PERIRENAL EFFUSION IN DOGS AND CATS WITH ACUTE RENAL FAILURE

Perirenal fluid accumulation has been described as an ultrasonographic feature of urine leakage, hemorrhage, abscessation, or neoplasia. The purpose of this retrospective study was to report perirenal effusion as an additional ultrasonographic finding in canine and feline patients with acute renal failure. The causes of acute renal failure in 18 patients included nephrotoxicity (4), leptospirosis (3), ureteral obstruction (2), renal lymphoma (2), ureteronephrolithiasis (2), prostatic urethral obstruction (1) and interstitial nephritis and ureteritis (1). An underlying cause was not identified in three patients. The sonographic finding of perirenal fluid was bilateral in 15 patients. Unilateral perirenal fluid was identified ipsilateral to the site of ureteric obstruction in two patients. Large effusions extended into the caudal retroperitoneal space. Additional sonographic findings suggestive of renal parenchymal disease included mild (5), moderate (5) or severe (2) pyelectasia, increased renal echogenicity (11), increased (9) or decreased renal size (2) and ureteral and/or renal calculi (3). There did not appear to be an association between the volume of perirenal fluid and the severity of renal dysfunction. All patients with large effusions underwent euthanasia. Perirenal fluid developing in acute renal failure is thought to be an ultrafiltrate associated with tubular back-leak into the renal interstitium that overwhelms lymphatic drainage within the perirenal and retroperitoneal connective tissues although obstruction to urine flow may also play a role. Localized perirenal retroperitoneal free fluid may be a useful ultrasonographic feature to assist with the characterization of, and determination of prognosis in, patients with suspected renal disease.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING AND HISTOPATHOLOGICAL FEATURES OF A SKULL BASE CHORDOMA IN A CAT

An 8‐year‐old domestic short‐haired cat was presented with anorexia, lethargy, ataxia and one episode of consciousness loss. A midline vertically orientated, biconcave, extra‐axial mass originating from the basioccipital bone was detected on magnetic resonance images of the head. The mass was T1W iso‐ to hypointense when compared with normal grey matter, T2W hyperintense with small areas of isointensity and heterogeneously enhanced with contrast. Multiple signal voids were observed on T2^* images. Histopathological evaluation confirmed a chordoma. To the authors’ knowledge this is the first report of the imaging characteristics of a chordoma affecting the skull base in a cat.     

MAGNETIC RESONANCE IMAGING FEATURES OF PARASPINAL INFECTION IN THE DOG AND CAT

The magnetic resonance (MR) imaging findings in 22 dogs and two cats with confirmed paraspinal infection of the thoracolumbar spine were characterized. These findings included extensive T2-hyperintense areas (24/24), abscessation (20/24), mild inherent T1-hyperintensity of muscle and abscesses (18/24), and postcontrast enhancement (24/24). Changes involved the vertebral canal in four patients. The longus coli muscles were affected in one cat. Thoracolumbar changes in the remaining 23 patients involved the iliopsoas and epaxial muscles in 23/23 and 19/23 patients, respectively. Iliopsoas muscle abscessation was unilateral in 12/23, and bilateral in 6/24 patients. Abscessation involved both epaxial and iliopsoas muscles in 2/23 patients and the epaxial muscles alone in one patient. A contrast-enhancing sinus tract within the deep thoracolumbar fascia was present in 10/23 patients. Lumbar vertebrae periosteal reactions were identified in 19/23 patients on MR images compared with 15/17 patients with radiography. A focal area of signal void suspected to represent foreign material was seen in 5/23 patients but foreign material was actually found in only two of these five. There was no recurrence of clinical signs following MR imaging and revision surgery. MR imaging permits the severity and extent of changes associated with paraspinal infection to be characterized and allows the location, number and any communication of sinus tracts to be documented.     

