Unusual vascular ring anomaly associated with a persistent right aortic arch in two dogs

An unusual vascular ring anomaly consisting of a persistent right aortic arch and a left ligamentum arteriosum extending from the main pulmonary artery to an aberrant left subclavian artery and left aortic arch remnant complex was identified in a German shepherd dog and a great Dane. The left subclavian artery and left aortic arch remnant complex originated at the junction between the right distal aortic arch and the descending aorta and coursed dorsal to the oesophagus in a cranial direction. The attachment of the ligamentum arteriosum to the aberrant left subclavian artery was approximately 5 cm cranial to the point of origin of the aberrant left subclavian artery and left aortic arch remnant complex from the descending aorta in both dogs. This anomaly observed in both dogs is similar to an anomaly reported in humans, in which a persistent right aortic arch is found in conjunction with an aberrant left subclavian artery and a left aortic arch remnant (Kommerell's diverticulum). Surgical ligation and division of the left ligamentum arteriosum in both dogs, along with division of the left subclavian artery in the great Dane, resulted in resolution of clinical signs in both of the dogs in this report.     

Persistent right aortic arch and aberrant left subclavian artery in a white Bengal tiger (Panthera tigris).

A 3-mo-old male white Bengal tiger (Panthera tigris) presented with the chief complaint of regurgitation of solid food since weaning at 2 mo of age. Compared with its littermates, the tiger was in poor body condition and weighed only 10.3 kg when its littermates were estimated at 20-25 kg. Thoracic radiographs showed a megaesophagus cranial to the heart base. A contrast esophagram more clearly outlined the megaesophagus, and fluoroscopy demonstrated normal motility of the caudal esophagus. Endoscopic examination revealed a structure coursing dorsally from right to left over the esophagus and a constrictive band on the left of the esophagus at the heart base. Nonselective angiography confirmed the presence of a persistent right aortic arch, as well as an aberrant left subclavian artery. A left fourth intercostal thoracotomy was performed, and the ligamentum arteriosum was double ligated and divided. The left subclavian artery did not cause significant compromise of the esophagus and was not manipulated at surgery. The tiger recovered well from anesthesia and surgery. Solid food was slowly introduced over a 2-mo period without any regurgitation. The cub gained weight rapidly after surgery.     

Surgical management of an aberrant left subclavian artery originating from a left patent ductus arteriosus in a dog with a right aortic arch and abnormal branching

An increase in the availability of advanced imaging modalities has led to improved recognition of cardiovascular anomalies. Computed tomography angiography (CTA) provides a non-invasive means of acquiring 3D images with a relatively short acquisition time thereby providing essential information in regards to patient anatomy and procedure planning. The dog in this report had a right aortic arch and abnormal branching with an aberrant left subclavian artery originating from the ampulla of a left patent ductus arteriosus (PDA) that was detected with CTA. The PDA was creating a volume overload to the left side of the heart as well as contributing to the vascular ring and compression of the esophagus. Therefore, ligation and transection instead of a minimally invasive catheter-based procedure was required. This aortic arch anomaly and surgical management have not been previously reported in dogs.     

Vascular ring anomaly with coarctation of the aorta in a cat

A 13-week-old, entire male domestic shorthaired cat was presented with a nine-week history of regurgitation following the ingestion of food. A diagnosis of a vascular ring anomaly with coarctation of the aorta was based on clinical signs, angiography and echocardiography. Surgical exploration via a right lateral thoracotomy confirmed the existence of a persistent right aortic arch with right ligamentum arteriosum, aortic coarctation and an aberrant left subclavian artery. Following the surgical transection of the aberrant left subclavian artery, the cat made an uneventful recovery, showing normal swallowing function with no evidence of regurgitation. Twelve months after surgery, the cat had no special dietary requirements and remained clinically normal.     

Hypoplastic aberrant left subclavian artery in a dog with a persistent right aortic arch

Vascular ring anomalies (VRA) are relatively uncommon cardiovascular disorders in canine patients. The most common VRA is a persistent right aortic arch (PRAA) with a left ligamentum arteriosum, however various other vascular anomalies resulting in tracheoesophageal compression have also been reported. We report a case of a dog with a PRAA and left ligamentum arteriosum with a hypoplastic aberrant left subclavian artery resulting in asymmetric cervicobrachial circulation. Selective angiography and ECG-gated multi-detector computed tomography were utilized in the evaluation of these defects. The case presented represents a unique vascular anomaly of the aortic arch not previously described in veterinary medicine.     

