COMPARISON OF COMPUTED TOMOGRAPHY AND ABDOMINAL RADIOGRAPHY FOR DETECTION OF CANINE MECHANICAL INTESTINAL OBSTRUCTION

Vomiting, often caused by mechanical intestinal obstruction, is common in dogs. Equivocal radiographic signs often necessitate repeat radiographs or additional imaging procedures. For our prospective, case‐controlled, accuracy study, we hypothesized the following: (1) using computed tomography (CT), radiologists will be more sensitive and specific for detecting mechanical intestinal obstruction and recommending surgery compared to using radiographs; and (2) using measurements, radiologists will be more sensitive and specific using radiographs or CT for detecting mechanical intestinal obstruction and recommending surgery. Twenty dogs had abdominal radiographs and abdominal CT. Seventeen dogs had abdominal surgery and three dogs were not obstructed based on clinical follow‐up. Confidence levels (five‐point scale) of three experienced radiologists for mechanical intestinal obstruction and recommending surgery were recorded before and after making selected measurements. Eight dogs had surgically confirmed mechanical intestinal obstruction, and 12 dogs did not have obstruction. For detecting mechanical intestinal obstruction, CT was more sensitive (95.8% vs. 79.2%) and specific (80.6% vs. 69.4%) compared to radiographs, but the difference was not statistically significant. For recommending surgery, radiography was more sensitive (91.7% vs. 83.3%) and specific (83.3% vs. 72.2%) than using CT, but differences were not statistically significant. We reported objective CT measurements for predicting small mechanical intestinal obstruction. By incorporating these objective data, the diagnosis of mechanical intestinal obstruction changed in five of 120 instances (radiographs and CT). In no instance (0/120), did the objective data change the recommendation for surgery. Using CT or abdominal radiographs for the detection of canine mechanical intestinal obstruction is sensitive and specific when evaluated by experienced veterinary radiologists.     

OFF‐SITE SMARTPHONE VS. STANDARD WORKSTATION IN THE RADIOGRAPHIC DIAGNOSIS OF SMALL INTESTINAL MECHANICAL OBSTRUCTION IN DOGS AND CATS

Off‐site consultations by board‐certified veterinary radiologists benefit residents and emergency clinicians by providing immediate feedback and potentially improving patient outcome. Smartphone devices and compressed images transmitted by email or text greatly facilitate availability of these off‐site consultations. Criticism of a smartphone interface for off‐site consultation is mostly directed at image degradation relative to the standard radiographic viewing room and monitors. The purpose of this retrospective, cross‐sectional, methods comparison study was to compare the accuracy of abdominal radiographs in two imaging interfaces (Joint Photographic Experts Group, off‐site, smartphone vs. Digital Imaging and Communications in Medicine, on‐site, standard workstation) for the diagnosis of small intestinal mechanical obstruction in vomiting dogs and cats. Two board‐certified radiologists graded randomized abdominal radiographs using a five‐point Likert scale for the presence of mechanical obstruction in 100 dogs or cats presenting for vomiting. The area under the receiver operator characteristic curves for both imaging interfaces was high. The accuracy of the smartphone and traditional workstation was not statistically significantly different for either reviewer (P = 0.384 and P = 0.536). Correlation coefficients were 0.821 and 0.705 for each reviewer when the same radiographic study was viewed in different formats. Accuracy differences between radiologists were potentially related to years of experience. We conclude that off‐site expert consultation with a smartphone provides an acceptable interface for accurate diagnosis of small intestinal mechanical obstruction in dogs and cat.     

