ULTRASONOGRAPHIC ASSESSMENT OF FRACTURE HEALING AFTER PLATE OSTEOSYNTHESIS

The goals of this study were to assess the ability of ultrasonography (US) to assess uncomplicated fracture healing and to establish normal images. Twenty-two dogs, ranging in age from 6 to 180 months were studied. Body weight ranged from 2.2 to 60 kg. All fractures were treated by plate osteosynthesis. US (B-mode and power Doppler) and radiography were performed until both were consistent with complete healing. B-mode US was performed in all dogs, and power Doppler US in 14. Fracture healing was judged to be complete based on US earlier than when based on radiography. The tissue immediately adjacent to the plate appeared vascularized on power Doppler images at a time when the tissue at the fracture site had a negative power Doppler exam. US appears useful for assessment of primary fracture healing and power Doppler was useful for detecting vascularization at the fracture site in nonhealed fractures. Power Doppler interrogation should be performed away from any metal implant, as a result from an interrogation adjacent to an implant will not reflect actual vascularization at the fracture site.     

CLINICAL SIGNIFICANCE OF RENAL PELVIC DILATATION ON ULTRASOUND IN DOGS AND CATS

Renal pelvic dilatation is often recognized sonographically in dogs and cats, but ranges of measurements expected with different urologic conditions remain unknown. Ultrasound images of 81 dogs and 66 cats with renal pelvic dilatation were reviewed, and six groups were formed based on medical records: (I) clinically normal renal function, and (II) clinically normal renal function with diuresis; (III) pyelonephritis; (IV) noninfectious renal insufficiency; (V) outflow obstruction; (VI) miscellaneous nonobstructive anomalies. Medians for maximal pelvic width (range) for group I was 2.0 mm (1.0–3.8) in 11 dogs, and 1.6 mm (0.8–3.2) in 10 cats; for group II, 2.5 mm (1.3–3.6) in 15 dogs, and 2.3 mm (1.1–3.4) in 16 cats; for group III, 3.6 mm (1.9–12.0) in nine dogs, and 4.0 mm (1.7–12.4) in seven cats; for group IV, 3.1 mm (0.5–10.8) in 33 dogs, and 2.8 mm (1.2–7.3) in 13 cats; for group V, 15.1 mm (5.1–76.2) in six dogs, and 6.8 mm (1.2–39.1) in 17 cats; and for group VI, 3.8 mm (1.2–7.6) in seven dogs, and 3.0 mm (1.3–7.5) in three cats. Pelvic width in group I was lower than in groups III–V (P=0.0001), but did not significantly differ from group II. Pelvic width ≥13 mm always indicated obstruction. While the proportion of bilateral pelvic dilatation was not different among groups, the difference in pelvic width (maximal–minimal) was greater in group V vs. groups I, II, and IV (P=0.0009). These results confirm that renal pelvic dilatation can be detected sonographically in dogs and cats with clinically normal renal function, and that it increases with renal insufficiency, pyelonephritis, or outflow obstruction. Nevertheless, renal pelvic width varies substantially within groups and should be interpreted with caution.     

DOPPLER ULTRASONOGRAPHIC ESTIMATION OF RENAL AND OCULAR RESISTIVE AND PULSATILITY INDICES IN NORMAL DOGS AND CATS

Resistive index (RI) and pulsatility index (PI) are indirect measurements of blood flow resistance that may be used to evaluate vascular changes in renal and ophthalmologic diseases. To our knowledge, no reports are available describing values for renal and ocular PI index in the unsedated dog and ocular RI and PI indices in the unsedated cat. The purpose of this study was to measure normal values for both intrarenal and ocular RI and PI within the same subject in unsedated clinically normal dogs and cats. Twenty-seven dogs and 10 cats were considered healthy by means of physical examination, CBC, biochemical profile, urinalysis, and ultrasonography. Systolic blood pressure was measured by Doppler ultrasonography. Intrarenal and ocular arteries were scanned by pulsed Doppler ultrasonography to calculate RI and PI. No significant differences were noted between the values obtained for the right vs. the left kidney and eye. The upper values of these indices were calculated as mean+2 standard deviations resulting in 0.72 and 1.52 for dog renal RI and PI; 0.7 and 1.29 for cat renal RI and PI; 0.76 and 1.68 for dog ocular RI and PI; and 0.72 and 1.02 for cat ocular RI and PI.     