CROSSED RENAL ECTOPIA WITH FUSION IN A CAT

In humans, crossed renal ectopia is a rare, usually asymptomatic, congenital malpositioning of the kidneys, involving wandering of one or both embryonic kidneys across the midline and usually fusion with its contralateral partner. This is the first report of crossed renal ectopia in the cat. A 7-year-old, neutered male cat was presented with polyuria, polydipsia, and a palpable abdominal mass. Diagnostic investigations, including clinical pathology, survey and contrast radiography, and ultrasonography, confirmed the presence of an ectopic left kidney fused with an orthotopic right kidney, with concurrent renal failure and hypertension. Many features of crossed renal ectopia in this cat are similar to those described in humans, however the vascular supply, the presence of renal failure, and the axial rotation of the fused kidney are atypical.     

IMAGING DIAGNOSIS—IMAGING AND HISTOPATHOLOGIC CHARACTERISTICS OF A VERTEBRAL HAMARTOMA IN A CAT

A 9‐month‐old domestic shorthair cat had progressive ambulatory paraparesis, proprioceptive ataxia, and thoracolumbar hyperesthesia. An extradural mass affecting the left pedicle and lamina of the second lumbar vertebra (L2) causing marked spinal cord impingement was identified in magnetic resonance (MR) images. The mass was predominantly calcified in computed tomographic (CT) images. A hemilaminectomy was performed to resect the mass. Clinical signs were greatly improved at 12‐month follow‐up. The histopathologic diagnosis was vascular hamartoma. To our knowledge, this is the first report describing the MR characteristics of a vascular hamartoma associated with the vertebral column.     

HYDROTHORAX SECONDARY TO A PERINEPHRIC PSEUDOCYST IN A CAT

Hydrothorax was identified in a 14-year-old Siamese cat with a pre-existent perinephric pseudocyst. The pleural fluid was classified as a low-protein transudate. Intrapseudocystic scintigraphy confirmed a direct communication between the pseudocyst and the pleural space. The hydrothorax resolved following pseudocystectomy and unilateral nephrectomy, demonstrating that the psendocyst caused the hydrothorax.     

MAGNETIC RESONANCE IMAGING OF OCULAR AND ORBITAL DISEASE IN 5 DOGS AND A CAT

Magnetic resonance (MR) images were acquired in five dogs and one cat with ocular and orbital disease. MR images were obtained in the dorsal or oblique dorsal, and oblique sagittal planes. Pathologic changes identified in MR images included inflammatory lesions, cystic structures, and neoplasms. All abnormalities were readily apparent in TI-weighted images. MR findings in affected animals were often similar in signal intensity, location, and growth pattern to those found in people with comparable diseases. Although no MR changes were considered pathognomonic for a given disease, MR imaging provided detailed information on the homogeneity, extent and invasiveness of the lesions.     

REVIEW OF DIAGNOSTIC IMAGING OF EAR DISEASES IN THE DOG AND CAT

Diagnostic imaging techniques (conventional radiography, computed tomography and magnetic resonance imaging) are an essential tool in the diagnostic work-up of ear diseases. Conventional radiography is commonly used, but often lacks sensitivity. Computed tomography (CT) and magnetic resonance (MR) are complementary imaging studies of the middle ear, labyrinth, internal auditory canal and their contents. CT provides excellent images of bony structures and is indicated where osseous changes are of greatest diagnostic importance. MR is superior in imaging soft tissue components including intralabyrinthine fluid. Therefore, more than one of these imaging techniques may be required in order to make a diagnosis.     

IMAGING DIAGNOSIS—MAGNETIC RESONANCE IMAGING OF A NEURONAL HETEROTOPIA IN THE BRAIN OF A CAT

A domestic shorthair kitten was presented for evaluation and further treatment of seizures. Magnetic resonance imaging of the brain revealed a large multilobulated mass in the third ventricle extending into the right lateral ventricle with secondary obstructive hydrocephalus. The mass was homogeneously isointense to gray matter on T2W, T2‐FLAIR, T2^*W, T1W, and ADC images, and hyperintense on DW‐EPI. There was no appreciable contrast enhancement. Seizures were managed medically and with subsequent ventriculoperitoneal shunt placement. Clinical status later deteriorated and the cat was euthanized. Histopathology confirmed that the mass was the result of neuronal heterotopia. To the authors’ knowledge this is the first report of neuronal heterotopia in a cat.     

