Cranial mediastinal carcinomas in nine dogs*

Nine dogs were diagnosed with cranial mediastinal carcinomas. Based on histological and immunohistochemical analysis, four dogs were diagnosed with ectopic follicular cell thyroid carcinomas, one dog with ectopic medullary cell thyroid carcinoma, two dogs with neuroendocrine carcinomas and two dogs with anaplastic carcinomas. Clinical signs and physical examination findings were associated with a space‐occupying mass, although one dog was diagnosed with functional hyperthyroidism. Surgical resection was attempted in eight dogs. The cranial mediastinal mass was invasive either into the heart or into the cranial vena cava in three dogs. Resection was complete in six dogs and unresectable in two dogs. All dogs survived surgery, but four dogs developed pulmonary thromboembolism and two dogs died of respiratory complications postoperatively. Adjunctive therapies included pre‐operative radiation therapy (n = 1) and postoperative chemotherapy (n = 3). Three dogs had metastasis at the time of diagnosis, but none developed metastasis following surgery. The overall median survival time was 243 days. Local invasion, pleural effusion and metastasis did not have a negative impact on survival time in this small case series.     

Laparoscopic Splenectomy for Treatment of Splenic Hemangiosarcoma in a Dog

Objective: To report laparoscopic splenectomy in a dog. Study Design: Clinical report. Animals: Mixed breed dog (n=1). Methods: Hemangiosarcoma was diagnosed by ultrasound‐guided fine‐needle aspiration of a splenic mass in an 11‐year‐old, 30 kg, mixed breed dog. No metastatic disease was identified during complete staging (chest radiographs, echocardiogram, and abdominal ultrasonography); however, cystic calculi were identified. Laparoscopic splenectomy using Ligasure V was performed through 3 portals and the calculi were removed by laparoscopic‐assisted cystoscopy. Results: Total surgical time was 2 hours and for laparoscopic splenectomy, 65 minutes. The celiotomy incision for splenic removal was 7 cm. The dog recovered uneventfully and was ambulatory 2 hours postoperatively. Conclusion: Laparoscopy with Ligasure V facilitated successful removal of a spleen with a 3 cm mass. Clinical Relevance: Laparoscopic splenectomy in dogs is feasible for removal of a normal‐sized spleen with a moderate‐sized mass.     

Thymoma‐associated lymphocytosis in a dog

A 9‐year‐old female spayed English Springer Spaniel was evaluated for a cranial mediastinal mass and lymphocytosis. Flow cytometric immunophenotyping of peripheral blood lymphocytes revealed 97% as CD3 positive, confirming a T‐cell lineage. Additionally, T‐cell subset assessment showed 53.2% to be double‐negative T‐lymphocytes, expressing neither CD4 nor CD8 surface markers. The number of double‐negative lymphocytes in circulation coincided with the number of T‐cell receptor (TCR) γδ‐expressing T‐cells in circulation. Molecular T‐cell clonality analysis of TCR Gamma (TCRG) gene rearrangement showed a polyclonal expansion of T‐lymphocytes. Histopathology confirmed the mass to be a thymoma, supporting the diagnosis of thymoma‐associated T‐cell lymphocytosis. Resolution of the lymphocytosis after removal of the thymoma provided further evidence for this diagnosis. To the authors' knowledge, this case is only the second report of thymoma‐associated peripheral lymphocytosis in the veterinary literature, and is the first to report a confirmed thymoma‐associated peripheral γδ T‐cell lymphocytosis in a dog.     

Radiotherapy-induced tumor lysis syndrome in a dog with thymoma

A 13-year-old, female, mixed-breed dog with a huge cranial mediastinal mass underwent radiotherapy (RT). On the following day, the dog presented with lethargy and anorexia. Hematological examination revealed elevated levels of blood urea nitrogen, creatinine, inorganic phosphorus, potassium, lactate dehydrogenase, creatine phosphokinase and aspartate aminotransferase, decreased calcium level, and metabolic acidosis. Urine output markedly decreased. The patient recovered with fluid therapy and diuretic therapy; however, died suddenly from an unknown cause 11 days after RT completion. Histopathological examination after necropsy showed thymoma in the cranial mediastinum and extensive tubular necrosis of both kidneys which may be due to RT-induced tumor lysis syndrome (TLS). This report suggests that the risk of TLS should be evaluated in dogs with thymoma who undergo RT.     

