ACCURACY OF A COMPUTED TOMOGRAPHY BRONCHIAL WALL THICKNESS TO PULMONARY ARTERY DIAMETER RATIO FOR ASSESSING BRONCHIAL WALL THICKENING IN DOGS

Computed tomography is increasingly being used in veterinary medicine to evaluate animals with pulmonary signs such as coughing, tachypnea, and exercise intolerance, however, a quantitative measure of bronchial wall thickening has yet to be validated in veterinary medicine. Canine chronic bronchitis is a disease that is characterized histologically by thickening of the bronchial walls. Thoracic CT images of 16 dogs with chronic bronchitis and 72 dogs presenting for conditions unrelated to cough were evaluated. A ratio comparing the bronchial wall thickness to the adjacent pulmonary artery diameter was obtained in the right and left cranial and caudal lung lobes. There was no significant difference in dogs with chronic bronchitis or unaffected dogs between the left and right hemithorax, patient weight, patient age, image slice thickness, or CT machine used. Dogs with chronic bronchitis were found to have a significantly greater ratio than unaffected dogs (P < 0.001). The ratios in the cranial lung lobes were found to be significantly greater than the caudal lung lobes in both chronic bronchitis and unaffected dogs (P < 0.001). A receiver operating characteristic curve of the ratios in the cranial lung lobes had an area under the curve of 0.912, indicating high accuracy in predicting for bronchial wall thickening. A ratio of ≥0.6 in the cranial lung lobes was found to have a sensitivity of 77% and specificity of 100% in predicting for the presence of chronic bronchitis, and we propose using this cut‐off as supportive of bronchial wall thickening on CT.     

Cytological Analysis of Bronchoalveolar Lavage Fluid in the Diagnosis of Spontaneous Respiratory Tract Disease in Dogs: A Retrospective Study

Results of cytological analysis of bronchoalveolar lavage (BAD fluid were compared with clinical diagnoses in dogs that presented with signs of respiratory disease to referral hospitals. Of 68 dogs in which a clinical diagnosis was possible, BAL cytological findings were considered definitive for the diagnosis in 17 cases (25%), supportive of the diagnosis in 34 cases (50%), and not helpful in 17 cases (25%). Findings were most often considered supportive of or definitive for the clinical diagnosis in dogs with alveolar or bronchial radiographic patterns, or the presence of pulmonary masses. BAL results among lung lobes differed in 23 of 63 dogs (37%) with diffuse radiographic patterns. Tracheal wash cytology differed from BAL fluid cytology in 45 of 66 dogs (68%). Bronchoalveolar lavage was a clinically useful procedure for the diagnostic evaluation of dogs with signs of respiratory disease.     

Use of the distomedial-proximolateral oblique radiographic view of the elbow joint for examination of the medial coronoid process in dogs

OBJECTIVE: To describe and evaluate a new radiographic view of the elbow joint in dogs that would potentially enhance observation of the medial coronoid process (MCP). SAMPLE POPULATION: 20 cadaver limbs from 10 dogs and clinical examination of 100 elbow joints of 53 dogs. PROCEDURE: Twenty elbow joints from 10 cadavers were imaged by use of mediolateral, flexed mediolateral, craniocaudal, craniolateral-caudomedial oblique (Cr15L-CdMO), and distomedial-proximolateral oblique (Di35M-PrLO) radiographic views before and after placement of 3 lead pellets placed on the cranial, medial, and craniodistal aspect of the MCP. Three examiners independently reviewed these radiographs. One hundred elbow joints of 53 dogs with forelimb lameness and signs of pain elicited on palpation of the elbow joint were examined. These joints were radiographed and treated by use of arthroscopy. Three examiners independently graded the radiographs. RESULTS: The MCP was identified on all Di35M-PrLO views made during the anatomic study. The Di35M-PrLO view had the largest area under the receiving operating characteristic (ROC) curve for detection of abnormalities of the MCP. Fractured and nonfractured MCP could only be significantly differentiated on Di35M-PrLO and mediolateral views. The Di35M-PrLO view had a higher agreement between examiners than other radiographic views for detection of fractures of the MCP. CONCLUSION AND CLINICAL RELEVANCE: The Di35M-PrLO view enhances the identification of anomalies and fragmentation of the MCP in dogs, compared with other radiographic views. The Di35M-PrLO view may be of benefit for early screening of dogs potentially affected with elbow dysplasia.     

Chronic tracheobronchial syndrome in eight dogs.