MAGNETIC RESONANCE IMAGING OF THE NORMAL EYE AND ORBIT OF THE DOG AND CAT

Magnetic resonance (MR) images of the normal eye and orbit of the dog and cat were acquired. T1-weighted, proton-density, and T2-weighed images were obtained in the oblique dorsal, straight sagittal, and oblique sagittal planes. Signal intensity for the various orbital structures differed among the three resonance techniques. T1-weighted images provided the greatest contrast of the retrobulbar structures. T-1 weighted images also had the highest signal to noise ratio, thereby providing the best anatomic detail. Anatomic components of the globe, retrobulbar structures and ocular adnexa were easily seen in all MR sections. The oblique dorsal and oblique sagittal planes were superior for evaluating the optic nerve in its entirety.     

CORRELATIVE IMAGING FINDINGS IN SEVEN DOGS AND ONE CAT WITH SPINAL ARACHNOID CYSTS

Information regarding 7 dogs and 1 cat with a spinal arachnoid cyst is presented. All patients were evaluated with survey radiographs and myelography. Computed tomography (CT) following myelography, magnetic resonance (MR) imaging, and sonography, were used in some of the patients. These imaging techniques were evaluated to determine their efficacy in diagnosing arachnoid cysts, ascertaining the extent and internal cyst architecture and detecting associated spinal cord abnormalities. Survey radiographs were nondiagnostic in all patients. Myelographically, the arachnoid cyst was visible in all patients, with partial blockage to flow of contrast medium. CT provided additional information on localization and lateralization of the cyst, and allowed measurement of the degree of spinal cord compression. MR imaging enabled identification of an associated syringomyelia. Sonography was useful for defining the cyst wall and characterizing the internal architecture of the cyst cavity and adjacent spinal cord. Measurements of the degree of spinal cord compression could be made and were similar to measurements made from CT. Additionally, sonography was considered a useful technique for orientating the surgeon to the location and extent of the cyst. In the absence of the availability of CT or MR imaging for evaluating patients with an arachnoid cyst, sonography is considered a valuable technique for directly assessing the spinal cord for associated disease. Decompressive surgery was performed on 4 dogs and 1 cat, all with successful outcomes.     

IMAGING DIAGNOSIS—GASTRIC PNEUMATOSIS IN A CAT

Gastrointestinal foreign bodies were removed surgically from a 9‐year‐old Siamese cat. Two days later the cat became lethargic and started regurgitating. A degenerative leukocytosis and drop in packed cell volume were present. Gastric wall thickening with intramural gastric air was detected radiographically and sonographically. Gastric ulceration with a focal necrotic area was seen endoscopically. At surgery, the stomach wall was emphysematous. Clinical signs resolved following partial gastrectomy and medical management. Intramural gastric air with declining clinical course was a significant impetus to return to surgery.     

IMAGING DIAGNOSIS—SUBLUMBAR PSEUDOMYCETOMA IN A PERSIAN CAT

A 6-year-old Persian cat was examined for constipation, anorexia, and vomiting that was subsequently found to be due to a pseudomycetoma originating from the descending colon and sublumbar region, and causing mechanical obstruction of the colon and rectum. Multiple discrete hyperechoic foci likely representing fungal grains within the lesion gave the mass a coarse echotexture on ultrasound and was supportive of the diagnosis and computed tomography allowed delineation the extent of the mass. A pseudomycetoma is a granulomatous/pyogranulomatous reaction that surrounds dermatophytic fungal hyphae. Definitive diagnosis of a dermatophytic pseudomycetoma requires identification of the etiologic agent by cultivation or immunohistochemical staining. A pseudomycetoma should be included in the differential diagnosis for an abdominal mass in a Persian cat, especially is accompanied by the sonographic findings noted above.     

IMAGING DIAGNOSIS: COMPUTED TOMOGRAPHIC FINDINGS IN A CASE OF ADENOSQUAMOUS CARCINOMA OF THE HEAD AND NECK IN A CAT

A 15‐year‐old female spayed domestic long‐haired cat was referred for trismus, hypersalivation, and bilateral ocular discharge. On examination, the cat showed pain on palpation of the left zygomatic arch, palpable crepitus of the frontal region, and limited retropulsion of both globes. A contrast‐enhanced sinonasal computed tomographic study was performed, showing facial distortion and extensive osteolysis of the skull, extending beyond the confines of the sinonasal and paranasal cavities. Additionally, soft tissue and fluid accumulation were observed in the nasal cavities and paranasal sinuses. Postmortem biopsy samples acquired from the calvarium yielded a histologic diagnosis of sinonasal adenosquamous carcinoma, a rare and particularly aggressive neoplasm previously only reported in the esophagus of one cat.     