Unusual Combination of Multiple Vascular Anomalies in a German Shepherd Puppy with Megaoesophagus

A 2‐months‐old male German shepherd puppy was referred for regurgitation and delayed growth. Radiographic and endoscopic investigations revealed a precardiac megaoesophagus and oesophageal constriction at the level of the heart base. At post‐mortem examination, a specific form of persistent right aortic arch characterized by an aberrant left subclavian artery in combination with a ligamentum arteriosum originating at the aberrant left subclavian artery (PRAA‐SA‐LA) was detected. A complete‐type persistent left cranial vena cava (PLCVC) was also observed. This is the first report describing the association between PRAA‐SA‐LA and PLCVC in a dog with megaoesophagus.     

Use of 3D printer technology to facilitate surgical correction of a complex vascular anomaly with esophageal entrapment in a dog

A 10 week old female intact Staffordshire terrier was presented with a total of five congenital cardio-thoracic vascular anomalies consisting of a patent ductus arteriosus (PDA) with an aneurysmic dilation, pulmonic stenosis, persistent right aortic arch, aberrant left subclavian artery and persistent left cranial vena cava. These abnormalities were identified with a combination of echocardiogram and computed tomography angiography (CTA). The abnormalities were associated with esophageal entrapment, regurgitation, and volume overload of the left heart with left atrial and ventricular enlargement. A 2 cm diameter aneurysmic dilation at the junction of the PDA, right aortic arch and aberrant left subclavian artery presented an unusual surgical challenge and precluded simple circumferential ligation and transection of the structure. A full scale three dimensional model of the heart and vasculature was constructed from the CTA and plasma sterilized. The model was used preoperatively to facilitate surgical planning and enhance intraoperative communication and coordination between the surgical and anesthesia teams. Intraoperatively the model facilitated spatial orientation, atraumatic vascular dissection, instrument sizing and positioning. A thoracoabdominal stapler was used to close the PDA aneurysm prior to transection. At the four-month postoperative follow-up the patient was doing well. This is the first reported application of new imaging and modeling technology to enhance surgical planning when approaching correction of complex cardiovascular anomalies in a dog.     

Subgross investigation of vessels originating from arcus aortae in guinea-pig (Cavia porcellus)

The vessels that originate from the aortic arch were studied in 16 adult guinea-pigs. Two major vessels, the left subclavian artery and the brachiocephalic trunk, were easily identified as they were branching off from the aortic arch. The brachiocephalic trunk, at first branched off to the left common carotid artery and continued as a common trunk, which was then divided into the right subclavian artery and the right common carotid artery. The left subclavian artery branched off to the following vessels: the costacervical trunk, the internal thoracic artery, a common trunk from which the dorsal scapular artery and the vertebral artery originated, and the superficial cervical artery. The right subclavian artery branched off to the bronchoesophageal artery (in five cadavers), the caudal thyroid artery (in three cadavers) and the tracheal artery (in three cadavers) in addition to the above vessels. There were two vertebral arteries branching off to the right subclavian artery in all dissected cadavers. However, only 10 cadavers had two vertebral arteries originating from the left subclavian artery. The first vertebral artery originated from the common trunk, whereas the second vertebral artery arose from the dorsal scapular artery. The second vertebral artery entered the foramen transversarium of the seventh cervical vertebrae and anastomosed with the first vertebral artery just before entering the foramen transversarium of the sixth cervical vertebrae.     

Subgross and macroscopic investigation of blood vessels originating from aortic arch in the chinchilla (Chinchilla lanigera)

A total of 10 adult, healthy, male chinchilla (Chinchilla lanigera) were used to investigate the vessels originating from aortic arch. Coloured latex was injected into the carotid arteries following conventional anatomical applications in all the chinchillas examined. The brachiocephalic trunk and the left subclavian artery arose from the aortic arch at the level of the second intercostal region in the thoracic cavity. The right and left subclavian arteries detached branches at the level of first intercostal region and divided into the following vessels: internal thoracic artery, dorsal scapular artery, vertebral artery, superficial cervical artery and axillar artery. The vessels originating from the aortic arch displayed some significant differences in chinchillas compared to rats, guinea pigs, rabbits, porcupines and other laboratory rodents.     