COMPARISON OF RADIOGRAPHY AND ULTRASONOGRAPHY FOR DIAGNOSING SMALL‐INTESTINAL MECHANICAL OBSTRUCTION IN VOMITING DOGS

A cross‐sectional study was performed on acutely vomiting dogs to compare the accuracy of radiography and ultrasonography for the diagnosis of small‐intestinal mechanical obstruction and to describe several radiographic and ultrasonographic signs to identify their contribution to the final diagnosis. The sample population consisted of 82 adult dogs and small‐intestinal obstruction by foreign body was confirmed in 27/82 (33%) dogs by surgery or necropsy. Radiography produced a definitive result (obstructed or not obstructed) in 58/82 (70%) of dogs; ultrasonography produced a definitive result in 80/82 (97%) of dogs. On radiographs, a diagnosis of obstruction was based on detection of segmental small‐intestinal dilatation, plication, or detection of a foreign body. Approximately 30% (8/27) of obstructed dogs did not have radiographic signs of segmental small‐intestinal dilatation, of which 50% (4/8) were due to linear foreign bodies. The ultrasonographic diagnosis of small‐intestinal obstruction was based on detection of an obstructive lesion, sonographic signs of plication or segmental, small‐intestinal dilatation. The ultrasonographic presence or absence of moderate‐to‐severe intestinal diameter enlargement (due to lumen dilatation) of the jejunum (>1.5 cm) was a useful discriminatory finding and, when present, should prompt a thorough search for a cause of small‐intestinal obstruction. In conclusion, both abdominal radiography and abdominal ultrasonography are accurate for diagnosing small‐intestinal obstruction in vomiting dogs and either may be used depending on availability and examiner choice. Abdominal ultrasonography had greater accuracy, fewer equivocal results and provided greater diagnostic confidence compared with radiography.     

Ultrasonography of small intestinal obstructions: a contemporary approach

Objectives : To assess the accuracy of intestinal ultrasound for diagnosis of intestinal obstruction in dogs and cats. Methods : A prospective clinical study was performed. Inclusion criteria were dogs and cats with clinical signs suggestive of gastrointestinal obstruction. Animals with no obstruction detected on ultrasound were excluded if they could not be monitored for 48 hours to confirm absence of obstruction. Sonographic diagnosis of small intestinal obstruction was based on identification of at least two findings suggestive of intestinal obstruction. Results : Ninety‐two patients suspected of having intestinal obstruction were included. Correct diagnosis of intestinal obstruction was made in 21 cases (23%), and in 68 (74%) this diagnosis was excluded. Interpretation of the images on prospective analysis had sensitivity, positive predictive, specificity and negative predictive values of 100%, 87.5%, 95.8% and 100%, respectively. Clinical Significance : Ultrasonography is an excellent method for investigation of animals with gastrointestinal disorders, and is particularly useful for excluding obstructive processes.     

MICRONODULAR ULTRASOUND LESIONS IN THE COLONIC SUBMUCOSA OF 42 DOGS AND 14 CATS

Micronodular ultrasound lesions have been detected in the colonic submucosa of dogs and cats at our hospital. The lesions had rounded/oval shapes, measured 1–3 mm in size, and exhibited a hypo/anechoic ultrasonographic pattern. To our knowledge, these lesions have not been previously reported in human or veterinary patients. The purpose of this retrospective study was to determine whether micronodular lesions were associated with other abdominal ultrasound abnormalities or clinical findings. Medical records of dogs and cats with sonographic reports describing micronodular lesions within the colonic submucosa were reviewed. Concurrent ultrasonographic abnormalities were recorded and compared with clinical sidgns and follow‐up data. A total of 42 dogs and 14 cats met inclusion criteria. Concurrent sonographic abnormalities included the following: increased colon wall thickness (12.5%); small bowel wall thickening, altered layering, and/or hyperechoic mucosa (45%); abdominal effusion (29%); caudal mesenteric lymphadenopathy (46%); mesenteric lymphadenopathy (27%); and pericolic peritoneal fat reactivity (9%). Fifty of 56 animals presented with diarrhea. Twenty‐seven cases had clinical signs of colitis and ultrasonographic lesions were limited to the colonic submucosa. In nine cases, follow‐up examination at 6–8 weeks showed resolution of clinical and ultrasonographic signs. Ultrasonographic and clinical examinations in 17 patients at 12–18 months and in 20 patients at 18–30 months from initial diagnosis showed resolution of submucosal lesions and clinical signs of enteropathy. The authors propose that micronodular submucosal ultrasound lesions may represent reactive intraparietal lymphoid follicles and may be indicators of colonic inflammatory diseases in dogs and cats.     