THE LITERATURE OF VETERINARY IMAGING: THE ANALYSIS OF A QUESTIONNAIRE

250 veterinarians, including 143(57.7%) non-radiologists, replied to a questionnaire on current literature of veterinary imaging. Veterinary Readiology & Ultrasound was considered the best overall journal, being chosen as first choice by 51.6% respondents. It was also judged to have the best photographic reproduction. No book was chosen as first choice by more than 18.4%. Three, Textbook of Diagnostic Radiology, Thrall; Diagnostic Radiology of the Dog & Cat, Kealy and Thoracic Radiography of the Dog & Cat, Suter & Lord, were chosen by 18.4%, 16.8% and 13.2% respondents respectively. Clinically orientated papers and review articles were the preferred contents of journlas. Experience of colleagues and journals were adjudged the best source of information on diagnostic imaging. Differences in results between radiologists and non-radiologists were not great and geographic differences were few. Of the 112 respondents who had published papers on veterinary imaging, 30 (26.4%) were non-radiologists.     

BILATERAL PERINEPHRIC PSEUDOCYSTS AND POLYCYSTIC KIDNEYS IN A FERRET

A 3-year-old castrated male domestic ferret was evaluated for abdominal distention. Survey lateral and dorsoventral abdominal radiographs were made. There were two soft tissue radiopacities consistent with grossly enlarged kidneys displacing small bowel and colon cranially, ventrally and caudally. Abdominal ultrasound was performed and revealed bilateral perinephric pseudocysts and polycystic kidneys. The perinephric pseudocysts were found to be dilated renal capsules on exploratory surgery and were drained. On follow up examinations, the pseudocysts were drained by ultrasound-guided paracentesis. The perinephric cyst fluid was distinguished from urine by measuring creatinine concentration and plans were made to resect the renal capsules due to rapid re-accumulation of pseudocyst fluid. The ferret's condition deteriorated and euthanasia was performed. Post-mortem examination was declined by the owner. Perinephric pseudocysts are rare and this is the first published report in a ferret. Ultrasound examination is the most rapid, accurate and non-invasive method for diagnosis of perinephric pseudocysts.     

ARACHNOID CYST IN CEREBELLAR PONTINE AREA OF A CAT-DIAGNOSIS BY MAGNETIC RESONANCE IMAGING

A male Persian cat with epileptiform convulsions was evaluated by magnetic resonance imaging. A space occupying lesion filled with cerebrospinal fluid, believed to be a caudal fossa arachnoid cyst, was found. This condition, which has not been previously described in the cat, was thought to be an incidental finding in the subject of this report.     

DISSEMINATED HISTOPLASMOSIS WITH OSSEOUS LESIONS IN A CAT WITH FELINE LYMPHOSARCOMA

A cat was presented with a non-weight-bearing lameness of the left thoracic limb, painful joints and lymphadenopathy. Marked bilateral osteolysis of the distal radial and ulnar metaphyses was detected radiographically. A post mortem diagnosis of disseminated histoplasmosis and feline lymphosarcoma was made.     

IMAGING DIAGNOSIS—EXTRAHEPATIC BILIARY TRACT OBSTRUCTION SECONDARY TO A DUODENAL FOREIGN BODY IN A CAT

A 13-month-old, neutered female domestic shorthaired cat was evaluated for vomiting, anorexia, and lethargy. The cat was icteric and hyperbilirubinemic. Radiographically a partially radiolucent proximal duodenal foreign body was suspected. Ultrasonographically, there was a foreign body at the level of the duodenal papilla and dilation of the common bile duct and cystic duct; a diagnosis of extrahepatic biliary tract obstruction secondary to a duodenal foreign body was made. Sonographic findings were confirmed at surgery and a duodenal foreign body was removed. This information defines duodenal foreign body as a cause of extrahepatic biliary obstruction in cats.