INITIAL INFLUENCE OF RIGHT VERSUS LEFT LATERAL RECUMBENCY ON THE RADIOGRAPHIC FINDING OF DUODENAL GAS ON SUBSEQUENT SURVEY VENTRODORSAL PROJECTIONS OF THE CANINE ABDOMEN

Identification of the duodenum and potential abnormalities on survey abdominal radiographs is often difficult unless it contains gas. This study investigated the effect of patient positioning on the presence of duodenal gas in survey abdominal radiographs. One hundred dogs receiving a three‐view survey abdominal radiographic study were enrolled in a prospective, randomized study where all dogs were divided into two groups. Group A (n = 51) dogs had a left lateral projection first, followed by a ventrodorsal projection, ending with a right lateral projection. Group B (n = 49) dogs had a right lateral projection first, followed by a ventrodorsal projection, ending with a left lateral projection. The presence of gas within the duodenum and level of distribution of gas throughout the duodenum were recorded for all three projections. In addition, the presence or absence of duodenal pseudoulcers was evaluated on all three projections for each dog. The results for the two groups were compared using Chi‐square analysis with a P‐value of less than 0.05 being considered significant. Results showed that dogs first placed in left lateral recumbency were significantly more likely to have duodenal gas on the subsequent ventrodorsal and right lateral radiographic projections compared to dogs first placed in right lateral recumbency (P‐value < 0.0001). Pseudoulcers were seen in 11 dogs that had duodenal gas making the visualization of pseudoulcers on survey abdominal radiographs somewhat commonplace. This study emphasizes the benefit of using initial left lateral abdominal projections prior to other views for subsequent evaluation of the duodenum.     

RADIOGRAPHIC HEART-VOLUME ESTIMATION IN NORMAL CATS

Heart volume mensuration was evaluated on conventional radiographs from eight normal cats in different body positions using computed tomography (CT). Heart volumes were calculated from orthogonal thoracic radiographs in ventral and dorsal recumbency and from radiographs exposed with a vertical X-ray beam in dorsal and lateral recumbency using the formula for an ellipsoid body. Heart volumes were also estimated with CT in ventral, dorsal, right lateral and left lateral recumbency. No differences between heart volumes from CT in ventral recumbency and those from CT in right and left lateral recumbency were seen. In dorsal recumbency, however, significantly lower heart volumes were obtained. Heart volumes from CT in ventral recumbency were similar to those from radiographs in ventral and dorsal recumbency and dorsal/left lateral recumbency. Close correlation was also demonstrated between heart volumes from radiographs in dorsal/ left lateral recumbency and body weights of the eight cats.     

THE CANINE LATERAL THORACIC RADIOGRAPH

Selected structures seen on right and left lateral thoracic radiographs of 12 dogs were evaluated for differences in position, size, and shape. The size and position of the cardiac silhouette were different when thoracic radiographs made in left and right lateral recumbency were compared. These changes were, however, considered insignificant. The position of the right cranial lobe bronchus relative to the left varied in right lateral recumbency and left lateral recumbency. The right cranial lung lobe was better aerated when dogs were positioned in left lateral recumbency.
Lesions seen in the caudal portion of the left cranial lung lobe or the right middle lobe were masked when the affected lobe was dependent, and enhanced when the affected lung lobe was non-dependent. It is believed that this difference occurred due to compression of the dependent lung with greater aeration of the non-dependent lung.     

Vertebral heart size in healthy Australian cattle dog

The vertebral heart score or size (VHS) measurement is routinely used to provide a more objective measurement of cardiomegaly in dogs. However, breed or body conformation can influence the VHS. To assess the specific VHS for the Australian Cattle Dog, left‐to‐right lateral, right‐to‐left lateral, dorsoventral and ventrodorsal thoracic radiographs from 20 individuals free from cardiac and pulmonary disease were obtained. The mean VHS was significantly higher in Australian Cattle Dog (10.5 ± 0.4 vertebrae), when compared with the average VHS for 100 normal dogs of different breeds that had been initially published (9.7 ± 0.5 vertebrae). This emphasizes the importance of breed‐specific VHS ranges. In our study group of normal Australian Cattle Dogs, the mean VHS was 10.5 ± 0.5 vertebrae (mean ±SD) on right lateral and 10.3 ± 0.5 vertebrae on left lateral radiographs. The VHS on right lateral views was significantly larger than on left lateral views. The VHS was 10.5 ± 0.6 vertebrae on dorsoventral and 11.1 ± 0.6 vertebrae on ventrodorsal radiographs. The VHS on ventrodorsal views was significantly larger than on dorsoventral views.     

