EFFECT OF CONTRAST MEDIUM DOSE AND IMAGE ACQUISITION TIMING ON URETERAL OPACIFICATION IN THE NORMAL DOG AS ASSESSED BY COMPUTED TOMOGRAPHY

Computed tomography (CT) excretory urography was performed in five adult female dogs after intravenous injection of a bolus of four different doses of water-soluble iodinated contrast medium (100, 200, 400, and 800 mg1/kg). CT images centered over the urinary bladder were performed before injection and 1,3,5,7,9,11,15,20,25,30,40,50, and 60 minutes after injection. Opacification of both ureters was evaluated by measuring maximum CT number of individual ureters at each time. Time opacification curves were generated for each dose. Best opacification of the ureters was obtained with 400 and 800 mgl/kg, with a constant peak at 3 minutes and durable opacification for 1 hour. Insufficient opacification was obtained with lower dose of 100 and 200 mgI/kg.     

THE FUNCTIONAL ASPECTS OF THE NEPHROGRAM IN EXCRETORY UROGRAPHY: A REVIEW

The nephrographic phase of the excretory urogram may be used to qualitatively assess some functional aspects of renal disease. Functional abnormalities of the kidney which alter the normal pattern of nephrographic opacification may be associated with renal perfusion abnormalities, glomerular dysfunction, intra or extrarenal obstruction, renal tubular necrosis and adverse reactions (renal or systemic) to iodinated contrast media. The time of maximum nephrographic opacification following intravenous injection of contrast medium and variations in nephrographic opacity before and after maximum opacification may help differentiate these disease processes. Standard radiographic and urographic techniques must be used to prevent changes caused by variations in contrast medium dosage and filming sequence from being misinterpreted as functional renal abnormalities.     

EVALUATION OF THE URETER AND URETEROVESICULAR JUNCTION USING HELICAL COMPUTED TOMOGRAPHIC EXCRETORY UROGRAPHY IN HEALTHY DOGS

Abdominal computed tomography (CT) using a protocol designed for evaluation of the ureters was performed on six normal purpose-bred research dogs. After noncontrast CT, a postcontrast scan was performed 3 min post midpoint of injection of 400 mgI/kg body weight of diatrizoate meglumine/sodium. Ureteral and ureterovesicular junction anatomy were readily assessed with minimal patient preparation. The ureters were similar in size to reported values and the renal pelvis, ureter, and ureterovesicular junction were easily identified on both noncontrast and contrast-enhanced scans. There was a significant relationship between bladder volume and interureterovesicular junction distance but not between bladder volume and ureterovesicular junction to internal urethral orifice distance. A reliable bony landmark for the identification of the internal urethral orifice could not be determined. The results of this preliminary study of normal anatomy should facilitate the clinical use of CT in the evaluation of ureteral disease (e.g., ureteral ectopia).     

ENTERIC DUPLICATION IN TWO DOGS

Enteric duplication, a developmental malformation of the alimentary tract resulting in juxtaintestinal cyst-like formations, was diagnosed in 2 dogs. The sonographic, gross, and histopathologic characteristics of the malformation reported in people include: a fusion between the wall of the duplication cyst and the adjoining segment of the alimentary tract, a hypoechoic tunica muscularis layer in the outer free wall of the cyst, a shared muscular wall between the cyst and the adjoining normal bowel, and a similar or heterotopic epithelial lining of the lumen of the cyst. Both dogs in this series had characteristic sonographic, gross and histopathologic patterns described for enteric duplication in people. Three adjoining cysts that communicated and shared a common wall with the ileum were present in the first dog. Ectopic gastric mucosa was present in the single cyst that shared a common wall with the jejunum in the second dog. Other abdominal cystic masses may mimic the gross appearance of the duplication cyst and can potentially result in a misdiagnosis of the underlying etiology. Sonographic findings are characteristic for duplication cysts and are the preferred primary diagnostic modality, however, histopathology is warranted to confirm the diagnosis.     

