Panagiotis Mantis

Brain and spinal cord haemorrhages associated with Angiostrongylus vasorum infection in four dogs

Multifocal haemorrhages associated with Angiostrongylus vasorum infection were observed in the central nervous system of four dogs with neurological signs including depression, seizures, spinal pain and paresis. In magnetic resonance images the majority of the lesions were isointense or slightly hyperintense in T1-weighted images, hyperintense in T2-weighted images and hypointense in T2*-weighted (gradient echo) images, compatible with haemorrhages more than seven days old. Lesions were found in the brain of three of the dogs and in the spinal cord of two. The cerebrospinal fluid contained high concentrations of protein and evidence of erythrophagia. All the dogs had coagulopathy and pulmonary haemorrhage of varying severity. A vasorum larvae were detected in the faeces of each of the dogs. Neural A vasorum was confirmed at postmortem examination in two dogs.

Characteristics of magnetic resonance images of granulomatous meningoencephalomyelitis in 11 dogs

The characteristics of magnetic resonance imaging (mri) of the brains and spinal cords of 11 dogs with histologically confirmed granulomatous meningoencephalomyelitis (gme) were determined. The lesions were in the brain of eight of the dogs, in the brain and spinal cord of two, and in the spinal cord alone in one dog. A single lesion was present in four of the dogs and multiple lesions were found in six. In one dog with intracranial signs, no visible lesions could be detected on mri. No meningeal enhancement was detected in T1-weighted images post-contrast, or in fluid attenuation inversion recovery (flair) images, but there were histological lesions in the meninges in nine of the dogs. The T2-weighted images and flair sequences were characterised in all cases by hyperintensity, whereas the signal intensity of the lesions on T1-weighted images was variable. After the administration of paramagnetic contrast, some of the lesions showed no enhancement, but others showed marked patterns of enhancement. The lesions in 10 of the dogs were easily identifiable by mri and the images had several unifying characteristics, but they could not be considered disease-specific.

Lack of associations between ultrasonographic appearance of parenchymal lesions of the canine liver and histological diagnosis

OBJECTIVE To assess if there are any ultrasonographic features that may enable tentative diagnosis of hepatic parenchymal disease. METHODS Records of 371 dogs that had abdominal ultrasonography and abnormal liver on biopsy or necropsy were reviewed. RESULTS Histological diagnoses were hepatitis (n=77), nodular hyperplasia (n=47), vacuolar change (n=45), fibrosis (n=32), primary hepatic carcinoma (n=30), lymphoma (n=28), metastatic neoplasia (n=27), necrosis (n=21), lipidosis (n=17), haemangiosarcoma (n=13), round cell tumour (n=9), hepatocellular adenoma (n=8), degenerative change (n=6), steroid hepatopathy (n=7) and extramedullary haematopoiesis (n=4). The most prevalent ultrasonographic features were multifocal lesions (63% livers with haemangiosarcoma and 43% livers with hepatocellular carcinoma), diffuse lesions (71% livers with steroid hepatopathy, 44% livers with fibrosis and 40% livers with vacuolar hepatopathy), hyperechoic lesions (71% livers with steroid hepatopathy, 41% livers with lipidosis and 38% livers with fibrosis), heterogeneous lesions (62% livers with haemangiosarcoma), hepatomegaly (43% livers with steroid hepatopathy) and peritoneal fluid (62% livers with haemangiosarcoma). Target lesions were associated with malignancy in 67% instances. Marked variability in ultrasonographic appearance of lesions was observed for all diagnoses, and no statistically significant associations between ultrasonographic appearance and diagnosis were found. CLINICAL SIGNIFICANCE Histological examination remains essential for diagnosis of canine hepatic disease.

Radiographic signs in cats with nasal disease

Radiographic signs in 64 cats that had radiography as part of the diagnostic work-up for suspected nasal disease were reviewed in a blinded fashion. Final diagnoses in these cats were rhinitis in 27, primary nasal neoplasia in 21 and non-nasal disease in 16. The signs with highest predictive value for nasal neoplasia were displacement of midline structures (73%), unilateral generalised soft tissue opacity (70%), unilateral generalised loss of turbinate detail (69%) and evidence of bone invasion (64%). The only radiographic finding that occurred more frequently in cats with rhinitis was a nasal cavity within normal limits, and the predictive value of this sign was only 38%. Radiographic signs in cats with nasal neoplasia are similar to those reported in dogs, whereas the radiographic signs in cats with rhinitis are variable and non-specific, and may be absent.

