Ingmar Kiefer

Partial Lateral Corpectomy of the Thoracolumbar Spine in 51 Dogs: Assessment of Slot Morphometry and Spinal Cord Decompression

Objective: To report slot morphometry, degree of spinal decompression, and factors influencing decompression after partial lateral corpectomy (PLC) of the thoracolumbar spine in dogs with intervertebral disc disease. Study Design: Case series. Animals: Dogs (n=51) with predominantly ventrally located spinal cord compression. Methods: PLC (n=60) were performed. Spinal cord compression was determined by computed tomographic (CT) myelography (n=46), myelography (n=2) or magnetic resonance imaging (n=3). Postsurgical CT images were used to evaluate slot dimensions and orientation, and spinal cord decompression. The influence of age, body weight, breed, breed type (chondrodystrophic, nonchondrodystrophic), disc location, lateralization and mineralization, presurgical compression, slot morphometry, and surgeon on degree of decompression were evaluated. Results: Mean slot depth was 64.1% of vertebral body width; mean height, 43.0% of vertebral body height; mean cranial extension, 29.5%; median caudal extension, 22.0% vertebral body length; mean angulation from horizontal, 6.3°. Decompression was satisfactory in 90% of sites after PLC (58% complete, 32% good). None of the analyzed factors significantly influenced decompression. All lumbar spine PLC resulted in complete or good decompression compared with 83% after thoracic PLC (P=.052). Deeper slots tended to allow more complete decompression (P=.058). Conclusions: Thoracolumbar PLC results in satisfactory decompression in most cases with a better outcome in the lumbar spine than the thoracic spine. Achieving a slot depth equal to 2/3 of vertebral body width might facilitate complete decompression.OBJECTIVE To report slot morphometry, degree of spinal decompression, and factors influencing decompression after partial lateral corpectomy (PLC) of the thoracolumbar spine in dogs with intervertebral disc disease. STUDY DESIGN Case series. ANIMALS Dogs (n=51) with predominantly ventrally located spinal cord compression. METHODS PLC (n=60) were performed. Spinal cord compression was determined by computed tomographic (CT) myelography (n=46), myelography (n=2) or magnetic resonance imaging (n=3). Postsurgical CT images were used to evaluate slot dimensions and orientation, and spinal cord decompression. The influence of age, body weight, breed, breed type (chondrodystrophic, nonchondrodystrophic), disc location, lateralization and mineralization, presurgical compression, slot morphometry, and surgeon on degree of decompression were evaluated. RESULTS Mean slot depth was 64.1% of vertebral body width; mean height, 43.0% of vertebral body height; mean cranial extension, 29.5%; median caudal extension, 22.0% vertebral body length; mean angulation from horizontal, 6.3°. Decompression was satisfactory in 90% of sites after PLC (58% complete, 32% good). None of the analyzed factors significantly influenced decompression. All lumbar spine PLC resulted in complete or good decompression compared with 83% after thoracic PLC (P=.052). Deeper slots tended to allow more complete decompression (P=.058). CONCLUSIONS Thoracolumbar PLC results in satisfactory decompression in most cases with a better outcome in the lumbar spine than the thoracic spine. Achieving a slot depth equal to 2/3 of vertebral body width might facilitate complete decompression.

Computed tomography for the diagnosis and treatment monitoring of bacterial pneumonia in Indian pythons (Python molurus).

Eight Indian pythons (Python molurus) with clinical and microbiological evidence of pneumonia were examined by computed tomography (ct) before and after treatment. The results were assessed subjectively and measurements were taken following a standard protocol. Changes in the lung tissue of all the pythons were diagnosed, and the extent of the disease could be assessed. ct examinations after treatment showed an improvement in the six pythons whose clinical condition had improved, but in the other two pythons they demonstrated the severity of the disease. The subjective assessments were superior to the evaluation of measurements of attenuation in regions of interest. However, the average and the maximum attenuation provided additional information on the extent of the disease. Except for one python with only mild clinical signs, the attenuation after successful treatment was still higher than in healthy pythons.

A Novel Approach to Brachycephalic Syndrome. 1. Evaluation of Anatomical Intranasal Airway Obstruction.

