ULTRASONOGRAPHIC APPEARANCE OF FELINE ALIMENTARY LYMPHOMA

Abdominal ultrasonography was performed in seven cats with intestinal lymphoma and four cats with gastric lymphoma. Ultrasonographic abnormalities included the presence of a hypoechoic mass associated with the gastrointestinal tract, focal or diffuse thickening of the gastric wall, symmetric thickening of the bowel wall, loss of the normal layered appearance of the gastrointestinal wall, and abdominal lymphadenopathy. The thickness of the stomach wall ranged from 8 to 22 mm in cats with gastric lymphoma, and the thickness of the bowel wall ranged from 5 to 20 mm in cats with intestinal lymphoma. Fine needle aspiration of a gastrointestinal lesion was performed without complication in six cats, and was diagnostic for lymphoma in five out of six. Results of this study indicate that ultrasonography is an effective noninvasive means of identifying lesions consistent with alimentary lymphoma in cats.     

NORMAL CANINE PEDIATRIC GASTROINTESTINAL ULTRASONOGRAPHY

The normal sonographic appearance of the adult canine gastrointestinal tract has been described. Interpretation of abdominal ultrasonographic findings in puppies is difficult due to the lack of information on normal ultrasonographic findings. The gastrointestinal tract, jejunal lymph node size and the presence and appearance of abdominal fluid were investigated in 23 normal, 7–12-week-old Beagle puppies. The duodenal wall thickness was greater than in other parts of the gastrointestinal tract (mean 3.8 ± standard deviation [SD] 5 mm, range 3.2–4.8 mm). The mean stomach wall thickness was 2.7 ± SD 0.4 mm (range 2.2–3.7 mm), the mean jejunal wall thickness was 2.5 ± SD 0.5 mm (range 1.2–3.4 mm), and the mean colonic wall thickness was 1.3 ± SD 0.3 mm (range 0.7–2.0 mm). In addition, mean duodenal and jejunal mucosal layer thicknesses measured 2.7 ± SD 0.5 mm (range 2.0–3.8 mm) and 1.5 ± SD 0.4 mm (range 0.6–2.5 mm), respectively. Homogenous, hypoechoic jejunal lymph nodes were easily found and the mean thickness was 7.1 ± SD 2.2 mm (range 1.5–12.5 mm). A mild amount of anechoic free peritoneal fluid was present in all puppies.     

ULTRASONOGRAPHIC APPEARANCE OF CANINE GASTRIC POLYPS

Benign gastric polyps are uncommon in dogs and most are discovered incidentally. Polyps protruding into the pyloric antrum can cause gastric outflow obstruction. Clinical and ultrasonographic findings in seven dogs with histologically confirmed benign mucosal gastric polyps were reviewed. Sonographic findings such as shape, size, echogenicity, location, evidence of gastric wall thickening, wall layering, and size of regional lymph nodes were recorded. Five sessile and two pedunculated masses of different sizes (range 7–60 mm) and echogenicities were found. They primarily arose from the mucosal layer and protruded into the gastric lumen. Only one dog had a large inhomogeneous mass with a poorly visualized gastric wall layering. The polyps were all single, and were located in the pyloric antrum in six out of seven dogs. Although the ultrasonographic appearance allowed a presumptive diagnosis of mucosal gastric polyp, the final diagnosis was determined from histopathologic examination.     

ULTRASONOGRAPHIC APPEARANCE OF OVARIAN TUMORS IN 10 DOGS

Signalment, clinical history, physical examination, clinicopathologic, readiographic and ultrasonographic findings of 10 female dogs with histologically confirmed ovarian neoplasms were reviewed. Ultrasonographic images and reports were reviewed for (1) location, size, outer margins, and echogenicity of the mass(es), (2) presence of free abdominal fluid, (3) evidence of uterine abnormalities, and (4) signs of metastatic disease. The masses were classified according to their ultrasonographic pattern in solid, solid with cystic component, and cystic. The masses were ultrasonographically reported as being of ovarian origin in eight dogs, and this origin was included in the list of differentials in the remaining two dogs. When present, abdominal effusions and uterine abnormalities were diagnosed by means of ultrasound.     