Studying Cat (Felis catus) Diabetes: Beware of the Acromegalic Imposter

Naturally occurring diabetes mellitus (DM) is common in domestic cats (Felis catus). It has been proposed as a model for human Type 2 DM given many shared features. Small case studies demonstrate feline DM also occurs as a result of insulin resistance due to a somatotrophinoma. The current study estimates the prevalence of hypersomatotropism or acromegaly in the largest cohort of diabetic cats to date, evaluates clinical presentation and ease of recognition. Diabetic cats were screened for hypersomatotropism using serum total insulin-like growth factor-1 (IGF-1; radioimmunoassay), followed by further evaluation of a subset of cases with suggestive IGF-1 (>1000 ng/ml) through pituitary imaging and/ or histopathology. Clinicians indicated pre-test suspicion for hypersomatotropism. In total 1221 diabetic cats were screened; 319 (26.1%) demonstrated a serum IGF-1>1000 ng/ml (95% confidence interval: 23.6–28.6%). Of these cats a subset of 63 (20%) underwent pituitary imaging and 56/63 (89%) had a pituitary tumour on computed tomography; an additional three on magnetic resonance imaging and one on necropsy. These data suggest a positive predictive value of serum IGF-1 for hypersomatotropism of 95% (95% confidence interval: 90–100%), thus suggesting the overall hypersomatotropism prevalence among UK diabetic cats to be 24.8% (95% confidence interval: 21.2–28.6%). Only 24% of clinicians indicated a strong pre-test suspicion; most hypersomatotropism cats did not display typical phenotypical acromegaly signs. The current data suggest hypersomatotropism screening should be considered when studying diabetic cats and opportunities exist for comparative acromegaly research, especially in light of the many detected communalities with the human disease.

Computed tomographic signs of acromegaly in 68 diabetic cats with hypersomatotropism

In order to describe the signs of acromegaly in cats, a case-control study was done based on computed tomography (CT) scans of the heads of 68 cats with hypersomatotropism and 36 control cats. All cats with a diagnosis of hypersomatotropism had diabetes mellitus, serum insulin-like growth factor-1 >1000 ng/ml and a pituitary mass. Measurements of bones and soft tissues were done by two independent observers without knowledge of the diagnosis. Pituitary masses were identified in CT images of 64 (94%) cats with hypersomatotropism. Analysis of variance found a moderate effect of gender on the size of bones and a large effect of hypersomatotropism on the size of bones and thickness of soft tissues. In cats with hypersomatotropism the frontal and parietal bones were, on average, 0.8 mm thicker (P <0.001); the distance between the zygomatic arches was, on average, 5.4 mm greater (P <0.001); and the mandibular rami were, on average, 1.1 mm thicker (P <0.001) than in control cats. The skin and subcutis dorsal to the frontal bone were, on average, 0.4 mm thicker (P = 0.001); lateral to the zygomatic arch were, on average, 0.7 mm thicker (P <0.001); and ventral to the mandibular rami were, on average, 1.1 mm thicker (P = 0.002) in cats with hypersomatotropism than in control cats. The cross-sectional area of the nasopharynx was, on average, 11.1 mm2 smaller in cats with hypersomatotropism than in control cats (P = 0.02). Prognathia inferior and signs of temporomandibular joint malformation were both observed more frequently in cats with hypersomatotropism than in control cats (P = 0.03). Overall, differences between affected and unaffected cats were small. Recognising feline acromegaly on the basis of facial features is difficult.

COMPARISON OF COMPUTED TOMOGRAPHIC AND PATHOLOGIC FINDINGS IN 17 DOGS WITH PRIMARY ADRENAL NEOPLASIA

The CT appearance of canine adrenal masses has been reported, but associations between imaging features and pathologic features of these lesions have not been investigated in detail. The purpose of this study was to test associations between different types of adrenal neoplasia and their CT and pathologic features. A retrospective cross-sectional study was performed and inclusion criteria were histologic diagnosis of primary adrenal neoplasia, contrast-enhanced CT examination of the abdomen and surgical resection of the mass or necropsy examination. For all included dogs, CT images and histopathologic specimens were reviewed independently by two veterinary radiologists and a veterinary pathologist, respectively. Seventeen dogs met inclusion criteria. Diagnoses were adenocarcinoma in nine (53%) dogs, pheochromocytoma in five (29%) dogs, and adenoma in three (18%) dogs. Pheochromocytoma was associated with CT signs of vascular invasion (likelihood ratio = 4.8, 95% CI = 1.3-18.3, P = 0.03) and macroscopic vascular invasion (likelihood ratio = 9.6, 95% CI = 1.4-65.9, P = 0.02). There was excellent agreement between signs of vascular invasion in CT images and vascular invasion at surgery or necropsy (kappa = 0.86, P = 0.001). A peripheral contrast-enhancing rim in delayed postcontrast CT images was associated with fibrous encapsulation of the tumor (kappa = 0.53, P = 0.05), and a heterogeneous pattern of contrast distribution in delayed postcontrast CT images was associated with adrenal hemorrhage or infarction on histological examination (kappa = 0.45, P = 0.05). Findings indicated that CT enabled assessment of adrenal neoplasia features that reflected their biological behavior and pathological findings, however overlapping characteristics between tumor types limited the potential for reliably distinguishing them based on CT alone.

