IMAGING DIAGNOSIS—NASAL SEPTAL AND LARYNGEAL CYST‐LIKE MALFORMATIONS IN A THOROUGHBRED WEANLING COLT DIAGNOSED USING ULTRASONOGRAPHY AND MAGNETIC RESONANCE IMAGING

A foal was examined for abnormal upper airway noise. Endoscopically, there were narrowed nasal passages and an extralumenal mass of the cranial trachea. Using ultrasonography and magnetic resonance (MR) imaging of the larynx and cranial cervical trachea, irregular margins of the laryngeal cartilages and first tracheal ring containing areas consistent with fluid were identified. In MR images, a widened nasal septum was seen that contained material consistent with fluid. Postmortem examination confirmed the diagnosis of nasal septal, laryngeal, and cranial cervical tracheal cyst‐like lesions. This is a unique congenital condition, in which premortem imaging was instrumental in defining the abnormalities.     

Radiographic and computed tomographic appearance of tracheal collapse with axial rotation in four dogs

Tracheal collapse with axial rotation was diagnosed in four dogs. Radiographs showed increased tracheal dorsoventral height at the caudal cervical and thoracic inlet with and apparent intraluminal soft tissue opacity, mimicking an intraluminal tracheal foreign body. Computed tomography confirmed dorsoventral tracheal collapse with axial rotation in all dogs. Short‐term outcome with medical treatment of all dogs was excellent.     

THORACIC RADIOGRAPHIC FEATURES OF ANTICOAGULANT RODENTICIDE TOXICITY IN FOURTEEN DOGS

Thoracic radiographs and clinical records from 14 dogs with confirmed anticoagulant rodenticide toxicity were reviewed. Twelve of the 14 dogs were presented with a chief complaint of respiratory distress, and 12 had elevated prothrombin and activated partial thromboplastin times consistent with a coagulopathy secondary to a clotting factor deficiency. Thoracic radiographs of the 14 dogs were reviewed and abnomalities included increased mediastinal soft tissue opacity with extra and intrathoracic tracheal narrowing (4/14), increased mediastinal soft tissue opacity without tracheal narrowing (8/14), variable degrees of pleural effusion (13/14) and generalized, patchy interstitial/alveolar pulmonary infiltrates (8/14). Radiographic evidence of cardiomegaly and pulmonary artery abnormalities consistent with concurrent heartworm infestation were detected in one dog. In four dogs, dramatic tracheal narrowing was identified on the lateral thoracic radiograph caused by either mediastinal hemorrhage compressing the trachea or submucosal hemorrhage within the tracheal lumen. The trachea was displaced in a ventral direction in two dogs, and extra and intrathoracic luminal diameter narrowing was evident cranially in all four dogs. Two of these four dogs had soft tissue opacity within the dorsal trachea that extended from the larynx to the intrathoracic trachea. Twelve of the 14 dogs survived with standard treatment protocols utilizing injectable and oral vitamin K₁. One dog died from pancreatitis and disseminated intravascular coagulopathy. The other dog died soon after presentation due to severe, disseminated hemorrhage. Follow-up thoracic radiographs were made in four dogs that survived and showed resolution of the mediastinal, pleural and pulmonary changes within one to five days after the initiation of vitamin K₁ therapy.     

COMPUTED TOMOGRAPHIC,RADIOGRAPHIC, AND ENDOSCOPIC TRACHEAL DIMENSIONS IN ENGLISH BULLDOGS WITH GRADE 1 CLINICAL SIGNS OF BRACHYCEPHALIC AIRWAY SYNDROME