DOES MEASUREMENT OF SMALL INTESTINAL DIAMETER INCREASE DIAGNOSTIC ACCURACY OF RADIOGRAPHY IN DOGS WITH SUSPECTED INTESTINAL OBSTRUCTION?

The ratio between maximal small intestinal (SI) diameter and the height of the body of the fifth lumbar vertebra (L5) in radiographs has been reported as a diagnostic test in dogs with suspected intestinal obstruction. In order to assess the effect of the SI/L5 ratio on the accuracy of radiographic diagnosis of intestinal obstruction, lateral abdominal radiographs of 37 dogs with small intestinal obstruction and 48 nonobstructed dogs were mixed and examined independently by six observers who were unaware of the final diagnosis and who represented a range of experience. Observers first examined radiographs subjectively and stated the likelihood of obstruction (definitely not, probably not, equivocal, probably, definitely). Observers subsequently reexamined the radiographs, determined the SI/L5 ratio, and again stated the likelihood of obstruction. The most frequent cause of obstruction was foreign body (29/37, 78%). Dogs with SI obstruction had a significantly larger median SI/L5 ratio than nonobstructed dogs (P = 0.0002). Using an SI/L5 ratio of 1.7 for diagnosis of intestinal obstruction, sensitivity and specificity were 66%. Use of the SI/L5 ratio was not associated with increased accuracy of diagnosis for any observer, regardless of experience, hence this test may have no diagnostic impact.     

Performing both lateral abdominal radiographs may not improve the visualization of gas in the gastric outflow tract of cats

Reports in the veterinary literature support three‐view abdominal radiographs as a standard of practice for evaluating dogs with suspected gastrointestinal (GI) diseases. The usefulness of three‐view abdominal studies has not been evaluated in cats. Images from a prospective crossover group study with 20 healthy cats, and those from a retrospective cohort study of 110 cats, were reviewed and the location and degree of gas was assessed in the gastric outflow tract. Comparisons of the frequency of luminal gas were made between the views and between cats with GI disease versus cats without and between cats having sedation versus those without. Chi‐Square analysis was performed with P < .05 being considered significant. No significant difference was found in the location and degree of luminal gas in left versus right lateral views in all cats regardless of the order in which the views were obtained or in cats with GI disease versus cats without. Cats with gastric dilation had a higher overall frequency of gas; those with dilation with homogeneous material were higher than those with dilation with heterogeneous material. A higher frequency of gas was found in sedated cats than nonsedated, but further study is needed to determine the underlying cause. Based on these findings, a three‐view abdominal study for cats as a standard of practice may not be necessary, but obtaining the additional lateral view when gastric dilation is present might allow better visualization of the pyloric antrum and duodenum.     

Pneumothorax in cats with a clinical diagnosis of feline asthma: 5 cases (1990–2000)

Objective: This paper characterizes the clinical findings in 5 cats with feline asthma complicated by concurrent pneumothorax. Design: Retrospective study. Medical records of cats with concurrent diagnoses of asthma and pneumothorax that were presented to the Veterinary Hospital of the University of Pennsylvania from 1990 to 2000 were reviewed. Results: Of 421 cases of feline asthma, 5 cats fulfilled the inclusion criteria (1.2%). All 5 had respiratory distress at presentation. One cat was panting, and the other 4 cats had respiratory rates of 28, 52, 58 and 120 breaths per minute (bpm), respectively (mean RR 65±39 bpm). Historical findings included untreated chronic cough (n=3), previously treated asthma (n=1), and no previous illness (n=1). Thoracocentesis was performed in 4/5 cats, and 3 of those cats required thoracostomy tubes. Four cats required immediate oxygen supplementation, and 1 of those cats required ventilation. All 5 cats had evidence of pneumothorax on initial radiographs. Follow‐up radiographs revealed partial or complete resolution of pneumothorax in 4 cats which were discharged alive with total hospitalization of 2–7 days, but were then lost to follow‐up. One cat was euthanized because it could not be weaned off mechanical ventilation, and necropsy confirmed end‐stage feline asthma and emphysema. Conclusion: Small airway obstruction can predispose asthma patients to increased alveolar pressure, emphysema, and spontaneous pneumothorax, which can lead to dyspnea in affected cats. The short‐term outcome in these cats was good despite the severity of dyspnea at presentation.     