Thoracoscopic Subphrenic Pericardectomy Using Double‐Lumen Endobronchial Intubation for Alternating One‐Lung Ventilation

Objective— To report the technique, complications, and effectiveness of thoracoscopic subphrenic pericardectomy (SPP) using double‐lumen endobronchial intubation for alternating 1‐lung (OLV) in healthy dogs. Study Design— Prospective cohort study. Animals— Mature purpose‐bred dogs (n=7). Methods— Bronchoscope‐assisted placement of a left‐sided double‐lumen endobronchial tube, immediately before surgery, allowed intraoperative alternation of ventilation between lung fields. A camera portal was established in a subxyphoid location. Two instrument portals were established at the 4th–6th intercostal spaces on the right and left sides. A vessel‐sealing device was used to create the subphrenic pericardectomy. After termination of the procedure, dogs were humanely euthanatized under anesthesia and necropsy performed. In each dog, the extent of pericardectomy and any complications were evaluated. Results— Technical difficulties with tube placement occurred in 4 dogs, but alternating OLV was achieved in all dogs and SPP completed successfully. Median surgical time was 87.5 minutes (range, 80–105 minutes). At necropsy, 0.5–2 cm of pericardial tissue remained ventral to the intact phrenic nerve in 6 dogs; in 1 dog, the phrenic nerve was transected on the left side only. Conclusions— Thoracoscopic subphrenic pericardectomy is a technically feasible procedure in healthy dogs. Double‐lumen endobronchial intubation allowed alternating OLV without intraoperative bronchoscopically guided tube manipulation in all but 1 dog. Clinical Relevance— Thoracoscopic subphrenic pericardectomy could potentially be used for management of conditions where relief of pericardial constriction or access to intrapericardial structures is desired.     

Comparison of Short‐ and Long‐term Function and Radiographic Osteoarthrosis in Dogs After Postoperative Physical Rehabilitation and Tibial Plateau Leveling Osteotomy or Lateral Fabellar Suture Stabilization

Objectives— To compare short‐ and long‐term functional and radiographic outcome of cranial cruciate ligament (CrCL) injury in dogs treated with postoperative physical rehabilitation and either tibial plateau leveling osteotomy (TPLO) or lateral fabellar suture stabilization (LFS). Study Design— Prospective observational clinical study. Animals— Medium to large breed dogs with naturally occurring CrCL injury (n=65). Methods— Dogs with CrCL injury were treated with either TPLO or LFS and with identical physical rehabilitation regimes postoperatively. Limb peak vertical force (PVF) was measured preoperatively and at 3, 5, and 7 weeks, and 6 months and 24 months postoperatively. Stifles were radiographically assessed for osteoarthrosis (OA) preoperatively and 24 months postoperatively. Results— Thirty‐five dogs had LFS and 30 dogs had TPLO. Radiographic OA scores were significantly increased at 24 months compared with preoperative scores in all dogs. Radiographic OA scores preoperatively and at 24 months were not significantly different between treatment groups. PVF was significantly increased from preoperative to 24 months among both treatment groups but not significantly different between treatment groups preoperatively or at 3, 5, 7 weeks, 6, or 24 months. Conclusion— No significant difference in outcome as determined by ground reaction forces or radiographic OA scores were found between dogs with CrCL injury treated with LFS or TPLO. Clinical Relevance— LFS and TPLO remain good options for stabilizing stifles with CrCL injury with all dogs showing significant functional improvement. This study does not support the superiority of either surgical technique.     

Surgical correction of gastro‐oesophageal intussusception with bilateral incisional gastropexy in three dogs

Three dogs presented for evaluation of acute onset tachypnoea and dyspnoea following episodes of vomiting and/or regurgitation. Thoracic radiographs were suggestive of a gastro‐oesophageal intussusception in all three dogs; one dog also showed evidence of aspiration pneumonia. All three dogs underwent surgical correction with a bilateral incisional gastropexy. All dogs recovered from anaesthesia uneventfully and were discharged from the hospital 3 days after presentation. Persistent megaoesophagus was evident in all three dogs, and they are being chronically managed with a strict feeding regime and pro‐motility agents.     