TISSUE HARMONIC ULTRASOUND FOR IMAGING NORMAL ABDOMINAL ORGANS IN DOGS AND CATS

Normal cats (n = 38) and dogs (n = 40) were imaged with fundamental ultrasound and tissue harmonic ultrasound. Images of the liver, gall bladder, spleen, left kidney, urinary bladder, and jejunum were collected in all animals. Images of the left adrenal gland were collected in all dogs. All normal cats and dogs had improved imaging with tissue harmonic ultrasound. The number of organs with improved conspicuity ranged from one to all organs imaged. The most common organ to have improved conspicuity was the jejunum (100% of dogs and 89% of cats). Significant improvement by tissue harmonic ultrasound was seen in images of gall bladder (p = .05) and left adrenal gland (p = .02) in dogs, and spleen, urinary bladder, and intestinal images (p = .01) in cats. Significant improvement was seen in tissue harmonic ultrasound images of the gall bladder in dogs weighing greater than 16 kilograms (p = .03) and in the images of the urinary bladder of dogs weighing less than 16 kilograms (p = .02). These data suggest that image quality improvement of normal organs using tissue harmonic ultrasound is consistent but not predictable. The exception was the jejunum, where improvement was seen in all dogs. Sonographers should be cognizant of the potential benefits of tissue harmonic ultrasound.     

DIAGNOSIS OF URINARY TRACT OBSTRUCTION IN DOGS USING DUPLEX DOPPLER ULTRASONOGRAPHY

The ability of duplex Doppler ultrasonography to assist with the diagnosis of urinary tract obstruction was investigated in a study of 5 dogs with surgically induced, unilateral ureteral obstruction. The resistive index (RI) of obstructed kidneys was compared to that of controls and to the contralateral unobstructed kidneys. The RI was also evaluated following relief of obstruction. On the basis of an RI measurement ≥0.70 indicating obstruction, a sensitivity of 73% and a specificity of 77% was determined for the diagnosis of obstruction with Doppler ultrasonography. Although mean RI was elevated in obstructed kidneys compared to controls, it was concluded that a high false-negative rate (27%) limits the clinical usefulness of Doppler ultrasonography for the detection of urinary obstruction in dogs. The RI difference between obstructed and nonobstructed kidneys was also evaluated within individual animals, but the magnitude of difference between kidneys did not significantly improve the detection rate for obstruction.     

COLOR DOPPLER AND DOPPLER SPECTRAL ANALYSIS IN THE SPINAL CORD OF NORMAL DOGS

Doppler ultrasonography of the spinal cord was performed in 34 normal, anesthetized dogs following hemilaminectomy. This study was part of an investigation to evaluate the efficacy of a 21-aminosteroid compound and high dose methylprednisolone for the treatment of spinal cord trauma. Grey-scale images of the canine spinal cord were similar to those described for the spinal cord of people. Doppler waveforms of intraparenchymal spinal arteries exhibited high end diastolic blood flow velocities, indicating low resistance to flow. Doppler values (mean ± SD) for arteries immediately ventrolateral to the central canal were: Peak Systolic Velocity = 5.78 ± 2.5 cm/sec, Minimum Diastolic Velocity = 3.5 ± 1.62 cm/sec, Mean Velocity = 4.45 ± 1.96 cm/sec, Minimum Diastolic Velocity = 3.5 ± 1.62 cm/sec, Mean Velocity = 4.45 ± 1.96 cm/sec, Systolic/Diastolic ratio = 169 ± 0.19, Pulsatility Index = 0.53 ± 0.09, and Resistance Index = 0.4 ± 0.06.     

COLOR FLOW DOPPLER IMAGING AND DOPPLER SPECTRAL ANALYSIS OF THE BRAIN OF NEONATAL DOGS

Doppler ultrasonography was performed on the cerebral arteries o f 19 neontal dogs.Vascular structures were identified using anatomic preparations of brains pre-injected with a radiopaque silicone rubber product and cleared using a modified tissue clearing technique. Brain sections were subsequently radiographed of examined under a steromicroscope. Color flow Doppler imagin was used to facilitate positioning of the Doppler calipers for measurement of peak systolic velocity, minimum diastolic velocity, and resistance index. Blood flow velocities in the internal carotid and middle cerebral arteries were lower when measured intransvere images than in sagittal images. The rostral cerebral arteries could be measured using either plane but values obtained from different locations or using different methods of measurement were statistically different. Blood flow velocities generally increased during the first month after birth. Arterial signals were diphasic with flow throughout diastole. Resistance indices most often were between 0.6 and 0.7 and did not exceed 0.86.     