MRI CHARACTERISTICS OF FOURTH VENTRICLE ARACHNOID DIVERTICULA IN FIVE DOGS

Intracranial arachnoid diverticula (cysts) are rare accumulations of cerebrospinal fluid (CSF) within the arachnoid membrane. The purpose of this retrospective study was to describe magnetic resonance imaging (MRI) characteristics of fourth ventricle arachnoid diverticula in a group of dogs. The hospital's medical records were searched for dogs with MRI studies of the brain and a diagnosis of fourth ventricle arachnoid diverticulum. Clinical characteristics were recorded from medical records and MRI studies were reinterpreted by a board‐certified veterinary radiologist. Five pediatric dogs fulfilled inclusion criteria. Clinical signs included cervical hyperaesthesia, obtundation, tetraparesis, and/or central vestibular syndrome. In all five dogs, MRI findings were consistent with obstructive hydrocephalus, based on dilation of all ventricles and compression of the cerebellum and brainstem. All five dogs also had cervical syringohydromyelia, with T2‐weighted hyperintensity of the gray matter of the cord adjacent to the syringohydromyelia. A signal void, interpreted as flow disturbance, was observed at the mesencephalic aqueduct in all dogs. Four dogs underwent surgical treatment with occipitalectomy and durotomy. A cystic lesion emerging from the fourth ventricle was detected in all four dogs during surgery and histopathology confirmed the diagnosis of arachnoid diverticula. Three dogs made excellent recovery but deteriorated shortly after surgery and were euthanized. Repeat MRI in two dogs revealed improved hydrocephalus but worsening of the syringohydromyelia. Findings from the current study supported theories that fourth ventricle arachnoid diverticula are secondary to partial obstruction of the central canal or lateral apertures and that arachnoid diverticula are developmental lesions in dogs.     

BONE SARCOMA FOLLOWING ORTHOVOLTAGE RADIOTHERAPY IN TWO DOGS

In two dogs that received orthovoltage radiotherapy, osteosarcoma developed in irradiated bone 38 and 77 months after treatment. Irridiated bone in one dog was presumably normal prior to radiotherapy; irradiated bone in the other was infiltrated by an acanthomatous epulis. Both osteosarcomas were probably radiation induced. Radiation-induced bone sarcoma is an important, but uncommon, complication of radiaotherapy.     

EFFECTS OF FUROSEMIDE ON URETERAL DIAMETER AND ATTENUATION USING COMPUTED TOMOGRAPHIC EXCRETORY UROGRAPHY IN NORMAL DOGS

One of the limitations of computed tomographic excretory urography (CTEU) for diagnosis of ureteral disease in dogs is that normal ureteral peristalsis can cause intermittent and inconsistent filling. The aims of this study were to determine if the addition of furosemide to a standard CTEU protocol would increase identification of the ureteral segments, increase ureteral attenuation and increase ureteral diameter in normal dogs. Standard and furosemide‐enhanced CTEU scans were acquired in 14 healthy dogs 3 and 10 minutes postcontrast. Ureteral diameters, attenuation values, and percent ureteral filling scores were recorded without the knowledge of furosemide treatment. Comparisons were made between treatments for each postcontrast scan time. The addition of furosemide to the CTEU protocol improved visualization of the ureters by significantly increasing the number of ureteral segments that were able to be identified, as well as their diameter when imaging the patient 3 min following contrast injection (P = 0.012). No major side effects were observed at the dose of 4 mg/kg. There was no advantage to imaging dogs 10 min following contrast administration as the ureteral segments were less attenuating and a smaller percentage of the ureter could be identified. We conclude that the addition of furosemide to canine CTEU studies is safe and may help improve visualization of the ureters.     

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.     

RADIOGRAPHIC ASPECTS OF GASTRIC ULCERS IN DOGS

This paper is a retrospective analysis of the radiographic appearance of one benign and four malignant gastric ulcers in dogs. The benign gastric was diagnosed radiographically following gastric surgery and was healed at necropsy 28 months after diagnosis. Malignant gastric ulcers were confirmed at surgery and/or necropsy. None of the five ulcers penetrated the normally expected gastric contour. Mucosal fold pattern was either partially or completely effaced with all five ulcers. Undermining appeared to be present asymmetrically in the benign and one malignant ulcer, and symmetrically in one malignant ulcer. Tissue surrounding the ulcers joined the normal gastric wall very abruptly in three malignant ulcers. This transition was more gradual in the benign ulcer and was not identified in one malignant ulcer. None of these ulcers completely fit the criteria used in people to diagnose benign gastric ulcer. Prospective evaluation of more cases with a more thorough radiographic technique is needed     

IMAGING DIAGNOSIS—RADIOGRAPHY AND ULTRASONOGRAPHY OF BILATERAL CONGENITAL URETEROVESICAL JUNCTION STENOSIS CAUSING HYDRONEPHROSIS AND HYDROURETER IN A FERRET (MUSTELA PUTORIUS FURO)