Cardiac‐gated,phase contrast magnetic resonance angiography is a reliable and reproducible technique for quantifying blood flow in canine major cranial abdominal vessels

Blood flow changes in cranial abdominal vessels are important contributing factors for canine hepatic disease. This prospective, experimental, pilot study aimed to evaluate cardiac‐gated, phase contrast magnetic resonance angiography (PCMRA) as a method for characterizing blood flow in canine major cranial abdominal vessels. Eleven, healthy, adult beagle dogs were sampled. Cardiac‐gated, phase contrast magnetic resonance angiography of the cranial abdomen was performed in each dog and blood flow was independently measured in each of the major cranial abdominal vessels by three observers, with two observers recording blood flow values once and one observer recording blood flow values three times. Each dog then underwent ultrasonographic examination of the liver with fine needle aspirations and biopsies submitted to cytologic and histologic examination. The mean absolute stroke volume and velocity were respectively 9.6 ± 1.9 ml and –11.1 ± 1.1 cm/s for the cranial abdominal aorta, 2.1 ± 0.6 ml and –6.6 ± 1.9 cm/s for the celiac artery, and 2.3 ± 1.0 ml and –7.9 ± 3.1 cm/s for the cranial mesenteric artery. The mean absolute stroke volume and velocity were respectively 6.7 ± 1.3 ml and 3.9 ± 0.9 cm/s for the caudal vena cava and 2.6 ± 0.9 ml and 3.2 ± 1.2 cm/s for the portal vein. Intraobserver reliability was excellent (intraclass correlation coefficient > 0.9). Interobserver reproducibility was also excellent (intraclass correlation coefficient 0.89–0.99). Results of liver ultrasonography, cytology, and histopathology were unremarkable. Findings indicated that cardiac‐gated, phase contrast magnetic resonance angiography is a feasible technique for quantifying blood blow in canine major cranial abdominal vessels. Blood flow values from this sample of healthy beagles can be used as background for future studies on canine hepatic disease.     

A wound retraction device for laparoscopic-assisted intestinal surgery in dogs and cats

Objectives: To report experience with laparoscopic‐assisted intestinal resection and anastomosis for treatment of discrete intestinal masses using a novel wound retraction device. Study Design: Case series. Animals: Dogs (n=2) and cats (6). Methods: Dogs and cats with discrete intestinal masses identified by ultrasonography without evidence of intestinal perforation or peritonitis, were included. A 2 portal technique was used; 1 portal was enlarged for insertion of the wound retraction device through which the intestine was examined as thoroughly as possible. The diseased portion of the intestine was exteriorized through the wound retractor and resection and anastomosis of the intestinal mass performed. Results: Of the 8 animals, laparoscopic‐assisted intestinal resection and anastomosis through the wound retractor was performed in 2 dogs and 3 cats. In 3 cats, based on either location or extent of the lesion, 2 were converted to laparoscopic‐assisted intestinal biopsies and 1 to an open colocolostomy. No other intra‐ or perioperative complications were encountered and all animals survived to discharge. Conclusions: Laparoscopic‐assisted intestinal resection and anastomosis can be performed in select canine and feline patients with modestly sized, discrete intestinal masses.     

Clinical safety of percutaneous ultrasound‐guided fine‐needle aspiration of adrenal gland lesions in 19 dogs

Objective

To evaluate the safety of fine‐needle aspiration of adrenal gland lesions in dogs and to characterise the risks in a subset of patients with cytologically or histopathologically diagnosed phaeochromocytoma.

Materials and Methods

Retrospective review of medical records of dogs that underwent percutaneous ultrasound‐guided fine‐needle aspiration of adrenal gland lesions between August 2014 and December 2016. Nineteen dogs were identified, with three undergoing bilateral adrenal gland aspiration and one dog undergoing aspiration twice, yielding 23 cytology samples in total. Data collected included signalment, concurrent medical conditions, current medications, blood pressure and heart rate before adrenal fine‐needle aspiration, imaging characteristics of the adrenal gland lesions and any clinically apparent procedure‐related complications.

Results

Phaeochromocytoma was diagnosed in nine of 19 dogs, including one dog with bilateral phaeochromocytoma. One dog developed ventricular tachycardia following aspiration of an adrenal gland lesion cytologically consistent with a phaeochromocytoma.

Clinical Significance

Percutaneous ultrasound‐guided fine‐needle aspiration of adrenal gland lesions appears to be relatively safe, even in phaeochromocytoma, but further data are required to lend more weight to this finding. Minimally invasive aspirates could be considered as part of the diagnostic algorithm in the investigation of an incidentally detected adrenal gland lesion of uncertain clinical significance.     

