Thoracoscopic foreign body removal and right middle lung lobectomy to treat pyothorax in a dog

A three-year-old, 30-kg, spayed female German wirehaired pointer was presented for coughing, pyrexia and lethargy. Thoracic radiographs showed mild right-sided pleural effusion, moderate pneumothorax and a pulmonary lesion in the right middle or caudal lung lobe. A diagnosis of pyothorax was established by fine needle aspiration of the pleural effusion. Thoracoscopic exploration was performed using one-lung ventilation. A vegetal foreign body (grass awn) and an abscess were observed in the distal part of the right middle lung lobe. The foreign body was removed and a right middle lung lobectomy was performed, both thoracoscopically. No complications were noted. The dog was discharged 48 hours after surgery, and no recurrence of the clinical signs was observed during the follow-up time period (three years and three months). Thoracoscopy is a minimally invasive alternative to thoracotomy to explore and successfully treat some non-chronic pyothoraces in dogs, including lesions affecting the right middle lung lobe.     

IMAGING DIAGNOSIS—NUCLEAR SCINTIGRAPHIC,RADIOLOGICAL, AND PATHOLOGIC CHARACTERISTICS OF METASTATIC PILOMATRICOMA IN A DOG

A 6‐year‐old castrated Goldendoodle dog was presented for left‐sided lameness of 3 weeks’ duration. Focal, moderate to marked increased ^99mTc‐methylene diphosphonate (^99mTc‐MDP) uptake was detected in the right caudal lung lobe, caudal angle of the left scapula, and the distal aspect of the left femur with whole body bone phase scintigraphy. Radiographs identified a well‐circumscribed, oval‐shaped soft tissue opaque mass in the right caudal lung lobe; a suspect oval‐shaped osteolytic lesion in the proximal third of the left scapula; and an osteolytic lesion in the distal aspect of the left femur. Metastatic pilomatricoma was confirmed histologically at all three sites.     

The localization of a conjunctivoscleral foreign body via high‐resolution microscopy coil magnetic resonance imaging in a dog

A 3‐year‐old French bulldog was presented to the ophthalmology service of the Vetsuisse Faculty, University of Zurich with a 3‐day history of conjunctival swelling of the left eye (OS). Ophthalmologic examination revealed a moderate conjunctival hyperemia and chemosis. A migrating foreign body having entered the conjunctival fornix behind the nictitating membrane was suspected. Within the first 24 hours of medical management, OS developed a panuveitis and a scleral perforation was highly suspected. Ocular and orbital ultrasound as well as conventional magnetic resonance imaging (MRI) examinations failed to confirm the presence of a perforating foreign body. A High‐Resolution MRI (HR‐MRI) using a microscopy coil was then performed with findings consistent with a perforating and migrating foreign body. A grass awn of 12 mm length was surgically retrieved “ab externo” from its’ point of entry into the sclera. To the best of our knowledge, HR‐MRI has not yet been used to examine canine eyes. This case report supports the idea that orbital imaging can be greatly enhanced with the introduction of HR‐MRI using microscopy coils with clinically relevant implications.     

Radiographic, computed tomographic, and ultrasonographic findings with migrating intrathoracic grass awns in dogs and cats.

The purpose of this study was to describe the clinical, radiographic, and computed tomographic findings in dogs and cats with migrating intrathoracic grass awns. Thirty-five dogs and five cats with visual confirmation of a grass awn following surgery, endoscopy or necropsy, and histology were assessed. The medical records and all diagnostic imaging studies were reviewed retrospectively. Labrador Retrievers or English Pointers < 5 years of age, with a history of coughing and hyperthermia, were the most common presentations. Seventeen animals had an inflammatory leukogram of which 14 had a left shift or toxic neutrophils. Radiographs were performed in 38 animals and computed tomography (CT) in 14. Thoracic radiographs were characterized by focal pulmonary interstitial to alveolar opacities (n = 26) that occurred most commonly in the caudal (n = 19) or accessory lobes (n = 8). Additional findings included pneumothorax (n = 9), pleural effusion (n = 8), and pleural thickening (n = 7). Pulmonary opacities identified on radiographs correlated to areas of pneumonia and foreign body location. CT findings included focal interstitial to alveolar pulmonary opacities (n = 12) most commonly in the right caudal lung lobe (n = 9), pleural thickening (n = 11), mildly enlarged intrathoracic lymph nodes (n = 10), soft tissue tracking (n = 7) with enhancing margins (n = 4), pneumothorax (n = 6), pleural effusion (n = 4), and foreign body visualization (n = 4). Histologic diagnoses included pulmonary and mediastinal granulomas or abscesses, bronchopneumonia, and pleuritis. Migrating intrathoracic grass awns should be considered as a differential diagnosis in coughing, febrile animals with focal interstitial to alveolar pulmonary opacities, pleural effusion, pleural thickening, and/or pneumothorax on radiographs or CT.     