SONOGRAPHY OF THE MUSCULOSKELETAL SYSTEM IN DOGS AND CATS

Sonography of the musculoskeletal system in dogs and cats was undertaken to evaluate the application of this imaging procedure in orthopedics. In most of the patients a 7,5 MHz linear transducer was used because of its flat application surface and its resolving power. The evaluation of bone by sonography is limited, but sonography can provide addition information regarding the bone surface and surrounding soft tissue. Ultrasound is valuable for assessing joint disease. Joint effusion, thickening of the joint capsule and cartilage defects can be identified sonographically. It is also possible to detect bone destruction. Instabilities are often identified with the help of a dynamic examination. Soft tissue abnormalities of the musculoskeletal system lend themselves to sonographic evaluation. Partial or complete muscles or tendon tears are able to be differentiated and the healing process can be monitored. Most of the diseases that are in the area of the biceps or the achilles tendon, such as dislocation of the tendon, old injuries with scarification, free dissecates in the tendonsheath, tendinitis and/or tendosynovitis can be differentiated by sonography. In addition, with clinical and laboratory findings, it is often possible to make a correct diagnosis with ultrasound in patients with abscesses, foreign bodies, hematomas, soft tissue tumors and lipomas.     

EVALUATION OF RENAL HEMODYNAMICS IN AWAKE AND ISOFLURANE-ANESTHETIZED CATS WITH PULSED-WAVE DOPPLER AND QUANTITATIVE RENAL SCINTIGRAPHY

The feasibility and reproducibility of obtaining the pulsed-wave Doppler measurements of resistive index (RI) and pulsatility index (PI) were investigated in intrarenal arteries of normal, nonsedated cats, and cats anesthetized with isoflurane. In addition, relative renal function and relative renal blood flow were evaluated using quantitative renal scintigraphy. The percentage of injected dose uptake, time to peak activity, and two indices of renal blood flow (K/A ratio and flow index) obtained during the first pass of ^99mTc-MAG₃, were determined for both awake and anesthetized cats. Results indicate that measuring RI and PI in nonsedated cats is readily accomplished and that the results are reproducible within an animal. Mean RI and PI values in the awake cats were 0.55 and 0.8, respectively. Significant differences between the awake and anesthetized cats were found for all pulsed-wave Doppler and quantitative renal scintigraphic measurements evaluated.     

COLOR DOPPLER ULTRASONOGRAPHY IN PREDICTION OF THE REDUCIBILITY OF INTUSSUSCEPTED BOWEL IN 15 YOUNG DOGS

Color Doppler ultrasonography was performed in 15 young dogs with intestinal intussusception to test the hypothesis that color Doppler findings can be used as a predictor of the manual reducibility of the intussusception at celiotomy. Color flow Doppler ultrasonography indicated blood flow within mesentery of the intussuscepted bowel in 12 of 15 dogs and reduction was achieved in nine of these 12 dogs (75%). In the remaining three dogs and in three dogs where no color Doppler signal were observed, an irreducible intussusception was confirmed at celiotomy. Color Doppler ultrasonography is a useful method for predicting the reducibility of intussusception in dogs.     

DOPPLER ULTRASOUND OF THE PROSTATE IN NORMAL DOGS AND IN DOGS WITH CHRONIC LYMPHOCYTIC-LYMPHOPLASMOCYTIC PROSTATITIS

The prostate gland of 11 normal dogs and five dogs with histological confirmed chronic lymphocytic or lymphoplasmocytic prostatitis were imaged with grey-scale and Doppler ultrasound. Three vessel types (prostatic artery, capsular artery and parenchymal artery) were identified with color Doppler and the resistive index and maximum and minimum velocities were measured with pulsed wave Doppler. No differences between normal dogs and dogs with prostatitis was identified in either grey-scale ultrasound or in any Doppler parameters measured. Regardless of histologic diagnosis, acepromazine (0.05 mg/kg IV) caused a significant decrease in capsular artery maximum and minimum velocities and prostatic artery resistive index. This study establishes normal Doppler ultrasound parameters for the intact male canine prostate gland. Additional studies are necessary to further evaluate the clinical utility of Doppler ultrasound in canine prostatic diseases.     