Tracheal hypoplasia is commonly seen in English Bulldogs affected with brachycephalic airway syndrome. Previously published diagnostic criteria for tracheal hypoplasia in this breed have been a radiographic tracheal diameter:tracheal inlet ratio (TD:TI) < 0.12 or a tracheal diameter:third rib diameter ratio (TD:3R) < 2.0. Computed tomography has become increasingly used for airway evaluation, however published information is lacking regarding CT tracheal dimensions in English Bulldogs. Objectives of this prospective cross‐sectional study were to describe radiographic and CT tracheal dimensions in a sample of clinically normal English Bulldogs and compare these values with tracheoscopy scores. Computed tomography (n = 40), radiography (n = 38), and tracheoscopy (n = 40) studies were performed during a single general anesthesia session for each included dog. Tracheal measurements were recorded at three locations: cervical, thoracic inlet, and thorax. Tracheal diameters were narrowest at the thoracic inlet with all techniques. Computed tomographic measurements averaged 19% greater than radiographic measurements. All included dogs had radiographic tracheal measurements greater than the previously published criteria for tracheal hypoplasia. Mean CT TD:TI was 0.26 (± 0.03, 0.20–0.33), and mean CT TT:3R was 2.27 (± 0.24, 1.71–2.74). Radiographic TD:TI and CT TD:TI were significantly correlated (P = 0.00); however radiographic TT:3R and CT TT:3R were not significantly correlated (P = 0.25). Tracheoscopy identified hypoplastic changes in all dogs and tracheoscopy scores were not correlated with CT or radiography diameter measurements. In conclusion, findings indicated that some CT and radiographic tracheal diameter measurements were comparable in English Bulldogs however diameters for both imaging techniques were not comparable with tracheoscopy scores.     

COMPUTED TOMOGRAPHIC CHARACTERISTICS OF ODONTOGENIC NEOPLASMS IN DOGS

Odontogenic neoplasms are locally invasive oral tumors in dogs. The purpose of this retrospective study was to describe CT characteristics for varying histopathologic types of canine odontogenic neoplasms. A board‐certified veterinary radiologist who was unaware of histologic findings reviewed and scored imaging studies. A total of 29 dogs were included in the study. Twenty‐three of these dogs had concurrent dental radiographs. The most common CT characteristics for all tumor types were a direct association with or in the region of multiple teeth in 96.4% (27/28), contrast enhancement in 96.3% (26/27), alveolar bone lysis in 93.1% (27/29), and mass‐associated tooth displacement in 85.2% (23/27). Mass‐associated cyst‐like structures were identified in 53.6% (15/28) and were only present in tumors containing odontogenic epithelium. Canine acanthomatous ameloblastomas (n = 15) appeared as extra‐osseous (10/15) or intra‐osseous (5/15) masses. Intra‐osseous canine acanthomatous ameloblastomas were more likely to have mass‐associated cyst‐like structures and were subjectively more aggressive when compared with extra‐osseous canine acanthomatous ameloblastomas. Amyloid‐producing odontogenic tumors (n = 3) had subjectively uniform CT imaging characteristics and consisted of round soft tissue and mineral attenuating masses with multiple associated cyst‐like structures. Fibromatous epulides of periodontal ligament origin (n = 4) were contrast enhancing extra‐osseous masses that were rarely referred for CT examinations and 25% (1/4) were not visible with CT. Other odontogenic tumors were less represented or had more variable CT imaging characteristics. Mass‐associated tooth destruction was appreciated more often with dental radiographs and extra‐oral tumor extension was identified more often with CT.     

MAGNETIC RESONANCE IMAGING CONTRAST ENHANCEMENT OF EXTRA‐OCULAR MUSCLES IN DOGS WITH NO CLINICAL EVIDENCE OF ORBITAL DISEASE

Enhancement of extra‐ocular muscles has been reported in cases of orbital pathology in both veterinary and medical magnetic resonance imaging. We have also observed this finding in the absence of orbital disease. The purpose of this retrospective study was to describe extra‐ocular muscle contrast enhancement characteristics in a group of dogs with no known orbital disease. Magnetic resonance images (MRI) from dogs with no clinical evidence of orbital disease and a reportedly normal MRI study were retrieved and reviewed. Contrast enhancement percentages of the medial, lateral, ventral, and dorsal rectus muscles were calculated based on signal‐to‐noise ratios that were in turn determined from hand‐traced regions of interest in precontrast, immediate postcontrast and 10‐min postcontrast scans. Comparison measurements were made in the pterygoid muscle. Contrast enhancement of the extra‐ocular muscles was observed in all patients (median contrast enhancement percentage 45.0%) and was greater than that of pterygoid muscle (median contrast enhancement percentage 22.7%). Enhancement of the extra‐ocular muscles persisted 10 min after contrast administration (median contrast enhancement percentage 43.4%). Findings indicated that MRI contrast enhancement of extra‐ocular muscles is likely normal in dogs.     

