Magnetic resonance imaging appearance of the brain and cervical spinal cord in an edema disease affected pig

A 7‐week‐old male pig was presented with signs of a central nervous system disorder. An MRI of the head and cervical spine was performed immediately after euthanasia. The MRI revealed multifocal bilaterally symmetric T2‐weighted hyperintense lesions in the brain and spinal cord, likely due to a toxic metabolic process. Histopathological examination supported the MRI findings and confirmed the diagnosis of edema disease due to Shiga‐like toxin produced by Escherichia coli. This is the first case published of the MRI findings in an edema disease affected pig.     

Cerebrospinal fluid analysis and magnetic resonance imaging in the diagnosis of neurologic disease in dogs: a retrospective study

BACKGROUND: Diagnosis of central nervous system (CNS) abnormalities in dogs can be challenging antemortem. Historically, cerebrospinal fluid (CSF) analysis has been used for routine diagnostic evaluation of animals with suspected neurologic disease; however, with increasing availability of magnetic resonance (MR) imaging, the need for concurrent CSF analysis may be questioned. OBJECTIVE: The purpose of this study was to retrospectively assess and compare the diagnostic information contributed from MR imaging and CSF analysis in a population of dogs presenting with neurologic disease. METHODS: Results of concurrent MR imaging and CSF analysis were evaluated in dogs presented for neurologic diseases. Based on clinical diagnosis, the sensitivity of CSF analysis and MR imaging for detecting a nervous system abnormality was calculated. Dogs with diagnoses confirmed by other diagnostic modalities were also evaluated separately. RESULTS: A total of 256 dogs were included in the study. For clinical diagnoses in which abnormalities were expected, MR imaging abnormalities were found in 89% and CSF abnormalities in 75% of dogs; CSF abnormalities were more common than MR imaging abnormalities only in inflammatory CNS disease. The majority of CSF abnormalities were nonspecific; an etiologic diagnosis was determined in only 2% of CSF samples. MR imaging excelled in detecting structural disorders, revealing 98% of vertebral abnormalities. In confirmed cases (n = 55), 76% of MR images and 9% of CSF samples were diagnostic. When intervertebral disk disease (IVDD) and vertebral malformation were excluded from analysis (n = 16 remaining), 25% of MR images and 6% of CSF cytology results were highly indicative of the confirmed diagnoses; CSF titer results provided the diagnosis in 25% of these cases. CONCLUSION: CSF analysis may not be necessary when MR findings of IVDD or vertebral malformation/instability are obvious; however, when the cause of neurologic disorder is uncertain, concurrent MR imaging and CSF analysis provides the greatest assistance in establishing a clinical diagnosis.     

Double-outlet right ventricle in a 10-month-old Friesian filly

A 10-month-old Friesian filly had a presentation that was consistent with chronic left- and right-sided congestive heart failure. Clinical pathology findings included abnormal haematological and biochemical variables, abnormal blood gas values and increased serum concentration of cardiac troponin I. Echocardiography revealed cardiac chamber dilation and dextropositioning of the aorta. Radiography revealed a generally enlarged heart and pulmonary interstitial infiltration. These findings were supported at necropsy and the diagnosis of double-outlet right ventricle was confirmed. The pathological changes and physiological responses subsequent to double-outlet right ventricle have not previously been described in detail in horses. Clinical progression closely resembles that seen in humans, in whom antemortem diagnosis relies on echocardiography. In horses, complex cardiac disease presents a diagnostic challenge to the clinician. Appropriate therapy must be based on an accurate diagnosis.     

Successful surgical debridement of a cerebral Streptococcus equi equi abscess by parietal bone flap craniotomy in a 2-month-old Warmblood foal

Brain abscesses and intracranial masses have been regularly described in horses. Treatment often is difficult and unrewarding and mortality rate high. This case report describes the successful treatment of a cerebral abscess in a 2-month-old female Warmblood foal with severe neurological signs of acute onset. Computed tomography (CT) revealed a 3 × 4 × 4 cm cerebral mass in the left brain hemisphere with severe cerebral oedema. Craniotomy, using a parietal bone flap technique, allowed the abscess to be sampled, drained and lavaged. Immediately, post-surgery the foal showed significant clinical improvement. Sample culture confirmed Streptococcus equi equi infection. The foal was medically treated for 6 weeks, leading to complete clinical and radiographical recovery. Intracranial surgery in equine medicine is limited. Using a parietal bone flap instead of partial craniectomy to gain access to the cerebrum is a less invasive procedure leading to a better aesthetic result and should be considered for the treatment of cerebral masses in the horse.     

