Kathy A. Spaulding

IMAGING DIAGNOSIS—GASTRIC PNEUMATOSIS IN A CAT

Gastrointestinal foreign bodies were removed surgically from a 9-year-old Siamese cat. Two days later the cat became lethargic and started regurgitating. A degenerative leukocytosis and drop in packed cell volume were present. Gastric wall thickening with intramural gastric air was detected radiographically and sonographically. Gastric ulceration with a focal necrotic area was seen endoscopically. At surgery, the stomach wall was emphysematous. Clinical signs resolved following partial gastrectomy and medical management. Intramural gastric air with declining clinical course was a significant impetus to return to surgery.

Bilateral Testicular Germ Cell–Sex Cord–Stromal Tumor in a Pekin Duck (Anas platyrhynchos domesticus)

Abstract An intact male white pekin duck (Anas platyrhynchos domesticus) was presented for examination because of respiratory distress and 2- to 3-month history of lameness and lethargy. Results of radiography, ultrasonography, and cytologic examination revealed a large neoplastic mass in the coelom. The duck was euthanatized, and results of necropsy revealed 2 large, lobulated masses in the coelom and a small nodule on the liver. Histopathologic examination of the large masses revealed a collision pattern testicular tumor consisting of Sertoli, seminoma, and interstitial cell components. The hepatic nodule was a metastatic lesion consistent with a Sertoli cell testicular tumor. This is the first reported case of a mixed germ cell–sex cord–stromal tumor in a duck.

Multi-organ involvement of Heterobilharzia americana infection in a dog presented for systemic mineralization

Canine schistosomiasis due to Heterobilharzia americana is a clinically underdiagnosed disease in dogs, which is found primarily in the Gulf Coast and south Atlantic region of the United States. A 3-year-old dog from Texas with a clinical diagnosis of systemic mineralization of unknown origin in the absence of evidence of hypercalcemia was found at necropsy to have severe disseminated H. americana infection involving the liver, pancreas, small and large intestine, lungs, and kidneys. Calcification of many of the large number of H. americana eggs gave the false impression of soft-tissue mineralization on radiographic and ultrasonographic images. Polymerase chain reaction amplification and sequencing of DNA derived from formalin-fixed sections of small intestine and liver, using primers specific for a 487–base pair segment of the H. americana small subunit ribosomal RNA gene, confirmed the presence of H. americana.

IMAGING DIAGNOSIS—HETEROBILHARZIA AMERICANA INFECTION IN A DOG

An approximately three-year-old mixed breed female dog was evaluated for peritoneal effusion, anorexia, intermittent vomiting, and diarrhea. Radiographically, there was mineralization of the wall of small intestinal segments. Sonographic findings were consistent with multisystemic mineralization of liver, small intestinal wall, and pancreas. Multifocal granulomas containing schistosome eggs (Heterobilharzia americana) were identified histologically. The mineralization pattern described herein is an uncommon presentation of severe diffuse heterobilharziasis in a dog.

ULTRASONOGRAPHIC CHARACTERISTICS OF LIPIDURIA IN CLINICALLY NORMAL CATS

Echoes are frequently seen in the urinary bladder of cats during abdominal ultrasound. These have been attributed to hematuria, pyuria, crystalluria, and lipid. However, sonographic findings have not been previously correlated with urinalysis. We prospectively evaluated 40 clinically normal cats via ultrasound, serum chemistry, and urinalysis. Thin layer chromatography was performed on the urine to determine the amount (mg) of lipid subfractions including diacylglycerol, triglyceride, phospholipid, free fatty acid, cholesterol, and cholesterol ester. Ninety percent (36/40) of the cats in our population had sonographic echoes suspended in the urinary bladder, with most having a subjective score of mild echoes (n = 20). None of the sonographic echoes were gravity dependent or caused distal acoustic shadowing, reverberation, or twinkle artifact. Of the cats with sonographic echoes in the urine, 66% (24/36) had no significant findings on urinalysis other than the presence of lipid. The total amount of subjective sonographic echoes was not significantly related to the total amount of fat measured on thin layer chromatography or the number of lipid droplets seen on urinalysis. An increased amount of urine diacylglycerol was significantly associated with clumping of echoes (P = 0.02) and the amount of lipid droplets seen on urinalysis (P = 0.04). An association between increased amounts of urine diacylglycerol and the amount of echoes seen on ultrasound approached significance (P = 0.05). Findings from this study support previously published theories that sonographic echoes within the urinary bladder of clinically normal cats may be due to urine lipid.

