Susanne M. Stieger-Vanegas

Primary synovial osteochondromatosis of the stifle in an English Mastiff

A two-year-old, 97 kg, male neutered English Mastiff was evaluated for left pelvic limb lameness of five months duration localized to the stifle joint. Following radiographic, computed tomographic and arthroscopic examination, the lameness was subsequently diagnosed as being caused by primary synovial osteochondromatosis. In total, 194 osteochondral bodies were removed using arthroscopy in combination with a mini-arthrotomy. Histology and immunohistochemistry of the loose osteochondral fragments confirmed the diagnosis with a moderately high degree of differentiation and low cellularity. Nuclear staining for Ki-67 revealed decreasing differentiation and increasing cellularity in the fragments. At the 13 months telephone follow-up the owner reported that the dog was free from lameness and had a vastly improved function compared with preoperative levels, although mild lameness did occasionally occur. This is the first report of computed tomography, arthroscopy and immunohistochemistry confirming a case of primary synovial osteochondromatosis in a dog.

MRI evaluation of spontaneous intervertebral disc degeneration in the alpaca cervical spine

Animal models have historically provided an appropriate benchmark for understanding human pathology, treatment, and healing, but few animals are known to naturally develop intervertebral disc degeneration. The study of degenerative disc disease and its treatment would greatly benefit from a more comprehensive, and comparable animal model. Alpacas have recently been presented as a potential large animal model of intervertebral disc degeneration due to similarities in spinal posture, disc size, biomechanical flexibility, and natural disc pathology. This research further investigated alpacas by determining the prevalence of intervertebral disc degeneration among an aging alpaca population. Twenty healthy female alpacas comprised two age subgroups (5 young: 2–6 years; and 15 older: 10+ years) and were rated according to the Pfirrmann‐grade for degeneration of the cervical intervertebral discs. Incidence rates of degeneration showed strong correlations with age and spinal level: younger alpacas were nearly immune to developing disc degeneration, and in older animals, disc degeneration had an increased incidence rate and severity at lower cervical levels. Advanced disc degeneration was present in at least one of the cervical intervertebral discs of 47% of the older alpacas, and it was most common at the two lowest cervical intervertebral discs. The prevalence of intervertebral disc degeneration encourages further investigation and application of the lower cervical spine of alpacas and similar camelids as a large animal model of intervertebral disc degeneration.

Effect of hind limb position on the craniocaudal length of the lumbosacral space in anesthetized dogs

OBJECTIVE To investigate whether rostral extension of the hind limbs increases the cranio-caudal dorsal interlaminar distance between the seventh lumbar vertebra and the sacral bone (LS distance) in sternally recumbent anesthetized dogs. STUDY DESIGN Prospective clinical study. ANIMALS Eighteen dogs (eight neutered males, three intact males, six spayed females, one intact female) of various breeds, weighing 4-34 kg and ranging in age from 1 to 13 years. METHODS Each dog was grouped by size: small (≤ 10 kg), medium (15-20 kg) or large (≥ 25 kg). Each dog was anesthetized and positioned in sternal recumbency. Computed tomography (CT) of the lumbosacral area was performed with the hind limbs resting on the stifle and the feet extended posteriorly, and then with the hind limbs extended rostrally. LS distance, craniocaudal dorsal interlaminar distance between sixth and seventh lumbar vertebra (L6-L7 distance), length of L7 vertebral body and lumbosacral angle (LS angle) were measured on a reconstructed mid-sagittal CT image from the two hind limb positions. The measurements from the two hind limb positions for the whole dog population and by size were compared using Students T tests. Diagnostic interpretation of the CT images was performed. RESULTS The length of L7 was taken as the reference value as it was not affected by hind limb position. LS distance, L6-L7 distance and LS angle were significantly higher when the hind limbs were extended rostrally in all three size groups. The CT images of ten dogs showed clinically undetected osteoarthrosis of the ileo- and lumbosacral area. CONCLUSIONS AND CLINICAL RELEVANCE Rostral extension of the hind limbs significantly increases LS and L6-L7 distance and LS angle even in dogs with clinically undetected osteoarthrosis of the ileo- and lumbosacral area, and may enhance the ease of lumbosacral epidural injection in sternally recumbent anesthetized dogs.