Chronic tracheobronchial syndrome was diagnosed in eight dogs which had had a chronic mild cough for two to 13 months but were otherwise clinically normal. In five of them there was evidence of contact with other coughing dogs before the appearance of clinical signs and the majority at first responded favourably to antibacterial therapy. The coughing occurred mainly when the dogs pulled on their leads or became excited. Three cases had bronchoscopic evidence of active airway inflammation, and five had varying numbers of inflammatory cells (neutrophils) in bronchial aspirates. There was no evidence of excessive production of mucus in the airways of any of the dogs. Seven had an increased bronchial pattern on radiographs but only one of the dogs has developed chronic bronchitis.     

Canine bronchomalacia: a clinicopathological study of 18 cases diagnosed by endoscopy

Canine bronchomalacia (BM) is characterized by weakness leading to collapse of the bronchial wall. A prospective study of 18 affected dogs (age range: 1-15 years) was undertaken to characterize the clinicopathological and histological features of BM. Poodles and Yorkshire terriers were commonly affected. Half of the dogs were overweight or obese. The clinical presentation was a mild, wheezing, chronic cough and pulmonary crackles were heard in 28% of the dogs. Compatible radiographic changes were present in 61% of the dogs. Using bronchoscopy, both lungs were affected in half of the animals, whereas in the others the disease appeared to affect predominantly the left lung. Analysis of bronchoalveolar lavage fluid and biopsies of bronchial mucosa revealed pure or mixed neutrophilic inflammation. Underlying infectious bronchitis was considered possible in 56% of the dogs. It was concluded that canine BM may present as an isolated clinical entity associated with infection and/or inflammation.     

Spontaneous Crenosoma vulpis infection in 10 dogs: laboratory,radiographic and endoscopic findings

Crenosoma (C.) vulpis infection was diagnosed in 10 dogs aged between 0.5 and 12 years (median 4 years) during a 4-year period. The predominant clinical sign in all dogs was coughing which lasted from 1 day to > 4 months. Hematological abnormalities included eosinophilia in 5/9 dogs, basophilia in 3/9 dogs, and mild monocytosis in 6/9 dogs. Thoracic radiographs (n = 9) were normal in 1 dog, showed a mild bronchial or interstitial pattern in 4 dogs, and moderate to marked changes (bronchial-interstitial to alveolar) in 4 dogs. Endoscopic findings (n = 9) varied from mild erythematous bronchitis (n = 3) to marked bronchitis with accumulation of large amounts of mucus (n = 2), irregular nodular mucosal surface (n = 2), accumulation of pus (n = 1), and bronchial hemorrhage (n = 1). Adult worms were observed in 2 dogs. Bronchial lavage cytology revealed inflammation with predominance of eosinophils in 7/10 dogs, eosinophils and neutrophils in 2/10 dogs, and neutrophils in 1/10 dogs. C. vulpis larvae were identified in the BAL of 5/10 dogs. Fecal examinations with the Baermann technique was the most sensitive method and positive in all 10 dogs. C. vulpis infection has to be considered in the differential diagnosis in dogs of all ages presenting with acute or chronic cough.     

Elevated canine pancreatic lipase immunoreactivity concentration in dogs with inflammatory bowel disease is associated with a negative outcome

O bjectives : To investigate whether elevated canine pancreatic lipase immunoreactivity (CPLI) concentrations in dogs with inflammatory bowel disease (IBD) is associated with a worse clinical outcome.
M ethods : Serum CPLI assays were performed on serum stored from cases diagnosed with IBD. Thirty-two dogs with CPLI results within the reference range were designated as the control group and 15 dogs had CPLI above the reference range. Clinical signs, age, serum lipase and amylase activities, serum albumin and cobalamin concentrations, abdominal ultrasound examination, histopathology on small intestinal biopsies, management of IBD and outcome were compared between the two groups.
R esults : No significant differences were found in clinical activity score (P=0·54), number of antibiotic-responsive disease cases (P=0·480), number of steroid-responsive disease cases (P=0·491), serum amylase activity (P=0·058), serum cobalamin concentration (P=0·61), serum albumin concentration (P=0·052), abdominal ultrasound score (P=0·23) and histopathology scores for IBD (P=0·74) between the two groups. Dogs with increased CPLI concentration were significantly older and had a higher serum lipase activity than dogs with a CPLI concentration within the normal reference range (P=0·001, P=0·001, respectively). Moreover, dogs with increased CPLI concentration responded poorly to steroid treatment (P=0·01) and were significantly more likely to be euthanased at follow-up (P=0·02).
C linical S ignificance : CPLI should be measured in cases of canine IBD as elevated CPLI was associated with a worse outcome.     