Magnetic resonance imaging and histological classification of intracranial meningiomas in 112 dogs

BACKGROUND: Intracranial meningiomas are the most common primary brain tumors in dogs. Classification of meningiomas by tumor grade and subtype has not been reported, and the value of magnetic resonance imaging (MRI) characteristics for predicting tumor subtype and grade has not been investigated. HYPOTHESIS: Canine intracranial meningiomas are a heterogenous group of tumors with differing histological subtypes and grades. Prediction of histopathological classification is possible based on MRI characteristics. ANIMALS: One hundred and twelve dogs with a histological diagnosis of intracranial meningioma. METHODS: Retrospective observational study. RESULTS: Meningiomas were overrepresented in the Golden Retriever and Boxer breeds with no sex predilection. The incidence of specific tumor grades was 56% benign (Grade I), 43% atypical (Grade II), and 1% malignant (Grade III). Grade I histological subtypes included meningothelial (43%), transitional (40%), microcystic (8%), psammomatous (6%), and angiomatous (3%). No statistically significant (P < .05) associations were found among tumor subtype or grade and any of the MRI features studied. CONCLUSIONS AND CLINICAL IMPORTANCE: Meningiomas in dogs differ from their counterparts in humans mainly in their higher incidence of atypical (Grade II) tumors observed. MRI characteristics do not allow for prediction of meningioma subtype or grade, emphasizing the necessity of histopathology for antemortem diagnosis. The higher incidence of atypical tumors in dogs may contribute to the poorer therapeutic response in dogs with meningiomas as compared with the response in humans with meningiomas.     

Hematuria in a 3-month-old filly with an internal umbilical abscess and internal iliac artery aneurysm

A 3-month-old foal with a history of acute hematuria was evaluated. Hydronephrosis and hydroureter were visualized upon renal ultrasonography of the left kidney. Cystoscopy identified a blood clot occluding the left ureter. Computed tomography (CT) revealed a large retroperitoneal abscess at the level of the aortic bifurcation and a left internal iliac aneurysm. Due to the severity of the lesions and the poor prognosis, the filly was euthanized and the clinical findings were confirmed by post-mortem examination. This report emphasizes the value of obtaining a precise diagnosis via CT in order to avoid unviable treatment approaches when confronted with this unusual secondary complication of omphaloarteritis.Key clinical message:Umbilical complications are routinely diagnosed in equine neonatal medicine, and commonly lead to septicemia, physitis, and septic arthritis; severe internal umbilical abscessation, and subsequent vascular and urinary disorders are uncommon sequelae.     

Pharmacokinetics of acyclovir in adult horses

Objective: To determine the pharmacokinetics of acyclovir administered intravenously (IV) and orally to healthy adult horses. Design: Random cross‐over with an approximate 1‐week washout period between trials. Setting: University veterinary medical teaching hospital. Animals: Six healthy adult research herd horses. Interventions and main results: Acyclovir was administered IV (10 mg/kg in 1 L isotonic crystalloid solution over 60 minutes) and orally (20 mg/kg) to healthy adult horses. Plasma samples were obtained and acyclovir concentrations were determined by high‐pressure liquid chromatography. Peak concentration (mean±SD) for IV acyclovir was 13.74±5.88 μg/mL at the completion of the 1‐hour infusion. The half‐life of the distribution phase (α) was 0.16 hours while the half‐life of the elimination phase (β) was 9.6 hours. The steady‐state volume of distribution was 3.93±1.21 L/kg. We were unable to measure pharmacokinetics after PO acyclovir as plasma concentrations were below the lower limits of detection in all 6 horses. Conclusions: IV administration of acyclovir to healthy adult horses achieves concentrations within the sensitivity range described for equine herpes virus‐type 1. The oral bioavailability of acyclovir in horses is low and additional studies are required.     

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.     

Magnetic resonance imaging and pathological findings in a cat with brain contusions

Necropsy was performed on a mongrel male cat of unknown age weighing 1.3 kg, which probably encountered a traffic accident. Gross pathological examination of the brain revealed reddish colour of the right cerebral hemisphere and haemorrhages on the surface of the right frontal lobe to temporal lobe. Histologically, there was diffuse vacuolation in the cortex of the right frontal lobe and extensive haemorrhages in the base of brain. These histopathological findings were consistent with areas of abnormal signals found on post-mortem magnetic resonance imaging (MRI). In this study, the MRI findings were identical to that reported in human cases of head trauma as well as histopathological changes.     