Computed tomographic features of the osseous structures of the external acoustic meatus, tympanic cavity, and tympanic bulla of llamas (Lama glama)

OBJECTIVE To evaluate the osseous structures of the external acoustic meatus, tympanic cavity, and tympanic bulla of llamas (Lama glama) by use of computed tomography (CT) and establish measurement values for use in detection of abnormalities associated with the external or middle ear in llamas. ANIMALS 10 adult llama heads without any evidence of ear disease. PROCEDURES Heads of 10 healthy llamas euthanized by use of a captive bolt striking the dorsal aspect of the skull were collected. Transverse images of the heads were acquired with 1-mm slice thickness, and images were reconstructed in sagittal and dorsal planes. Measurements of the bony structures of the external and middle ear of each head were obtained. RESULTS The osseous external acoustic meatus curved ventrally as it tracked medially. Its narrowest portion was located at the level of the tympanic annulus. The tympanic bulla conformation differed widely from the bubble-shaped tympanic bulla in dogs and cats. The bulla was divided by the stylohyoid fossa into a larger caudolateral and a smaller caudomedial process; its interior had a honeycombed structure with pneumatized cells similar to the honeycombed appearance of the human mastoid process. CONCLUSIONS AND CLINICAL RELEVANCE Results provided new information regarding the shape and dimensions of the osseous external and middle ear structures in adult llamas without ear disease. Specific landmarks for location of the external acoustic meatus, tympanic cavity, and tympanic bulla in relation to each other were identified. Knowledge of the CT appearance of normal structures will help clinicians to identify changes attributable to middle ear otitis, external ear canal stenosis, or congenital malformations of the ear in this species.

Cardiac-gated computed tomography angiography in three alpacas with complex congenital heart disease.

BACKGROUND The prevalence of congenital heart disease is higher in camelids than in other domestic species and complex defects, often involving the great vessels, are more frequently encountered in llamas and alpacas than in other species. Some of these complex defects can be difficult to accurately characterize via echocardiography, the most commonly used diagnostic imaging technique to evaluate the heart in veterinary patients. Contrast-enhanced, electrocardiogram (ECG)-gated computed tomography (CT) has proven utility for the evaluation of human patients with certain congenital heart defects, including those with conotruncal septation defects and other abnormalities involving the formation of the great vessels. METHODS Three alpaca crias, 4 days, 5 weeks and 14 months of age were clinically evaluated and subjected to a complete color-flow Doppler echocardiogram and a contrast-enhanced ECG-gated CT. RESULTS These alpacas exhibited a variety of clinical findings including lethargy, failure to thrive, exercise intolerance, heart murmur, and/or respiratory difficulty. All three crias were subsequently diagnosed with complex cardiac defects including pulmonary atresia with a ventricular septal defect (VSD), a truncus arteriosus with a large VSD, and a double outlet right ventricle with a large VSD and aortic hypoplasia. In each case, the diagnosis was confirmed by postmortem examination. CONCLUSION Color flow echocardiographic evaluation identified all of the intra-cardiac lesions and associated flow anomalies but contrast-enhanced ECG-gated CT permitted more accurate assessment of the morphology of the extracardiac structures and permitted a more precise determination of the exact nature and anatomy of the great vessels.