An 8‐month‐old neutered male ferret was presented for vaccination and preventive treatment for adrenal gland disease. Abdominal ultrasound revealed severe bilateral hydronephrosis and hydroureter. Excretory urography and negative contrast cystography showed bilateral ureterovesical junction stenosis. Positive retrograde cystography demonstrated right ureteral reflux. A subcutaneous ureteral bypass was placed in the left kidney; however, it had to be removed 3 months later due to an obstruction and persistent urinary tract infection. Bilateral ureteroneocystotomy was performed. Although congenital strictures are uncommon in veterinary patients, they should be included in the differential diagnosis in ferrets presenting with hydronephrosis and hydroureter of undetermined cause.     

SPONTANEOUS PNEUMOPERITONEUM SUBSEQUENT TO GASTRIC VOLVULUS IN TWO DOGS

In two dogs spontaneous pneumoperitoneum developed following gastric volvulus. The pneumoperitoneum resulted from splenic necrosis and Klebsiella pneumoniae peritonitis in one and from a gastric perforation near the gastroesophageal junction in the other. The first dog was successfully treated by splenectomy, abdominal lavage, and systemic antibiotic therapy; the other was treated by closure of the perforation, tube gastrostomy, abdominal lavage, and systemic antibiotic therapy. One dog was euthanized four weeks after surgery because of metastatic cancer, and the other was euthanized six weeks after surgery due to recurrence of abdominal distention and peritonitis.     

RESULTS OF MYELOGRAPHY IN SEVEN DOGS WITH MYELOMALACIA

Myelomalacia is a hemorrhagic infarction of the spinal cord that can occur as a sequel to acute spinal cord injury. Myelomalacia may be focal or diffuse; the diffuse form is typically associated with cranial migration of neurologic signs ("ascending syndrome") and is often fatal. In a retrospective study of seven affected dogs, diffuse myelomalacia was associated with intervertebral disc extrusion in five dogs, focal myelomalacia was associated with fibrocartilagenous embolus in one dog, and had no apparent cause in one dog. The myelographic signs included a variable degree of contrast medium infiltration into the spinal cord in six dogs (86%) and/or spinal cord swelling in six dogs (86%). In one dog with focal myelomalacia, the only myelographic sign was spinal cord swelling.     

INTERMITTENT CRANIAL LUNG HERNIATION IN TWO DOGS

Two aged dogs with chronic obstructive airway disease were evaluated because of intermittent swelling of the ventral cervical region. Radiographs made at expiration and caudal positioning of the forelimbs allowed identification of intermittent cervical lung herniation of the left and right cranial lung lobe in both dogs. Pulmonary hyperinflation, increased expiratory effort, and chronic coughing were considered responsible for the lung herniation. Cervical lung hernia should be included in the differential diagnoses of intermittent cervical swelling in dogs with chronic respiratory disorders associated with increased expiratory effort and chronic coughing.     

RADIOGRAPHIC APPEARANCE OF CONFIRMED PULMONARY LYMPHOMA IN CATS AND DOGS

Herein we describe the thoracic radiographic appearance of confirmed pulmonary lymphoma. Patients with thoracic radiographs and cytologically or histologically confirmed pulmonary lymphoma were sought by contacting American College of Veterinary Radiology members. Seven cats and 16 dogs met the inclusion criteria, ranging in age from 4 to 15 years. Method of diagnosis was via ultrasound‐guided cytology (four), surgical biopsy (two), ultrasound‐guided biopsy (one), and necropsy (16). Radiographic findings varied but ranged from normal (one) to alveolar (six) and/or unstructured interstitial infiltrates (11), nodules and/or masses (eight), and bronchial infiltrates (four). Additional thoracic radiographic findings included pleural effusion and lymphadenopathy. The results of this evaluation indicate a wide variability in thoracic radiographic abnormalities in cats and dogs with pulmonary lymphoma.     

