 and multifactorial in 2. CLINICAL SIGNIFICANCE This study demonstrates that whilst errors of diagnosis do occur during ultrasonographic examination of the abdomen, understanding the causes of these errors will contribute to the development of this imaging modality.

Ultrassonografia abdominal pré-operatória em cães e gatos com suspeita de tumores abdominais

The aim of this study was evaluate efficacy of the ultrassonographic exam in the defining the location of the abdominal neoplasm and to estimate the accuracy of the method in screening the malignant neoplasm process. In 24 patients of 113 animals evaluated by the ultrassonographic exam it was observed a mass and/or a intermingled nodule in different organs in the abdominal cave, classified as type I, II, II(+) e III. It was compared the sonographic findings with surgical and histopathological analysis. The determination of the mass origin was correct in 20 (83%) animals and the percentage accuracy of malignant ultrasound determination was 91.67%. So, it is believed that the ultrasound is interesting to determine the malignancy in advanced cases, especially in those patients who have aggressive lesions.

Anatomia ultrassonográfica dos linfonodos abdominais de furões europeus hígidos

In recent years the ferret (Mustela putorius furo) has become popular pet featuring a ever growing population in Brazil, and being increasingly found in veterinary clinics. This study aimed to evaluate the ultrasound anatomy of abdominal lymph nodes of healthy ferrets. We used 20 animals, nine of which males and eleven females, with overall mean age of three years. We located the mesenteric lymph nodes in 100% of the ferrets, the pancreatic-duodenal lymph nodes and the splenic ones in 55%, the gastric lymph node in 20%, and the hepatic lymph node in 5%. We measured their lengths. It is concluded that the location and sonographic characteristics of the abdominal lymph nodes in ferrets are very similar to the abdominal lymph nodes of cats. This is a preliminary orientation for the location of abdominal lymph nodes of healthy ferrets.

Importance of fasting in preparing dogs for abdominal ultrasound examination of specific organs.

OBJECTIVE To describe the effect of fasting on the technical success of abdominal ultrasonography specifically in respect of examination of the gall bladder, duodenum, pancreas, adrenal glands and portal vein in dogs. METHODS Randomised, prospective study of 150 dogs with a variety of physical characteristics. Animals were divided into two groups of 75 dogs each. Dogs in Group 1 were fasted for 8 to 12 hours before ultrasonographic evaluation and those in Group 2 were not but received food anytime between 10 minutes and 2 hours before the procedure. RESULTS Intraluminal gas can influence the visibility of organs, but intraluminal gas accumulation occurred independently of fasting status. The assessment of abdominal organs was not affected by whether or not an animal was fasted. CLINICAL SIGNIFICANCE Routine fasting of dogs before abdominal ultrasonography is not essential.

Assessment of umbilical artery flow and fetal heart rate to predict delivery time in bitches

The aim of this study was to quantitatively investigate the oscillation of the fetal heart rate (HR) in advance of normal delivery and whether this index could be used to indicate impending delivery. In addition, fetal HR oscillation and umbilical artery resistive index (RI) were correlated to determine if the combination of these parameters provided a more accurate prediction of the time of delivery. Sonographic evaluation was performed in 11 pregnant bitches to evaluate the fetal HR and umbilical artery RI at the following antepartum times: 120 to 96 hours, 72 to 48 hours, 24 to 12 hours, and 12 to 1 hours. Statistical analysis indicated a correlation between the oscillation of fetal HR and the umbilical artery RI. As delivery approached a considerable reduction in the umbilical artery RI was documented and greater oscillations between maximum and minimum HRs occurred. We conclude that the quantitative analysis of fetal HR oscillations may be used to predict the time of delivery in bitches. The combination of fetal HR and umbilical artery RI together may provide more accurate predictions of time of delivery.

Avaliação ultrassonográfica do meato acústico em cães

The purpose of this study was to determine the viability of ultrasonographic evaluation of the external ear in dogs. The thickness and architecture of the ear wall and tympanic bulla of 10 Labrador Retrievers without ear disease was evaluated. The examination was performed with an ultrasound system and a 14 MHz bidimentional linear-array transducer and general anesthesia, before and after the infusion of saline solution into the ear canal. The maxillary artery was identified with color Doppler and helped to establish the location of the tympanic bulla in all dogs. The proximal wall was less well-defined when compared with the distal wall of the ear canal. Dogs with increased ceruminal content within the ear canal showed a hypoechoic epithelium. The tympanic membrane was not identified. It was concluded that ultrasound evaluation is feasible and needs to be explored as clinical diagnostic tool for the diagnosis of ear diseases in dogs.