Ultrasonography in gastrointestinal disease in cattle

Ultrasonography is an ideal diagnostic tool for investigating gastrointestinal disorders in cattle. It is performed on standing non-sedated cattle using a 3.5 MHz linear transducer. In animals with traumatic reticuloperitonitis, inflammatory fibrinous changes, and abscesses can be imaged; however, magnets and foreign bodies are difficult to visualize because of the gas content of the reticulum. Ultrasonography can be used to assess the size, position and contents of the abomasum. Percutaneous ultrasound-guided abomasocentesis can be performed to evaluate the nature and chemical composition of its contents. In left displacement of the abomasum, the abomasum is seen between the left abdominal wall and the rumen. It contains fluid ingesta ventrally and a gas cap of varying size dorsally. Occasionally, the abomasal folds are seen in the ingesta. In cattle with right displacement of the abomasum, the liver is displaced medially from the right abdominal wall by the abomasum, which has an ultrasonographic appearance similar to that described for left displacement. Motility and diameter of the intestine are the most important criteria for ultrasonographic assessment of ileus. However, the cause of the ileus is rarely determined using ultrasonography. In cases with ileus of the small intestine, there is at least one region of dilatation of the intestine and motility is reduced or absent. In cattle with caecal dilatation, the caecum can always be imaged from the right lateral abdominal wall. The wall of the caecum closest to the transducer appears as a thick, echogenic, semi-circular line.     

Presumed acquired dynamic pectus excavatum in a cat

An 11-year-old, spayed female American domestic shorthair cat was presented with open-mouth breathing and dyspnea due to respiratory tract disease. Radiographically, there was thickening of the retropharyngeal soft tissue and soft palate, focal pulmonary change, and severe pectus excavatum (PE), best seen on the left lateral view. Repeat thoracic radiographs 4 months later showed persistent PE, but only on the right lateral view; PE was absent on the left lateral view. The dynamic component of the observed PE was presumably acquired secondary to chronic upper respiratory disease and/or concurrent increased pliability of the thoracic wall from prolonged prednisolone treatment.     

Bilateral stifle osteochondritis dissecans in a cat

A 9-month-old, castrated male, domestic shorthaired cat was presented for progressive right hind-limb lameness. A diagnosis of osteochondritis dissecans of the lateral femoral condyle was made based on radiographs and physical examination, and was confirmed by right lateral stifle arthrotomy. The cartilage flap was removed, and the underlying bone was curetted. Seven months later, the cat was sound on the right leg but developed a left hind-limb lameness. A similar lesion was found in the left leg and was treated identically. Fourteen months after presentation, the cat was sound on both hind limbs.     

EFFECT OF DEPENDENCY VERSUS NONDEPENDENCY ON LUNG LESION VISUALIZATION

Paraffin blocks and mineral oil were used as a model to determine the effect of dependency versus nondependency on radiographic visualization of lung lesions in lateral thoracic radiographs. It was concluded that the increased opacity of the material surrounding the lesion, not contact between the heart and the lesion, was responsible for the inability to detect lung disease in the dependent lung. The results were tested in dogs with pneumonia in the right middle lung lobe. When the dog was in right lateral recumbency, the dependent right lung was increased in opacity and decreased in volume and the pulmonary lesion was difficult to detect. When the dog was in left lateral recumbency, the nondependent right lung was increased in volume and decreased in opacity and the pulmonary disease was clearly visible. A single recumbent lateral radiograph must not be used to assess a dog with suspected lung disease because lesions in the dependent lung lobes may not be detected.     

RADIOGRAPHIC DIAGNOSIS OF GASTROINTESTINAL DISORDERS IN THE FOAL

Abdominal discomfort in the foal presents a diagnostic challenge, because the small size of the foal precludes rectal palpation. Standing lateral horizontal beam abdominal radiographs using conventional techniques were evaluated as a diagnostic aid to identify the presence and location of gastrointestinal disorders in foals presented with colic. Forty foals were radiographed prior to surgery (20 foals), necropsy (7 foals), or clinical diagnosis (13 foals). Clinical, surgical, or necropsy findings were then correlated to radiographic findings. Gastrointestinal disease was accurately identified on radiographs as the source of colic in 25 of 26 foals that had surgical or postmortem confirmation. The site of disease, whether gastric, small intestinal, large intestinal, or a combination, was accurately determined from radiographs. Standing lateral abdominal radiographs were determined to be a valuable diagnostic aid in the foal presented with colic.     

