Olivier Taeymans

Portal Vein Thrombosis in 33 Dogs: 1998–2011

BACKGROUND Portal vein thrombosis (PVT) has been reported infrequently in dogs. OBJECTIVES To characterize the presentation, associated disease conditions, and outcome in dogs with PVT. ANIMALS Client-owned dogs with a diagnosis of PVT and a complete medical record. METHODS Records were retrospectively analyzed for presentation, history, physical examination, clinicopathologic data, diagnostic imaging, treatment, and outcome. RESULTS Thirty-three dogs were included. Common clinical signs were vomiting, diarrhea, abdominal pain, ascites, and signs of hypovolemic shock. Associated disease conditions included hepatic (14/33), neoplastic (7/33), immune (5/33), and infectious (4/33) diseases, protein-losing nephropathy (3/33), hyperadrenocorticism (2/33), protein-losing enteropathy (1/33), and pancreatitis (1/33). Fourteen dogs were receiving glucocorticoids at the time of diagnosis. Twenty-nine dogs had at least 1 predisposing condition for venous thrombosis, and 11 had 2 or more. Thrombocytopenia (24/33), increased liver enzyme activity (23/33), and hypoalbuminemia (20/33) were common laboratory abnormalities. Clinical syndromes at the time of PVT diagnosis included shock (16/33), systemic inflammatory response syndrome (SIRS), (13/33) and disseminated intravascular coagulation (3/33). Twenty-four dogs had acute and 9 had chronic PVT. Multiple thrombi were found in 17/33 dogs. Nineteen dogs survived to discharge. Dogs treated with anticoagulant therapy were more likely, whereas those with acute PVT, multiple thromboses or SIRS were less likely to survive. CONCLUSIONS AND CLINICAL IMPORTANCE Hepatic disease is a common pre-existing condition in dogs with PVT. PVT should be considered in dogs with risk factors for venous thrombosis presenting with abdominal pain, ascites, and thrombocytopenia. Studies evaluating anticoagulant therapy in the management of PVT are warranted.

COMPARISON BETWEEN CLINICAL, ULTRASOUND, CT, MRI, AND PATHOLOGY FINDINGS IN DOGS PRESENTED FOR SUSPECTED THYROID CARCINOMA

This study compares clinical, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and pathology findings in 16 prospectively, and seven retrospectively recruited dogs presented for suspected thyroid carcinoma. Of these, 17 were confirmed thyroid carcinoma, while six were initially misdiagnosed. These included four carotid body tumors, one para-esophageal abscess, and one undifferentiated squamous cell carcinoma. Thyroid carcinomas occurred in older dogs without evidence of sex predilection, and were more often unilateral. All were large, heterogeneous, moderately to strongly vascularized, and most commonly contained areas of dystrophic mineralization and/or fluid accumulations. On MRI, thyroid carcinomas appeared hyperintense compared to surrounding musculature in all imaging sequences used, while on CT they had a lower attenuation value than normal thyroid gland tissue. Histologically confirmed tumor capsule disruption with invasion of the surrounding structures was most commonly detected with MRI. Palpation was not an accurate predictor of locally invasive vs. well-encapsulated masses. Computed tomography had the highest specificity (100%) and MRI had the highest sensitivity (93%) in diagnosing thyroid carcinoma, while ultrasound had considerably lower results. We conclude that ultrasound is adequate for use as a screening tool for dogs with suspected thyroid carcinoma, but recommend either CT or MRI for preoperative diagnosis and staging.

Penetrating injuries in dogs and cats. A study of 16 cases.

The objective of this retrospective study was to assess radiographical and surgical findings, surgical management and outcome of penetrating injuries in dogs and cats by evaluating patient records. Sixteen patients were identified (15 dogs and one cat), four with gunshot wounds, and 12 with fight wounds (11 with bite wounds, one struck by a claw). The thoracic cavity was affected in six patients, the abdominal cavity in three cases. Both cavities were affected in five dogs and the trachea in two cases. All of the patients with fight wounds were small breed dogs. Multiple injuries to internal organs that required intervention were found surgically after gunshot wounds and a high amount of soft tissue trauma requiring reconstruction was present after fight wounds. Radiography diagnosed body wall disruption in two cases. All of the affected thoracic body walls in the fight group had intercostal muscle disruptions which was diagnosed surgically. Fourteen patients survived until discharge and had a good outcome. In conclusion, penetrating injuries should be explored as they are usually accompanied by severe damage to either the internal organs or to the body wall. A high level of awareness is required to properly determine the degree of trauma of intercostal muscle disruption in thoracic fight wounds.

