Mario Cipone

ULTRASONOGRAPHIC AND PATHOLOGIC FEATURES OF INTESTINAL SMOOTH MUSCLE HYPERTROPHY IN FOUR CATS

The ultrasonographic findings for four cats with intestinal smooth muscle hypertrophy are described. In two cats, intestinal smooth muscle hypertrophy was associated with chronic enteritis. In the remaining two cats, intestinal smooth muscle hypertrophy affected the intestinal tract proximal to stenosis due to alimentary lymphoma and an intestinal foreign body, respectively. Moderate increased thickness of the affected intestinal wall, measuring 7–8 mm, was evident on abdominal ultrasonographic examination of all subjects. In addition, the ultrasonographic five‐layered feature of the intestinal wall was maintained, and only the muscular layer appeared thickened. Abdominal ultrasound allowed a presumptive diagnosis of intestinal smooth muscle hypertrophy that was confirmed histologically in all cats.

Intermittent Gastroesophageal Intussusception in a Dog: Clinical Features, Radiographic and Endoscopic Findings, and Surgical Management

M. Pietra1*, F. Gentilini1, S. Pinna2, F. Fracassi1, A. Venturini2 and M. Cipone1 Department of Veterinary Clinical Science (1Section of Internal Medicine; 2Section of Surgery), Faculty of Veterinary Medicine, University of Bologna, 40064 Ozzano dell’Emilia (BO), Italy *Correspondence: Dipartimento Clinico Veterinario, Universita degli Studi di Bologna, V ia T olara di Sopra 50, 40064, Ozzano dell’Emilia (BO), Italy E-mail: mpietra@vet.unibo.it

Ultrasonographic measurement of the relative thickness of intestinal wall layers in clinically healthy cats

The normal sonographic thickness of the individual layers (ie, mucosa, submucosa, muscularis and subserosa-serosa) of the intestinal wall was evaluated in 20 clinically healthy cats. The mean thickness of the wall was 2.20, 2.22, 3.00 and 2.04 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively. The mean thickness of the mucosal layer was 1.27, 1.20, 0.46 and 0.49 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively, and its contribution to wall thickness was significantly greater than that of the other layers in the duodenum (57.7%) and jejunum (55.2%). The mean thickness of the submucosal layer was 0.36, 0.36, 1.49 and 0.53 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively, and its contribution to wall thickness was greater than that of the muscularis in the duodenum (16.3%), jejunum (16%) and ileum (fold) (49.8 %). The mean thickness of muscularis was 0.28, 0.35, 0.66 and 0.65 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively, with a corresponding contribution to wall thickness of 12.7 %, 14.4%, 22% and 31.6%. Finally, the mean thickness of serosa was 0.29, 0.31, 0.38 and 0.38 mm for duodenum, jejunum, ileum (fold) and ileum (between folds), respectively, with a corresponding contribution to wall thickness of 13.3%, 14.4%, 12.7 % and 18.7%. These values can provide baseline information that might be useful in evaluating intestinal disorders affecting preferentially some of the intestinal layers.

Use of computed tomography in thoracic diseases of small animals.

Radiographic evaluation of the thorax in small animals is one of the most important and most frequently performed diagnostic tests in small-animal practice. It offers good visualization of different intrathoracic structures and is particularly useful for the evaluation of pulmonary disorders (Schwarz and Tidwell, 1999). Nevertheless, a more complete assessment of the lung and the other surrounding thoracic structures may be obtained by use of alternative imaging techniques such as ultrasonography, scintigraphy and computed tomography (CT) (Spann et al., 1998; Tidwell, 2000). The aim of this study was to evaluate the role of CT in the diagnostic protocol of canine and feline patients affected by thoracic diseases.