Grass awn migration in dogs and cats: a retrospective study of 182 cases

A retrospective study of 182 cases of grass awn migration in dogs and cats seen during a 1-year period was performed. The 182 cases comprised 61% of all foreign body-related cases during that year. Compared with the total hospital population, there was an increased prevalence of grass awn problems in the Springer Spaniel, Golden Retriever, Brittany Spaniel, and Airedale Terrier, but a decreased prevalence in German Shepherd Dogs, Miniature Poodles, and Dachshunds. The most common site of grass awn localization was the external ear canal, involving 51% of grass awn cases. Other common sites of grass awn localization included the interdigital webs, eye, nose, lumbar area, and thoracic cavity. Only 8 of the 182 animals were cats and 7 of the 8 had ocular involvement.     

IMAGING DIAGNOSIS—URETHROVAGINAL FISTULA CAUSED BY A MIGRATING GRASS AWN IN THE VAGINA

A young intact female dog was presented with urinary incontinence. Abdominal ultrasound revealed the presence of hyperechoic linear structures within the cranial vagina suggestive of foreign material. A computed tomography (CT) retrograde vaginourethrogram demonstrated the presence of a fistulous tract between the urethra and vagina. A presumptive diagnosis of urethrovaginal fistula due to migration of foreign material was made. The grass awn was removed with vaginoscopic‐guided retrieval. Fourteen days later, surgical repair of the fistula and an ovariohysterectomy were done. This case report emphasizes the usefulness of CT for diagnosis and precise anatomical localization of genitourinary tract fistulas.     

ULTRASONOGRAPHIC FEATURES OF GRASS AWNS IN THE URINARY BLADDER

Grass awns are a common cause of foreign body disease in animals, but little is known about their presence in the lower urinary tract. The ultrasonographic features of grass awns in vivo and in vitro have been described in detail. The purpose of this report is to describe the clinical and sonographic features of grass awns in the urinary bladder of dogs and cats. Three male Yorkshire terriers (one of which was examined twice) and one female domestic short‐haired cat were evaluated for signs of lower urinary tract disease, and an intravesicular grass awn was suspected based on ultrasound examination. The grass awn appeared ultrasonographically as a bladder stone (n=1) or a linear hyperechoic structure (n=4) with or without acoustic shadowing that was easy to identify due to contrast with surrounding urine. The presence of a grass awn within the urinary bladder was confirmed during exploratory surgery. In all patients, the route of entry of the grass awn was thought to have been retrograde migration from the urethral opening. The ultrasonographic appearance of grass awns in the bladder is consistent with that in other tissues.     

CT is helpful for the detection and presurgical planning of lung perforation in dogs with spontaneous pneumothorax induced by grass awn migration: 22 cases

Spontaneous pneumothorax induced by grass awns accounts for 5% of spontaneous pneumothorax and 22.5% of thoracic grass awn cases. Previous studies report limited interest of CT for spontaneous pneumothorax. Aims of this retrospective case series were to describe CT features of this condition and determine if CT features can efficiently localize the perforation site. Dogs that had a spontaneous pneumothorax, CT examination, thoracic surgery, and confirmed lung perforation due to a grass awn were included. Computed tomography studies were reviewed and compared to the surgical findings.  In 19 of 22 (86.4%) dogs, the pneumothorax or its recurrence were ipsilateral to the perforation site. The perforation site was identified in 21 of 22 (95.5%) dogs and involved the caudal lobes in 20 of 22 (90.9%) cases. The lateralization and the involved lung lobe corresponded to surgical findings in 21 of 22(95.5%) dogs. The perforation site was characterized as a soft tissue attenuating focus lying against an extensive pleural thickening in 21 of 22(95.5%) dogs. An adjacent defect in the visceral pleura was seen in 13 of 22(59.1%) dogs. A grass awn was seen in 11 of 22(50%) dogs.  The pneumothorax distribution and grass awn position consistently indicated the perforation side in this sample of dogs. The comparison with surgical findings suggests CT might be helpful for future presurgical planning of this etiology for pneumothorax.     

