IMAGING DIAGNOSIS—AORTIC THROMBOEMBOLISM ASSOCIATED WITH SPIROCERCOSIS IN A DOG

An 8-year-old neutered female Rhodesian Ridgeback developed acute, nonneurological right pelvic limb lameness. Femoral pulsation was poor, and oscillometric blood pressure measurements between the two pelvic limbs differed markedly. A caudal aortic right external iliac embolus was detected sonographically. Radiographically, there was a caudal esophageal mass and thoracic vertebral spondylitis typical of spirocercosis. Using CT-angiography, a caudal thoracic aortic aneurysm with a mural thrombus was detected. The dog recovered following heparin and aspirin therapy but signs recurred 7 months later. Subsequently, the patient improved on treatment and remains asymptomatic. This report illustrates the value of CT-angiography in detecting aortic thrombosis in dogs with spirocercosis.     

Clinical and neurological characteristics of aortic thromboembolism in dogs

OBJECTIVES: To characterise the clinical presentation and neurological abnormalities in dogs affected by aortic thromboembolism. METHODS: The medical records of 13 dogs diagnosed with aortic thromboembolism as the cause of the clinical signs, and where a complete neurological examination was performed, were reviewed retrospectively. RESULTS: The onset was acute in only four dogs, chronic in five dogs (with all of these presenting as exercise intolerance) or chronic with acute deterioration in four dogs. Dogs with an acute onset of clinical signs were more severely affected exhibiting neurological deficits, while dogs with a chronic onset of disease predominantly presented with the exercise intolerance and minimal deficits. The locomotor deficits included exercise intolerance with pelvic limb weakness (five of 13), pelvic limb ataxia (one of 13), monoparesis (two of 13), paraparesis (two of 13), non-ambulatory paraparesis (two of 13) and paraplegia (one of 13). There was an apparent male predisposition and the cavalier King charles spaniel was overrepresented. CLINICAL SIGNIFICANCE: The rate of onset of clinical signs appears to segregate dogs affected by aortic thromboembolism into two groups, with different clinical characteristics and outcomes. Dogs with an acute onset of the clinical signs tend to be more severely affected, while dogs with a chronic onset predominantly present with exercise intolerance. It is therefore important to consider aortic thromboembolism as a differential diagnosis in dogs with an acute onset of pelvic limb neurological deficits and in dogs with longer standing exercise intolerance.     

Aberrant migration and surgical removal of a heartworm (Dirofilaria immitis) from the femoral artery of a cat

A cat was evaluated for an acute‐onset of right pelvic limb paresis. Thoracic radiographs revealed normal cardiac size and tortuous pulmonary arteries. Abdominal ultrasound identified a heartworm (HW) extending from the caudal abdominal aorta into the right external iliac artery and right femoral artery. The cat was HW‐antigen positive. Echocardiography revealed a HW within the right branch of the main pulmonary artery and evidence of pulmonary hypertension. An agitated‐saline contrast echocardiogram revealed a small right to left intracardiac shunt at the level of the atria. Surgical removal of the HW was performed with no substantial postoperative complications. There was return of blood flow and improved motor function to the limb. The cat remains mildly paretic on the affected limb with no other clinical signs.     

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

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

Partial anomalous pulmonary venous connection in a dog

A 2-year-old male intact Belgian Malinois was presented for exercise intolerance. A grade III/VI left basilar systolic murmur was detected. Echocardiography revealed moderate right atrial and ventricular dilation and increased pulmonic outflow velocity. Thoracic radiographs showed right heart enlargement and a dilated caudal vena cava. In addition, on the left lateral projection, an enlarged aberrant right cranial pulmonary lobar vein was suspected to be diverging ventrally from the course of the right cranial lobar bronchus and inserting more ventrally than normal in the region of the right atrium. A left-to-right pulmonary vascular shunt was suspected, and the patient underwent further diagnostics under general anesthesia. An agitated saline study was positive, suggestive of a concurrent right to left shunt. A right heart catheterization was performed. Angiography was inconclusive. Oximetry testing revealed an increase in oxygen saturation within the right atrium at the level of the caudal cava supportive of a left-to-right shunt in this region. Computed tomography angiography revealed a large single pulmonary vein that anomalously entered into the caudolateral aspect of the right atrium (left-to-right shunt) and was suspicious for a small arteriovenous malformation between the right caudal pulmonary artery and the right pulmonary vein returning to the left atrium (right to left shunt). The patient was diagnosed with a partial anomalous pulmonary venous connection and a possible arteriovenous malformation.     