Safety of contrast-enhanced ultrasonography in dogs and cats: 488 cases (2002-2011)

OBJECTIVE To determine the incidence of adverse events within 24 hours after contrast-enhanced ultrasonography (CEUS) in dogs and cats and compare the risk of death within 24 hours after imaging for animals that underwent ultrasonography with and without injection of a contrast agent. DESIGN Retrospective case-control study. ANIMALS 750 animals (411 case dogs, 238 control dogs, 77 case cats, and 24 control cats). PROCEDURES At 11 institutions, medical records were reviewed of dogs and cats that had CEUS performed (cases) as were medical records of dogs and cats with clinical signs similar to those of case animals that had ultrasonography performed without injection of a contrast agent (controls). Information regarding signalment; preexisting disease; type, dose, and administration route of contrast agent used; immediate (within 1 hour after CEUS) and delayed (> 1 and ≤ 24 hours after CEUS) adverse events; and occurrence and cause of death (when available) was extracted from each medical record. Risk of death within 24 hours after ultrasonography was compared between case and control animals. RESULTS Of the 411 case dogs, 3 had immediate adverse events (vomiting or syncope) and 1 had a delayed adverse event (vomiting). No adverse events were recorded for case cats. Twenty-three of 357 (6.4%) clinically ill case animals and 14 of 262 (5.3%) clinically ill control animals died within 24 hours after ultrasonography; risk of death did not differ between cases and controls. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that CEUS was safe in dogs and cats.

Thyroid Imaging in the Dog: Current Status and Future Directions

This review describes the advantages and disadvantages of radiography, ultrasonography, and nuclear medicine in the 2 most frequent thyroid pathologies of the dog: acquired primary hypothyroidism and thyroid neoplasia. Ultrasonography and scintigraphy remain the 2 most indicated imaging modalities for these thyroid abnormalities. However, as in human medicine, computed tomography and magnetic resonance imaging also have potential indications. This is especially the case in the evaluation of the extent, local invasiveness, and local or distant metastases of thyroid neoplasia. Based on experience with different imaging modalities in people, we suggest future directions in the imaging of the canine thyroid gland.

Magnetic resonance imaging characteristics of equine head disorders: 84 cases (2000-2013).

The equine head is an anatomically complex area, therefore advanced tomographic imaging techniques, such as computed tomography or magnetic resonance imaging (MRI), are often required for diagnosis and treatment planning. The purpose of this multicenter retrospective study was to describe MRI characteristics for a large sample of horses with head disorders. Horses imaged over a period of 13 years were recruited. Eighty-four horses met the inclusion criteria, having neurological (n = 65), sinonasal (n = 14), and soft tissue (n = 5) disorders. Magnetic resonance imaging accurately depicted the anatomy and allowed identification of the primary lesion and associated changes. There were good correlations between MRI findings and intraoperative or postmortem results. Magnetic resonance imaging showed the exact localization of the lesions, their size, and relation to surrounding structures. However, in the neurological group, there were 45 horses with no MRI abnormalities, 29 of which had a history of recurrent seizures, related to cryptogenic epilepsy. Magnetic resonance imaging was otherwise a valuable diagnostic tool, and can be used for studying a broad range of head disorders using either low-field or high-field magnets.

