Neurological signs and results of magnetic resonance imaging in 40 cavalier King Charles spaniels with Chiari type 1-like malformations

In human beings a Chiari type 1 malformation is a developmental condition characterised by cerebellar herniation and syringohydromyelia. Abnormalities compatible with such a malformation were identified by magnetic resonance imaging in 39 cavalier King Charles spaniels with neurological signs and in one neurologically normal cavalier King Charles spaniel that was examined postmortem. The dogs with these abnormalities had a wide variety of neurological signs, but there was no apparent correlation between the neurological signs and the severity of cerebellar herniation, syringohydromyelia or hydrocephalus.     

Bilateral Morgagni hernia in a donkey

This case report describes the clinical presentation and management of a donkey admitted with acute signs of abdominal pain that was diagnosed with a bilateral Morgagni hernia, a rare type of congenital diaphragmatic hernia. For more than 8 months before presentation, the donkey had been showing signs of recurrent mild abdominal pain that responded favourably to medical treatment. On admission, the donkey had mild tachycardia and tachypnoea. Radiography and ultrasound of the thorax and abdomen showed thoracic herniation of the large colon. Exploratory laparotomy was performed, and the sternal and diaphragmatic flexures of the large colon, as well as the left hepatic lobe, were found incarcerated in a bilateral Morgagni hernia. Intestine and liver were removed from the hernia, and the large colon was exteriorised. The defect in the diaphragm was repaired by stapling a polyester mesh circumferentially around the hernia ring and covering the mesh with an excised section of the greater omentum. No further complications and no recurrence of colic were observed during an 8-month follow-up period.     

Syringohydromyelia in Cavalier King Charles spaniels

Syringohydromyelia secondary to foramen magnum overcrowding is described in seven Cavalier King Charles spaniels. Clinical signs were consistent with a central spinal cord lesion. The most common signs were persistent scratching at the shoulder region with apparent neck, thoracic limb, or ear pain and thoracic limb lower motor neuron deficits. The diagnosis was made by magnetic resonance imaging. The syringohydromyelia is postulated to be a consequence of an occipital bone malformation resulting in a small caudal fossa and cerebellar herniation. Clinical signs improved but did not completely resolve when the dogs received treatment with corticosteroids or nonsteroidal anti-inflammatory drugs.     

Comparison of the relative occipital bone volume between Cavalier King Charles spaniels with and without syringohydromyelia and French bulldogs

Our aim was to determine the relative volume of the occipital bone of Cavalier King Charles spaniels with and without syringohydromyelia and normal French bulldogs to reappraise the role of a possible insufficiency of the paraxial mesoderm in the pathogenesis of the caudal occipital malformation syndrome. Analysis of the occipital bone volume of 43 dogs based on computed tomography datasets was performed. Volume was determined by means of three-dimensional models. Using manual segmentation of the occipital bone in sagittal, transverse, and dorsal images, the volume of the occipital bone and the rest of the skull was calculated. The absolute occipital bone volume was put in relation to the total skull volume, the occipital bone index. For the Cavalier King Charles spaniels without syringomyelia, the median occipital bone index was 0.0681; for Cavalier King Charles spaniels with syringomyelia, it was 0.0646 and for French bulldogs, it was 0.0676. There was no global difference of the occipital bone index between examined groups (P = 0.4331). A reduced volume of the occipital bone was not found in Cavalier King Charles spaniels in general in comparison to French bulldogs, or in Cavalier King Charles spaniels with syringomyelia compared to Cavalier King Charles spaniels without syringomyelia. These results do not support occipital hypoplasia as a cause for syringomyelia development, challenging the paraxial mesoderm insufficiency theory. This also suggests that the term Chiari-like malformation, a term derived from human studies, is not appropriate in the Cavalier King Charles spaniel.     

Congenital diaphragmatic eventration in a stillborn foal.

A stillborn full term foal was presented at necropsy.The dilated duodenum and the dorsal and ventral left colon and cecum extended into the thoracic cavity and were encased by a thin transparent membrane originating from the diaphragm. The congenital condition was diagnosed as a developmental anomaly with diaphragmatic eventration. To the authors' knowledge, this is the first report of diaphragmatic eventration in a Thoroughbred stillborn foal.     