What is your diagnosis?

A 10‐YEAR‐OLD, male neurered golden retriever presented with a three‐month :history of intermittent left thoracic limb lameness. The owner reported that the lameness was worse on uneven ground and after exercise. At times, while resting, the dog held the left thoracic limb off the ground. The lameness had partially responded to non‐steroidal anti‐inflammatories and strict rest, bur had deteriorated again after the exercise level was increased. On examination, flexion of both carpiillicited pain responses in the animal. The dog was 3/10 lame on the left thoracic limb.     

Canine leishmaniasis with nephrotic syndrome and aortic and caudal vena cava thromboembolism

Objective – To describe a case of leishmaniasis associated with nephrotic syndrome and aortic and caudal vena cava thrombosis in a dog. Case Summary – A 3‐year‐old male Boxer was referred to the Faculty of Veterinary Medicine, Lisbon, with vomiting, polyuria, polydipsia, lethargy, anorexia, and weight loss. On admission, the dog was thin, quiet, and dehydrated. Initial laboratory abnormalities were compatible with a diagnosis of leishmaniasis (confirmed by serology and bone marrow aspirate), and nephrotic syndrome. Three days later, the animal developed lumbar pain, paraparesis, and absent femoral pulses. Coagulation tests showed a marked reduction in antithrombin (AT) and a mild increase in serum fibrinogen concentration. A diagnosis of thromboembolism was made. In spite of treatment aimed at controlling the primary condition and decreasing further thrombus formation, necrosis developed in the distal right pelvic limb and the nail beds of the left pelvic limb. Against medical advice, medication was stopped and, 15 days later, the dog returned to the hospital, showing extensive necrosis of both pelvic limb extremities. Euthanasia was performed at the owner's request. Necropsy showed a thrombus localized at the distal aorta and extending into the right iliac artery, and an additional thrombus extending from both femoral veins onto the caudal vena cava. New or Unique Information Provided – Thromboembolic disease is rare in dogs with leishmaniasis with nephrotic syndrome. This case suggests that a marked decrease in AT and a mild increase in serum fibrinogen may elicit a hypercoagulable state in these patients.     

Kinetic gait analysis of healthy dogs on two different surfaces

Objective— To determine the effects of 2 different, commonly used surfaces with different coefficients of friction on ground reaction forces in normal dogs.
Study Design— Prospective, observational, single cross-over study.
Animals— Dogs (n=10) with no gait abnormalities.
Methods— Dogs were acclimated to the force plate and 5 valid trials for each dog and each limb were recorded. Velocity and acceleration were tightly controlled. Each dog was tested on both surfaces sequentially in different sequences. Data analysis was done on peak vertical force, peak impulse, breaking and propulsion peak forces and impulses. Three-way repeated measures analysis of variance was used to separately evaluate the effect of floor type on force plate measures in fore and hind limbs, while controlling for side (left versus right) and experimental replicate. P -values<.05 were considered significant. Mean force and 95% confidence interval for the 6 variables analyzed for all limbs on each surface were calculated.
Results— There were no significant differences in ground reaction forces between the linoleum and the carpet surface for thoracic or pelvic limbs for all gait variables measured. There were no significant differences between each individual gait trial per dog between the right and left thoracic limbs trials nor differences between the right and left pelvic limb trials.
Conclusions— Normal dogs had no change in their ground reaction forces on linoleum and carpet surfaces.
Clinical Relevance— Kinetic results from multi-center or comparative trials will not be affected by use of either linoleum or carpet surfaces.     