COMPARISON OF THE RESISTIVE INDEX TO CLINICAL PARAMETERS IN DOGS WITH RENAL DISEASE

The resistive index (RI) is a measurement of arteriole vascular resistance and is obtained by pulsed-wave Doppler interrogation. The diagnostic potential of the renal resistive index (RI) was retrospectively investigated in 142 kidneys from 81 dogs. The resistive index of each kidney was compared to clinical laboratory parameters, clinical diagnoses, and sonographic findings. The mean renal resistive index (RI) for 22 normal kidneys was 0.61 (standard deviation = 0.06). An elevation in the mean renal RI (>0.70) was found for the clinical diagnoses of acute renal failure and congenital dysplasia. When a RI of greater than 0.70 was considered abnormal, the sensitivity and specificity of the RI in determining normal vs, abnormal kidneys were 38% and 96% respectively.     

APPROACHES FOR ULTRASONOGRAPHIC EVALUATION OF LONG BONES IN THE DOG

The objective of this study was to identify access portals for ultrasonographic evaluation of canine long bones (humerus, radius, ulna, femur, and tibia). A 7.5 MHz linear transducer was used in five medium-sized dogs (range of 25-35 kg body weight). Good approaches could be identified for all long bones. For the proximal humerus, a cranial portal, and the distal humerus, a lateral portal is suggested. For the radius and ulna, a craniolateral approach seemed to be the best. In the hindlimb, a medial approach for the femur and a craniolateral approach for the tibia were the most effective approaches.     

ULTRASONOGRAPHIC DIAGNOSIS OF PORTOSYSTEMIC SHUNTING IN DOGS AND CATS

The value of ultrasonography was evaluated in 85 dogs and 17 cats presented with a clinically suspected portosystemic shunt (PSS). A PSS was confirmed in 50 dogs and nine cats (single congenital extrahepatic in 42, single congenital intrahepatic in 11, and multiple acquired in six). Six dogs and one cat had hepatic microvascular dysplasia, and 29 dogs and seven cats had a normal portal system. Ultrasonography was 92% sensitive, 98% specific, and had positive and negative predictive values of 98% and 89%, respectively, in identifying PSS, with an overall accuracy of 95%. When a PSS was identified with ultrasonography, extrahepatic, intrahepatic, and multiple acquired PSS could be correctly differentiated in 53/54 patients (98%). The combination of a small liver, large kidneys, and uroliths had positive and negative predictive values of 100% and 51% for the presence of a congenital PSS in dogs. The portal vein/aorta (PV/Ao) and portal vein/caudal vena cava (PV/ CVC) ratios were smaller in animals with extrahepatic PSSs compared with animals with microvascular dysplasia, intrahepatic PSSs and those without portal venous anomalies (P<0.001). All dogs and cats with a PV/Ao ratio of < or = 0.65 had an extrahepatic PSS or idiopathic noncirrhotic portal hypertension. Dogs and cats with PV/Ao and PV/CVC ratios of > or = 0.8 and > or = 0.75, respectively, did not have an extrahepatic PSS. Reduced or reversed portal flow was seen in four of four patients with multiple acquired PSSs secondary to portal hypertension. The presence of turbulence in the caudal vena cava of dogs had positive and negative predictive values of 91% and 84%, respectively, for the presence of any PSS terminating into that vein.     

DOPPLER MEASUREMENT OF SPLANCHNIC BLOOD FLOW DURING DIGESTION IN UNSEDATED NORMAL DOGS

The purpose of this study was to measure splanchnic blood flow during digestion in unsedated dogs by using duplex Doppler sonography. The study population consisted of 12 healthy dogs. Blood flow in the cranial mesenteric artery, the celiac artery, and the aorta was measured before a test meal and at 20, 60, and 90 minutes after eating. The following measurements were made or calculated: vessel diameter, peak systolic velocity, end diastolic velocity, mean velocity, resistive index, pulsatility index, and flow volume. There was a significant postprandial decrease in the resistive and pulsatility indices in both the cranial mesenteric (preprandial RI = 0.867, postprandial RI = 0.796, preprandial PI = 3.033, postprandial PI = 2.173) and the celiac (preprandial RI = 0.854, postprandial RI = 0.769, preprandial PI = 2.639, postprandial PI = 1.930) arteries. In both vessels the end diastolic velocity, the mean velocity, and the flow volume increased significantly postprandially. These changes occurred significantly earlier in the celiac artery than in the cranial mesenteric artery. The findings most likely correspond to postprandial splanchnic vasodilation. Doppler ultrasound provide a good methode of detecting changes in postprandial splanchnic blood flow in the dog.     