ENDOSCOPIC RETROGRADE CHOLANGIO-PANCREATOGRAPHY IN HEALTHY BEAGLES

Endoscopic retrograde cholangiography and pancreatography was performed in seven healthy Beagles to assess the common bile duct and the accessory pancreatic duct after retrograde filling with an iodine contrast medium. All dogs had a major and a minor duodenal papilla. One Beagle had additionally an accessory papilla. The diameter of the contrast filled ducts was measured at three defined measure points (MP1-3) in ventrodorsal radiographs and left lateral radiographs. In ventrodorsal radiographs of endoscopic retrograde cholangiography the common bile duct had a straight craniomedial course. The mean duct diameter was from proximal to distal 3.04 +/- 1.89mm at MP1, 2.38 +/- 1.23 mm at MP2, and 2.11 +/- 0.84 mm at MP3. In ventrodorsal radiographs of endoscopic retrograde pancreatography, the left and right branch of the accessory pancreatic duct united in the pancreatic body. The mean diameter of the right branch was 0.88 +/- 0.14 mm at MP1, 0.72 +/- 0.2 mm at MP2 and 0.61 +/- 0.11 mm at MP3. The left branch had a diameter of 0.93 +/- 0.28 mm at MP1, 0.86 +/- 0.21 at MP2, and 0.6 +/- 0.07 mm at MP3. The mean length was 81.6 +/- 14.3 mm for the right and 107.0 +/- 24.9mm for the left branch. In left lateral radiographs of endoscopic retrograde pancreatography, it was not possible to differentiate the left from the right branch. Both branches ran nearly parallel and showed similar diameters but slight differences in length. The study proves that endosopic retrograde cholangio-pancreatography is possible in dogs. Radiographs taken from dogs in dorsal recumbency allow an objective assessment of the common bile duct and the accessory pancreatic duct.     

RADIOGRAPHIC EVALUATION OF CAUDAL VENA CAVA SIZE IN DOGS

Dilation of the caudal vena cava (CVC) on lateral thoracic radiographs is often interpreted as suggestive of right-sided congestive heart failure. To quantitate the clinical utility of evaluating CVC size as an indicator of right-sided heart disease, we compared the ratio of the diameter of the CVC as measured on a left lateral thoracic radiograph to the descending aorta (Ao), length of the thoracic vertebra above the tracheal bifurcation (VL), and width of the right fourth rib (R4) in 35 dogs with right heart disease and 35 control dogs. Each CVC ratio (CVC/Ao, CVC/VL, CVC/R4) was statistically larger in dogs with right heart disease. Response operating characteristic curves and likelihood ratios were used to determine ratios helpful in identifying dogs with right heart disease. A CVC/Ao > 1.50, CVC/VL > 1.30, or CVC/R4 > 3.50 are strongly suggestive of a right-sided heart abnormality in a patent.     

RADIOGRAPHIC AND ECHOCARDIOGRAPHIC ASSESSMENT OF LEFT ATRIAL SIZE IN 100 CATS WITH ACUTE LEFT‐SIDED CONGESTIVE HEART FAILURE

The aims of this study were to evaluate left atrial size in cats with acute left‐sided congestive heart failure. We hypothesized that left atrial size as determined by thoracic radiography can be normal in cats with acute left‐sided congestive heart failure. One hundred cats with acute left‐sided congestive heart failure in which thoracic radiography and echocardiography were performed within 12 h were identified. Left atrial size was evaluated using right lateral and ventrodorsal radiographs. Measurements were compared to two‐dimensional echocardiographic variables of left atrial size and left ventricular size. On echocardiography, left atrial enlargement was observed in 96% cats (subjective assessment) whereas maximum left atrial dimension was increased (>15.7 mm) in 93% cats. On radiographs left atrial enlargement (subjective assessment) was found in 48% (lateral view), 53% (ventrodorsal view), and 64% (any view) of cats whereas left atrial enlargement was absent in 36% of cats in both views. Agreement between both methods of left atrial size estimation was poor (Cohen's kappa 0.17). Receiver operating characteristic curve analysis identified a maximum echocardiographic left atrial dimension of approximately 20 mm as the best compromise (Youden index) between sensitivity and specificity in the prediction of radiographic left atrial enlargement. Left atrial enlargement as assessed by thoracic radiography may be absent in a clinically relevant number of cats with congestive heart failure. Therefore, normal left atrial size on thoracic radiographs does not rule out presence of left‐sided congestive heart failure in cats with clinical signs of respiratory distress.     

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.     

Surgical repair of a congenital lateral abdominal wall hernia in a neonatal foal

A 16‐hour‐old Quarter Horse filly presented for evaluation of a soft mass in the right caudoventral lateral abdominal wall. Radiography and ultrasonography confirmed the presence of a nonreducible lateral abdominal wall hernia with small intestine located between the skin and body wall. The size of the defect itself could not be imaged and the filly was taken to surgery. A 4 cm vertical defect that appeared congenital was found in the transverse abdominal muscle and was repaired by primary apposition. This case report describes the repair and outcome of this unusual type of congenital hernia.     