Ultrasound-guided retrieval of plant awns

In dogs, surgical removal of plant awns causing a foreign body granuloma or abscess may be challenging. The inability to localize the foreign body during surgical removal often leads to abscess recurrence. In this report, we describe ultrasound-guided retrieval as an alternative to standard surgical retrieval in animals where the plant awn can be identified sonographically. This procedure was used in six dogs with a superficial abscess due to a plant awn, and in all dogs the foreign body was successfully retrieved with Hartmann forceps. No complication was observed and no abscess recurred. Minimally invasive ultrasound-guided plant awn retrieval appears to be a safe effective method of retrieving superficially located plant awns in the dog.     

IMAGING DIAGNOSIS—CONGENITAL LOBAR EMPHYSEMA IN A DOG

A 14‐week‐old female West Highland White Terrier developed acute dyspnea. Radiographically there was an enlarged, hyperlucent caudal portion of the left cranial lung lobe and a diffuse, severe interstitial‐to‐alveolar pattern in the remaining lung lobes that was accentuated caudodorsally. Computed tomography confirmed the presence of the emphysematous lobe and further showed it to have focal lobar bronchial collapse. Lung lobe resection was performed, and the diagnosis was congenital lobar emphysema secondary to bronchial cartilage hypoplasia.     

Unusual congenital pulmonary anomaly with presumed left lung hypoplasia in a young dog

A seven‐month‐old, entire, male miniature schnauzer dog was referred with acute vomiting, inappetence and depression primarily as a result of a gastric foreign body (pine cones). During investigations, thoracic radiographs revealed increased volume of the right lung lobes, deviated cardiomediastinal structures and elevation of the heart from the sternum. Thoracic computed tomography revealed left cranial lung lobe hypoplasia and extension of the right cranial lung parenchyma across the midline to the left hemithorax. Branches of the right pulmonary vessels and bronchi also crossed the midline and extended to the left caudal lung lobe. These findings suggested that the right and left lungs were fused. In humans this finding is consistent with horseshoe lung, which is an uncommon congenital malformation. To the authors’ knowledge, this case represents the first report of such a pulmonary anomaly in a dog.     

Migrating grass awn within the intraconal part of the retrobulbar space in a dog

A 1.5-year-old MC Cardigan Welsh Corgi was presented for a right oral fistula associated with left tonsil enlargement that responded to medical treatment. A first computed tomography scan was performed and showed no signs of a foreign body. Medical treatment was continued for 2 additional weeks and the dog was free of clinical signs for 3 months. The dog was presented again for a 3-day history of anorexia and marked pain when opening the jaw. The repeat computed tomography scan revealed a migrating foreign body near the optic canal of the right eye, and surgical exploration confirmed that it was trapped within the intraconal part of the retrobulbar space, abutting the optic nerve. The foreign body was surgically removed through an osteotomy of the zygomatic bone. The dog fully recovered with no vision loss. Based on the literature search, this is the first published report describing a migrating grass awn located in the intraconal part of the retrobulbar space, abutting the optic nerve.     

IMAGING DIAGNOSIS—CELIAC ARTERY PSEUDOANEURYSM ASSOCIATED WITH A MIGRATING GRASS AWN

The ultrasound and computed tomography findings of a retroperitoneal pseudoaneurysm associated with a grass awn are described in a 10‐month‐old dog. Ultrasound was used to localize the lesion and surrounding reaction as well as to determine its relationship with the celiac artery, but inadequate Doppler settings hindered the diagnosis of its vascular nature. Dual phase CT enabled further characterization, particularly its close relationship with the major retroperitoneal vessels. The imaging examination was fundamental in recommending nonsurgical therapy. The dog died as a consequence of the rupture of this pseudoaneurysm. A grass awn was confirmed.     

IMAGING DIAGNOSIS—EXTRAHEPATIC BILIARY TRACT OBSTRUCTION SECONDARY TO A BILIARY FOREIGN BODY IN A CAT

An 11‐year‐old, neutered female British Shorthair cat was referred with a 4‐week history of abdominal pain and vomiting. Abdominal ultrasonography revealed a dilated common bile duct containing a spindle‐shaped structure with several reflecting interfaces. Differentials that were considered included an intraluminal foreign body, or helminth parasites within the common bile duct. Surgical exploration of the abdominal cavity demonstrated the presence of two grass awns obstructing the common bile duct. Anomalies of the portal vasculature were noted during surgery and were considered an incidental finding. The clinical signs resolved following surgical removal of the grass awns.     