ULTRASONOGRAPHIC FEATURES OF CANINE LIPOMAS

The purpose of this study was to evaluate the ultrasonographic features of canine lipomas. A group of 94 dogs with a soft tissue mass was considered. All dogs were examined ultrasonographically and cyto/histologic examination was performed. Twenty-four dogs, whose mass was diagnosed as a lipoma, were selected. Fifty-five lipomas were present on the 24 dogs. Fifty-one lipomas were superficial and located subcutaneously. Four lipomas were deep and located in the paratesticular region. Ultrasonographically, lipomas appeared as oval, well-defined, encapsulated, striated masses.     

ULTRASONOGRAPHIC APPEARANCE OF URETHRAL TRANSITIONAL CELL CARCINOMA IN TEN DOGS

The mucosal margin of the urethra is best assessed by positive contrast urethrography, but ultrasonography offers complementary information such as urethral wall thickness and size of medial iliac lymph nodes. Ultrasonography of the urethra is quick, noninvasive and does not require sedation or general anesthesia. In patients with complete urethral obstruction, ultrasonography may be the only way to image the urethra. Twelve dogs which were presented to Tufts University School of Veterinary Medicine with clinical signs referable to the urinary bladder, urethra or vagina were examined ultrasonographically. Seven were neutered females and five were neutered males. Each dog had a hyperechoic, nonshadowing line at the epithelial surface of the proximal urethra. In the seven female patients and one of the males, the urethral wall was also thick and hypoechoic to surrounding tissue. In the other males, the urethral epithelial changes were at the level of the prostate, and the limits of the urethra were not visible. In six dogs, the urethral change was the only abnormality seen, while in six, bladder wall, bladder luminal and/or prostatic parenchymal changes were also detected. Three patients had hydronephrosis, and one had enlarged medial iliac lyumph nodes. Biopsies were obtained via suction with urinary catheterization (n = 6), exploratory celiotomy (n = 3), urethroscopy (n = 2), or at post-mortem (n = 1). A histopathologic diagnosis of urethral transitional cell carcinoma was obtained in ten dogs. The ultrasonographic appearance was not pathognomonic for transitional cell carcinoma, as one dog with transitional cell dysplasia and one dog with severe ulcerative and necrosupperative cystitis and urethral stricture had similar findings.     

ULTRASONOGRAPHIC FEATURES OF CANINE GASTROINTESTINAL PYTHIOSIS

Pythiosis is a chronic pyogranulomatous infection of the gastrointestinal tract or skin caused by the water borne pathogen Pythium insidiosum. The ultrasonographic features of nine dogs with gastrointestinal pythiosis are reported. The stomach, duodenum, jejunum or colon were affected. All dogs had thickening of the gastrointestinal wall and areas with obliteration of the normal layered appearance. In one dog an eccentric mass was found arising from the serosal surface of the wall of the colon with mild diffuse wall thickening. Regional lymph node enlargement was seen in seven of the nine dogs. One dog had invasion of the pancreas and signs compatible with extrahepatic biliary obstruction. When compared to previous reports of gastrointestinal neoplasia, the features of wall thickening, loss of layering and regional lymphadenopathy are not considered specific for gastrointestinal pythiosis. Histological examination of tissue specimens is required for diagnosis.     

ULTRASONOGRAPHIC ANATOMY OF THE CANINE ELBOW

To produce detailed ultrasonographic images of the soft tissue structures around the canine elbow joint, a series of greyhound cadaver limbs were scanned both intact and dissected in a water bath. Suitable transducer positions and bone landmarks are described and the ultrasonographic appearance of the lateral collateral ligament, anconeal process, triceps tendon, origin of olecranon ligament, biceps tendon insertion, medial collateral ligament, and medial coronoid process are illustrated. Improved understanding of the anatomy of the canine elbow will support clinical ultrasonography of this region.     