Computed tomography angiography of coarctation of the aorta in a dog

Coarctation of the aorta has been described previously as either a post-mortem or angiographic finding in three dogs with clinical signs related to the aortic coarctation. A 10-year-old dog was presented for evaluation of suspected laryngeal paralysis. On physical examination, femoral pulses were absent bilaterally, with an indirect systolic blood pressure difference of 60 mmHg between the ipsilateral thoracic and pelvic limbs. Coarctation of the aorta was detected on a thoracic computed tomographic angiography study. The coarctation was pre-ductal in position, with extensive dilation of the descending thoracic aorta. Characteristic rib changes that are seen in humans with coarctation were not apparent in this dog. 3D reconstructions of the thorax provided high vascular definition with exact localization of the aortic narrowing.     

Congenital kyphosis secondary to lumbar vertebral hypoplasia causing paraparesis in a Friesian foal

A 5‐day‐old Friesian colt was presented with a history of severe bilateral pelvic limb weakness since birth. Clinical examination revealed a painful dorsal deviation of the spinous processes of the lumbar vertebrae, pelvic limb paraparesis and grade 4/5 ataxia. Radiographic examination revealed kyphosis due to hypoplasia and malformation of the 5 lumbar vertebrae present. At myelography performed immediately after euthanasia, dorsal deviation of the myelographic contrast column was demonstrated at the level of T18–L4 with suspected spinal cord compression noticeable at L1. There was no lateral deviation of the spinal cord or scoliosis of the vertebrae visible.     

Ischemic Optic Neuropathy in a Dog with Acute Bilateral Blindness and Primary Systemic Hypertension

A 6‐year‐old neutered female Jack Russell terrier was investigated for sudden onset prechiasmatic bilateral blindness, left circling, reduced proprioception in the right pelvic limb and right facial allodynia. Electroretinography was normal. Magnetic resonance imaging (MRI) examination revealed that the right optic nerve and the optic chiasm were hyperintense on diffusion weighted imaging and hypointense on apparent diffusion coefficient map consistent with ischemic optic neuropathy. A concurrent lacunar infarct was detected in the left rostral colliculus. Primary systemic hypertension was diagnosed based on blood pressure measurement and no detectable abnormalities on hematology, comprehensive serum biochemistry, urinalysis including protein/creatinine and cortisol/creatinine ratios and thoracic/abdominal imaging. Prednisolone for 10 days and amlodipine long‐term were administered. Vision was not recovered after 7 months. Repeat MRI supported the diagnosis of ischemic lesions and revealed a recent striatocapsular infarct. Ischemic optic neuropathy is a well‐recognized cause of blindness in humans and should be included as a differential diagnosis for acute prechiasmatic blindness in dogs.     

Amelioration of caudal thoracic syringohydromyelia following surgical management of an adjacent arachnoid cyst

A nine-year-old male, neutered, pug was presented for investigation of progressive ambulatory paraparesis and pelvic limb ataxia of three months' duration. Magnetic resonance imaging was suggestive of caudal thoracic syringohydromyelia with an adjacent intradural arachnoid cyst. The cyst was marsupialised following dorsal laminectomy. Neurological status had improved 10 weeks following surgery when repeat magnetic resonance imaging revealed reduced spinal cord compression both as a result of resolution of the cyst and reduction in size of the syringohydromyelia. At 17 months following surgery, the dog showed further improvements in neurological status, exhibiting mild pelvic limb ataxia and proprioceptive deficits. Improved cerebrospinal fluid flow following surgery may have played a role in the improvement in both conditions. The presence of syringohydromyelia in this context does not preclude a favourable clinical outcome following surgical management.     

Dual-energy X-ray absorptiometry measurement of bone-mineral density in the distal aspect of the limbs in racing Greyhounds