OBJECTIVE To evaluate airway obstruction due to abnormal intranasal anatomy in 3 brachycephalic dog breeds using computed tomography and rhinoscopy. STUDY DESIGN Prospective clinical study. ANIMALS A total of 132 brachycephalic dogs (66 Pugs, 55 French Bulldogs, and 11 English Bulldogs) with severe respiratory distress due to brachycephalic syndrome. METHODS Computed tomography and anterior and posterior rhinoscopy were performed to evaluate endonasal obstruction. RESULTS All dogs had abnormal conchal growth that obstructed the intranasal airways. Rostral aberrant turbinates (RAT) were common in Pugs (90.9%) but less frequent in French (56.4%) and English (36.4%) Bulldogs. Caudal aberrant turbinates (CAT) obstructing the nasopharyngeal meatus were commonly found in all breeds (66.7%). Deviation of the nasal septum was an almost consistent finding in Pugs (98.5%) but was less common in bulldogs. Obstructing turbinates had multiple points of mucosal contact responsible for obstruction of the intranasal airway. Interconchal and intraconchal mucosal contacts were evident in 91.7% of dogs. CONCLUSION Selective breeding for short head conformation reduces the size of the nasal cavities to such an extent that intranasal structures grow aberrantly and malformed, leading to obstructed air conducting spaces. Intranasal airway obstruction of brachycephalic dogs may contribute to their exercise and heat intolerance because of impaired pulmonary ventilation and compromised thermoregulatory functions of the canine nose. Failure to address intranasal obstruction might be an explanation for lack of therapeutic success after conventional surgery for brachycephalic syndrome. Future consideration should be given to the diagnosis, management, and treatment of this newly described aspect of airway obstruction.

Ultrasonographic Diagnosis of an Endocarditis Valvularis in a Burmese Python (Python molurus bivittatus) with Pneumonia

Abstract An 11-yr-old Burmese python (Python molurus bivittatus) was presented with a history of respiratory symptoms. Computed tomography and an endoscopic examination of the left lung were performed and revealed severe pneumonia. Microbiologic examination of a tracheal wash sample and an endoscopy-guided sample from the lung confirmed infection with Salmonella enterica ssp. IV, Enterobacter cloacae, and Klebsiella pneumoniae. Computed tomographic examination demonstrated a hyperattenuated structure within the heart. Echocardiographic examination revealed a hyperechoic mass at the pulmonic valve as well as a dilated truncus pulmonalis. As therapy for pneumonia was ineffective, the snake was euthanized. Postmortem examination confirmed pneumonia and infective endocarditis of the pulmonic valve caused by septicemia with Salmonella enterica ssp. IV. Focal arteriosclerosis of the pulmonary trunk was also diagnosed. The case presented here demonstrates the possible connection between respiratory and cardiovascular diseases in snakes.

Morphological Pulmonary Diffusion Capacity for Oxygen of Burmese Pythons (Python molurus): a Comparison of Animals in Healthy Condition and with Different Pulmonary Infections

A qualitative and quantitative morphological study of the pulmonary exchange capacity of healthy and diseased Burmese pythons (Python molurus) was carried out in order to test the hypothesis that the high morphological excess capacity for oxygen exchange in the lungs of these snakes is one of the reasons why pathological processes extend throughout the lung parenchyma and impair major parts of the lungs before clinical signs of respiratory disease become apparent. Twenty-four Burmese pythons (12 healthy and 12 diseased) were included in the study. A stereology-based approach was used to quantify the lung parenchyma using computed tomography. Light microscopy was used to quantify tissue compartments and the respiratory exchange surface, and transmission electron microscopy was used to measure the thickness of the diffusion barrier. The morphological diffusion capacity for oxygen of the lungs and the anatomical diffusion factor were calculated. The calculated anatomical diffusion capacity was compared with published values for oxygen consumption of healthy snakes, and the degree to which the exchange capacity can be obstructed before normal physiological function is impaired was estimated. Heterogeneous pulmonary infections result in graded morphological transformations of pulmonary parenchyma involving lymphocyte migration into the connective tissue and thickening of the septal connective tissue, increasing thickness of the diffusion barrier and increasing transformation of the pulmonary epithelium into a columnar pseudostratified or stratified epithelium. The transformed epithelium developed by hyperplasia of ciliated cells arising from the tip of the faveolar septa and by hyperplasia of type II pneumocytes. These results support the idea that the lungs have a remarkable overcapacity for oxygen consumption and that the development of pulmonary disease continuously reduces the capacity for oxygen consumption. However, due to the overcapacity of the lungs, this reduction does not result in clinical signs and disease can progress unrecognized for an extended period.