ULTRASONOGRAPHIC APPEARANCE AND ETIOLOGY OF CORRUGATED SMALL INTESTINE

An ultrasound pattern of corrugated, and sometimes thickened, bowel wall has been associated with pancreatitis and small intestinal lymphangiectasia. In a retrospective study, records of dogs and cats with an ultrasound diagnosis of corrugated bowel were examined for age, breed, gender, presenting complaint, abdominal radiographic results, and final diagnosis. Eighteen dogs and six cats had an ultrasound diagnosis of corrugated bowel. The final diagnosis was pancreatitis (12 of 24), peritonitis (4 of 24), enteritis (2 of 24), pancreatic neoplasia (2 of 24), diffuse abdominal neoplasia (1 of 24), lymphocytic-plasmacytic enteritis (1 of 24), thrombosis/infarction (1 of 24), and protein-losing enteropathy and acute renal failure (1 of 24). The presence of bowel wall corrugation, although a nonspecific finding, should alert one-to the possibility of pancreatitis, enteritis, peritonitis, neoplasia, or bowel wall ischemia.     

ULTRASONOGRAPHIC DESCRIPTION OF CANINE MASTITIS

Ultrasonographic images were acquired of the mammary glands of 40 bitches with physiologically lactating (n = 20) or inflamed glands (n = 20). Echogenicity, structure, homogeneity, thickness, and distinguishability of each tissue layer were assessed. Additionally, overall echogenicity was noted. In the normal lactating gland, different tissues could be differentiated easily. The parenchyma was, without exception, separated from adjacent tissues and was visible as medium echogenic tissue with a coarse-grained structure. The tissue always had some echogenic lines and anechoic areas and was slightly heterogeneous. The loss of distinct layering of the tissue was characteristic of an inflamed mammary gland and inflamed regions had reduced echogenicity. Additionally in five bitches with mastitis, the ultrasound examination was repeated five times for documentation of the progress of the illness and associated changes, supplemented with a color Doppler sonogram to assess changes in blood vessel density. Information from the examinations carried out via B-mode did not allow treatment success to be predicted. Two bitches with reduced blood vessel density centrally had a poor outcome whereas three bitches with increased blood vessel density had a good outcome. Thus, Doppler sonography might be a useful tool to obtain information of the prognosis in acute canine mastitis.     

ULTRASONOGRAPHIC FINDINGS IN CANINE GASTRIC NEOPLASIA IN 13 PATIENTS

The ultrasonographic findings in 13 canine patients with histopathologically proven gastric tumors were reviewed. The echogenicity of gastric wall lesions was variable and independent of the type of tumor. All dogs had an increase in gastric wall thickness and in only one dog was the wall layering intact. Regional lymph node involvement was a common finding, but abnormalities within the liver were seen in only one patient. Gastric neoplasia was observed most commonly in middle-aged and old, medium- to large-sized dogs. Carcinoma was the most common tumor found. In this study, with a limited number of animals and limited tumor types, it appeared that thickening of the gastric wall, accompanied by loss of gastric wall layering and enlargement of regional lymph nodes were ultrasonographic signs likely to be found with gastric neoplasia. In this limited study the histologic type of gastric tumor could not be predicted on the basis of the ultrasound examination.     

ULTRASONOGRAPHIC DIAGNOSIS OF CANINE HYDROCEPHALUS

The brains of 23 canine patients and six random-source dogs were examined ultrasonographically through the bregmatic fontanelle or a surgical craniotomy. Fifteen dogs had abnormal neurologic signs; the others were normal on neurologic examination. Untrasound results were compared with signalment, clinical signs, electroencephalography, computed tomography, radiology and histopathology. The purposes of the study were to demonstrate the use of ultrasound for the diagnosis of canine hydrocephalus and to determine whether there is a relationship between ventricular size and clinical signs. Lateral ventricles were considered enlarged if lateral ventricular height, ventricle-mantle ratio, or ventricle-hemisphere ratio, at the level of or caudal to the interthalamic adhesion in the transverse plane, exceeded 0.35 cm, 0.25 or 0.19, respectively. Of the 29 dogs examined, 14 had enlarged lateral ventricles and abnormal neurologic signs. Five dogs had enlarged lateral ventricles but appeared neurologically normal (occult hydrocephalus). Correlation was poor between ventricular size and clinical signs.     