Elbow joint luxation in a 1-month-old foal

This paper reports on luxation of the elbow joint without concomitant fracture in a 1-month-old foal. Conservative treatment, with closed reduction and full-limb bandaging, including caudal and lateral splints, seemed successful initially, however, failed to provide enough stability and luxation recurred, and open reduction and surgical placement of prosthetic collateral ligaments was required. Luxation of the elbow joint should be considered when acute non-weight bearing forelimb lameness occurs associated with pain and swelling in the area of the elbow in young foals. Closed reduction failed to provide sufficient joint stability.     

Epiploic foramen entrapment of the large colon in a 9-month-old Thoroughbred filly

A 9-month-old Thoroughbred filly was presented for colic of a few hours’ duration. Examination revealed tachycardia at 64 beats/min, and a colon displaced to the right with wall oedema on ultrasound. After an hour of intravenous fluid therapy, the filly became restless and exploratory laparotomy was performed. Impaction and incarceration of the large colon up to the caeco-colic fold through the epiploic foramen (EF) were diagnosed. After evacuating the colonic contents through a pelvic flexure enterotomy, the EF entrapment (EFE) was reduced. The large colon appeared congested with a fragile serosa, serosal tear at its antimesenteric aspect, and amotile for the remainder of the surgery. Colon motility resumed as evidenced by ultrasonographic examination on the second day post-surgery, and despite pasty diarrhoea, the filly made a complete and uneventful recovery and was alive at 6 months’ follow-up. Epiploic foramen entrapment of the large colon is very rare but should be included as a differential diagnosis of colon displacements, even in young horses, requiring prompt surgical resolution.     

Reoccurrence of a paranasal osteoma following surgical removal in a 6-month-old Warmblood filly

A 6-month-old Warmblood filly presented for evaluation of a left sided unilateral mucopurulent discharge of 5 weeks' duration. Upper airway endoscopy revealed a large, smooth mass in the region of the ethmoturbinates. Dorso-ventral and lateral radiographs of the head revealed a large osseous mass in the left paranasal area. A biopsy was performed under general anaesthesia and an osteoma was diagnosed. A computed tomography (CT) examination was performed to guide surgical removal. Surgery was performed under general anaesthesia and a large mass was removed ~15 × 9 cm. A CT examination 3 months following surgery revealed three small areas of mineralisation. It was difficult to differentiate if these were areas of regrowth or portions of the original mass that were not entirely removed. A CT examination 8 months later revealed one of the areas had increased moderately in size. A second surgery was performed standing to remove the growth. A final CT 8 months later revealed no further evidence of a bone growth. This report describes the successful removal of an osteoma regrowth following initial surgical removal and, to the best of the authors’ knowledge, is the first to describe the reoccurrence of an osteoma after surgical intervention. It also describes a successful rhinotomy in the standing equine patient. This case highlights the importance of serial follow-up imaging after surgical removal as osteoma regrowth occurred in this case.     

Magnetic resonance imaging findings in Finnish Spitz dogs with focal epilepsy

Eleven Finnish Spitz dogs with focal seizures and 3 healthy controls were evaluated. General clinical and neurological examinations, blood examination, urinalysis, cerebrospinal fluid examination, electroencephalography (EEG), and magnetic resonance imaging (MRI) of the brain were performed on all dogs. On EEG examination, focal epileptic activity was found in 7 of 11 dogs (64%), and generalized epileptic activity was observed in 4 of 11 dogs (36%). MRI (performed with 1.5 T equipment) detected changes in 1 epileptic dog. Mild contrast enhancement after gadolinium injection was identified in this dog's right parietal cortex. However, no such changes were observed in repeated magnetic resonance images. Special emphasis was given to seizure history to determine any correlations between seizure intervals and MRI findings. Our results indicate that Finnish Spitz dogs with focal seizures suffer from focal idiopathic epilepsy and have nondetectable findings on MRI or pathology. MRI showed poor sensitivity in detecting epileptogenic areas in our patients with focal seizures. Reversible MRI changes in 1 dog could have been caused by seizures.     

Magnetic resonance imaging of two suspected cases of global brain ischemia

Objective: To describe the clinical findings and magnetic resonance imaging (MRI) characteristics of two animals with suspected global brain ischemia (GBI). Series summary: Two brachycephalic animals (Persian cat and Boston terrier) presented for altered mentation, blindness, ataxia, and seizures after being anesthetized. Common to both anesthetic protocols was ketamine. Clinically, the neurological deficits developed rapidly and did not progress after the initial 24 hours. MRI findings were most consistent with GBI. MRI, including pre‐ and post‐T1 weighted, T2 weighted, and fluid‐attenuated inversion recovery (FLAIR) studies, was used to image these animals. Abnormalities were seen post‐T1, T2, and FLAIR. Both animals improved neurologically with supportive care over several weeks, but both remained blind. New information: The use of MRI for diagnosing GBI.