EX VIVO COMPUTED TOMOGRAPHIC EVALUATION OF MORPHOLOGY VARIATIONS IN EQUINE CERVICAL VERTEBRAE

Diagnostic imaging is one of the pillars in the clinical workup of horses with clinical signs of cervical spinal disease. An improved awareness of morphologic variations in equine cervical vertebrae would be helpful for interpreting findings. The aim of this anatomic study was to describe CT variations in left–right symmetry and morphology of the cervical and cervicothoracic vertebrae in a sample of horses. Postmortem CT examinations of the cervical spine for horses without congenital growth disorders were prospectively and retrospectively recruited. A total of 78 horses (27 foals, 51 mature horses) were evaluated. Twenty‐six horses (33.3%) had homologous changes in which a transposition of the caudal part of the transverse process (caudal ventral tubercle) of C6 toward the ventral aspect of the transverse process of C7 was present (n = 10 bilateral, n = 12 unilateral left‐sided, n = 4 unilateral right‐sided). There was one horse with occipito‐atlantal malformation, two horses with rudimentary first ribs bilaterally, and one horse with bilateral transverse processes at Th1, representing homeotic (transitional) vertebral changes. Chi‐square tests identified no significant differences in the number of conformational variations between the group of mature horses with or without clinical signs (P = 0.81) or between the group of mature horses and the group of foals (P = 0.72). Findings indicated that, in this sample of horses, the most frequently identified variations were homologous variations (transposition of the caudal part of the transverse process of C6–C7) in the caudal equine cervical vertebral column. Homeotic (transitional) variations at the cervicothoracic vertebral column were less common.     

A quantitative study on the trachea of the dog

This study was carried out to record the detailed morphometric structure of the trachea in dogs using 15 female and four male healthy adult mongrel dogs. The diameter and thickness of each tracheal ring were measured, the number of tracheal rings varying from 36 to 45. All data were subjected to statistical analysis which was carried out on individual sections of the trachea, i.e. the cranial cervical, middle cervical, thoracic inlet and the intrathoracic tracheal regions, which consisted of 12, 12, nine and 12 tracheal rings, respectively. Fusion of the tracheal rings was especially obvious in the cranial cervical and thoracic inlet regions as a result of neck movements. The diameter and thickness of the tracheal rings are smallest at the thoracic inlet level because the direction of the trachea changes at this point where the thoracic inlet is relatively small and surrounded by bone. The ratios of inner transverse to inner vertical and outer transverse to outer vertical diameters were almost the same, between 1.14 and 1.25 in all regions, which indicated that the trachea is near-circular in shape in the dog. At the thoracic inlet level cross-sectional lumen areas are 7 and 6% smaller than those in the middle cervical and intrathoracic regions, respectively. The thinnest cartilage was seen at the thoracic inlet level where there is a risk of tracheal collapse.     

Tracheal foreign bodies in the cat and the use of fluoroscopy for removal: 12 cases

OBJECTIVES: To gather information to support the use of fluoroscopically guided removal of tracheal foreign bodies in cats. It was also the intent to produce a case series and look at the long-term outcome following tracheal foreign body removal. METHODS: A retrospective study was performed. This looked at cases of tracheal foreign bodies in cats seen at the University of Bristol veterinary school at Langford over an eight-year period. Outcome was assessed via telephone conversations with the owners. RESULTS: Twelve cats were presented with tracheal foreign bodies during this time. Ten of these foreign bodies were successfully removed using fluoroscopy and two using bronchoscopy. All cats survived. Follow-up was available for nine cats and showed no long-term complications. CLINICAL SIGNIFICANCE: Forceps removal under fluoroscopic guidance is a rapid, safe, and effective method for removal of tracheal foreign bodies in cats. It should be considered as an alternative to bronchoscopy for removal of tracheal foreign bodies in cats. Indeed, in cases where bronchoscopy has failed, it can be attempted to avoid thoracotomy. Successful removal of tracheal foreign bodies in cats is associated with a good long-term outcome.     

