Tharwat Mohamed

Clinicopathological and ultrasonographic findings in 40 water buffaloes ( Bubalus bubalis ) with traumatic pericarditis

Forty buffaloes with traumatic pericarditis were examined to characterise the ultrasonographic findings in buffaloes with traumatic pericarditis, determine the extent of the lesions and assess the prognosis. The most noticeable clinical presentations were presternal oedema (73 per cent) and jugular and mammary vein distension (88 per cent). Laboratory findings included neutrophilic leucocytosis, elevated total protein concentration, hypoalbuminaemia, hypergammaglobulinaemia and increased concentration of free fatty acids. Ultrasonographically, fluid in the pericardium appeared as either mild or massive anechoic accumulations containing fibrin threads or were imaged as homogenous, echogenic pericardial effusions. Moderate to severe corrugation of the reticular wall was observed. Deposits of fibrinous tissue interspersed with fluid pockets were seen between the reticulum, dorsal ruminal sac and diaphragm. Perireticular and mediastinal abscesses were imaged and appeared as echogenic lines with anechoic, echogenic, homogenous or heterogeneous contents. Additional ultrasonographic findings included hepatomegaly, dilation of the caudal vena cava, hepatic and portal veins, ascites, echogenic pleural effusions and vegetations of the tricuspid, mitral and pulmonary valves. The ultrasonographic findings were confirmed at postmortem examination.

Ultrasonographic imaging of experimentally induced pancreatitis in cattle.

This study was conducted to determine the ultrasonographic patterns of pancreatitis evoked in cattle, with reference to laboratory and pathological findings. Using ultrasonographic guidance, acute necrotizing pancreatitis was induced in six cows by injecting chloroform into the pancreatic tissue. Ultrasonographic examination was then performed once daily for nine days. Pancreatic lesions were visible 24h after induction of pancreatitis, as represented by a uniform increase in echogenicity and by intralobular and subcapsular fluid accumulation. As the experiment progressed, patchy hypoechogenic foci appeared within the gland parenchyma. Amylase and lipase activities showed rapid increases. Post mortem examination revealed gross and microscopic necrotic and haemorrhagic lesions in the body and right lobe of the pancreas, accompanied by oedema and fibrosis. Ultrasonography was found to be extremely useful for the detection and characterization of experimentally induced pancreatitis and to monitor its progression in the cow. These findings are of potential value as a reference for the diagnostic workup of bovine pancreatitis, and ultrasonography is seen as a promising non-invasive technique for the diagnosis of suspected pancreatitis in cattle.

Clinicopathological findings and echocardiographic prediction of the localisation of bovine endocarditis

Thirty-six cows with confirmed vegetative endocarditis at postmortem examination were examined in this study. In 33 cows, echocardiography showed lesions of the pulmonic, tricuspid and mitral valves. Ten healthy cows were enrolled in the study as controls. In diseased cows, clinical signs included recurrent fever, dyspnoea, epistaxis, tachycardia, murmurs, weight loss, decreased milk production, jugular and mammary vein distension with palpable pulse, and ventral and submandibular oedema. Laboratory abnormalities included neutrophilic leukocytosis, elevated protein concentrations, hypoalbuminaemia, hypergammaglobulinaemia, azotaemia and elevated serum creatinine concentration. High serum activities of aspartate aminotransferase, γ-glutamyl transpeptidase and lactate dehydrogenase were also detected. Echocardiography showed small, medium-sized or large hyperechogenicity, thickening, and proliferative or vegetative lesions of the tricuspid (n=11), mitral (n=5) and pulmonic valves (n=19). Confirmatory diagnosis was made at postmortem examination. Echocardiography could detect vegetations in 33 of the 36 cows (92 per cent). The sensitivity of ultrasound in detecting valvular endocarditis was 89 per cent for tricuspid valves, 83 per cent for mitral valves and 95 per cent for pulmonic valves.