IMAGING DIAGNOSIS—INTRAPERICARDIAL RIGHT AURICLE ANEURYSM IN A DOG

An 11‐year‐old, male, Pekinese was examined because of a sporadic, nonresponsive, nonproductive cough. Radiographically there was cardiomegaly and a soft tissue mass in the cranial mediastinum. Echocardiographically, chronic degenerative valvular disease was diagnosed. Furthermore, a large anechoic structure located cranial to the right atrium was detected. Computed tomography was performed to define the mediastinal mass and a right auricle aneurysm was diagnosed. The dog died suddenly 1 day after the diagnostic imaging procedures. At necropsy, a right auricular aneurysm without discontinuity of the pericardial sac was confirmed. Intrapericardial right auricular aneurysm should be included in the differential diagnoses of cranial mediastinal masses.     

COMPUTED TOMOGRAPHY-GUIDED PERCUTANEOUS BIOPSY IN THE DOG AND CAT: DESCRIPTION OF TECHNIQUE AND PRELIMINARY EVALUATION IN 14 PATIENTS

A technique for computed tomography (CT)-guided percutaneous biopsy described for use in humans was adapted to the dog and cat and is evaluated in 14 patients. Nine retrobulbar, 1 cranial mediastinal and 4 pulmonary masses and 1 hilar lymph node were biopsied in 13 dogs and 1 cat. Tissue samples sufficient for diagnosis were obtained in 12 of the 15 lesions. Diagnoses were made following cytologic (3/12) or histopathologic (3/12) evaluation or both (6/12) and included retrobulbar lymphoma, carcinoma, spindle cell sarcoma and suppurative inflammation; pulmonary carcinoma, granuloma and eosinophilic/histiocytic inflammation; nasal carcinoma, thymoma and metastatic carcinoma of a hilar lymph node. In each patient, the needle tip was identified within the lesion on the CT image. The primary limitation was non-diagnostic samples in 3 of 15 lesions due to necrosis or insufficient tissue. Complications were minor. In addition to biopsy guidance, CT imaging provided information not obtainable with fluoroscopy or ultrasonography which assisted in tumor staging and therapy planning. Although a larger number of patients and biopsy locations would be required for a thorough assessment, the free-hand technique described in this preliminary report appeared to be a safe and useful option of biopsy guidance in the dog and cat.     

A Laparoscopic‐Sutured Gastropexy Technique In Dogs: Mechanical and Functional Evaluation

Objective— To describe a laparoscopic‐sutured gastropexy technique in dogs and evaluate the tensile strength of the adhesion and effects on gastric function. Study Design— Experimental study. Animals— Female beagle dogs (n=7). Methods— A laparoscopic‐sutured gastropexy technique was evaluated by ex vivo tensile distraction tests 10 weeks after surgery. The effect of the adhesion on gastric emptying, mucosal permeability, and systemic inflammation were evaluated by monitoring the C‐reactive protein (CRP) and sucrose permeability, and by radiographic evaluation of gastric emptying 2 weeks before and 10 weeks after surgery. Results— Mean (±SD) tensile force to disrupt adhesions was 51.1±16.4 N. There was no significant postoperative increase in CRP concentration or change in sucrose permeability. The area under the curve representing the postprandial decrease in gastric radiographic area increased by 11% after gastropexy. Conclusions— This laparoscopic gastropexy technique had appropriate mechanical and functional characteristics with limited morbidity. Clinical Relevance— This laparoscopic‐sutured gastropexy provides adhesion strength comparable with other gastropexy techniques tested at 10 weeks postoperatively. Only minor changes in gastric emptying were observed 10 weeks after surgery.     

The pathogenesis of paraesophageal empyema in dogs and constancy of radiographic and computed tomography signs are linked to involvement of the mediastinal serous cavity

The mediastinal serous cavity is a normal anatomic space in the caudal mediastinum. Aims of this anatomic and case series study were to describe the signs of pathologic expansion of the mediastinal serous cavity observed during computed tomography (CT), review the underlying anatomy, perform a literature review, and evaluate the medical records of several dogs with mediastinal serous cavity empyema (paraesophageal empyema). The mesothelial lined mediastinal serous cavity is a cranial extension of the omental bursa, separated from the peritoneal cavity by the diaphragm, in the dorsal part of the caudal mediastinum, to the right of the esophagus, between the heart base and diaphragm. In five adult, large‐breed dogs with surgically and histologically confirmed paraesophageal empyema, macroscopic plant material was found at surgery in two dogs, adherence to adjacent lung was present in three different dogs, accessory lobectomy was performed in two dogs with subacute‐chronic pyogranulomatous pneumonia, and one dog had concurrent pyothorax and mediastinitis, but none had esophageal abnormalities. This study expands our understanding of the pathogenesis and basis for the imaging appearance of paraesophageal empyema in dogs by clarifying the underlying anatomic structures that direct development of this condition. The term empyema accurately describes this condition because the purulent material accumulates within an existing body cavity. The study also provides initial evidence that the development of paraesophageal empyema might be due to local extension of lung disease, such as foreign body migration or pneumonia. Computed tomography was helpful for diagnosis, assessing size, and determining the spread of disease.     