Use of Multidetector Computed Tomography in the Assessment of Dogs with Pericardial Effusion

Background Contrast‐enhanced multidetector computed tomography (MDCT) allows high spatial and temporal resolution imaging of cardiac, thoracic, and abdominal structures. Accurate determination of the cause of pericardial effusion (PE) is essential to providing appropriate treatment and prognosis. Echocardiography and pericardial fluid analysis may not differentiate between causes of PE and cannot identify extracardiac metastasis. Hypothesis/Objectives Describe the thoracic and abdominal MDCT findings and evaluate the utility of MDCT to differentiate between neoplastic and nonneoplastic causes of PE in dogs. Animals Eleven client‐owned dogs with PE diagnosed by echocardiography. Methods Prospective observational study. Transthoracic echocardiography (TTE), 3‐view thoracic radiography, and contrast‐enhanced thoracic and abdominal MDCT images were evaluated for the presence of cardiac masses, pulmonary metastases, and abdominal masses. Histopathology in 5 dogs and survival analysis in all dogs were evaluated. Results A neoplastic cause was identified in 6/11 dogs and a nonneoplastic cause was identified in 5/11. Cardiac MDCT findings were consistent with TTE findings in all dogs with right atrial (5/5) and heart base masses (1/1). Pulmonary metastases were identified in 1/11 dogs by thoracic radiography and in 2/11 dogs by MDCT. MDCT identified splenic or hepatic lesions consistent with neoplasia in 6/11 and 5/11 dogs, respectively. Focal MDCT pericardial changes at the pericardiocentesis site were noted in 3/11 dogs. Conclusions and Clinical Importance Multidetector computed tomography did not improve the detection of cardiac masses in dogs with PE over echocardiography. The benefit of MDCT was primarily in the detection of pulmonary metastases and extracardiac lesions using a single imaging modality.

Microscopic Evaluation of Peritumoral Lesions of Feline Injection Site Sarcomas Identified by Magnetic Resonance Imaging and Computed Tomography.

OBJECTIVE Determine whether dual-phase computed tomography angiogram (CTA) or magnetic resonance imaging (MRI) detect more peritumoral lesions of feline injection site sarcoma (FISS) and determine whether CTA or MRI imaging characteristics of peritumoral lesions correspond with microscopic findings. STUDY DESIGN Prospective clinical study. ANIMALS Ten client-owned cats with FISS. METHODS A fiducial marker detectable on CTA and MRI was sutured to the skin over the FISS as a standard reference point. All cats received MRI and CTA of the FISS, immediately followed by wide surgical excision. Targeted microscopic evaluation was performed on tissue with imaging-identified lesions and on the surgical margins. RESULTS A total of 87 imaging-identified peritumoral lesions were examined microscopically (median 4 per cat, range 3-9) with 17/87 (20%) categorized as neoplastic, 51/87 (59%) as nonneoplastic, and 19/87 (22%) as equivocal. In 25 instances, peritumoral lesions were seen on both imaging modalities at the same location. Unique imaging characteristics were seen in 5/17 neoplastic peritumoral lesions (4 cats; all different lesions; 1 CTA, 4 MRI). The CTA and MRI appearances of the remaining 12/17 neoplastic lesions were nonspecific, being observed across more than 1 microscopic category. CONCLUSION CTA and MRI identified a similar number of peritumoral lesions. The extensive overlap between imaging features of neoplastic and nonneoplastic lesions precludes definitive identification of neoplastic peritumoral FISS lesions using CTA or MRI.

Evaluation of the Diagnostic Accuracy of Conventional 2‐Dimensional and 3‐Dimensional Computed Tomography for Assessing Canine Sacral and Pelvic Fractures by Radiologists, Orthopedic Surgeons, and Veterinary Medical Students