Quantitative estimation of intestinal dilation as a predictor of obstruction in the dog

Mechanical obstruction is a major differential diagnosis for dogs presented with gastrointestinal problems. Small intestinal dilation is a cardinal sign of obstruction but its recognition depends upon the observer's experience and anecdotally derived parameters for normal small intestinal diameter. The objective of this study was to formulate a quantitative index for normal intestinal diameter and evaluate its usefulness in predicting small intestinal obstruction. The material consisted of survey abdominal radiographs of 50 normal dogs, 44 cases of intestinal obstruction and 86 patients which subsequently had an upper gastrointestinal examination. A ratio of the maximum small intestinal diameter (SI) and the height of the body of the fifth lumbar vertebra at its narrowest point (L5) was used, and a logistic regression model employed to determine the probability of an obstruction existing with varying degrees of intestinal dilation. A value of 1·6 for SI/L5 is recommended as the upper limit of normal intestinal diameter for clinical use. The model showed that obstruction is very unlikely if the SI/L5 value is less than this. Higher values were significantly associated with obstruction.     

Conjunctival lymphoma: immunophenotype and outcome in five dogs and three cats

Conjunctival lymphoma is well documented in the medical literature, but veterinary reports are few. We report five cases of canine lymphoma, and three of feline in which the presenting sign was conjunctival involvement. All animals were in apparently good health at the time of presentation, and attended the referring clinic because of conjunctival disease. One dog showed generalized lymphadenopathy at presentation, although the ocular lesion was the reason for consultation, but all other patients were well with no detectable disease beyond the eye. All cats were presented for their ocular disease. All dogs were confirmed to have T‐cell tumors, although the histological appearance of these was variable. In contrast, all cats had B‐cell tumors. Referring clinicians and owners were contacted for follow‐up information. Three dogs had been euthanased within 6 months of diagnosis for deterioration of general health. The remaining two were alive and showed no signs of systemic disease. Two cats had good survival following diagnosis, the other died of lesions that may not be related.     

RADIOGRAPHIC CHARACTERIZATION OF PRESUMED PLATE‐LIKE ATELECTASIS IN 75 NONANESTHETIZED DOGS AND 15 CATS

Discrete discoid or linear areas of increased soft opacity have been observed within the pulmonary parenchyma in thoracic radiographs of dogs and cats. Similar radiographic findings have been described in humans and termed plate‐like atelectasis. The purpose of this retrospective study was to describe locations and characteristics of presumed plate‐like atelectasis, presence of concurrent thoracic disease(s), and presence of persistent pulmonary changes on recheck thoracic radiographic studies in a cohort of dogs and cats. Hospital records between 2004 and 2011 were searched and a total of 90 cases were included (75 dogs and 15 cats, 2–17 years of age). Plate‐like atelectasis was most commonly found in left lateral radiographs. Plate‐like atelectasis was observed in the cranial thorax and was oriented in a dorsocranial to ventrocaudal direction in 68 (75%) patients. Plate‐like atelectasis averaged 29.6 ± 14.4 mm in length and 2.6 ± 1.3 mm in width. In 57 of the 90 patients (63%), plate‐like atelectasis was the only abnormality found. Plate‐like atelectasis was present in 7 of 22 cases where follow‐up radiographs were available. Findings from the current study indicated that, while the etiology of plate‐like atelectasis remains unknown, anatomic variations in sublobar pulmonary anatomy might account for pleural areas of atelectasis. The authors propose that the presence of plate‐like atelectasis may represent areas of atelectasis that track along sublobar lung lobe separations, an area of hypoventilation or decreased collateral ventilation, and/or area of decreased localized surfactant deficiency.     