ULTRASONOGRAPHIC CHARACTERIZATION OF FELINE ILEOCECOCOLIC ABNORMALITIES

The clinical signs of 29 cats with ultrasonographic abnormalities at the ileocecocolic junction were reviewed. Twenty-eight cats had gastrointestinal signs, with acute vomiting and diarrhea being most prevalent. Eighteen of 29 cats had enlarged cecal lymph nodes. Focal hyperechoic mesenteric fat was noted in 18 of 29 cats, and mild focal fluid accumulation was seen in seven of 29 cats. Six cats had a round cecum, and eight cats had cecal content. The cecal wall was thickened in 19 cats, and the ileal wall was mildly thickened in six cats. Three cats had changes involving the ascending colon adjacent to the ileocecocolic junction. Fourteen cats had no ultrasonographic evidence of changes in the remainder of the gastrointestinal tract, and 13 of these 14 cats were symptomatic for gastrointestinal disease. Four cats with resolution of the ultrasonographic changes also had resolution of clinical signs. These results suggest that ultrasonographic abnormalities at the level of the ileocecocolic junction in cats are clinically significant and are seen in cats with acute vomiting or diarrhea. Fine-needle aspirates and biopsies of the ileocecocolic area had a low diagnostic yield. When no other gastrointestinal abnormalities are detected, we therefore recommend follow-up ultrasound examinations of these patients.

MAGNETIC RESONANCE IMAGING CHARACTERISTICS OF SUSPECTED VERTEBRAL INSTABILITY ASSOCIATED WITH FRACTURE OR SUBLUXATION IN ELEVEN DOGS

The purpose of this study was to describe the magnetic resonance imaging (MRI) characteristics of suspected instability in dogs with vertebral fractures or subluxations. Eleven dogs that had MRI examinations of the spine prior to surgical stabilization of vertebral fractures and/or subluxations were included in the study. Nine dogs also had survey radiographs. Four dogs had cervical fracture or fracture-subluxation and presented with tetraplegia with intact nociception (n = 2) or nonambulatory tetraparesis (n = 2). Seven dogs had thoracolumbar fracture-subluxation or subluxation and presented with paraplegia with intact nociception (n = 5) or nonambulatory paraparesis (n = 2). A three-compartment model was applied to the interpretation of both the radiographic and MRI studies. Radiography identified compartmental disruption consistent with spinal instability in seven out of the nine cases radiographed. In MRI studies, rupture of the supportive soft tissue structures and/or fracture in at least two compartments could be visualized. Nine cases had spinal cord changes on MRI including signal intensity changes, swelling, compression, and intramedullary hemorrhage. Paravertebral muscle intensity changes were also visible at each trauma site. Magnetic resonance imaging provided helpful information on the location and extent of damage to supportive soft tissue structures and enabled assessment of spinal cord injury in this group of dogs with surgically confirmed vertebral fractures and subluxations.

Advanced Diagnostic Approaches and Current Management of Thyroid Pathologies in Guinea Pigs

The authors have encountered multiple clinical cases of clinical hyperthyroidism in the guinea pig, which responded positively to clinical treatment. Hyperactive thyroids in the guinea pig appear to exist causing typical clinical signs. An early accurate diagnosis of this pathologic state is important in the clinical setting. One of the authors has encountered a few clinical cases of hypothyroidism in guinea pigs. Hypothyroidism appears to be a rare condition and has been described anecdotally in the German literature. Because of the rarity of hypothyroidism, the text focuses mainly on the guinea pig as a hyperthyroid case. A short description of the clinical presentation of the hypothyroid animal is included at the end of the text.

CONTRAST ENHANCED SONOGRAPHIC ASSESSMENT OF FEEDING VESSELS AS A DISCRIMINATOR BETWEEN MALIGNANT VS. BENIGN FOCAL SPLENIC LESIONS

Contrast-enhanced sonography was conducted in 17 confirmed focal splenic lesions (five malignant, 12 benign). Relative echogenicity changes were used for subjective interpretation of lesion perfusion. A rapid influx of contrast agent, resulting in an increased relative echogenicity of the lesion, followed by a rapid clearance of contrast agent was referred to as early washin/early washout. There were 6/12 benign, and 3/5 malignant lesions characterized by early washin/early washout. Therefore, sensitivity, specificity, and accuracy for this parameter in differentiating malignant from benign lesions was 60%, 50%, and 53%, respectively. There were 2/12 benign, and 2/5 malignant lesions with persistent hypoperfusion throughout all phases. Therefore, sensitivity, specificity, and accuracy for malignancy using this criterion were 40%, 83%, and 71%, respectively. However, none of the benign and all malignant lesions were characterized by tortuous and persistently visible feeding vessels. This suggests that interpretation of splenic lesions cannot be performed accurately on the basis of echogenicity or persistent hypoperfusion, but that assessment of vascular tortuosity may be helpful in discriminating between a malignant vs. benign focal splenic lesion.