Fluoroscopic and radiographic evaluation of tracheal collapse in dogs: 62 cases (2001-2006)

OBJECTIVE: To compare the use of radiography and fluoroscopy for detection and grading of tracheal collapse in dogs. DESIGN: Retrospective case series. Animals-62 dogs with tracheal collapse. PROCEDURES: For each dog, tracheal collapse was confirmed fluoroscopically and lateral cervical and thoracic radiographic views were reviewed. A board-certified radiologist (who was unaware of the dogs' clinical history) evaluated the cervical, thoracic inlet, thoracic, carinal, and main stem bronchial regions in all fluoroscopic videos and radiographic images for evidence of collapse. Cervical, thoracic inlet, thoracic, and carinal regions in both radio-graphic and fluoroscopic studies were graded for collapse (0%, 25%, 50%, 75%, or 100% decrease in diameter). RESULTS: Lateral cervical and thoracic radiographic images were available for 54 dogs, and inspiratory and expiratory lateral cervical and thoracic radiographic images were available for 8 dogs. For detection of tracheal collapse, assessment of radiographic views was sensitive and had the best negative predictive value in the cervical and thoracic inlet regions. Assessment of radiographic views was most specific and had the best positive predictive value in the thoracic inlet, thoracic, carina, and main stem bronchial regions. Radiography underestimated the degree of collapse in all areas. Review of inspiratory and expiratory views improved the accuracy of radiography for tracheal collapse diagnosis only slightly. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with fluoroscopy, radiography underestimated the frequency and degree of tracheal collapse. However, radiography appears to be useful for screening dogs with potential tracheal collapse.     

Chronic Nasal Disease in the Dog: Its Radiographic Diagnosis

The radiographic signs of 40 dogs with chronic nasal disease were tabulated and compared with the definitive diagnoses. Erosion of the vomer bone and/or an external mass were present in 16 of 18 dogs that had nasal tumors. Areas of radiolucency in the nasal cavity were present in 8 of 15 dogs that had nasal fungal disease. Radiographic examination did not provide a highly reliable diagnosis for all dogs with chronic nasal disease.     

Idiopathic detrusor-urethral dyssynergia in dogs: a retrospective analysis of 22 cases

Results of a retrospective study of 22 dogs with signs of dysuria and/or stranguria in which a diagnosis of idiopathic detrusorurethral dyssynergia was made are presented. The diagnosis was based on the exclusion of detectable pathological conditions which could also cause urine outflow obstruction. The affected cases were 22 middle-aged male dogs (mean age 4·9 years) of large and giant breeds (mean bodyweight 36·7 kg). Nine dogs had had periodic clinical signs for longer than one year, one for seven months and eight for two to five weeks, while in four dogs signs had begun four to five days before referral. All dogs received the α-sympatholytic agent prazosin as an initial treatment and in 11 it remained the only therapy. There was a good effect in seven and a moderate response in the other four dogs. In one dog, prazosin was ineffective and was replaced by diazepam, which markedly reduced the signs. Three other dogs required frequent catheterisation and antibiotics were administered. These dogs responded favourably. Another three dogs with evidence of impaired bladder contractility were also treated with the parasympathomimetic agent carbachol. One did not improve and was euthanased. Four dogs developed bladder paralysis and severe infectious cystitis. Only one of these could be managed satisfactorily by long-term administration of prazosin, carbachol and antibiotics, and the others had to be euthanased.     

Comparison of radiographic assessments of the tibial plateau slope in dogs

OBJECTIVES: To evaluate the accuracy of 2 radiographic methods used to assess tibial plateau slope (TPS) in dogs and evaluate effects of film digitization and radiographic beam placement on TPS measurements. SAMPLE POPULATION: 16 hind limbs from dog cadavers weighing > 20 kg. PROCEDURES: Radiographs of tibiae were made with the radiographic beam centered over the stifle joint and midshaft of the tibia. Tibiae were collected, the femorotibial contact area was determined, and slope of the medial tibial condyle in relation to the tibial shaft was measured. Radiographs were digitized. Slope of the medial tibial condyle was measured on printed and digitized radiographs read in random order by 6 examiners unaware of anatomic measurements. Three examiners used a conventional measuring technique, and 3 examiners used an alternative measuring technique. RESULTS: Anatomic measurements were significantly higher than radiographic measurements made by use of the conventional interpretation method but did not differ from radiographic measurements made by use of the alternate method. Measurements from printed radiographs were lower than measurements from digitized radiographs for the 4 most experienced examiners. CONCLUSIONS AND CLINICAL RELEVANCE: Measurements made by use of a line tangential to the cranial, linear portion of the medial tibial condyle at the femorotibial contact point were accurate measurements of the anatomic TPS. Measurements made by use of the conventional TPS measurement method underestimated the anatomic TPS. Measurements made on digitized radiographs were typically more accurate than measurements made on printed radiographs.     