COMPARISON OF DIGITAL RADIOGRAPHY,ULTRASONOGRAPHY, AND POSITIVE CONTRAST VAGINOURETHROGRAPHY FOR DETERMINING REPRODUCTIVE STATUS OF FEMALE CATS

It is not always possible to identify female cats that have undergone previous ovariohysterectomy based on physical examination alone. An easy, cost‐effective method for screening female cats for reproductive status would be helpful for avoiding unnecessary exploratory laparotomies. The purpose of this prospective study was to compare diagnostic sensitivities of digital radiography, ultrasonography, and positive contrast vaginourethrography for determining reproductive status in female cats. Sixty‐seven recently euthanized female cats of unknown medical history and reproductive status were randomly selected and included in the study. Digital abdominal radiography, digital abdominal radiography with compression, abdominal ultrasonography, and positive contrast vaginourethrography were performed in sequence by a board‐certified veterinary radiologist and a second‐year radiology resident. Immediately following diagnostic imaging procedures, necropsy was performed. Ultrasonography of the uterus had the highest sensitivity (86%) for determining reproductive status of all the imaging modalities tested. The specificity was 88%, and the positive predictive value and negative predictive value were 96% and 68%, respectively. The calculated sensitivities and specificities of other modalities were as follows: digital radiographs (28%, 100%), digital compression radiographs (58%, 100%), and vaginourethrography (32%, 100%). Based on McNemar's test statistic, there was a significant difference in the sensitivity of ultrasound compared to digital radiographs (P ≤ 0.05), compression radiographs (P ≤ 0.05), and vaginourethrogram (P ≤ 0.05). Findings from the current study indicated that ultrasonography is a sensitive diagnostic test for determining reproductive status in female cats. Although more readily available in private practice and shelters, digital radiography and vaginourethrography are not reliable predictors of reproductive status.     

Sensitivity and specificity of fasting ammonia and serum bile acids in the diagnosis of portosystemic shunts in dogs and cats

Background: Portosystemic shunt (PSS) is the most common cause of hepatic encephalopathy in dogs and cats. Fasting ammonia and serum bile acids (SBA) are used to diagnose PSS, but their true sensitivity and specificity have not been fully evaluated, especially in cats. Objectives: The purpose of this study was to determine the diagnostic accuracy of fasting ammonia and SBA concentrations in the diagnosis of PSS in dogs and cats and to compare diagnostic accuracy between species. Methods: A retrospective analysis of data from 373 dogs and 85 cats presented to the clinic from 1996 to 2006 was carried out. Based on clinical, laboratory, and imaging findings, animals were grouped as having PSS, parenchymal hepatic disease, or extrahepatic disease. The sensitivity and specificity of ammonia and SBA concentrations for the diagnosis of PSS were calculated and receiver‐operating characteristic analysis was used to optimize cut‐offs. Results: Using the upper limit of laboratory reference intervals (ammonia, 59 μmol/L; SBA, 20 μmol/L), the sensitivity and specificity of ammonia was 85% and 86% in dogs, and 83% and 76% in cats, respectively. The sensitivity and specificity of SBA was 93% and 67% in dogs, and 100% and 71% in cats, respectively. Using optimal cut‐off points for ammonia (dogs, 57 μmol/L; cats, 94 μmol/L) the sensitivity and specificity was 91% and 84% in dogs and 83% and 86% in cats, respectively. Using optimal cut‐off points for SBA (dogs, 58 μmol/L; cats, 34 μmol/L) the sensitivity and specificity was 78% and 87% in dogs and 100% and 84% in cats. Conclusion: Increased fasting ammonia and SBA concentrations are accurate indicators of PSS. An improvement in diagnostic accuracy can be achieved by using defined optimal cut‐off points for the selective diagnosis of PSS.     

The diagnostic yield of conventional radiographs and computed tomography in dogs and cats with maxillofacial trauma