Determination of Pelvic Limb Alignment in the Large‐Breed Dog: A Cadaveric Radiographic Study in the Frontal Plane

Objectives— To report a method for radiographic determination of the mechanical axis of the canine pelvic limb and its relationship to the joints and bone axes. To report reference ranges for the relationships between the axes of the pelvic limb and for joint position relative to the pelvic limb axis. Study Design— Cadaveric radiographic anatomic study. Animals— Pelvic limbs (n=101) from normal midsized to large breed dogs; tibiae (n=105) from dogs with cranial cruciate ligament disease (previous study). Methods— Extended full‐limb radiography was performed and images analyzed to determine: mechanical joint reference angles (femur, tibia), pelvic limb axis, tibiofemoral and metatarsotibial angle, mechanical axis—femur/metatarsus angle, and mechanical axis deviation (MAD) of the stifle/tarsus. Results— Mean mechanical angles were: lateral proximal femoral (103.7°±5.4°), lateral distal femoral (98.6°±2.5°), medial proximal tibial (92.2°±1.8°), medial distal tibial (95.9°±2.2°), tibiofemoral (9.1° varus ±2.8°), metatarsotibial (0.6° valgus ±2.1°). Mean mechanical axis—femur and—metatarsus angles were 5.6° (±1.7°) and 2.9° (±1.5°), respectively. Mean MAD of the stifle and tarsus were 3.6% (±1.1%) and 1.2% (±0.6%), respectively. Tibial angles were not different between dogs with and without cranial cruciate ligament disease. Conclusions— Mechanical axes of the canine pelvic limb and their relationship to the joints can be determined by full‐limb radiography. Clinical Relevance— Techniques and reference ranges may be useful for diagnosis, surgical planning, and postoperative assessment of pelvic limb deformities.     

Esophageal Dysfunction in Dogs with Idiopathic Laryngeal Paralysis: A Controlled Cohort Study

Objectives— To compare esophageal function in dogs with idiopathic laryngeal paralysis (ILP) to age and breed matched controls; to determine if dysfunction is associated with aspiration pneumonia over 1 year; and to compare clinical neurologic examination of dogs with ILP at enrollment and at 1 year. Study Design— Prospective controlled cohort study. Animals— Dogs with ILP (n=32) and 34 age and breed matched healthy dogs. Methods— Mean esophageal score was determined for each phase of 3 phase esophagrams, analyzed blindly. After unilateral cricoarytenoid laryngoplasty, dogs with ILP were reexamined (including thoracic radiography) at 1, 3, 6, and 12 months. Neurologic status was recorded at enrollment, 6 and 12 months. Results— Esophagram scores in dogs with ILP were significantly higher in each phase compared with controls, most notably with liquid (P<.0001). Dysfunction was more pronounced in the cervical and cranial thoracic esophagus. Five dogs that had aspiration pneumonia during the study had significantly higher esophagram scores than dogs that did not develop aspiration pneumonia (P<.02). Ten (31%) ILP dogs had generalized neurologic signs on enrollment and all ILP dogs developed neurologic signs by 1 year (P<.0001). Conclusions— Dogs with ILP also have esophageal dysfunction. Postoperative aspiration pneumonia is more likely in dogs with higher esophagram scores. Dogs with ILP will most likely develop generalized neuropathy over the course of 1 year. Clinical Relevance— Esophagrams and neurologic examinations should be performed on all dogs with ILP.     