OBJECTIVE: To determine those bones in the distal aspect of the limbs of Greyhounds with fatigue fractures that have the greatest left-to-right differences in bone-mineral density (BMD). SAMPLE POPULATION: Limbs obtained from 20 Greyhounds. PROCEDURE: Dual-energy x-ray absorptiometry (DXA) of the distal aspect of each limb and isolated bones from 10 dogs with a fracture of the central tarsal bone (CTB) of the right pelvic limb was performed. High-resolution scanning was performed on excised bones, and BMD measurements of CTB also were obtained from limbs of dogs without a CTB fracture. RESULTS: The BMD of the accessory carpal bone and calcaneus was not significantly different from the BMD of those bones in the contralateral limb. Although BMD of the CTB of the entire right pelvic limb and isolated bones from dogs with a CTB fracture was lower, compared with values for the entire left pelvic limb, values for isolated CTB from dogs without a CTB fracture were not significantly different. Metacarpal or metatarsal and thoracic or pelvic limb significantly affected BMD for measurements of the entire limb and isolated bones. Left-to-right differences in BMD were greatest for metacarpal 5. CONCLUSIONS AND CLINICAL RELEVANCE: Asymmetric adaptive remodeling of metacarpal 5 can be detected by DXA. The potentially confounding effects of CTB fracture and unknown racing history made it difficult to interpret BMD changes in the CTB of these specimens. Densitometry could be developed as an in vivo assessment for risk of fractures in racing Greyhounds.     

Eisenmenger's complex in a Holstein-Friesian cow

A 4.5-year-old, Holstein-Friesian cow presented with a 1-month history of severe exercise intolerance. Rectal examination and transrectal ultrasonography revealed a large mass in the left retroperitoneum. The heart rate was 70 to 80/min. Premature ventricular complexes and ventricular bigeminy were present on an electrocardiogram. Erythrocytosis was present and blood gas analysis revealed marked hypoxaemia. An echocardiogram demonstrated a large ventricular septal defect, a partially dextroposed aorta, and concentric hypertrophy of the right ventricular free wall. Colour flow Doppler echocardiography and a contrast echocardiographic study demonstrated a right-to-left shunt through the ventricular septal defect. Eisenmenger's complex was diagnosed. The patient was euthanased. Necropsy confirmed the gross cardiac lesions identified by echocardiography and an abscess in the apex of the left ventricle. Severe pulmonary arterial lesions were present, consistent with a marked increased in pulmonary vascular resistance. Actinomyces pyogenes was cultured from abscesses of the retroperitoneum and the ventricular apex.     

Effects of trial repetition, limb side, intraday and inter-week variation on vertical and craniocaudal ground reaction forces in clinically normal Labrador Retrievers

OBJECTIVES: To document the contributions of trial repetition, limb side, and intraday and inter-week measurements on variation in vertical and craniocaudal ground reaction force data. Methods: Following habituation, force and time data were collected for all four limbs of seven Labrador Retrievers during sets of five valid trot trials. Each set was performed twice daily (morning and afternoon), every seven days for three consecutive weeks. A repeated measures analysis of variance was used to determine the effects of limb, trial, intraday, and inter-week factors on ground reaction force data for the thoracic and pelvic limbs. RESULTS: Of the four factors evaluated, variation due to trial repetition had the largest magnitude of effect on ground reaction forces. Trial within a set of data had an effect on all craniocaudal, but not vertical, ground reaction force variables studied, for the thoracic limbs. The first of five trials was often different from later trials. Some thoracic limb and pelvic limb variables were different between weeks. A limb side difference was only apparent for pelvic limb vertical ground reaction force data. Only pelvic limb craniocaudal braking variables were different between sets within a day. DISCUSSION AND CLINICAL SIGNIFICANCE: When controlling for speed, handler, gait, weight and dog breed, variation in ground reaction forces mainly arise from trial repetition and inter-week data collection. When using vertical peak force and impulse to evaluate treatment, trial repetition and inter-week data collection should have minimal effect of the data.     

Evaluation of an Oscillometric Blood Pressure Monitor on Anesthetized Cats and the Effect of Cuff Placement and Fur on Accuracy