Herniation of the urinary bladder through a congenitally enlarged inguinal canal in a cat

A two-year-old, castrated male Main Coon cat was referred because of chronic, recurrent pollakiuria, haematuria, and acute vomiting. On clinical examination, a smooth, soft-tissue mass, suspected to be the urinary bladder, was palpable outside of the abdominal wall in the inguinal area. On radiographs, the urinary bladder was found to be extra-abdominal, and herniated through an enlarged right inguinal canal at exploratory coeliotomy.The left inguinal canal was also enlarged. The urinary bladder was repositioned and fixed to the caudal abdominal wall by incisional cystopexy and both enlarged inguinal canals were partially closed with an interrupted suture pattern.     

A VALENTINE‐SHAPED CARDIAC SILHOUETTE IN FELINE THORACIC RADIOGRAPHS IS PRIMARILY DUE TO LEFT ATRIAL ENLARGEMENT

Conflicting information has been published regarding the cause of a valentine‐shaped cardiac silhouette in dorsoventral or ventrodorsal thoracic radiographs in cats. The purpose of this retrospective, cross‐sectional study was to test the hypothesis that the valentine shape is primarily due to left atrial enlargement. Images for cats with a radiographic valentine‐shaped cardiac silhouette and full echocardiography examination were retrieved and independently reviewed. A subjective scoring system was used to record severity of radiographic valentine shape. Subjective radiographic evidence of left atrial enlargement in a radiographic lateral projection and a final diagnosis based on medical records were also recorded. A total of 81 cats met inclusion criteria. There was a strong positive correlation (P < 0.001) between echocardiographic left atrial size and severity of radiographic valentine shape. There was no effect of echocardiographic right atrial size on the severity of valentine shape, except when concurrent with severe left atrial enlargement. In this situation, right atrial enlargement increased the likelihood of observing a severe valentine shape. There was no effect of right atrial enlargement on the shape of the cardiac silhouette when left atrial enlargement was absent or only mild to moderate. There was no correlation between the category of final diagnosis of cardiac disease and the severity of valentine shape. Findings from this study supported the hypothesis that a valentine‐shaped cardiac silhouette in radiographs is due primarily to left atrial enlargement in cats, with right atrial enlargement only impacting the shape if concurrent with severe left atrial enlargement.     

Radiographic anatomy of the canine liver: simple measurements determined from the lateral radiograph

The literature on plain film evaluation of the canine liver is reviewed and the problems associated with radiographic hepatometry in this species and in man are outlined. Methods used to determine liver size in man are briefly described. Liver measurements obtained from lateral recumbent radiographs of 20 German Shepherd Dogs were examined statistically. The ratio of a measurement of liver length to second lumbar vertebra body length was found to be of statistical value, as was the relative position of the junction separating left medial, right medial and quadrate lobes from a further part of the right medial and left lateral lobes. The extrapolation of these results to other breeds is discussed.     

Quantitative noninvasive assessment of liver size in clinically normal dogs

Measurements of liver size were made from radiographs of 16 clinically normal anesthetized dogs. Two measurements were made from each of 3 views: right and left lateral and ventrodorsal. Each measurement was correlated with liver weight and volume. Liver weight and volume were also correlated with both measurements from the same radiograph multiplied together. All measurements, with the exception of ventrodorsal depth, correlated significantly (P less than 0.05) with liver weight and volume. The multiplication of the 2 measurements made from the right lateral radiograph correlated most highly with liver weight. These data were then compared with those from similar studies involving liver measurements obtained from nuclear scintigraphic and ultrasonographic scans on the same dogs. The radiographic measurements made from the right lateral view had the highest correlation with liver weight, followed by the nuclear scintigraphic measurements made from the same position.     

Aortic foreign body (airgun pellet) embolism in a cat

A five-year-old female domestic shorthair cat presented with clinical signs typical of an aortic saddle thromboembolism. An echocardiogram and thoracic radiographs excluded cardiac disease as a source of the thrombus. Two heavy metal opacity, pellet-like objects were seen in the thoracic and abdominal radiographs. Abdominal ultrasound demonstrated occlusion of aortic blood flow by the abdominal pellet but could not indicate whether this was due to a penetrating aortic wound or pellet embolisation. A necropsy confirmed a penetrating left ventricular cardiac wound with subsequent embolisation of the pellet to the abdominal aorta.