Comparison of techniques for transdiaphragmatic thoracic drainage after diaphragmatic defect closure in dogs: a cadaveric study

Four thoracic evacuation techniques for pneumothorax elimination after diaphragmatic defect closure were compared in 40 canine cadavers. After creating a defect in the left side of the diaphragm, thoracic drainage was performed by thoracostomy tube insertion through the defect and a small (DD-SP) or large (DD-LP) puncture created in the caudal mediastinum, or through both the diaphragmatic defect and intact contralateral diaphragm with a small (DI-SP) or large (DI-LP) puncture in made in the caudal mediastinum. Differences in intrapleural pressure (IPP) between the right and left hemithoraxes after air evacuation along with differences in IPP before making a defect and after air evacuation in each hemithorax were calculated. A difference (p ≤ 0.0011) in IPP between the left and right hemithoraxes after air evacuation as well as before making a defect and after air evacuation in the right hemithorax was detected for the DD-SP group. No significant differences (p ≥ 0.0835) were observed for the DI-LP, DD-LP, or DI-SP groups. Creation of a large mediastinal puncture or thoracic evacuation through both a diaphragmatic defect and intact contralateral diaphragm can facilitate proper pneumothorax elimination bilaterally after diaphragmatic defect closure in dogs with a small puncture in the caudal mediastinum.     

Thoracotomy for repair of a large dorsal diaphragmatic hernia in an 18‐year‐old mare

An 18‐year‐old Arabian‐mix mare was presented with a history of severe colic. Emergency exploratory celiotomy revealed diaphragmatic hernia, with a large rent in the left dorsal aspect of the diaphragm and large colon volvulus. Attempts to close the defect in the diaphragm in dorsal recumbency were unsuccessful. Therefore, a thoracic approach through lateral thoracotomy was elected, and a mesh was attached to the diaphragm using skin staples. While in dorsal recumbency, the mare suffered from significant respiratory acidosis. Thus, the mare was tilted into reverse Trendelenburg (30° head upward) and ventilation improved markedly. The mare recovered uneventfully, and was doing well 5 years after surgery.     

Hemidiaphragmatic reconstruction with a transversus abdominis muscle flap after resection of a solitary diaphragmatic mesothelioma in a dog

CASE DESCRIPTION: A 2-year-old Siberian Husky was evaluated because of a 2-week history of coughing and gagging and decreased appetite and activity level. CLINICAL FINDINGS: Radiography, surgery, and immunohistochemical examination revealed a solitary sclerosing mesothelioma extending from the left thoracic diaphragmatic surface that was adherent to the pericardium and the caudal mediastinum. TREATMENT AND OUTCOME: The tumor was resected along with most of the left hemidiaphragm, and the left transversus abdominis muscle was used to reconstruct the diaphragm. The 13th rib formed the base of the muscle flap. The muscle flap was transposed into the defect so that the mesothelium-lined surface faced the thoracic cavity and the deep aspect of the muscle formed the abdominal surface of the diaphragm. To minimize risk of adhesions, the exposed raw aspect of the abdominal surface was covered with porcine small intestinal submucosa. Recovery was uncomplicated, and the dog's appetite and activity level soon returned to normal. Evaluation 54 days after surgery revealed 2 subcutaneous masses on the thorax and masses in the liver and both kidneys; histologic and immunohistochemical analyses revealed metastasis of the original tumor. The dog was euthanatized. CLINICAL RELEVANCE: Hemidiaphragmatic reconstruction with a transversus abdominis muscle flap after resection of a diaphragmatic tumor was successful. The muscle flap was easily harvested and transposed into the diaphragmatic defect.     

Canine Congenital Diaphragmatic Hernia

Congenital diaphragmatic hernia, affecting both sexes, was present in five of 27 puppies from three father-daughter matings. A purebred Golden Retriever was the common sire. The defect occurred in the left dorsolateral portion of the diaphragm, suggesting failure of closure of the left pleuroperitoneal canal during embryonic development. These findings, and a previous report of a similar defect in neonatal puppies, are consistent with autosomal recessive inheritance of canine diaphragmatic defects.     

Thoracoscopic-assisted diaphragmatic hernia repair using a thoracic rib resection

OBJECTIVE: To describe the surgical treatment of a dorsal diaphragmatic hernia in an adult horse using thoracic rib resection aided by thoracoscopy and a flank incision. STUDY DESIGN: Case report. ANIMAL POPULATION: One client-owned horse. RESULTS: A six-year-old Dutch warmblood gelding was admitted for colic-associated colonic incarceration in a diaphragmatic hernia. Seven weeks after the initial colic surgery, the gelding underwent surgery to repair the defect. Thoracoscopy and a flank incision were used to identify the location of the hernia and the subsequent site of rib resection. The stomach was adhered to the edges of the defect, leaving only a small residual hole. Resection of the 14th rib provided excellent exposure of the defect and closure of the remaining hernia. CONCLUSION AND CLINICAL RELEVANCE: Thoracic rib resection can provide access to diaphragmatic hernias in adult horses. Thoracoscopy or a flank incision, or both, may aid in determining which rib is best resected.     