Ultrasonographic diagnosis of omasal leiomyoma in a cow

GASTROINTESTINAL (GI) tumours in cattle are rare. In 1·3 million animals examined at slaughter in the UK, only three tumours occurred specifically in the GI tract (Anderson and Snadison 1969). Among 1400 cattle examined postmortem in New York, neoplasms were found in the forestomachs of eight animals (0·6 per cent), the only forms being fibroma and lymphosarcoma (Bertone and others 1985). Other reports of GI tumours in cattle include papilloma and squamous cell carcinoma in Kenya (Plowright 1955, Plowright and others 1971) and northern England (Jarrett 1973). Smooth muscle tumours of the GI tract have been found to develop mostly in the small intestine in dogs and cats (Engle and Brodey 1969, ter Haar and others 1998) and cows (Bertone 1990); none has been reported in the forestomachs of cows. Ultrasonography has proved to be the most effective and least invasive diagnostic method of detecting GI tumours in dogs and cats (Paoloni and others 2002), and it has also been used increasingly as part of the diagnostic evaluation of cattle with a variety of GI disorders, such as traumatic reticuloperitonitis (Braun and others 1993). However, the ultrasonographic features of GI tumours in cattle have not yet been delineated. This short communication describes the ultrasonographic, laboratory and clinicopathological findings of an omasal leiomyoma in a cow. A six-year-old Holstein cow, weighing 534 kg, presented with intermittent fever and a one-month history of inappetence. Clinical signs included anorexia, depression and ataxia. The cow remained thin and frequently ran a rectal temperature of 38·8 to 39·5°C; but heart and respiratory rates were within normal ranges (55 bpm and 16 breaths per minute, respectively). Rumen movements were inaudible. The back grip test, pain percussion test on the reticulum and pole test on the sternum elicited only a mild reaction. The left and right sides of the thorax and the right side of the abdomen were clipped and shaved. Ultrasonic coupling gel was liberally applied to the wet skin to ensure good contact and a 3·5 MHz linear transducer was firmly held against the body wall with the cow in a standing position. With the transducer placed over the left ventral thorax, the reticular contractions were monitored for three minutes, as described by Braun and Götz (1994). The entire ventral thorax right and left of the sternum and the right and left thoracic walls were then scanned up to the elbow joints. The outer contours of the reticulum were visualised and the echogenic changes recorded. The omasum was scanned medially and to the right of the ventral midline. The reticular biphasic contractions were not detectable, the reticular contour was uneven and a loss of normal layering was observed. Deposits of echogenic material appeared on the reticular wall, cavitated by hypoechogenic fluid, and a space-occupying mass was identified within the lumen of the omasum. The echotexture of the lesion was inconsistent and echogenic, and the margins were asymmetric (Fig 1). Blood gas analysis showed no abnormalities. Echocardiographic tracings demonstrated atrial fibrillation, a deep QRS complex and irregular T waves. Haematology showed leucocytosis (21,300 leucocytes/μl, reference range 4000 to 12,000/μl) and neutrophilia (18,851 neutrophils/μl, reference range 600 to 4000/μl). Serum chemistry revealed hypoalbuminaemia (8·6 g/litre, reference range 30·3 to 35·3 g/litre) and hyperproteinaemia (100 g/litre, reference range 21 to 36 g/litre), attributed to hypergammaglobulinaemia (73·4 g/litre, reference range 16·9 to 22·5 g/litre), which suggested a chronic inflammatory disease or neoplasia. These findings supported differential diagnoses of traumatic reticuloperitonitis, reticular abscess, reticular adhesions, pleuritis, and pulmonary and hepatic diseases. Ultrasonography of the forestomachs and liver narrowed the diagnosis to either traumatic reticuloperitonitis or a space-occupying mass in the omasum. The results also revealed a high activity of gamma glutamyl transferase (62 U/litre, reference value 6·1 to 17·4 U/litre), indicating a degree of liver impairment, which may have also accounted for the hypoalbuminaemia. All laboratory values were referenced from Kaneko and others (1997). The cow had a poor prognosis and was euthanased. Postmortem examination revealed fibrinous, thick-walled inflammatory deposits interspersed with jelly-like serous fluid adhering to the reticulum, omasum and abomasum, as well as to the rumen. A pedunculated, grape-like mass (18 x 14 cm) was attached to the ventral omasal wall (Fig 2). No ulceration or abrasions were observed on the surface of the mass and the cut surface had a lobulated appearance. Neither a diaphragmatic reticular adhesion nor any metallic foreign body or trace was observed. A specimen from the omasal mass was fixed in buffered 10 per cent formalin, embedded in paraffin, stained with haematoxylin and eosin and examined histologically. There was a proliferation of smooth muscle cells in the omasal muscularis in intertwisting fascicles of well differentiated cells; the fascicles arranged in an exceedingly irregular pattern, transversing at intersecting and obtuse angles to one another. The smooth muscle cells had abundant cytoplasm and irregular fusiform nuclei with vesiculated chromatin. There was marked submucosal oedema with diffuse infiltration of lymphocytes, macrophages and a few neutrophils. Mitotic figures were scarce. The histological picture was compatible with a diagnosis of leiomyoma (Fig 3). Leiomyomas, benign tumours of smooth muscle, are the most common gynaecological tumours in domestic animals FIG 1: Longitudinal sonogram of an omasal leiomyoma imaged at the seventh intercostal space. Note the asymmetric, inhomogenous and the echogenic patterns of the tumour. The mass appeared to project into the omasal lumen. Lt Lateral, Md Medial, 1 Right ventral thoracic wall, 2 Sternal part of the diaphragm and peritoneum, 3 Liver, 4 Omasal wall, 5 Omasal lumen

Transcutaneous ultrasound-guided pancreatic biopsy in cattle and its safety: a preliminary report

This study describes a free-hand technique for percutaneous pancreatic biopsy in cattle with ultrasound-guidance using a 14G spinal biopsy needle. Its safety was evaluated based on 36 consecutive procedures. To assess the immediate effects of pancreatic biopsy, 31 cows were necropsied shortly after the procedure and examined. The remaining five cows were examined daily for eight days and then necropsied and examined. No life-threatening complications nor clinically detectable abnormalities were observed. Changes indicative of inflammation were not apparent in total and differential WBC counts or in total protein and fibrinogen concentrations. A small increase of amylase activity was detected in only one cow kept for the eight-day observation period. Serum lipase activity increased significantly on day four after biopsy. Urea nitrogen, creatinine, glucose and the activities of aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltransferase remained within reference ranges. Changes in the peritoneum and pancreas observed at necropsy were negligible. We conclude that percutaneous ultrasound-guided pancreatic biopsy did not appear to influence the cows condition adversely and the procedure provided an excellent method of obtaining a pancreatic specimen for histological examination. The procedure was considered safe, fast, cost-effective, and practical when performed properly. We believe that the technique can be used in cows with suspected pancreatic disease for making an ante mortem diagnosis.