Meningoencephalitis in a dog due to trichosporon montevideense

Meningoencephalitis due to infection with Trichosporon montevideense was diagnosed in a 4-year-old dog with a brief clinical history of rapidly progressing neurological signs that culminated in a comatose state. No significant gross lesions were found at post-mortem examination. Microscopically, a few scattered areas of pyogranulomatous inflammation with a few small, non-pigmented fungal hyphae were found within the cerebrum surrounding the lateral ventricles. A Trichosporon sp. was identified through culture of the brain and species was determined via sequence analysis of the internal transcribed spacer region of the Trichosporon rRNA gene. DNA in-situ hybridization confirmed the diagnosis. This is the first reported case of Trichosporon-associated meningoencephalitis in a dog.

Formulation of a standardized protocol and determination of the size and appearance of the spleen in healthy cats.

Standard protocol for splenic measurement is warranted to aid in interpretation when sonographically imaging the spleen of cats. The purpose of this study was to describe the appearance and size of healthy cat spleens, and to develop a standard method of evaluation. Data were obtained from 31 clinically healthy non-sedated cats with no sonographic abnormalities. The sonographic appearance of the spleen’s relative echogenicity compared to the left renal cortex and the hepatic parenchyma was recorded. Splenic height was measured at three sites. Three measurements were determined at each site, and the mean value of these three measurements was determined and used for data analysis. A significance level of P <0.05 was used for analysis, which was performed using S-PLUS software (version 8.1). The mean proximal height of the spleen was 7.1 mm. The mean body sagittal height was 9.3 mm. The mean height of the tail of the spleen was 8.7 mm (95% confidence interval). The splenic parenchymal echogenicity was less than the left renal cortex echogenicity and greater than the liver in 17/31cats; less than the left kidney cortex and equal to the liver in 5/31cats; equal to the cortex of the left kidney and greater than the liver in 5/31 cats; equal to the liver and renal cortex in 2/31 cats; and less than the liver and kidney with the renal cortex less than the liver in 2/31 cats. The protocol recommended for consistent evaluation of the spleen in the cat includes three specific measurements.

Imaging diagnosis--pulmonary alveolar proteinosis in a dog.

A young dog was presented for cyanosis and right heart failure. Radiographic and CT characteristics included right heart/pulmonary artery enlargement, hepatomegaly, abdominal effusion, and severe, generalized air-space filling. Focal increased opacities were present in the peripheral lung, as were multiple pulmonary blebs and bullae. Echocardiographic findings were consistent with cor pulmonale and pulmonary hypertension. Bronchoscopic findings were consistent with chronic inflammation. Pulmonary alveolar proteinosis (PAP) was confirmed at necropsy. Pulmonary alveolar proteinosis is an interstitial lung disease that results in accumulation of phospholipoproteinaceous material and should be included as a differential diagnosis for dogs with these clinical and imaging characteristics.

IMAGING DIAGNOSIS—SYNOVIAL MYXOMA OF LUMBAR VERTEBRAE ARTICULAR PROCESS JOINT

Magnetic resonance (MR) imaging and histopathology were used to diagnose an articular process synovial myxoma in a dog. On MR images, the tumor was characterized by distortion of the left L1-L2 articular process, widening of the articular process joint, and the presence of a mass contiguous with the synovium of the articular process that displaced the spinal cord. The tumor was T2-hyperintense, T1-hypointense, relative to muscle, and had mild contrast enhancement. The MR features of articular process synovial myxoma may be distinct from other diseases of the articular process joint.

Extruded gallbladder mucoceles have characteristic ultrasonographic features and extensive migratory capacity in dogs

Limited information is available on the ultrasonographic characteristics of extruded gallbladder mucoceles. The objective of this retrospective case series study was to describe the ultrasonographic features of extruded gallbladder mucoceles in a group of dogs. Medical records of four veterinary centers were searched between June 2010 and January 2018 for all dogs with a suspected extruded gallbladder mucocele based on abdominal ultrasound. Seven client-owned dogs met the inclusion criteria. All seven dogs had a discrete, heteroechoic, multilayered, stellate, or striated mass within the peritoneal cavity. Blood flow was not present in these structures. Four of these structures were identified in the caudal abdomen. In five cases, the gallbladder lumen was filled with material similar in appearance to the free-floating peritoneal mass. Four cases were confirmed surgically and one case was confirmed at necropsy. Histopathology of the gallbladder wall was evaluated in all surgical cases and analysis of the free-floating material was performed in one of the four cases. Extruded gallbladder mucoceles have common imaging characteristics that may be helpful in establishing a presumptive diagnosis. Additionally, these structures may have extensive migratory capacity. The results of the study justify the recommendation for exploration of the entire abdomen during cholecystectomy for gallbladder mucocele removal.