ULTRASONOGRAPHIC ASSESSMENT OF THE CANINE SCIATIC NERVE

To describe the ultrasonographic technique for investigation of the canine sciatic nerve, four canine cadaver pelvic limbs, two live healthy dogs, and five canine patients with suspected peripheral sciatic nerve lesions were examined with a high-resolution linear ultrasound transducer. The caudal part of the lumbosacral trunk and the origin of the sciatic nerve were visualized through the greater ischiatic foramen. The two components of the sciatic nerve, common peroneal and tibial nerves, were distinguished along the entire length of the nerve, until they branched at the level of the distal femur. In healthy live dogs they appeared as two adjacent hypoechoic tubular structures with internal echotexture of discontinuous hyperechoic bands, surrounded by a thin rim of highly echogenic tissue. The common peroneal component had a smaller diameter and was on the cranial aspect of the tibial component. An ultrasonographic lesion compatible with a peripheral nerve sheath tumor was found in one dog. Improved understanding of the ultrasonographic anatomy of the sciatic nerve supports clinical use of this modality.     

ULTRASONOGRAPHIC ANATOMY OF THE NORMAL CANINE CALCANEAL TENDON

To provide a series of detailed ultrasonographic images of the canine calcaneal tendon, greyhound cadaver pelvic limbs were scanned with a high-resolution transducer, and images compared with dissected specimens. The three components of the calcaneal tendon are the tendons of insertion of the gastrocnemius, superficial digital flexor, and a conjoined tendon formed by tendons from the biceps femoris, semitendinosus, and gracilis. Each of these three tendons was visible in transverse ultrasound images, each measuring 2.4-3.2-mm thick at mid-calcaneal tendon. Improved understanding of the anatomy of the calcaneal tendon will support clinical ultrasonography of this region.     

ULTRASONOGRAPHIC FEATURES OF CANINE HEPATIC NODULAR HYPERPLASIA

Hepatic nodular hyperplasia is a benign, usually clinically inapparent, proliferative lesion commonly found at necropsy in older dogs. Three examples of hepatic nodular hyperplasia are described in dogs with clinical signs compatible with hepatic disease in which ultrasonography revealed a variety of echotextural changes in the liver similar to those reported in primary or secondary hepatic neoplasia. In subsequent in vitro ultrasonographic studies of hepatic nodular hyperplasia lesions detected at necropsy in dogs without clinical signs of hepatic disease, only subtle echotextural changes were seen. Hence, hepatic nodular hyperplasia may be inapparent in vivo in many dogs. Hepatic nodular hyperplasia is a potentially confusing sporadic finding which must be considered by ultrasonographers examining dogs with clinical signs of hepatic disease. The diagnosis of hepatic neoplasia should not be made on the basis of ultrasonographic findings alone.     

ULTRASONOGRAPHIC ANATOMY OF THE NORMAL CANINE STIFLE

Ultrasonographic examination of the normal canine stifle joint was performed to characterize its normal anatomy. Stifles of four normal adult dogs were imaged in sagittal and transverse planes and each anatomic structure visualized was recorded. Normal anatomic structures consistently seen included the patellar tendon, medial and lateral menisci, the cranial cruciate ligament and femoral condyle cartilage. The caudal cruciate ligament was visualized in two dogs. Collateral ligaments and meniscal ligaments were not visualized. The dogs were then euthanized and each stifle was isolated. Following removal of superficial muscles and skin, each stifle was imaged in a water bath to definitively identify the structures that had previously been visualized on the live dogs. The ultrasonographic appearance of the isolated stifle specimens was similar to that found in live dogs. The results of this study indicate that ultrasound can be used to image the normal anatomy of the canine stifle. The echogenicity of the patellar ligament, cruciate ligaments, menisci and articular cartilage was similar to that previously reported in equine stifles and human knees.     