Objective— To compare the diagnostic yield of conventional radiographs and computed tomography (CT) images of the skulls of dogs and cats with maxillofacial trauma (MFT).
Study Design— Prospective study.
Animals— Dogs (n=9) and 15 cats with MFT.
Methods— CT-scans and skull radiographs (4 standard projections) for each animal were evaluated using a semi-quantitative scoring system for the ability to identify 26 predefined, clinically relevant anatomic features (Part 1), and 27 predetermined potential traumatic injuries (Part 2). For Part 1, mean scores for each anatomic feature were recorded for every view and imaging modality. For Part 2, studies were evaluated for the frequency of cases where each predetermined traumatic injury was identified.
Results— Part 1: On radiographs it was easy to identify 17 of 26 anatomic features whereas 6 features were very difficult or impossible to identify on any view. All structures were considered easy or very easy to identify on CT. Scores for CT were lower than radiographs for evaluating dental occlusion and the integrity of the mandibular body. Part 2: CT scans demonstrated 1.6 times more maxillofacial injuries for dogs and 2.0 times more for cats than conventional radiographs. The average number of MFT injuries per animal by radiographs and CT-scan was 4.8 and 7.6 in dogs, and 3.8 and 7.7 in cats, respectively.
Conclusion— CT is superior to conventional skull radiography for identification of anatomic structures and traumatic injuries in dogs and cats. Skull radiography is useful for visualizing the mandibular body and dental occlusion.
Clinical Relevance— CT allows for accurate assessment, diagnosis and treatment planning of MFT in dogs and cats.     

Acute postretinal blindness: ophthalmologic,neurologic, and magnetic resonance imaging findings in dogs and cats (seven cases)

Objective To describe the ophthalmologic, neurologic, and magnetic resonance imaging (MRI) findings of seven animals with acute postretinal blindness as sole neurologic deficit. Methods Medical records were reviewed to identify dogs and cats with postretinal blindness of acute presentation, that had a cranial MRI performed as part of the diagnostic workup. Only animals lacking other neurologic signs at presentation were included. Complete physical, ophthalmic, and neurologic examinations, routine laboratory evaluations, thoracic radiographs, abdominal ultrasound, electroretinography, and brain MRI were performed in all animals. Cerebrospinal fluid analysis and postmortem histopathologic results were recorded when available. Results Four dogs and three cats met the inclusion criteria. Lesions affecting the visual pathways were observed on magnetic resonance (MR) images in six cases. Location, extension, and MRI features were described. Neuroanatomic localization included: olfactory region with involvement of the optic chiasm (n = 4), pituitary fossa with involvement of the optic chiasm and optic tracts (n = 1), and optic nerves (n = 1). Of all lesions detected, five were consistent with intracranial tumors (two meningiomas, one pituitary tumor, two nasal tumors with intracranial extension), and one with bilateral optic neuritis that was confirmed by cerebrospinal fluid analysis. Histologic diagnosis was obtained in four cases and included one meningioma, one pituitary carcinoma, one nasal osteosarcoma, and one nasal carcinoma. Conclusions Central nervous system (CNS) disease should be considered in dogs and cats with acute blindness, even when other neurologic deficits are absent. This study emphasizes the relevance of MRI as a diagnostic tool for detection and characterization of CNS lesions affecting the visual pathways.     

Feline gastrointestinal adenocarcinoma: a review and retrospective study

Feline gastrointestinal adenocarcinomas are the most common nonhematopoietic gastrointestinal tumors in cats. They are highly malignant tumors causing intestinal obstruction due to the annular, stenosing nature to their growth. Current literature is largely based on surveys of pathology records. Therefore, a retrospective study was conducted to evaluate clinical course and prognosis with surgical excision of the tumor. In published reports feline gastrointestinal adenocarcinoma represented 20-35% of gastrointestinal neoplasia in the cat; the average age was greater than ten years; and there was a greater incidence in Siamese. The small intestine accounted for 70% of cases. In this retrospective study, cats usually had a long history of non-specific gastrointestinal disease; weight loss and vomiting were the most common signs. Abdominal radiographs demonstrate intestinal obstruction, and an abdominal mass is often palpable. With intestinal resection and anastomosis, median survival time was 2.5 months (range: 0-24 months). Tubular adenocarcinomas may have a better prognosis than other histological types, especially if metastasis is not present at the time of surgery. A significant disease-free interval is possible in some cases.     