Management of 13 cases of canine respiratory disease using inhaled corticosteroids

OBJECTIVES: To determine the value of inhaled corticosteroids in the management of chronic inflammatory airway disease in dogs. METHODS: Medical records of dogs that were presented for the investigation of respiratory disease were reviewed retrospectively. Criteria for inclusion were knowledge of previous medical treatment including side effects, diagnosis of the underlying disease, use of inhaled corticosteroids and at least two-months follow-up data.RESULTS: Thirteen dogs that fulfilled the criteria were identified. Ten dogs were diagnosed with chronic bronchitis and three with eosinophilic bronchopneumopathy. Four dogs had not previously received corticosteroid treatment for their respiratory disease, and all these showed a reduction or a resolution of clinical signs without obvious side effects after inhaled corticosteroid therapy. Nine dogs had previously received oral or parenteral corticosteroids for treatment of their respiratory disease, and all had exhibited side effects. Five of these dogs were treated with inhaled corticosteroids alone, and all exhibited an improvement in clinical signs without observable side effects. The remaining four dogs were treated with a combination of inhaled and oral corticosteroids, and all showed improvement in clinical signs and reduction in side effects. Inhaled medication was well tolerated in all dogs. CLINICAL SIGNIFICANCE: Inhaled corticosteroids were used for the management of chronic bronchitis and eosinophilic bronchopneumopathy in 13 dogs, and these may have the advantage of reducing side effects associated with oral corticosteroids.     

Chronic tracheobronchial disease in the dog.

Tracheobronchial collapse and chronic bronchitis (CB) are the two most common forms of chronic tracheobronchial disease in dogs. These conditions may exist independently of one another, although CB and some degree of tracheobronchial collapse often co-exist in the same patient. Diagnosis of CB can be established on clinical grounds alone, whereas radiographic or bronchoscopic evidence is required to confirm the diagnosis of tracheobronchial collapse. Although glucocorticoid drug therapy remains one of the most effective methods for managing CB, surgical implantation of a prosthetic airway device may be of great benefit for some dogs with a focal area of collapsing trachea. With early diagnosis and aggressive medical and surgical management, the prognosis for many dogs with chronic tracheobronchial disease is good for reasonable quality of life.     

Assessment of the value of the vertebral heart scale in the radiographic diagnosis of cardiac disease in dogs

In order to assess the influence of the vertebral heart scale (VHS) on the accuracy of the radiographic diagnosis of cardiac disease, thoracic radiographs of 50 dogs with proven cardiac disease, 26 with other thoracic diseases, and 50 with no clinical signs of cardiovascular or respiratory disease were mixed and examined by three independent, blinded observers chosen to represent a range of radiographic abilities. They first examined all the radiographs without making measurements of VHS and made a diagnosis. They then re-examined the radiographs, and measured VHS on both lateral and dorsoventral or ventrodorsal radiographs before again recording a diagnosis without reference to their original diagnoses. For all the observers, the dogs with cardiac disease had a higher mean VHS than the normal dogs. A VHS over 10.7 on the lateral radiograph was a moderately accurate sign of cardiac disease. The observers' accuracy of diagnosis did not change significantly as a result of using VHS as an adjunct to a subjective assessment of the radiographs.     

Serum lipid concentrations in dogs with tail chasing

O bjective : To characterise lipid profile in dogs with tail chasing.
M ethods : Fifteen dogs with tail chasing were included in this study. A behavioural diagnosis was made for each dog on the basis of the dog's behavioural history, clinical signs and results of other medical assessments. None of the dogs had concurrent medical disease that would account for compulsive tail chasing. Blood samples were taken from each dog after a fasting period of 12 to 16 hours to measure total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and very low-density lipoprotein cholesterol levels. Fifteen control dogs were also enrolled on the basis of normal physical examination results, complete blood count and serum biochemistry profiles.
R esults : Dogs with tail chasing had significantly higher total cholesterol (P < 0·01), high-density lipoprotein cholesterol (P<0·05) and low-density lipoprotein cholesterol (P<0·001) compared with control dogs. Very low-density lipoprotein cholesterol and triglyceride levels did not differ significantly between the groups.
C linical S ignificance : Tail chasing may be associated with serum cholesterol elevations in dogs. High serum cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol levels may be used as biochemical parameters of compulsive tail chasing in clinical settings.     