Unusual vascular ring anomaly associated with a persistent right aortic arch and an aberrant left subclavian artery in German pinschers

The objective of this study was to describe a specific form of persistent right aortic arch (PRAA) in three German pinscher dogs and to analyse the mode of inheritance in the breed. This type of PRAA is characterised by a left retro-oesophageal subclavian artery in combination with a ligamentum arteriosum originating at the aberrant left subclavian artery (PRAA-SA-LA). This rare combination of anomalies has only been reported in two isolated cases in other dog breeds and the occurrence of any form of PRAA was not previously known to occur in the German pinscher. In the present study, 18 cases of this congenital anomaly were ascertained and their high degree of relatedness and inbreeding could be shown through pedigree analysis. Three of the affected dogs underwent further clinical investigations, and post-mortem examination (two cases) and findings at surgery (one case) verified the diagnosis of PRAA-SA-LA. A monogenic autosomal recessive mode of inheritance was not likely.     

Aberrant right subclavian artery causing megaoesophagus in three cats

Three entire, domestic, shorthair male cats (age range: 3 months to 5 years) were referred because of regurgitation. Megaoesophagus attributable to aberrant right subclavian artery, originating from the aorta at the level of the fourth intercostal space, was diagnosed in all cats using thoracic radiography and CT angiography. One cat had concurrent patent ductus arteriosus with a normal aortic arch. Three‐dimensional volume‐rendered CT images were used to assess the malformations and to plan surgery for the treatment of the vascular anomalies. Different surgical approaches were used in the two kittens. The third cat was not operated. CT angiography is well suited for preoperative planning in cats with aberrant right subclavian artery alone or in combination with other vascular anomalies.     

Branching pattern of aortic arch in the Korean water deer

This study examined the branching pattern of the aortic arch and its major branches in Korean water deer (Hydropotes inermis argyropus, Heude, 1884). Silicone casts were taken from the vessels of 23 carcasses (male 14, female 9) with body weights ranging from 1.3-16.0 kg through a retrograde injection into the abdominal aorta. The findings were compared with those from other domestic ruminants. Only the brachiocephalic trunk (Bct) branched from the aortic arch in all carcasses. In 19 of the 23 cases, the Bct branched into the left subclavian artery (LSb), the left common carotid artery (LCc), and then trifurcated into the right common carotid artery (RCc), right costocervical trunk (RCct) and right subclavian artery (RSb). The subclavian artery (Sb) branched into the costocervical trunk (in left), internal thoracic artery (It), and superficial cervical artery (Sc) in that order, and continued as the axillary artery. Instead of separated carotid arteries, the bicarotid trunk from the Bct was observed in only three males and one female. Two of these males had different branching orders of the It and Sc from the Sb in one or both sides. The other male had a RCct from the RSb. The left costocervical trunk (LCct) arose from the LSb in all cases, and branched into the highest intercostal artery, the dorsal scapular artery, and the deep cervical arteries in that order, and continued as the vertebral artery. In 22 cases, the RCct branched directly from the Bct at the same point in which the RCc (or bicarotid trunk) and RSb separated. The artery branching pattern from the RCct was similar to that of the LCct. These results suggest that the Korean water deer has a Bct with different branching patterns from those of domestic ruminants.     

Double aortic arch in a Siamese cat.

A double aortic arch is described in an 8-week-old female Siamese cat. In this case a vascular ring anomaly consistent with a double aortic arch is described in a cat. Stridor and dysphagia were noted in the cat. Radiography showed an esophageal dilation, with constriction at the fifth intercostal space. At necropsy, the esophagus and trachea were constricted at the base of the heart. The cause of the constriction of both the esophagus and trachea was a vascular ring formed by well-developed right and left aortic arches. The ascending aorta divided into two asymmetrical arches. The right aortic arch was larger than the left. The origin of the major arteries from the aortic arches were anomalous.     

Chronic otitis externa/media with total ear canal ablation and bulla curettage in a North American bison (Bison bison).

An adult female North American bison (Bison bison) with a chronic otitis externa/media of the right ear was examined because of a 4-mo history of intermittent anorexia, apparent painful behavior, and auricular discharge from the right ear. Computerized tomography (CT) demonstrated osteolysis of the tympanic, petrous, and squamous aspects of the temporal bone with soft tissue replacement and sclerosis of the right bulla. A total ear canal ablation with bulla curettage was performed, and cefazolin-impregnated polymethacrylate beads were left within the right bulla and the remnant temporal bone. Six months after the surgery, the bison had no clinical signs of otitis media.     