Gastrointestinal foreign bodies in dogs and cats: a retrospective study of 208 cases

O bjectives : To establish predilection sites of obstruction and to investigate clinical factors associated with a poor outcome.
M ethods : A retrospective study of 208 consecutive cases over a 48-month period from first-opinion practice.
R esults : Overall, 91 per cent of cases recovered with higher survival rates from discrete foreign bodies (94 per cent in dogs and 100 per cent in cats) as opposed to linear foreign bodies (80 per cent in dogs and 63 per cent in cats). English bull terriers, springer spaniels, Staffordshire bull terriers, Border collies and Jack Russell terriers were over-represented. In dogs, 63 per cent of obstructions occurred in the jejunum but foreign objects were encountered at all points along the gastrointestinal tract. A longer duration of clinical signs, the presence of a linear foreign body and multiple intestinal procedures were associated with significantly increased mortality. Neither the degree of obstruction (partial or complete) nor the location of the foreign body was shown to have a significant influence on survival.
C linical S ignificance : Prompt presentation, diagnosis and surgical intervention improve the outcome of gastrointestinal obstruction by foreign bodies. At surgery, the minimal number of intestinal procedures should be performed to restore the integrity of the alimentary tract.     

Multimodality characterization of a noncommunicating congenital duodenal duplication cyst causing pyloric outflow obstruction in a young dog

A 10‐month‐old German Shepherd Dog presented for evaluation of intermittent vomiting. Abdominal radiographs revealed a marked right cranial mass effect. Initial differentials included abscess/cyst or less likely neoplasia from undetermined origin. On abdominal ultrasound the mass appeared cystic and thin walled. Computed tomography revealed a large cystic lesion originating from the pyloroduodenal junction causing pyloric outflow obstruction. A noncommunicating duodenal duplication cyst was found on exploratory laparotomy and further confirmed with histopathology and immunohistochemistry. Enteric duplication cyst should be considered as a differential in young dogs with gastrointestinal signs and a cystic abdominal mass detected with different imaging modalities.     

Thread and sewing needles as gastrointestinal foreign bodies in the cat: a review of 64 cases

Sixty-four cases of gastrointestinal linear foreign body in the cat were reviewed. Most of the cats were less than 4 years old. The most common clinical signs were persistent vomiting, partial to complete anorexia, and depression. Abdominal palpation by itself was rarely diagnostic. Diagnosis in approximately 75% of the cases was possible, however, by using a combination of oral examination and abdominal palpation. Survey radiography contributed to the diagnosis in 86% of the cases in which it was used, based on evidence of bowel plication, presence of tapered, enteric gas bubbles, gathering of the small intestine, peritonitis, intestinal needles, or bowel obstruction. Surgery (gastrotomy and multiple enterotomies) was necessary in 96.9% of the cases, and most of the cats so treated did well (83.9%). Approximately 50% of the cats with linear foreign body-induced bowel lacerations recovered.     

Feline large granular lymphocyte lymphoma: An Italian Society of Veterinary Oncology (SIONCOV) retrospective study

Feline large granular lymphocyte (LGL) lymphoma is an uncommon subtype of lymphoma characterized by a grave prognosis and scarce response to chemotherapy. There are limited reports on clinico‐pathological and prognostic factors. One‐hundred and 9 cats with newly diagnosed LGL lymphoma that underwent initial staging (including hematology, serum biochemistry, thoracic radiographs and abdominal ultrasound), and followed‐up were retrospectively evaluated. LGL lymphoma was localized within the gastrointestinal tract with or without extra‐intestinal involvement in 91.7% of the cases, and at extra‐gastrointestinal sites in 8.3%. Symptoms were frequent. Anemia (31.2%) and neutrophilia (26.6%) were commonly observed, and 14 (12.8%) cats had neoplastic circulating cells. Frequent biochemistry abnormalities included elevated ALT (39.4%) and hypoalbuminemia (28.4%). Twenty (54.1%) of 37 cats had elevated serum LDH. Treatment varied among cats, and included surgery (11%), chemotherapy (23%), corticosteroids (38.5%) and no treatment (27.5%). Median time to progression (MTTP) was 5 days, and median survival time (MST) 21 days. MST was significantly shorter in the case of substage b, circulating neoplastic cells, lack of chemotherapy administration, and lack of treatment response. A small subset of cats (7.3%) survived more than 6 months, suggesting that a more favorable clinical course can be found among LGL lymphoma patients.