Morphological study of tracheal shape in donkeys with and without tracheal obstruction

Reason for performing study: There is limited information on the gross tracheal morphology of donkeys with or without tracheal abnormalities. Objectives: To: 1) examine the morphology of tracheas of donkeys with and without clinical and/or post mortem evidence of tracheal obstruction; 2) record the cross‐sectional dimensions and shapes of tracheal rings at fixed sites; and 3) document prevalence, sites and characteristics of detected tracheal abnormalities. Methods: The tracheas of 75, predominantly aged (median age 30 years, range 7–48 years) donkeys that died or were subjected to euthanasia on humane grounds were examined. Five had severe dyspnoea due to tracheal obstruction (with intercurrent lung disease in 3), while 7 had post mortem evidence of severe tracheal airway obstruction. Every 5th tracheal ring was dissected free and the inner and outer vertical and transverse dimensions and cross sectional areas were measured. Each dissected ring was photographed and the shape of the trachea was classified as normal or, in one of 6 abnormal grades, according to the type and degree of structural abnormality present. Results: The tracheas had a mean of 43 (range 34–50) tracheal rings that tended to be more oval in shape in the distal cervical region. Only 31.2% of rings examined had a circular to oval shape. Dorso‐ventral flattening was present in 0.9% of tracheal rings, dorsal ligament separation in 24.4%, slight cartilage deformity in 26.0%, moderate cartilage deformity in 10.4%, marked cartilage deformity in 1.9% and miscellaneous other abnormalities in 4.9% of tracheal rings. The 12 donkeys with ante or post mortem evidence of tracheal obstruction had significantly increased tracheal abnormality grade in comparison to the remaining donkeys. Conclusions and potential relevance: Structural tracheal abnormalities are present in most old donkeys, but generally do not cause clinical problems in these sedentary animals unless intercurrent pulmonary disease is present.     

COMPARISON OF FLUOROSCOPY AND COMPUTED TOMOGRAPHY FOR TRACHEAL LUMEN DIAMETER MEASUREMENT AND DETERMINATION OF INTRALUMINAL STENT SIZE IN HEALTHY DOGS

Tracheal collapse is a progressive airway disease that can ultimately result in complete airway obstruction. Intraluminal tracheal stents are a minimally invasive and viable treatment for tracheal collapse once the disease becomes refractory to medical management. Intraluminal stent size is chosen based on the maximum measured tracheal diameter during maximum inflation. The purpose of this prospective, cross‐sectional study was to compare tracheal lumen diameter measurements and subsequent selected stent size using both fluoroscopy and CT and to evaluate inter‐ and intraobserver variability of the measurements. Seventeen healthy Beagles were anesthetized and imaged with fluoroscopy and CT with positive pressure ventilation to 20 cm H₂O. Fluoroscopic and CT maximum tracheal diameters were measured by three readers. Three individual measurements were made at eight predetermined tracheal sites for dorsoventral (height) and laterolateral (width) dimensions. Tracheal diameters and stent sizes (based on the maximum tracheal diameter + 10%) were analyzed using a linear mixed model. CT tracheal lumen diameters were larger compared to fluoroscopy at all locations (P‐value < 0.0001). When comparing modalities, fluoroscopic and CT stent sizes were statistically different. Greater overall variation in tracheal diameter measurement (height or width) existed for fluoroscopy compared to CT, both within and among observers. The greater tracheal diameter measured with CT and lower measurement variability has clinical significance, as this may be the imaging modality of choice for appropriate stent selection to minimize complications in veterinary patients.     