Tracheal signs and associated vascular anomalies in dogs with persistent right aortic arch

Medical records of 55 dogs with 1 or more vascular rings around the esophagus and trachea were reviewed to determine the nature and frequency of related vascular anomalies and to determine the reliability of tracheal deviation on radiographs for the diagnosis of persistent right aortic arch (PRAA). Fifty-two (95%) of the 55 dogs had PRAA. Of the 52 dogs with PRAA, 44% had coexisting compressive arterial anomalies: 17 had retroesophageal left subclavian artery and 6 had double aortic arch with atretic left arch. Characteristic tracheal deviation was consistently present in dogs with PRAA. Moderate or marked focal leftward curvature of the trachea near the cranial border of the heart in dorsoventral (DV) or ventrodorsal (VD) radiographs was found in 100% of available radiographs of 27 dogs with PRAA. Moderate or marked focal narrowing of the trachea also was noted in 74% of DV or VD radiographs and 29% of lateral radiographs of the dogs. Tracheal position in 30 of 30 dogs with megaesophagus and 62 of 63 control dogs was midline or rightward in VD or DV radiographs. Histology in a neonatal dog with PRAA revealed evidence of tracheal deviation and compression even before birth. Focal leftward deviation of the trachea near the cranial border of the heart in DV or VD radiographs is a reliable sign of PRAA in young dogs that regurgitate after eating solid food, and contrast esophagrams are not necessary to confirm the diagnosis of vascular ring compression.     

Branches of the aortic arch in the cynomolgus macaque (Macaca fascicularis).

The aortic arch branching patterns of 49 male macaques (Macaca fascicularis) were described and classified according to the classification systems of DeGaris, and the incidence of each pattern was determined. The most frequent pattern observed was a two-branch type in which a truncus communis of intermediate length (7 to 11 mm) and the left subclavian artery constituted the only aortic arch branches. Five patterns not previously described in the cynomolgus were observed. Comparison of the cynomolgus and the rhesus macaques indicated a significant difference between the two species with the rhesus generally having a shorter truncus communis.     

Squamous cell carcinoma in an American bison (Bison bison bison)

The following case report is, to the best of our knowledge, the first documentation of a squamous cell carcinoma in a full-blooded American bison (Bison bison bison). This female bison developed an ulcerated lesion on the left flank, at the site of a brand, in the summer of her eighth year. In the winter of her ninth year, as the lesion continued to grow, a biopsy was performed, and a diagnosis of squamous cell carcinoma was made. Ultimately, there was metastasis to the liver, a lung, and a prefemoral lymph node.     

Gross anatomy of the heart of the alpaca (Vicugna pacos,Linnaeus 1758)

The available information about anatomical characteristics of the cardiovascular system of the alpaca (Vicugna pacos, Linnaeus 1758) is scarce. The general objective of this work was to describe its heart anatomy. We dissected six adult animals and five neonates. The heart of the alpaca was located in the middle mediastinum, with a craniocaudal extension from the third to the sixth rib. No ligament that connected the fibrous pericardium to the sternum or to the diaphragm was detected. In the right atrium, there was a developed crista terminalis and small pectinate muscles. In the right ventricle, the septomarginal trabecula was very large. From the proximities of the interventricular septum arose small septomarginal trabeculae that ended in carnous trabeculae of the septal wall. The left atrium included little developed pectinate muscles. On the left ventricle, both papillary muscles were bilobed. Two left septomarginal trabeculas were detected in this ventricle. The left subclavian artery was originated from the aortic arch separately from the brachiocephalic trunk, and bicarotid trunk was present. The other branches of the subclavian artery were similar to the domestic ruminants. The arterial supply of the heart was of the right type. In conclusion, the heart anatomy of alpaca and the irrigation of thoracic cavity were more similar to those of old world camels and different from domestic ruminants.     

Clinical Parelaphostrongylus tenuis infection in two captive American bison (Bison bison)

CASE DESCRIPTION: 2 juvenile (17 and 19 months of age) male American bison (Bison bison) were examined because of acute bilateral hind limb weakness and ataxia; 1 animal also had urinary incontinence. TREATMENT AND OUTCOME: Given the clinical signs and rapid deterioration in the condition of these 2 animals, obtaining a definitive diagnosis was considered essential to minimizing the risk of disease in the remaining bison herd and among other animals at the facility. Therefore, both affected animals were euthanized. At necropsy, no gross abnormalities were seen. Histologic examination of sections of the brains from both animals revealed mild to moderate multifocal aggregates of eosinophils and mononuclear cells in perivascular regions of the meninges and gray matter of the cerebrum, cerebellum, and brainstem. Systematic examination of multiple sections of brain and spinal cord revealed evidence of nematode sections and aberrant parasite migration. CLINICAL RELEVANCE: Findings suggested that CNS migration of Parelaphostrongylus tenuis in American bison may cause clinical signs. These findings have implications for the management of captive bison and free-ranging bison sharing ranges with white-tailed deer (Odocoileus virginianus), the definitive host, and elk (Cervus elaphus canadensis).