Objectives — (1) To determine the usefulness of one specific oscillometric monitor for making indirect measurements of arterial pressure in cats. (2) To determine the difference between two specific cuff placement sites. (3) To determine if clipping the hair beneath the cuff has an affect on the accuracy of oscillometric blood pressure determination.
Study Design — Prospective study comparing the accuracy of the Datascope Passport (Data-scope Corp, Paramus, NJ) with concurrent invasive measurements.
Animals — Six anesthetized domestic felines weighing 4.5 to 5 kg.
Methods — The direct arterial pressure was measured using a cannula placed in the right common carotid artery. Oscillometric cuffs of appropriate size were placed on both thoracic limbs distal to the elbow and both pelvic limbs distal to the stifle. The hair in the areas of cuff placement on the right limbs was clipped circumferentially. Measurements of systolic, diastolic, and mean arterial pressure (MAP) were taken for each site during normotension, hypotension, and hypertension. Comparisons between indirect and direct measurements were made using a parametric analysis of method comparison.
Results — No significant differences were noted when die clipped limbs were compared with the corresponding limbs which were left undipped ( P >.378) or when the thoracic limb measurements were compared widi those of the pelvic limb ( P >.088). There were significant differences ( P <.002) between the two pressure measurement methods for the systolic, diastolic, and mean arterial pressures over all three pressure ranges.
Conclusions — The Datascope Passport did not accurately estimate the invasively measured arterial pressure.
Clinical Relevance — Use of noninvasive blood pressure monitoring equipment is increasing in use in veterinary medicine, and the accuracy of one specific monitor is reported.     

Pneumorrhachis in a rottweiler

An 8·5-year-old, female, neutered, Rottweiler was presented for investigation of progressive ataxia of one week duration. Proprioception was absent in the left pelvic limb and reduced on the right, thoracolumbar hyperalgesia was evident and pelvic limb segmental spinal reflexes were normal. Magnetic resonance imaging (MRI) demonstrated a spherical region of signal void compressing the spinal cord between the fifth and sixth thoracic vertebrae and several non-compressive degenerate intervertebral discs. Computed tomography (CT) of the region confirmed the findings and identified the lesion as gas. A dorsolateral hemilaminectomy was performed to decompress the spinal cord and achieved complete resolution of the clinical signs on examination after 3 months. This is the first known reported case of spontaneous pneumorrhachis in a veterinary patient.     

Agenesis and Dysgenesis of the Navicular Bone as Cause of Lameness and Malalignment in Two Foals

A three-week-old warmblood colt was referred for a two-week history of lameness on the left thoracic limb, and a two-month-old Quarter Horse–mix filly was referred for malaligned pelvic limbs since birth. The foals were diagnosed with agenesis and dysgenesis of the navicular bone, respectively. In this report, we present clinical signs, diagnostics, and postmortem workup of the two cases.     

Centronuclear myopathy in a Border collie dog

A two‐year old, male entire Border collie was presented with a one‐year history of exercise‐induced collapsing on the pelvic limbs. Physical examination revealed generalised muscle atrophy. Neurological examination supported a generalised neuromuscular disorder. Electromyography revealed spontaneous electrical activity in almost all muscles. Unfixed and formaldehyde‐fixed biopsy samples were collected from the triceps brachii, longissimus and vastus lateralis muscles. Histopathological, histochemical and ultrastructural examinations of biopsy specimens were consistent with either centronuclear or myotubular myopathy. The dog clinically improved with supportive treatment with L‐carnitine, co‐enzyme Q10 and vitamin B compound. To the authors’ knowledge, this is the first report of centronuclear/myotubular myopathy in a Border collie.     

Surgical treatment of a double aortic arch in a dog

An 8-month-old spayed female Labrador retriever dog was evaluated for regurgitation 6 months after surgery for a suspected vascular ring anomaly. The dog had a history of regurgitation and slow development as a puppy. An initial left-sided exploratory thoracotomy was unsuccessful in identifying and treating a vascular ring anomaly. The dog was subsequently presented to the PennVet Emergency Service for regurgitation. Thoracic radiography showed cranial thoracic esophageal dilation and an esophageal foreign body that was then removed endoscopically. Subsequent computed tomographic (CT) angiography revealed a double aortic arch. A left 4th intercostal space thoracotomy was performed. The smaller left aortic arch and a left ligamentum arteriosum were ligated and transected. The dog recovered uneventfully and was healthy at the 1-month follow-up visit. This is the 5th reported successful surgical correction of a double aortic arch in a dog. Computed tomographic angiography was essential in diagnosis and surgical planning.Key clinical message:Although uncommon, double aortic arches can occur and present a diagnostic and surgical challenge when a persistent right aortic arch is suspected. Computed tomographic angiography provides an accurate preoperative diagnosis and allows for surgical planning.