MAGNETIC RESONANCE IMAGING FEATURES OF INTRACRANIAL GRANULAR CELL TUMORS IN SIX DOGS

Magnetic resonance (MR) imaging characteristics of intracranial granular cell tumors (GCTs) have been previously reported in three dogs. The goal of this retrospective study was to examine a larger number of dogs and determine whether distinctive MR characteristics of intracranial GCTs could be identified. Six dogs with histologically confirmed intracranial GCTs and MR imaging were included. Tumor location, size, mass effect, T1‐ and T2‐weighted signal intensity, and peritumoral edema MR characteristics were recorded. In all dogs, GCTs appeared as well‐defined, extra‐axial masses with a plaque‐form, sessile distribution involving the meninges. All tumors were located along the convexity of the cerebrum, the falx cerebri, or the ventral floor of the cranial vault. All tumors were mildly hyperintense on T1‐weighted images, and iso‐ to hyperintense on T2‐weighted images. A moderate‐to‐severe degree of peritumoral edema and mass effect were evident in all dogs. Findings indicated that, while several MR imaging characteristics were consistently identified in canine cerebral GCTs, none of these characteristics were unique or distinctive for this tumor type alone.     

Atypical lateral tracheal collapse in a Yorkshire terrier

A 10-month-old, neutered female Yorkshire terrier was presented with a 6-month history of inspiratory dyspnoea, coughing and exercise intolerance. Tracheoscopy revealed marked lateral-to-lateral fixed collapse of the cervical trachea and mild collapse of the thoracic trachea. Surgical exploration revealed a marked reduction in lateral tracheal width and multiple malformed tracheal rings. Placement of extraluminal ring prostheses around the cervical trachea resulted in widening of the tracheal diameter and an immediate improvement in clinical signs. 6 years postoperatively the patient was reported to have an excellent quality of life with complete resolution of clinical signs.     

IMAGING DIAGNOSIS—COMPUTED TOMOGRAPHY FINDINGS IN A CASE OF METASTATIC OVARIAN ADENOCARCINOMA IN A DOG

A 5‐year‐old female entire German Shepherd presented for otitis and lethargy. An incidental abdominal mass was identified on examination. Ultrasound examination (US) identified a heterogeneous left ovarian mass. Computed tomography (CT) was performed for surgical planning and staging. The reproductive tract was removed en bloc and submitted for histopathology. Multiple small (1–5 mm) nodules identified at coeliotomy on the surface of the liver, spleen and peritoneum were biopsied. The lesions were not visible on CT nor US on review. This is the first case report of the CT findings of ovarian papillary adenocarcinoma with carcinomatosis.     

RADIOGRAPHIC QUANTIFICATION OF TRACHEAL DIMENSIONS OF THE NORMAL THOROUGHBRED HORSE

Radiographic measurement of tracheal dimensions in the horse may be useful in evaluating upper and lower respiratory tract conditions due to the gradient of pressure changes between these areas. Lateral radiographs of the trachea of 15 normal sedated Thoroughbred horses were made at inspiration and expiration and magnification-corrected mean airway heights measured were, respectively: larynx: 5.89 and 5.86 cm; trachea at the third cervical vertebra (C3): 4.17 and 4.04 cm; at the fifth cervical vertebra (C5): 3.62 and 3.59 cm; at the first thoracic vertebra (T1): 3.4 and 3.23 cm; and carina: 3.85 and 4.12 cm. The ratio of airway height to nearby vertebral body lengths, at inspiration and expiration were, respectively: laryngeal height at C3: 0.56 and 0.56; tracheal height at C3: 0.4 and 0.39; at C5: 0.37 and 0.37; at T1: 0.59 and 0.59; and carina height: 0.91 and 0.94. The ratio of tracheal height to the thoracic inlet at inspiration and expiration was, respectively, 0.15 and 0.15. There was not a statistically significant association between airway diameter and phase of respiration. No association was found between tracheal height and body mass or height at the withers. Radiographic tracheal height can be measured independent of respiratory phase in sedated horses. It is suggested that the ratio of tracheal height to an adjacent bony landmark is more reliable for comparison between horses and tracheal height measurement should be made at C5, due to a lower standard deviation. If only thoracic radiographs are made, measurements of tracheal height at the thoracic inlet may be valuable.     