Craniotomy with cystoperitoneal shunting for treatment of intracranial arachnoid cysts in dogs

Objective— To describe a technique of decompressive craniotomy with cystoperitoneal shunt (CPS) placement for treatment of canine intracranial arachnoid cyst (IAC), and to evaluate outcome in 4 dogs. Study Design— Retrospective study. Animals— Dogs (n=4) with IAC. Methods— Medical records of dogs diagnosed with IAC by magnetic resonance imaging (MRI; 3 dogs) or computed tomography (CT; 1 dog) were evaluated. All dogs had varying degrees of neurologic dysfunction before surgery. A combined lateral (rostrotentorial)/suboccipital craniotomy was performed sacrificing the transverse sinus on the operated side. The rostral (ventricular) end of a low‐pressure valve shunt (3.0 mm outer diameter, 7.0 cm length) was placed transversely into the cyst cavity; the distal end was placed in the peritoneal cavity. All dogs were rechecked at various intervals by ≥1 of the authors either directly, by telephone consultation with owners, or both. Three dogs were imaged postoperatively (CT–1 dog; MRI–1; ultrasonography–1). Results— Intraoperative complications were limited to excessive transverse sinus hemorrhage requiring blood transfusion in 1 dog. There were no postoperative complications. Clinical signs of neurologic dysfunction resolved in 3 dogs and improved substantially in 1 dog. The latter dog required long‐term, low‐dose corticosteroid therapy. No dogs required repeat surgery. Mean follow‐up time was 23.8 months (range, 12–43 months). Collapse of the intracranial cyst was verified in 3 dogs with repeat imaging. In 2 dogs, there was no evidence of the cyst on CT or MRI; in the third dog, a small amount of fluid was demonstrated rostral to the cerebellum on ultrasonography, but there was no identifiable cyst. In 1 dog, the rostral aspect of the shunt had shifted; however, this was not associated with any clinical deterioration. Conclusion— Craniotomy with CPS placement was well tolerated and resulted in sustained improvement or resolution of dysfunction. Cyst decompression was verified in 3 dogs that were re‐imaged. None of the patients required re‐operation. Excessive transverse sinus hemorrhage is a potential danger that may necessitate blood transfusion. Other IAC patients treated with this method will need to be evaluated to fully evaluate its effectiveness. Clinical Significance— Craniotomy with CPS placement may be an effective treatment method for dogs clinically affected with IAC.     

Cranial vena cava aneurysm in a dog

A 1.5-year-old mixed breed dog was presented for evaluation of arrhythmia and a cranial mediastinal density was noted on thoracic radiographs. The density was determined to be a cranial vena cava aneurysm based on ultrasonographic and angiographic testing. No treatment was initiated and the dog remains asymptomatic for the cranial vena cava aneurysm at 6 years of age. Although rare, cranial vena cava aneurysm should be a differential diagnosis for dogs with cranial mediastinal abnormalities on thoracic radiographs.     

PULMONARY ANGIOGRAPHY WITH 64‐MULTIDETECTOR‐ROW COMPUTED TOMOGRAPHY IN NORMAL DOGS

Pulmonary angiography using 64‐multidetector‐row computed tomography (MDCT) was used to evaluate pulmonary artery anatomy, and determine the sensitivity of pulmonary artery segment visualization in four Beagle dogs using images reconstructed to 0.625 mm and retro‐reconstructed to 1.25 and 2.5 mm slice thickness. Morphologically, characteristic features included a focal narrowing in the right cranial pulmonary artery in all dogs, which should not be mistaken as stenosis. While the right cranial pulmonary artery divided into two equally sized branches that were tracked into the periphery of the lung lobe in all dogs, only a single left cranial (cranial portion) lobar artery was present. Compared with 1.25 and 2.5 mm retro‐reconstructions, 0.625 mm reconstructions allowed for detection of significantly (P≤0.05) more pulmonary artery segments and sharper depiction of vessel margins. Clinical applications such as prevalence and significance of diameter changes, and detection of pulmonary arterial thrombembolism on lobar and sublobar level, using pulmonary angiography with 64‐MDCT applying 0.625 mm reconstruction slice thickness remain to be established.     

Concurrent renal amyloidosis and thymoma resulting in a fatal ventricular thrombus in a dog

Thymoma‐associated nephropathies have been reported in people but not in dogs. In this report, we describe a dog with thymoma and concurrent renal amyloidosis. A 7‐year‐old castrated male Weimaraner was presented for progressive anorexia, lethargy, and tachypnea. The dog was diagnosed with azotemia, marked proteinuria, and a thymoma that was surgically removed. Postoperatively, the dog developed a large left ventricular thrombus and was euthanized. Necropsy confirmed the presence of a left ventricular thrombus and histopathology revealed renal amyloidosis. We speculate that the renal amyloidosis occurred secondary to the thymoma, with amyloidosis in turn leading to nephrotic syndrome, hypercoagulability, and ventricular thrombosis. This case illustrates the potential for thymoma‐associated nephropathies to occur in dogs and that dogs suspected to have thymoma should have a urinalysis and urine protein creatinine ratio performed as part of the pre‐surgical database.