RADIOGRAPHIC LIVER SIZE IN PEKINGESE DOGS VERSUS OTHER DOG BREEDS

Differential diagnoses for canine liver disease are commonly based on radiographic estimates of liver size, however little has been published on breed variations. Aims of this study were to describe normal radiographic liver size in Pekingese dogs and to compare normal measurements for this breed with other dog breeds and Pekingese dogs with liver disease. Liver measurements were compared for clinically normal Pekingese (n = 61), normal non‐Pekingese brachycephalic (n = 45), normal nonbrachycephalic (n = 71), and Pekingese breed dogs with liver disease (n = 22). For each dog, body weight, liver length, T11 vertebral length, thoracic depth, and thoracic width were measured on right lateral and ventrodorsal abdominal radiographs. Liver volume was calculated using a formula and ratios of liver length/T11 vertebral length and liver volume/body weight ratio were determined. Normal Pekingese dogs had a significantly smaller liver volume/body weight ratio (16.73 ± 5.67, P < 0.05) than normal non‐Pekingese brachycephalic breed dogs (19.54 ± 5.03) and normal nonbrachycephalic breed dogs (18.72 ± 6.52). The liver length/T11 vertebral length ratio in normal Pekingese (4.64 ± 0.65) was significantly smaller than normal non‐Pekingese brachycephalic breed dogs (5.16 ± 0.74) and normal nonbrachycephalic breed dogs (5.40 ± 0.74). Ratios of liver volume/body weight and liver length/T11 vertebral length in normal Pekingese were significantly different from Pekingese with liver diseases (P < 0.05). Findings supported our hypothesis that Pekingese dogs have a smaller normal radiographic liver size than other breeds. We recommend using 4.64× the length of the T11 vertebra as a radiographic criterion for normal liver length in Pekingese dogs.     

MAGNETIC RESONANCE IMAGING FEATURES OF INTRACRANIAL ASTROCYTOMAS AND OLIGODENDROGLIOMAS IN DOGS

Astrocytomas and oligodendrogliomas represent one third of histologically confirmed canine brain tumors. Our purpose was to describe the magnetic resonance (MR) imaging features of histologically confirmed canine intracranial astrocytomas and oligodendrogliomas and to examine for MR features that differentiate these tumor types. Thirty animals with confirmed astrocytoma (14) or oligodendroglioma (16) were studied. All oligodendrogliomas and 12 astrocytomas were located in the cerebrum or thalamus, with the remainder of astrocytomas in the cerebellum or caudal brainstem. Most (27/30) tumors were associated with both gray and white matter. The signal characteristics of both tumor types were hypointense on T1‐weighted images (12 each) and hyperintense on T2‐weighted images (11/14 astrocytomas, 12/16 oligodendrogliomas). For astrocytomas and oligodendrogliomas, respectively, common findings were contrast enhancement (10/13, 11/15), ring‐like contrast enhancement (6/10, 9/11), cystic regions within the mass (7/14, 12/16), and hemorrhage (4/14, 6/16). Oligodendrogliomas were significantly more likely to contact the brain surface (meninges) than astrocytomas (14/16, 7/14, respectively, P=0.046). Contact with the lateral ventricle was the most common finding, occurring in 13/14 astrocytomas and 14/16 oligodendrogliomas. No MR features were identified that reliably distinguished between these two tumor types. Contrast enhancement was more common in high‐grade tumors (III or IV) than low‐grade tumors (II, P=0.008).     

ACCURACY OF SURVEY RADIOGRAPHIC DIAGNOSIS OF INTERVERTEBRAL DISC PROTRUSION IN DOGS

To assess the diagnostic accuracy of survey radiography for canine thoracolumbar intervertebral disc protrusion, survey radiographs (lateral and ventrodorsal) of 64 dogs with surgically-confirmed thoracolumbar intervertebral disc protrusion, 51 dogs with negative myelograms and 29 dogs with various spinal conditions other than disc protrusion were reviewed by three independent observers who were unaware of any clinical information. There were marked differences in observer performance for diagnosis of intervertebral disc protrusion, although there were no significant differences in intraobserver diagnostic accuracy for small vs. large dogs. Accuracy of observers for determining sites of intervertebral disc protrusion using survey radiography was in the range 51-61%. All observers had low accuracy for identification of second sites of intervertebral disc protrusion. The most useful radiographic sign, narrowed intervertebral space, had only moderate sensitivity (range 64-69%) and moderate predictive value (range 63-71%) for intervertebral disc protrusion. Vacuum phenomenon was an infrequent but accurate sign of intervertebral disc protrusion. Recognition of multiple radiographic signs of intervertebral disc protrusion at one site was associated with increased accuracy of diagnosis. No observer was accurate enough to justify attempting targeted surgical treatment of intervertebral disc protrusion without myelography.     