Comparison of cerebral cranium volumes between cavalier King Charles spaniels with Chiari-like malformation, small breed dogs and Labradors

O bjectives : To ascertain whether cavalier King Charles spaniels (CKCSs) have a proportionately smaller caudal fossa compared with other small dogs and with Labradors. To evaluate if cerebellar herniation in CKCS correlates with caudal fossa volume.
M ethods : In this retrospective study, three-dimensional images were created from magnetic resonance imaging brain series of 117 dogs (split into three groups: CKCS, Labradors and small breeds) from which the volumes of the fossae and brain parenchyma were calculated. These volumes were transformed into percentages of total cranial cavity and parenchyma volumes, respectively. The percentages were statistically compared among the groups. The percentage of herniated cerebellum in the CKCS was compared using linear regression with the caudal fossa and parenchyma percentages.
R esults : Cavalier King Charles spaniels had a proportionately smaller caudal fossa compared with Labradors (P=0·002) but not to small breeds (P=0·103). Their caudal fossa parenchyma was proportionately the same volume as Labradors (P=0·976) but greater than small breeds (P=0·005). No relationship was found for the per cent of cerebellum herniated.
C linical S ignificance : The results support mesoderm insufficiency or craniosynostosis as the pathogenesis of Chiari-like malformation (CM) in CKCS. It presents evidence for overcrowding of the caudal fossa due to a mismatch of brain parenchyma and fossa volumes as to why CKCS and not other small dogs are affected.     

The use of porcine small-intestinal submucosa for abdominal wall reconstruction – a clinical case

A seven-year-old miniature dachshund was presented with a large contaminated bite wound centred on the left costal arch. Survey radiographs revealed a pneumomediastinum, a mid-body fracture of the left 11th rib and luxation of the xiphisternum. The compromised skin, ribs, xiphisternum, diaphragm and abdominal wall were surgically debrided. This resulted in a large combined thoracic and abdominal wall defect. The thoracic cavity was closed by diaphragmatic advancement. The abdominal wall defect was partially closed by advancing local abdominal musculature. A cranial abdominal mid-line defect remained and was repaired using two sheets of lyophilised porcine small-intestinal submucosa. Dehiscence of the skin exposing the SIS graft was seen but the abdominal repair remained intact. Eighteen months after the initial injury, the dog remained clinically well and no associated complications were reported.     

Rate of change of heart size before congestive heart failure in dogs with mitral regurgitation

Objectives : The objective of the study was to examine the changes in vertebral heart scale, and left atrial and ventricular dimensions before and at onset of congestive heart failure in cavalier King Charles spaniels with mitral regurgitation. Methods : Records and radiographs from 24 cavalier King Charles spaniels with mitral regurgitation were used. Vertebral heart scale (24 dogs), and left atrial dimension and left ventricular end diastolic and end systolic diameters (18 dogs) and their rate of increase were measured at intervals over years to the onset of congestive heart failure. They were plotted against time to onset of congestive heart failure. Results : Dimensions and rates of change of all parameters were highest at onset of congestive heart failure, the difference between observed and chance outcome being highly significant using a two-tailed chi-square test (P<0·001). Clinical significance : The left heart chambers increase in size rapidly only in the last year before the onset of congestive heart failure. Increasing left ventricular end systolic dimension is suggestive of myocardial failure before the onset of congestive heart failure. Rate of increase of heart dimensions may be a useful indicator of impending congestive heart failure.     

Canine keratoconjunctivitis sicca: disease trends in a review of 229 cases

OBJECTIVES: To investigate the disease patterns in dogs with keratoconjunctivitis sicca referred to the University of Glasgow Small Animal Hospital. METHODS: A retrospective study of 229 cases was carried out. RESULTS: There were 44 breeds in the study, with four breeds, English cocker spaniels, cavalier King Charles spaniels, West Highland white terriers and shih-tzus, making up 58 per cent of the cases. Among these four breeds, two breed-dependent disease patterns, one chronic and one acute, were identified. English cocker spaniels and West Highland white terriers had a mean age at onset of clinical signs of five years and one month and five years and six months, respectively, with more females affected than males. Clinical signs consisted predominantly of conjunctival hyperaemia and mucopurulent discharge, with a relatively low incidence of ulcerative keratitis. In contrast, cavalier King Charles spaniels and shih-tzus showed a more acute disease pattern with a biphasic age distribution at 0 to less than two years of age, and four to less than six and six to less than eight years of age, respectively, with more males affected than females and a significantly higher incidence of ulcerative keratitis in some cases resulting in corneal perforation. CLINICAL SIGNIFICANCE: The study reveals interbreed differences with respect to sex, age and risk of ulcerative keratitis which have not been detailed previously in a referral population.     