Veterinary e-CPD: a new model for providing online continuing professional development for the veterinary profession.

Continuing professional development (CPD) is widely recognized as an important element in effective lifelong learning for veterinary surgeons. Traditional methods of CPD do not suit all learners, as issues such as location, time, cost, and structure sometimes prevent individuals from completing the required number of CPD study hours per year. The rapid development of the Internet, and with it the increasing scope and sophistication of e-learning, provides new opportunities to address some of these constraints on the provision of CPD. This article describes one way in which e-learning has been deployed effectively to support veterinary surgeons in practice. Since 2003, a series of six-week e-CPD courses has been offered by the Royal Veterinary College (RVC) in an online format, with no face-to-face teaching component. Participants enrolled in courses from May 2006 to January 2007 were found to come from 23 different countries. Analysis of feedback forms indicates a general satisfaction with this new way of studying, with a significant majority of participants stating that they would wish to use this approach again in future. The feedback indicates that e-learning can offer an effective alternative to traditional face-to-face courses and that its popularity is likely to grow in future as veterinarians become increasing familiar with and confident about working online.

ASSOCIATIONS BETWEEN DUAL-PHASE COMPUTED TOMOGRAPHY FEATURES AND HISTOPATHOLOGIC DIAGNOSES IN 52 DOGS WITH HEPATIC OR SPLENIC MASSES.

Ability to noninvasively differentiate malignant from nonmalignant abdominal masses would aid clinical decision making. The aim of this retrospective, cross-sectional study was to identify features in dual-phase computed tomographic (CT) studies that could be used to distinguish malignant from nonmalignant hepatic and splenic masses in dogs. Medical records were searched for dogs that had an abdominal dual-phase CT examination, a hepatic or splenic mass, and subsequent histopathologic diagnosis. Computed tomographic images for all included dogs were acquired prior to and <30 s (early phase) and >60 s (delayed phase) after intravenous contrast administration. Fifty-two dogs with 55 masses were studied: 24 hepatic, including 14 (58%) malignant and 10 (42%) non-malignant; 31 splenic, including 18 (58%) malignant and 13 (42%) nonmalignant. There was substantial overlap in the pre- and postcontrast CT features of malignant and nonmalignant hepatic and splenic masses. Regardless of histologic diagnosis, hepatic masses most frequently showed marked, generalized enhancement in early phase images that persisted in the delayed phase. Splenic hemangiosarcoma and nodular hyperplastic lesions most frequently showed marked, generalized enhancement in early phase images that persisted in delayed images whereas most splenic hematomas had slight enhancement in early phase images. All splenic hematomas and 77% of the hemangiosarcomas had contrast accumulation compatible with active hemorrhage. There were no other significant differences in quantitative or categorical CT data between malignant and nonmalignant hepatic or splenic masses. Dual-phase CT of dogs with hepatic or splenic masses provides limited specific diagnostic information.

Computed tomography as an aid to management of chronic oropharyngeal stick injury in the dog

OBJECTIVE To describe the use of computed tomography scanning in the management of dogs with chronic signs after oropharyngeal stick injury. METHODS Dogs with a final diagnosis of chronic oropharyngeal stick injury that underwent a computed tomography scan during their investigation were selected retrospectively from case files at the Royal Veterinary College, London. RESULTS The six dogs were young (median age 3.1 years) and medium to large breed (19.0 to 42.0 kg). By the time of referral the most common clinical sign was cervical swelling (five dogs). Stick foreign bodies were apparent on the plain computed tomography images in all cases and appeared as well-demarcated, linear abnormalities. A ventral mid-line approach was used for foreign body retrieval, and the computed tomography findings corresponded well with the surgical findings, with stick foreign body length ranging from 1 to 7 cm. Closed suction drainage was used in five dogs, for two to four days. Clinical signs fully resolved postoperatively in all cases, although cervical swelling recurred three weeks after surgery in one case. This dog had the smallest foreign body, the greatest number of surgical interventions before referral (three) and the longest disease course before referral (eight months). CLINICAL SIGNIFICANCE Computed tomography scanning is accurate in identifying the presence and location of chronic stick foreign bodies. Recurrence of disease is possible despite successful retrieval of the wood fragments found by computed tomography scan.