MEASUREMENTS OF THE PULMONARY VASCULATURE ON THORACIC RADIOGRAPHS IN HEALTHY DOGS COMPARED TO DOGS WITH MITRAL REGURGITATION

This study reassessed the previously reported radiographic method of comparing pulmonary vessels versus rib diameter for differentiating healthy dogs and dogs with mitral regurgitation. The width of the right cranial pulmonary artery and vein at the fourth rib level, right caudal pulmonary artery and vein at the ninth rib level, and the diameters of the fourth rib and ninth rib were measured in prospectively recruited healthy dogs (n = 40) and retrospectively recruited dogs with mitral regurgitation (n = 58). In healthy dogs, the pulmonary arteries and accompanying veins were similar in size. The cranial lobar vessels were smaller than the fourth rib. However, 67.5% of right caudal pulmonary artery diameters and 65% of vein diameters were larger than the ninth rib in healthy dogs. The right caudal pulmonary vein diameter in dogs with mitral regurgitation, particularly those within moderate and severe grades, was significantly larger than that in healthy dogs (P < 0.001). The comparative method used to detect enlargement of the right caudal pulmonary vein relative to the accompanying pulmonary artery had the highest sensitivity (80.2%) and specificity (82.5%) for predicting mitral regurgitation. A cut‐off of 1.22 when applying the ninth rib criterion had better specificity (73%) than the most used value ≤ 1 (89.7% sensitivity and 63.8% specificity), although it has less sensitivity (73%). We recommend using the accompanying pulmonary artery and 1.22 × the diameter of the ninth rib as a radiographic criterion for assessing the size of the right caudal pulmonary vein and differentiating healthy dogs from those with mitral regurgitation.     

IMAGING CHARACTERISTICS OF INTRATHORACIC HISTIOCYTIC SARCOMA IN DOGS

In this retrospective study, two observers independently reviewed thoracic imaging studies of 39 dogs with confirmed histiocytic sarcoma. The most common findings were intrathoracic lymphadenopathy, identified by the first and second observers in 82.1% and 87.2% of dogs, respectively, and pulmonary masses (74.4% and 82.1%). Right middle lung lobe masses were significantly more common than masses in any other lung lobe (P<0.0013), with the majority having a ventral distribution. Sternal and tracheobronchial lymphadenopathy were significantly more common than cranial mediastinal lymphadenopathy (P‐values of 0.0002 and 0.012, respectively). Interobserver agreement regarding distribution of lymphadenopathy and pulmonary masses was good (κ=0.64 and 0.75, respectively). Other findings included pulmonary nodules, pleural effusion, and abnormal pulmonary patterns. In patients with CT examinations, the majority of masses were mildly to moderately enhancing and heterogeneous, poorly marginated, and bronchocentric. Lymphadenopathy and pulmonary masses are the most common intrathoracic findings in dogs with histiocytic sarcoma, and the strong predilection for the ventral aspect of the right middle lung lube may help to differentiate it from other types of neoplasia.     

ULTRASONOGRAPHIC FINDINGS IN 14 DOGS WITH ECTOPIC URETER

To evaluate ultrasonography as an alternative to contrast radiography for diagnosis of ectopic ureter in dogs, ultrasonography of the urinary tract was performed prospectively in a series of urinary incontinent dogs anesthetized for contrast radiography. Fourteen dogs had ectopic ureter based on surgical, necropsy or unequivocal contrast radiographic findings. There were eight females and six males of a variety of breeds; five were Labrador retrievers. Mean (range) age at the time of diagnosis was 1.2 (0.2–4) years for females and 3.5 (0.3–5) for males (p < 0.05). Ectopic ureters were unilateral in five dogs (2 left; 3 right) and bilateral in nine dogs. Both ultrasound images and contrast radiographs were positive for 21 (91%) ectopic ureters; the same two ectopic ureters were not detected using either modality. The termination of each of the five normal ureters was visible on ultrasound images; two (40%) were visible on radiographs. Other ultrasonographic findings included dilatation of the ectopic ureter and/or ipsilateral renal pelvis in ten (43%) instances, evidence of pyelonephritis in two dogs (with enlargement of the contralateral kidney in one dog), and urethral diverticuli in one dog. Ultrasonography is a practical diagnostic test for ectopic ureter in dogs. In this series there was close correlation between the ultrasonographic and contrast radiographic findings for each ectopic ureter, but ultrasonography enabled more accurate determination of normal ureteral anatomy.