Feasibility and reproducibility of echocardiographic assessment of regional left atrial deformation and synchrony by tissue Doppler ultrasonographic imaging in healthy dogs

OBJECTIVE To assess the feasibility and reproducibility of longitudinal tissue Doppler ultrasonographic imaging with regard to determination of velocity, strain, and strain rate (SR) of the left atrium (LA) and use those data to characterize LA synchrony (LAS) for a group of healthy dogs. ANIMALS 15 healthy dogs. PROCEDURES For each dog, apical 4- and 2-chamber echocardiographic views were obtained. Peak velocity, strain, and SR and time to peak value during systole, early diastole, and late diastole were measured for each of the 4 LA walls. To characterize LAS, mean and SD maximal late diastolic time difference (LAD) among the 4 walls were calculated on the basis of time to peak for velocity, strain, and SR; for each, the 95% confidence interval (mean ± 2SD) was calculated. Within-day and between-day intraobserver variability was calculated. RESULTS For all dogs, tissue velocity and SR had peak positive values during systole and 2 negative peaks during early and late diastole. Atrial strain had a peak positive value during systole, positive values during early diastole, and a negative peak value during late diastole. Reproducibility was acceptable for most variables. Diastolic strain and SR had the highest variability, but times to peak values were always reproducible. For velocity, strain, and SR, the 95% confidence interval for the maximal LAD was < 50 milliseconds and that for the SD of the LAD was < 23 milliseconds. CONCLUSIONS AND CLINICAL RELEVANCE Longitudinal tissue Doppler imaging of LA deformation was feasible in healthy dogs, and its application may be useful for understanding atrial pathophysiologic changes associated with various cardiac diseases in dogs.

Use of high-frequency ultrasonography for evaluation of skin thickness in relation to hydration status and fluid distribution at various cutaneous sites in dogs

OBJECTIVE To assess the usefulness of high-frequency diagnostic ultrasonography for evaluation of changes of skin thickness in relation to hydration status and fluid distribution at various cutaneous sites in dogs. ANIMALS 10 clinically normal adult dogs (6 males and 4 females) of various breeds. PROCEDURES Ultrasonographic examination of the skin was performed before and after hydration via IV administration of an isotonic crystalloid solution (30 mL/kg/h for 30 minutes). A 13-MHz linear-array transducer was used to obtain series of ultrasonographic images at 4 different cutaneous sites (the frontal, sacral, flank, and metatarsal regions). Weight and various clinicopathologic variables (PCV; serum osmolality; and serum total protein, albumin, and sodium concentrations) were determined before and after the infusion. These variables and ultrasonographic measurements of skin thickness before and after hydration were compared. RESULTS Among the 10 dogs, mean preinfusion skin thickness ranged from 2,211 microm (metatarsal region) to 3,249 microm (sacral region). Compared with preinfusion values, weight was significantly increased, whereas PCV; serum osmolality; and serum total protein, albumin, and sodium concentrations were significantly decreased after infusion. After infusion, dermal echogenicity decreased and skin thickness increased significantly by 21%, 14%, 15%, and 13% in the frontal, sacral, flank, and metatarsal regions, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Cutaneous site and hydration were correlated with cutaneous characteristics and skin thickness determined by use of high-frequency ultrasonography in dogs. Thus, diagnostic ultrasonography may be a useful tool for the noninvasive evaluation of skin hydration in healthy dogs and in dogs with skin edema.

Evaluation of the clinical signs and computed tomographic findings in 27 dogs with intracranial space-occupying lesions (1999-2000)

Recent advances in veterinary neurology and the concurrent greater availability of computed tomography (CT) and magnetic resonance imaging (MRI) have substantially increased the possibility of in vivo diagnosis of intracranial space-occupying lesions in companion animals (Kraft and Gavin, 1999; Bagley et al., 1999). However, an accurate evaluation of the neurological symptoms is essential to correctly guide the clinician in the subsequent diagnostic work-up. The purpose of this study was the evaluation of clinical signs and CT findings in 27 dogs with evidence of an intracranial space-occupying lesion on CT examination.