OBJECTIVE To determine, using 3 groups of evaluators of varying experience reading orthopedic CT studies, if 3-dimensional computed tomography (3D-CT) provides a more accurate and time efficient method for diagnosis of canine sacral and pelvic fractures, and displacements of the sacroiliac and coxofemoral joints compared with 2-dimensional computed tomography (2D-CT). STUDY DESIGN Retrospective clinical and prospective study. ANIMALS Dogs (n = 23): 12 dogs with traumatic pelvic fractures, 11 canine cadavers with pelvic trauma induced by a lateral impactor. METHODS All dogs had a 2D-CT exam of the pelvis and subsequent 3D-CT reconstructions from the 2D-CT images. Both 2D-CT and 3D-CT studies were anonymized and randomly presented to 2 veterinary radiologists, 2 veterinary orthopedic surgeons, and 2 veterinary medical students. Evaluators classified fractures using a confidence scale and recorded the duration of evaluation for each modality and case. RESULTS 3D-CT was a more time-efficient technique for evaluation of traumatic sacral and pelvic injuries compared with 2D-CT in all evaluator groups irrespective of experience level reading orthopedic CT studies. However, for radiologists and surgeons, 2D-CT was the more accurate technique for evaluating sacral and pelvic fractures. CONCLUSION 3D-CT improves sacral and pelvic fracture diagnosis when added to 2D-CT; however, 3D-CT has a reduced accuracy for evaluation of sacral and pelvic fractures if used without concurrent evaluation of 2D-CT images.

Dental pathology in conventionally fed and pasture managed dairy cattle

Healthy teeth are important in the first stages of digestion for dairy cattle, yet little is known about bovine dental disease. This study aimed to investigate dental pathology of dairy cattle in two parts. First dairy cattle cadaver heads (n=11) were examined at the time of culling. Second, the authors performed oral exams in cattle fed a total mixed ration (TMR) (n=200) and pasture-based (n=71) grazing cattle. Cadaver heads were imaged using radiography and computed tomography before gross dissection to study dental anatomy and pathology. The most prevalent dental abnormalities were excessive transverse ridging of the occlusal surface, the presence of diastemas and third molar dental overgrowths (M3DO) in cadaver heads. Average thickness of subocclusal dentine ranged from 3.5 mm to 5.8 mm in cheek teeth but was >10 mm in maxillary teeth with M3DO. Radiographic findings were compared with oral examinations in live cattle. Prevalence of M3DO upon oral examination was 19 per cent and 28 per cent in herds of cattle fed a TMR diet and 0 per cent in a herd of grazing cattle. Dental abnormalities are prevalent in dairy cattle but due to thin subocclusal dentine in the cheek teeth, established equine dental treatment methodology is not appropriate for bovine cheek teeth with the exception of those that have developed M3DO.

Contrast-enhanced computed tomography of the gastrointestinal tract in clinically normal alpacas and llamas

OBJECTIVE To assess the feasibility and usefulness of CT enterography to evaluate the gastrointestinal tract in clinically normal llamas and alpacas. DESIGN Prospective observational study. ANIMALS 7 clinically normal alpacas and 8 clinically normal llamas. PROCEDURES The imaging protocol included orogastric administration of iodinated contrast material mixed with water. Three hours later, helical CT scanning was performed of the entire abdomen with transverse and multiplanar sagittal and dorsal projections before and after IV iodinated contrast agent injection. RESULTS Both oral and IV contrast agents were well tolerated, and no adverse reactions were observed. Transverse images depicted the gastrointestinal tract and pancreas in the short axis; however, dorsal and sagittal projections aided in localizing and differentiating the various gastrointestinal segments, including the pancreas. In all camelids, the wall of the gastrointestinal tract was well differentiated. In all but 2 camelids, all gastrointestinal segments were well visualized and differentiated. In those 2 animals, the cecum was difficult to identify. Good distention of the small intestine was achieved by use of the oral contrast agent. The dorsal projections were useful to identify the pancreas in its entire length. CONCLUSIONS AND CLINICAL RELEVANCE The present study supplied new information about gastrointestinal wall thickness, intestinal diameter, and location of the pancreas and ileocecocolic junction in alpacas and llamas. Multiplanar contrast-enhanced CT was useful to reveal the various segments of the gastrointestinal tract, pancreas, and abdominal lymph nodes. The shorter time delay before imaging, compared with the delay with conventional barium studies, makes this technique complementary or superior to conventional radiographic or ultrasonographic studies for evaluation of the gastrointestinal tract.