IMAGING DIAGNOSIS—USE OF RADIOGRAPHY,COMPUTED TOMOGRAPHY,AND ENDOSCOPY IN THE DIAGNOSIS OF ESOPHAGEAL PERFORATION BY AN EXTRA‐LUMINAL TRACHEAL RING PROSTHESIS IN A GOLDEN RETRIEVER

A 6‐year‐old neutered male, Golden retriever presented with regurgitation and excitement‐induced coughing. Two years prior, extra‐thoracic tracheal collapse was diagnosed and extra‐luminal tracheal ring prostheses were placed. Radiographs at presentation showed mineralized and undulant cervical tracheal cartilages. A dorsally broad‐based soft tissue opacity bulged into the caudal cervical tracheal lumen. Esophageal dysmotility and barium accumulation were identified at this level on contrast esophography. Computed tomography showed migration of a prosthetic tracheal ring, resulting in perforation of the esophagus. Hair, foreign material, and dynamic tracheal narrowing were identified on esophagoscopy and tracheoscopy, respectively. Esophagostomy and foreign body removal were performed.     

Intraocular Foreign Body in a Dog

An unusual clinical case of panophthalmitis in the dog is discussed. Failure of resolution led to enucleation. Histopathology study showed an intraocular foreign body, probably a grass awn, that had migrated into the eye and established a panophthalmitis.     

Caudal mediastinal abscess due to a grass awn (Hordeum spp) in a cat

A two-and-a-half year-old male, domestic shorthaired cat was presented with a history of chronic expiratory dyspnoea, dysphagia and progressive weight loss. Thoracic radiography revealed a caudal mediastinal mass. Surgical exploration confirmed the presence of an abscess in the caudal mediastinum. Despite the good prognosis, euthanasia was performed at the owner's request and post-mortem examination revealed an abscess that had been caused by a grass awn located within.     

Conjunctivitis and ulcerative keratitis secondary to conjunctival plant foreign bodies in a herd of alpacas (Lama Pacos)

Purpose To describe six cases of conjunctivitis and ulcerative keratitis secondary to plant foreign bodies from weed‐contaminated grass hay which were lodged within the temporal conjunctival fornix in a herd of alpacas. Methods A total of 21 alpacas from the same farm developed blepharospasm and mucopurulent ocular discharge. Six of the 21 were evaluated at the University of Tennessee College of Veterinary Medicine within a 2‐week period. The six animals evaluated received an ophthalmic examination including slit‐lamp biomicroscopy, fluorescein staining, and topical corneal anesthesia for foreign body removal when necessary. Results Six animals had conjunctivitis characterized by hyperemia and mucopurulent discharge. Five animals had superficial ulcerative keratitis with intense corneal neovascularization and edema. In all cases, the keratitis was located at the temporal limbus. Seven plant foreign bodies were observed and were removed following topical corneal anesthesia in five animals. The plant seeds were identified as three common weed species found in orchard grass hay. Complete resolution of all clinical signs was achieved with foreign body removal and medical therapy. Conclusions Fan‐shaped temporal corneal ulcers may signify the presence of conjunctival foreign bodies in alpacas. Plant foreign bodies should be considered in addition to ocular infection when multiple animals of a herd are affected as outbreaks may occur with weed‐contaminated hay.     

Lung lobe torsion associated with chest wall defects in a dog

An 8-year-old, spayed, female poodle presented with exercise intolerance, lethargy, respiratory distress, retching, hyporexia and diarrhoea. Thoracic radiographs revealed increased opacity in the left cranial thoracic region. The fifth and sixth ribs appeared to be bulging cranially to caudally, and CT and surgical exploration confirmed the presence of a thoracic wall defect in that area. CT showed abrupt occlusion of the bronchus that branches into the left cranial lobe and consolidation of the caudal segment of left cranial lung lobe, which led to the diagnosis of lung lobe torsion. A thoracotomy was performed, the twisted lung lobe was surgically excised, and the defect in the thoracic wall was repaired. Respiratory distress gradually improved after the surgery, and there were no identified complications within the 2-year period following the procedure. Based on our literature search, this is the first reported case of lung lobe torsion caused by a thoracic wall defect in a dog.