USE OF ULTRASOUND TO DIAGNOSE DIAPHRAGMATIC RUPTURE IN DOGS AND CATS

Twenty-one cats and six dogs that presented to a first-opinion clinic with signs of dyspnea and muffled cardiac auscultation received ultrasonography to look for signs of diaphragmatic rupture. The presence or absence of diaphragmatic rupture was subsequently determined on the basis of unequivocal radiographic signs, surgical findings, or necropsy. Consistent findings in animals with diaphragmatic rupture were irregular or asymmetric cranial aspect of the liver and abdominal viscera in the thorax. Accuracy of ultrasonography was 25/27 (93%). One false-negative result occurred in a cat with a chronic diaphragmatic rupture in which adhesions between the liver and lung simulated the appearance of an intact diaphragm. One false-positive result occurred in a dog with an abscess involving the left lung and pleural cavity, which was misinterpreted as the stomach. The results of this study support use of ultrasonography in animals with suspected diaphragmatic rupture.     

上海闵行地区犬和猫中西尼罗河病毒病血清学调查

西尼罗病毒病是一种外来的新发性的虫媒人兽共患病,近年来已经成为全球公共卫生的新威胁。采用ELISA对上海市闵行地区犬和猫中西尼罗河病毒的血清学调查结果显示,在所调查的7个地区中,犬和猫中的抗体阳性率分别达到4.6%和15.5%。本调查数据和分析为制定科学、合理的防控对策提供了技术依据。     

RADIOGRAPHIC AND ULTRASONOGRAPHIC FINDINGS OF EMPHYSEMATOUS CYSTITIS IN FOUR NONDIABETIC FEMALE DOGS

The urinary bladder of four dogs with emphysematous cystitis was assessed radiographically. Ultrasonography was also performed using a 7.5-MHz microconvex probe in dorsal recumbency and in a standing position. Ultrasonographically there were bright echoes and reverberations typical of gas in all dogs. This was entrapped in the bladder wall as it appeared in the same location in recumbent and standing positions. Bladder size was reduced and bladder content was echogenic in all dogs. In only one out of the four dogs was a gas stripe seen in the bladder on radiographs. Proteus mirabilis was isolated from the urine of all patients. Diabetes was ruled out on the basis of urine and blood analysis. A small amount of gas can be difficult to detect on radiographs. Ultrasonography appears to be a more sensitive technique for detection of gas within the bladder at an early stage of emphysematous cystitis. Prevalence of emphysematous cystitis may be underestimated if only radiographs are made.     

DOPPLER MEASUREMENT OF HEPATIC ARTERIAL FLOW IN DOGS: TECHNIQUE AND PRELIMINARY FINDINGS

The common hepatic artery in 10 healthy adult beagles, 20 healthy pups (13 Deerhounds and seven Irish Wolfhounds), and seven dogs with either a congenital or acquired hepatic disorder was examined by duplex-Doppler ultrasonography. Peak systolic velocity (Vs), resistive index (RI), pulse rate, angle of insonation, and sample volume depth were recorded. Measurements in Beagles were made after a 24 h fast and repeated 2 h after feeding. The mean Vs and RI in fasted Beagles were 1.5 m/s (range 1.1-2.3 m/s) and 0.68 (range 0.62-0.74), respectively. Postprandially, there were no significant differences in any of these variables. Mean Vs and RI were lower in pups: 1.0 m/s (range 0.8-1.3 m/s) and 0.59 (range 0.46-0.65), respectively (P < .001). Two dogs with congenital arterioportal fistula had higher mean Vs (P < .001) and lower mean RI (P < .05) than normal pups. No significant differences were detected between normal Beagles, three dogs with portal vein thrombosis, and two dogs with acquired hepatic insufficiency. Differences in measured hepatic blood flow in dogs of different age or breed will complicate diagnostic use of hepatic arterial Doppler measurements.     

IMAGING ASSESSMENT OF THE MODIFIED DOUBLE CONTRAST BARIUM ENEMA USING CARBOXYMETHYLCELLULOSE ON RADIOGRAPHY AND ULTRASONOGRAPHY IN DOGS

A modified double contrast barium enema using carboxymethylcellulose was evaluated in beagle dogs and compared with dogs receiving a conventional barium enema. The experimental group was divided into three groups (1, 2, and 3) and given 30 ml/kg of different volume ratios of a barium vs. carboxymethylcellulose mixture. Each group underwent sonography following radiography. The volume ratio of one part barium to three parts carboxymethylcellulose was judged to be the optimal mixture, resulting in a general distribution of contrast and bowel radiolucency on radiographs and adequate postradiography sonography. The modified barium enema using carboxymethylcellulose is useful for assessing the general morphology and mucosal layers of the colon simultaneously on radiographs and ultrasonographs.