COMPARISON OF THE RADIOGRAPHIC AND TRACHEOSCOPIC APPEARANCE OF THE DORSAL TRACHEAL MEMBRANE IN LARGE AND SMALL BREED DOGS

The etiology and clinical significance of increased radiographic opacity along the dorsal margin of the tracheal lumen has long been debated. Most often, this opacity is attributed to redundancy of the dorsal tracheal membrane (DTM), a condition that occurs with tracheal collapse. We hypothesized that the underlying etiology of this radiographic opacity differs between small breed dogs with tracheal collapse and small or large breed dogs without tracheal collapse. The purpose of this prospective, cross‐sectional study was to compare the radiographic appearance of an increased opacity within the trachea to tracheoscopy findings in a group of small and large breed dogs. A total of 17 small breed dogs and 16 large breed dogs were included. Of these, only one did not have a radiographically visible DTM. Small breed dogs were divided into groups with tracheal collapse (n = 8) and those without (n = 9) based on tracheoscopy. Tracheal collapse was absent in larger breed dogs, however both large and small breed dogs demonstrated inward invagination of the DTM. In dogs with tracheal collapse, the DTM occupied a larger percentage of the tracheal luminal height on radiographs and a larger percentage of tracheal circumference on tracheoscopy vs. dogs with an invaginated DTM on tracheoscopy and dogs with no collapse and no invagination of the DTM. Findings supported the hypothesis that increased radiographic opacity along the dorsal margin of the trachea arises from different etiologies in dogs with and without tracheal collapse.     

SURVEY OF THE USE OF RADIOGRAPHY VS. ULTRASONOGRAPHY IN THE INVESTIGATION OF GASTROINTESTINAL FOREIGN BODIES IN SMALL ANIMALS

A question frequently asked by clinicians who are treating small animals suspected of having gastrointestinal foreign bodies is whether one imaging test such as survey radiography or ultrasonography is sufficient to make the diagnosis. A study was undertaken to try and answer this question. Survey abdominal radiography and ultrasonography was performed on 16 small animals (11 dogs, five cats) with clinical signs of an obstruction because of a confirmed gastrointestinal foreign body. The majority of the foreign bodies (14/16) were confirmed by surgical removal and were located in the small intestine. A gastric foreign body was retrieved endoscopically and a colonic foreign body was passed in the feces. Radiographically identifiable foreign bodies were evident in nine animals. Small intestinal overdistension was present radiographically in seven animals. Ultrasonography detected a foreign body in all 16 animals. The foreign bodies were identified by their distal acoustic shadowing and variable degrees of surface reflection. An intestinal perforation was detected sonographically but not radiographically. The value of additional sonographic findings including thickening of the gastrointestinal wall and loss of layering, free peritoneal fluid, and lymphadenopathy in these animals is discussed. The findings in this series suggest that in a small animal with a gastrointestinal foreign body, ultrasonography alone could be used to make the diagnosis and may be a more appropriate choice than survey radiography.     

IMAGING DIAGNOSIS—TRANSESOPHAGEAL ULTRASOUND‐GUIDED REMOVAL OF A MIGRATING GRASS AWN FOREIGN BODY IN A DOG

A 3‐year‐old English Setter dog was presented for an acute onset of coughing. Tracheobronchoscopic examination allowed localization and removal of one grass awn foreign body. A second migrated grass awn was suspected to be present in the left caudal lung lobe. Transesophageal ultrasound revealed an area of pulmonary consolidation in the dorsomedial portion of left caudal lobe and a linear hyperechoic structure consistent with a grass awn foreign body within the area of consolidation. Transesophageal ultrasonography was also used to provide anatomical landmarks that facilitated successful thoracoscopic removal of the foreign body.     

IMAGING DIAGNOSIS—COMPUTED TOMOGRAPHIC ANGIOGRAPHY CHARACTERISTICS OF MULTIPLE VASCULAR ANOMALIES IN A SENIOR DOG WITH LATE‐ONSET REGURGITATION

A 10‐year‐old dog weighing 3.4 kg presented with intermittent regurgitation. Esophagography revealed that the thoracic esophagus was compressed dorsally at the region of the fourth intercostal space and segmentally dilated from the second to third intercostal region. Three‐dimensional computed tomographic (CT) angiography confirmed a suspected vascular ring anomaly and also revealed multiple other vascular anomalies. These included aberrant right subclavian artery, absence of bilateral external jugular veins, right‐gastric caval shunt, and a completely duplicated caudal vena cava. Findings supported the use of thoracic CT angiography to rule out additional vascular malformations in dogs with suspected vascular ring anomaly.