Ultrasonographic features of intestinal intussusception in 10 dogs

Records of dogs that had abdominal ultrasonography and surgical or pathological diagnosis of intestinal intussusception between February 1992 and June 1997 were reviewed retrospectively. Ultrasound images were reviewed with respect to appearance of the intussusception, suspected location, evidence of predisposing cause and concurrent lesions. Ten intussusceptions were found, affecting a variety of breeds. The mean (range) age of affected dogs was 2·5 (0·3 to seven) years (four females and six males) and the reported duration of clinical signs, 48 (one to 150) days. Intussusceptions were jejunojejunal (five dogs), ileocolic (three), caecocolic (one) and colocolic (one). A concentric ring sign was identified ultrasonographically in each dog and anatomical location predicted correctly in five instances. Additional ultrasonographic findings associated with intussusceptions included intestinal neoplasm in two dogs, enlarged abdominal lymph nodes in two, multiple mesenteric cysts in one and intestinal foreign body in a further dog. Thus, ultrasonography enables accurate diagnosis of intestinal intussusception and is a useful method for searching for concurrent or predisposing lesions.     

A retrospective study of diagnosis in 109 cases of canine lower respiratory disease

Between 1983 and 1988, 109 cases of canine lower respiratory tract disease were examined and categorised according to clinical, radiographic and bronchoscopic findings and cytology of bronchial mucus. Non-specific chronic tracheobronchitis was diagnosed in 19 cases, bronchopneumonia (subacute or chronic) in 12 cases, bronchiectasis in 10 cases, parasitic bronchitis due to Oslerus osleri in 20 cases, eosinophilic bronchitis with or without bronchiectasis or alveolar infiltration in 25 cases, bronchial foreign bodies, mainly cereal ears, in 14 cases, primary neoplasia (adenocarcinomas) in six cases and miscellaneous disease in three cases. Features of these conditions are discussed. Although the aetiology of chronic bronchial disease may not always be ascertained, it is important to assign a dog to a diagnostic category so that the owner can be given a more accurate prognosis.     

RADIOGRAPHIC ASPECTS OF Pneumocystis carinii PNEUMONIA IN THE MINIATURE DACHSHUND

The thoracic radiographic changes of Pneumocystis carinii in 7 miniature Dachshunds were reviewed. The dogs were 7–12 months old and presented with polypnea, exercise intolerance and clinical signs suggestive of immune-incompetence. P. carinii pneumonia was diagnosed in all the dogs using transtracheal aspirate cytology and confirmed at postmortem in 3 dogs that died. Radiographically, diffuse pulmonary changes were present and varied from a mild interstitial and bronchial pattern to an alveolar pattern. Radiographic evidence of cor pulmonale was present in 1 dog. The most severe radiographic changes were seen in 2 of the dogs that died.     

Pulmonary infiltration with eosinophils in 14 dogs

Pulmonary infiltration with eosinophils was diagnosed in 14 dogs, whose age ranged from three months to 13 years. The predominant clinical sign was coughing. Dyspnoea, tachypnoea and pruritus were also observed. An absolute circulating eosinophilia was seen in eight dogs and basophilia in five dogs. Thoracic radiographic changes were variable and were not diagnostic. Bronchoscopic evidence of mild to severe bronchitis was present in 12 dogs. Abnormal numbers of eosinophils were found in bronchoalveolar lavage samples and, or, bronchial washings in all 14 cases, but no significant bacteria were recovered. Respiratory compliance was measured in five dogs and was abnormal in three. Faecal examination for helminth parasites was carried out in four cases, a large ascarid burden being identified in one. Intradermal skin testing was carried out in three dogs but was negative in all cases. Complete remission of signs was achieved with prednisolone in 12 cases with six dogs requiring continuous or repeated treatment. Three dogs died as a direct consequence of progression of the disease.     

IMAGING DIAGNOSIS—COMPUTED TOMOGRAPHY OF TRACTION BRONCHIECTASIS SECONDARY TO PULMONARY FIBROSIS IN A PATTERDALE TERRIER

An 8‐year‐old, Patterdale terrier was referred for evaluation of tachypnoea, exercise intolerance, and weight loss. Computed tomographic images showed pneumomediastinum, diffuse pulmonary ground glass opacity, and marked dilatation of peripheral bronchi, but no evidence of thickened bronchial walls. The histopathologic diagnosis was diffuse pulmonary interstitial fibrosis, type II pneumocyte hyperplasia, and bronchiectasis. The lack of evidence of primary bronchitis supported a diagnosis of traction bronchiectasis. Traction bronchiectasis can occur as a sequela to pulmonary fibrosis in dogs.