Morphological respiratory diffusion capacity of the lungs of ball pythons (Python regius)

This study aims at a functional and morphological characterization of the lung of a boid snake. In particular, we were interested to see if the pythons lungs are designed with excess capacity as compared to resting and working oxygen demands. Therefore, the morphological respiratory diffusion capacity of ball pythons (Python regius) was examined following a stereological, hierarchically nested approach. The volume of the respiratory exchange tissue was determined using computed tomography. Tissue compartments were quantified using stereological methods on light microscopic images. The tissue diffusion barrier for oxygen transport was characterized and measured using transmission electron micrographs. We found a significant negative correlation between body mass and the volume of respiratory tissue; the lungs of larger snakes had relatively less respiratory tissue. Therefore, mass-specific respiratory tissue was calculated to exclude effects of body mass. The volume of the lung that contains parenchyma was 11.9±5.0mm(3)g(-1). The volume fraction, i.e., the actual pulmonary exchange tissue per lung parenchyma, was 63.22±7.3%; the total respiratory surface was, on average, 0.214±0.129m(2); it was significantly negatively correlated to body mass, with larger snakes having proportionally smaller respiratory surfaces. For the air-blood barrier, a harmonic mean of 0.78±0.05μm was found, with the epithelial layer representing the thickest part of the barrier. Based on these findings, a median diffusion capacity of the tissue barrier ( [Formula: see text] ) of 0.69±0.38ml O(2)min(-1)mmHg(-1) was calculated. Based on published values for blood oxygen concentration, a total oxygen uptake capacity of 61.16mlO(2)min(-1)kg(-1) can be assumed. This value exceeds the maximum demand for oxygen in ball pythons by a factor of 12. We conclude that healthy individuals of P. regius possess a considerable spare capacity for tissue oxygen exchange.

Continuous Lumbar Hemilaminectomy for Intervertebral Disc Disease in an Amur Tiger (Panthera tigris altaica)

Abstract A 13-yr-old Amur tiger (Panthera tigris altaica) was presented for an acute onset of paraplegia. Spinal imaging that included plain radiographs, myelography, and computed tomography performed under general anesthesia revealed lateralized spinal cord compression at the intervertebral disc space L4–5 caused by intervertebral disc extrusion. This extrusion was accompanied by an extensive epidural hemorrhage from L3 to L6. Therefore, a continuous hemilaminectomy from L3 to L6 was performed, resulting in complete decompression of the spinal cord. The tiger was ambulatory again 10 days after the surgery. This case suggests that the potential benefit of complete spinal cord decompression may outweigh the risk of causing clinically significant spinal instability after extensive decompression.