Utility of Tissue Doppler Imaging in the Echocardiographic Evaluation of Left and Right Ventricular Function in Dogs with Myxomatous Mitral Valve Disease with or without Pulmonary Hypertension

Background In human medicine, right ventricular (RV) functional parameters represent a tool for risk stratification in patients with congestive heart failure caused by left heart disease. Little is known about RV alterations in dogs with left‐sided cardiac disorders. Objectives To assess RV and left ventricular (LV) function in dogs with myxomatous mitral valve disease (MMVD) with or without pulmonary hypertension (PH). Animals One‐hundred and fourteen dogs: 28 healthy controls and 86 dogs with MMVD at different stages. Methods Prospective observational study. Animals were classified as healthy or having MMVD at different stages of severity and according to presence or absence of PH. Twenty‐eight morphological, echo‐Doppler, and tissue Doppler imaging (TDI) variables were measured and comparison among groups and correlations between LV and RV parameters were studied. Results No differences were found among groups regarding RV echo‐Doppler and TDI variables. Sixteen significant correlations were found between RV TDI and left heart echocardiographic variables. Dogs with PH had significantly higher transmitral E wave peak velocity and higher E/eʹ ratio of septal (sMV) and lateral (pMV) mitral annulus. These 2 variables were found to predict presence of PH with a sensitivity of 84 and 72%, and a specificity of 71 and 80% at cut‐off values of 10 and 9.33 for sMV E/eʹ and pMV E/eʹ, respectively. Conclusions and clinical importance No association between variables of RV function and different MMVD stage and severity of PH could be detected. Some relationships were found between echocardiographic variables of right and left ventricular function.

Accelerated Idioventricular Rhythm in 9 Dogs

Accelerated idioventricular rhythm (AIVR) is an ectopic cardiac rhythm characterized by three or more consecutive premature ventricular complexes with a faster rate than the normal ventricular intrinsic escape rate of 30 to 40 bpm, but slower than the rate of ventricular tachycardia (VT) (Grimm and Marchlinski, 2000). Accelerated idioventricular rhythm is usually associated with abnormalities of the ventricular myocardium and altered automatism of the Purkinje’s fibres is thought to be the underlying electrophysiological mechanism (Olgin and Zipes, 2001). The difference between VT and AIVR depends on the rate at which the ectopic focus depolarizes (Grimm and Marchlinski, 2000; Olgin and Zipes, 2001). In humans, a heart rate limit of 110–120 bpm has been established as a cut-off for differentiating AIVR from VT (Grimm and Marchlinski, 2000). In the dog, an exact demarcation between AIVR and VT cannot be precisely established, owing to the extreme variability of the normal heart rate in this species. Some authors, after experimental induction of AIVR by injecting the myocardium of normal dogs with formalin, considered a ventricular rate limit of around 180 bpm to differentiate between VT and AIVR (Vassalle et al., 1977; Ilvento et al., 1982). Conversely, upper limits ranging from 110 to 160 bpm have been reported in veterinary textbooks based on subject size (Kittleson, 1998; Moı̈se, 1999; Coté and Ettinger, 2005). Owing to the scarce description of specific cases of AIVR in the canine literature, the aim of this paper is to report the clinical findings and outcome for nine dogs with AIVR recently brought to our attention.

Clinical and clinicopathologic findings in three dogs with steroid-responsive meningitis-arteritis (SRMA)

Steroid-responsive menigitis–arteritis (SRMA) in the dog is a well known disease in small animal practice (Russo et al., 1983; Meric et al., 1985; Irving and Chrisman, 1990; Presthus, 1991; Poncelet and Balligand, 1993; Tipold and Jaggy, 1994; Cizinauskas et al., 2000). The disease presents two clinical forms: the more typical acute form and the less common atypical (or chronic) form. The acute condition is characterized by fever, pain and cervical rigidity, pleocytosis with polymorphonuclear cells in the cerebrospinal fluid (CSF). The more protracted atypical form is associated with additional neurological deficits and mixed or mononuclear pleocytosis in the CSF. Elevated serum and CSF IgA levels have been found in both forms (Tipold and Jaggy, 1994; Tipold, 1995; Cizinauskas et al., 2000). Histopathologically, the disease is characterized by infiltration of inflammatory cells into the meninges and by inflammatorystenotic lesions of meningeal arteries (Meric et al., 1985). Long-term immunosuppressive corticosteroid therapy is required to obtain significant clinical improvement and remission of the disease. The present paper reports the clinical clinicopathological and follow-up findings in three dogs affected by SRMA examined at the Department of Veterinary Clinical Sciences of the University of Bologna.