ULTRASONOGRAPHIC APPEARANCE OF JEJUNAL LYMPH NODES IN DOGS WITHOUT CLINICAL SIGNS OF GASTROINTESTINAL DISEASE

The jejunal lymph nodes of 57 dogs without clinical signs of gastrointestinal disease were examined to characterize their ultrasonographic appearance on B-mode and power Doppler examination, and to obtain ultrasonographic measurements. The lymph nodes were mildly hypoechoic to the mesentery in 71% of dogs and isoechoic in 29%. All dogs, 6 years of age or older had jejunal lymph nodes of uniform echogenicity. In dogs less than 6 years of age, nonuniform lymph nodes with different echopatterns were observed. Although most lymph nodes had no blood flow based on power Doppler examination, hilar blood flow was detected in 33% of dogs, which were generally less than 2 years of age. The median maximum thickness of the jejunal lymph nodes was 3.9 mm (range 1.6–8.2 mm), and their median maximum width 7.5 mm (range 2.6–14.7 mm). There was a significant correlation between larger lymph node diameter and younger age and higher body weight. We concluded that patient age should be considered when interpreting the echopattern and vascularity of jejunal lymph nodes in dogs, and that the jejunal lymph nodes of dogs without clinical signs of gastrointestinal disease may exceed the previously stated upper limit of 5–6 mm thickness.     

CHANGES IN ULTRASONOGRAPHIC APPEARANCE OF ADRENAL GLANDS IN DOGS WITH PITUITARY-DEPENDENT HYPERADRENOCORTICISM TREATED WITH TRILOSTANE

Trilostane, a 3beta-hydroxysteroid dehydrogenase inhibitor, has been used successfully over the last few years for the treatment of canine pituitary-dependent hyperadrenocorticism. In a prospective study of 19 dogs with pituitary-dependent hyperadrenocorticism, the adrenal glands were measured before and at least 6 months after initiation of trilostane therapy. Right adrenal gland length and caudal pole thickness and left adrenal gland caudal pole thickness increased significantly (p < or = 0.05); there was no significant change in left adrenal gland length. Enlargement of adrenal glands during trilostane therapy may occur as a result of suppression of the negative feedback mechanism affecting cortisol production.     

ULTRASONOGRAPHIC EVALUATION OF GASTROINTESTINAL DISEASES IN SMALL ANIMALS

Sonographic findings of 18 dogs and four cats with gastrointestinal (GI) diseases were reviewed. Wall thickness, wall layer identification, wall symmetry, extension of the lesion, nature of the GI contents, motility, and regional and/or systemic involvement were recorded for each animal. Ultrasonographic appearance of gastrointestinal neoplasms, gastrointestinal obstruction, ileus, intussusception, inflammatory GI diseases, and congenital disorders are discussed.     

ULTRASONOGRAPHIC FINDINGS RELATED TO PROGNOSIS IN CANINE TRANSITIONAL CELL CARCINOMA

In human bladder cancer patients, ultrasonography is extensively used not only to identify tumor masses but also to evaluate tumor size, shape, echogenicity, location, and degree of tumor invasion into the bladder wall. The information revealed by ultrasonography delineates the tumor's biological features and facilitates prediction of prognosis. However, in veterinary medicine the feasibility of using ultrasonography for these purposes has not been fully investigated. In this retrospective study, we reviewed cases of dogs with histologically confirmed bladder mass lesions, including transitional cell carcinoma (n = 22) and polypoid cystitis (n = 5), to determine whether ultrasonography could reliably predict bladder wall involvement. By following patients with transitional cell carcinoma until death, we also determined whether ultrasonographic tumor size, shape, echogenicity, and mass location were related to prognosis. Wall involvement as revealed by ultrasound was significantly (P = 0.00005) associated with histological muscular layer involvement with a sensitivity of 93% (95% Confidence interval, 79–98%) and specificity of 92% (95% Confidence interval, 76–98%). Ultrasonographic wall involvement (P = 0.03, vs. noninvolvement), heterogeneous mass (P = 0.02, vs. homogeneous mass), and trigone location (P = 0.01, vs. other locations) characteristics were significantly associated with shorter survival times in transitional cell carcinoma cases. Findings indicated that ultrasonographic characteristics such as wall involvement, heterogeneous mass, and trigone location could be reliable prognostic indicators in canine transitional cell carcinoma.