Komplikationen sonographisch gestützter Leberbiopsien bei Hund und Katze

Gegenstand und Ziel: Zur Diagnosesicherung von sonographisch erfassten Veranderungen der Leber wird in der Regel eine ultraschallgestutzte Biopsie durchgefuhrt. Die haufigste Komplikation stellt dabei eine postinterventionelle Blutung dar, die zum Tod des Patienten fuhren kann. Ziel der Studie war zu uberprufen, ob ein Zusammenhang zwischen Veranderungen der Blutgerinnungswerte und einer sonographisch darstellbaren Blutung nach einer Leberbiopsie besteht. Material und Methoden: In die retrospektive Studie wurden Hunde und Katzen aufgenommen, bei denen eine ultraschallgestutzte Leberbiopsie erfolgt war. Einschlusskriterien waren ein dokumentierter Befund der Ultraschalluntersuchung und Befunde zum Parameter Thromboplastinzeit oder der Kombination aus aktivierter partieller Thromboplastinzeit und Prothrombinzeit. Die Daten wurden hinsichtlich des Vorliegens eines postinterventionellen Aszites und moglicher Risikofaktoren zu dessen Entstehung ausgewertet. Ergebnisse: Die Daten von 105 Patienten, 94 Hunden (89,5 %) und 11 Katzen (10,5 %), gingen in die Auswertung ein. Bei 26 von 105 Patienten (24,8 %) kam es zu postinterventionellen Komplikationen, davon waren 21,9 % Minorkomplikationen und 2,9 % Majorkomplikationen. Einen postinterventionellen Aszites entwickelten 22 von 94 Hunden (23,4 %) und vier von 11 Katzen (36,4 %). Ein Aszites nach Leberbiopsie trat bei drei von 10 (2,9 %) Hunden mit verlangerten Gerinnungszeiten von uber 25 % auf, wobei es sich bei zwei Hunden um einen geringgradigen und bei einem Hund um einen mittelgradigen Aszites handelte. Nach der Punktion wurde bei einer von zwei Katzen mit verlangerter Gerinnungszeit von mehr als 25 % ein mittelgradiger Aszites diagnostiziert. Zwischen dem Auftreten eines postinterventionellen Aszites und erhohten Gerinnungswerten lies sich kein statistisch signifikanter Zusammenhang nachweisen. Schlussfolgerung: Nach den Resultaten der Studie besteht kein Zusammenhang zwischen veranderten Gerinnungswerten und einer Blutung nach einer Leberbiopsie. Objective: Ultrasound-guided biopsies are obtained generally to reach a sound diagnosis in the case of sonographically detectable hepatic changes. The most common and well-known complication associated with ultrasound-guided biopsies is haemorrhage after sampling, which may lead to the patient’s death. The aim of this study was to evaluate a possible association between alterations in the coagulation parameters and sonographically observable haemorrhage following liver biopsies. Materials and methods: Dogs and cats in which an ultrasound-guided biopsy of the liver had been performed were retrospectively enrolled in the study. Inclusion criteria were thoroughly documented sonographic findings and the results of the coagula tion parameter thromboplastin time or a combination of the activated partial thromboplastin time and prothrombin time. The incidence of post-interventional ascites and possible risk factors were evaluated. Results: A total of 105 patients met the inclusion criteria and the data of 94 dogs (89.5 %) and 11 cats (10.5 %) were analysed. Post-interventional complications occurred in 26 of 105 patients (24.8 %), 21.9 % being minor and 2.9 % being major. Free abdominal fluid after intervention was sonographically detected in 22 of 94 dogs (23.4 %) and four of 11 cats (36.4 %). Three of 10 dogs (2.9 %) with a clinically significant prolongated coagulation time of > 25 % had ascites after biopsy. Only a small amount of fluid was detected in two of these three dogs, while a moderate amount of ascites was observed in the third dog. One of two cats with a prolonged coagulation time of > 25 % developed a moderate amount of ascites after the puncture. No statistically significant association was found between the occurrence of post-interventional ascites and a prolongation of the coagulation time. Conclusion: According to the study results, there is no obvi ous correlation between alterations in coagulation and haemorrhage after an ultrasound-guided liver biopsy.

Nephroblastom bei einer 2-jährigen Hündin

Eine 2-jahrige unkastrierte Boxerhundin wurde aufgrund von Polyurie, Polydipsie und reduzierter Futteraufnahme vorgestellt. Die sonographische Untersuchung des palpatorisch schmerzhaften Abdomens zeigte eine Zubildung der linken Niere mit Verdrangung der Organe im kranialen und mittleren Abdomen. Dimension und Invasivitat des Prozesses wurden mittels kontrastmittelverstarkter Sonographie und Computertomographie ermittelt. Die histopathologische Untersuchung einer Gewebeprobe ergab den Befund eines Nephroblastoms. Der Fallbericht beschreibt die klinischen, sonographischen und computertomographischen Befunde und dokumentiert den Verlauf ohne Therapie nach 5 Monaten. An intact female 2-year-old boxer presented with polydipsia, polyuria, and decreased feed intake. Palpation of the abdomen was painful. Sonography revealed an abdominal mass of the left kidney causing displacement of the organs located in the cranial and mid-abdomen. Dimen sion and invasiveness of the process were evaluated both by contrast enhanced ultrasound (CEUS) and contrast-enhanced computed tomography. Histopathological examination of a biopsy sample revealed a nephroblastoma. The case report describes the clinical, sonographic, and computed tomographic results and the outcome in the untreated dog over a period of 5 months.

Akute Nierenschädigung bei Hund und Katze durch spezifische Nephrotoxine – Diagnose und Management

Das klinische Bild eines Patienten mit akuter Nierenschadigung ist Ausdruck eines plotzlichen Anstiegs des Kreatinin- und Harnstoffspiegels sowie haufig auftretender Storungen im Elektrolyt-, Sauren-Basen- und Wasserhaushalt. Der Wechsel der Terminologie vom akuten Nierenversagen zum Begriff der „akuten Nierenschadigung“ soll verdeutlichen, dass es kein einmaliges Ereignis ist, sondern dass wiederholte Schadigungen zur Progression fuhren. Bei Hunden und Katzen zahlt die Aufnahme von Nephrotoxinen mit zu den haufigsten Auslosern [ 25 ]. Eine schnelle, aber gezielte Diagnostik und ein fruhzeitiger Beginn mit spezifischen und allgemeinen therapeutischen Masnahmen kann die Prognose im Einzelnen deutlich verbessern. Insgesamt bleibt diese allerdings schlecht.