Congenital Esophageal Hiatal Hernia in the Chinese Shar-Pei Dog

Esophageal hiatal hernia was diagnosed in 11 young Chinese Shar-Pei dogs between October 1985 and July 1991. The dogs ranged in age from 2 to 11 months and included 3 females and 8 males. The most common clinical signs were regurgitation, vomiting, and hypersalivation. Physical examination was normal in 6 dogs; abnormal physical examination findings in the other 5 dogs included fever, dehydration, hypersalivation, and pulmonary wheezes and crackles. Laboratory evaluation was significant only for neutrophilia in 5 dogs. A diagnosis of hiatal hernia was made on the basis of survey thoracic radio-graphic and/or barium esophagram findings of displacement of the esophagogastric junction and stomach into the thoracic cavity; the diagnosis was confirmed by surgery in 9 dogs and at necropsy in 2 dogs. Megaesophagus (n = 7), gastroesophageal reflux (n = 4), and esophageal hypomotility (n = 1) were additional findings in some dogs. Aspiration pneumonia was diagnosed in 7 of the dogs. Medical therapies formulated for the therapy of presumed reflux esophagitis generally failed to resolve the clinical signs associated with the hiatal hernia. Hiatal herniae were surgically repaired in 9 of the Shar-Peis by various combinations of diaphragmatic crural apposition, fixation of the esophagus to the diaphragmatic crus (esophagopexy), and left fundic tube gastropexy. Eight of the animals survived surgery, six of which have been asymptomatic since surgery (19 to 36 months). The megaesophagus, esophageal hypomotility, and bronchopneumonia resolved in all of these dogs. (Journal of Veterinary Internal Medicine 1993; 7:210–215. Copyright © 1993 by the American College of Veterinary Internal Medicine.)     

2002: Hiatal hernia in a puppy

A sliding hiatal hernia (where the terminal oesophagus, oesophagogastric junction and part of the stomach move cranially through a diaphragmatic defect) was diagnosed in a 4-month-old, Shar-Pei puppy presented for evaluation of regurgitation. The diagnosis was confirmed using radiography. Herniorraphy consisted of repositioning the stomach within the abdomen, plicating the diaphragmatic hiatus and performing a tube gastropexy to the left abdominal wall. Veterinary practitioners should have a high index of suspicion of hiatal hernia in young puppies, particularly Shar-Peis and British Bull Dogs, that present with persistent vomiting or regurgitation.     

Eyelid eosinophilic granuloma in a Siberian husky

Canine eosinophilic granuloma (CEG) is a rare skin disease of unknown origin. It has been reported in Siberian huskies, Cavalier King Charles spaniels and occasionally in other breeds. The lesions comprise nodules or plaques, mostly localised in the oral cavity. A case of a single cutaneous nodular lesion of CEG on the eyelid of a Siberian husky is described. Complete remission was achieved with oral glucocorticoid treatment.     

Eosinophilic diseases in two Cavalier King Charles spaniels

This report describes the clinical presentation of two Cavalier King Charles spaniels with different eosinophilic diseases. The first case presented with dyspnoea and a non-productive cough, and investigations demonstrated eosinophilic bronchopneumonopathy. The second dog was referred for the investigation of haemorrhagic vomiting and diarrhoea and was eventually diagnosed with eosinophilic enteritis. Both dogs had concurrent eosinophilic stomatitis, and both responded completely to immunosuppressive glucocorticoid therapy. This report is the first to describe the concurrence of eosinophilic stomatitis and systemic eosinophilic disease in Cavalier King Charles spaniels, and suggest that this breed may be predisposed to eosinophilic syndromes.     

Diaphragmatic herniation as a cause of lethargy and exercise intolerance in a mare.

A diaphragmatic hernia in which 90% of the large colon had herniated through a 16-cm linear tear in the diaphragm was found in a 12-year-old Quarter Horse mare. Clinical signs included lethargy and exercise intolerance. Diagnosis of diaphragmatic hernia was made based on careful thoracic auscultation, combined with ultrasonographic and radiographic examination of the thorax.     

Diaphragmatic hernia in a cat mimicking a pulmonary mass

A seven-year-old castrated British shorthair cross cat was presented for coughing of five-weeks duration. Thoracic radiographs and an unguided bronchoalveolar lavage showed changes consistent with inflammatory airway disease. In addition, a soft tissue density was evident in the thoracic films between the heart and the diaphragm. Exploratory thoracotomy demonstrated a diaphragmatic hernia, probably congenital in origin, with incarceration of a portion of the hepatic parenchyma. The herniated portion of liver was resected surgically and the defect in the diaphragm closed. The cat was given a 10-day course of doxycycline post-operatively and the cough did not recur subsequently. In retrospect, the hernia was potentially an incidental problem, the cat's coughing being attributable to inflammatory airway disease.