ULTRASONOGRAPHY OF THE NORMAL FELINE PANCREAS AND ASSOCIATED ANATOMIC LANDMARKS: A PROSPECTIVE STUDY OF 20 CATS

The sonographic appearance of the feline pancreas and associated anatomic landmarks including the pancreatic duct, duodenum, duodenal papilla, portal vein, and gastric lymph node were evaluated in 20 healthy, awake cats. The pancreas appeared nearly isoechoic to surrounding mesenteric tissues, isoechoic to slightly hyperechoic to adjacent liver lobes, and hypoechoic to the spleen. The mean thickness measurements for the right pancreatic lobe, body, and left pancreatic lobe were 4.5 mm (range 2.8-5.9), 6.6 mm (range 4.7-9.5), and 5.4 mm (range 3.4-9.0), respectively. The pancreatic duct was consistently visualized in the left pancreatic lobe and had a mean thickness of 0.8 mm (range 0.5-1.3). It could be differentiated from the pancreatic vessel, by its central location, and the duct's lack of Doppler flow signal. The duodenum was used as a landmark to identify the right lobe of the pancreas. The mean duodenal wall thickness measurement was 2.8 mm (range 2.1-3.8) in sagittal section, and 3.0 mm (range 2.2-4.4) in transverse section. The duodenal papilla was identified in 4 of 20 cats. It ranged in size from 2.9 to 5.5 mm in width, and had a maximum height of 4.0 mm in transverse section. The portal vein was used as a consistent anatomic landmark for identification of the left lobe and body of the pancreas. The mean diameter of the portal vein at the level where the pancreatic body joins the left pancreatic lobe was 4.3 mm (range 2.7-5.9) when viewed in sagittal section, and 4.5 mm (range 3.6-6.1) in transverse section. The gastric lymph node was identified cranial and ventromedial to the pyloroduodenal angle in 6 of 20 cats. It had an asymmetrical shape with a larger caudal pole in five of the six cats. The largest dimensions of the gastric lymph node were 10 mm in length, and 6 mm in width for the larger caudal pole, and 5.1 mm in width for the smaller cranial pole.     

TRANSESOPHAGEAL ULTRASONOGRAPHY OF THE NORMAL CANINE MEDIASTINUM

The mediastinum of eight normal research dogs was examined by transesophageal ultrasonography with a 5MHz frequency transducer to establish a baseline for future use of this new imaging modality as a diagnostic tool. Each examination consisted of 360 degree scans in both transverse and sagittal planes from the thoracic inlet to the esophageal hiatus. Dissections of four of these research dogs were then performed to confirm transesophageal ultrasonography findings. Transesophageal ultrasonography of the mediastinum was a good imaging modality for the evaluation of the heartbase, the major cranial mediastinal vessels, the descending aorta, and occasionally part of the azygos vein. Anatomic orientation was best obtained by beginning the examination at the heart base. Lymph nodes and smaller caliber vessels could not be distinguished from surrounding tissues; however, Doppler ultrasound was useful for identifying the smaller vessels. Although a 5 MHz frequency transducer is preferred for transesophageal echocardiography, a higher frequency transducer would improve the resolution of the images of small near-field structures and may be more appropriate for mediastinal imaging.     

INTRAOPERATIVE SPINAL ULTRASONOGRAPHY IN DOGS: NORMAL FINDINGS AND CASE-HISTORY REPORTS

Intraoperative spinal ultrasonography was performed in cervical and lumbar spine of 2 and 5 normal dogs, respectively, following ventral slot technique or dorsal or hemilamenectomy. The dura was hyperechoic, while the parenchyma was hypoechoic. The subarachnoid space was anechoic. An echogenic line was present in the center of the spinal cord, as seen in human. Pulsation of the spinal cord was noted during M-mode imaging. Clinical findings of one dog with thoracolumbar disk herniation and one with thoracic vertebral fracture/subluxation confirmed the usefulness of intraoperative spinal ultrasonography for real time evaluation of spinal canal spatial abnormalities (mass lesion and degree of spinal cord compression on scanning planes) and spinal cord motion. Follow-up ultrasound examinations were possible from 6 days postoperatively.     

NORMAL VARIATION IN SIZE OF THE LATERAL VENTRICLES OF THE LABRADOR RETRIEVER DOG AS ASSESSED BY MAGNETIC RESONANCE IMAGING

Detecting canine brain lesions on computed tomography (CT) or magnetic resonance (MR) scans can be difficult if the lesions do not enhance well following administration of intravenous contrast material. Changes in the shape and position of the ventricular system can be important in the diagnosis of such lesions. Normal variation within the canine ventricular system has not been documented. MR scans from 62 normal Labrador retriever type dogs were evaluated. Five dogs had symmetric enlargement of the ventricles, while nineteen dogs had mild to severe ventricular asymmetry. The incidence of asymmetry in normal dogs must be considered when using ventricular configuration as an indication of central nervous system abnormality.     

ULTRASONOGRAPHY OF INTESTINAL MAST CELL TUMORS IN THE CAT

The sonographic features of intestinal mast cell tumors (MCT) were reviewed in 14 cats. The mean age was 13.4 ± 2.5 years. There were 16 focal intestinal tumors and one diffuse submucosal infiltrate. The most common pattern was focal, hypoechoic wall thickening that was noncircumferential and eccentric (9/16 tumors) or circumferential, asymmetric, and eccentric (5/16 tumors). Nine of the cats had lesions in the jejunum or duodenum, four were at the ileocecocolic junction, and one cat had a colonic mass. Six MCTs had altered but not loss of wall layering, and the most commonly affected layer on ultrasound examination was the muscularis propria. Nine cats had enlarged abdominal lymph nodes, and seven were due to metastatic disease. Metastatic disease was not routinely detected by ultrasound in the liver (1/4 cats) or the spleen (0/3 cats). Concurrent small cell (T cell) lymphoma was present in four of 14 cats (29%).     

AGE-RELATED CHANGES IN THE ULTRASOUND APPEARANCE OF THE NORMAL FELINE PANCREAS

In humans, pancreatic hyperechogenicity and duct dilation are reported as normal aging changes. Similar changes have been reported with pancreatitis in the cat. We attempted to determine if aging changes occur in the ultrasound appearance of the normal feline pancreas. The pancreas of 84 normal (based on history, physical exam, biochemical profile, and feline trypsin-like immunoreactivity and pancreatic lipase immunoreactivity concentrations) cats of varying ages was scanned. Pancreatic width at the left limb and body, pancreatic duct diameter at left limb and body, and pancreatic echogenicity compared with liver and surrounding fat were noted and compared with age and body weight. Lower and upper limits of the 95% reference intervals for pancreatic left limb width were 2.6 and 9.5 mm, and 3.5 and 8.5 mm for the pancreatic body width. There was no significant difference in pancreatic width between the left limb and body. Lower and upper limits of the 95% reference interval for the diameter of the pancreatic duct at the left limb and body were similar, and were 0.65 and 2.5 mm. There was a weak but significant linear correlation between pancreatic duct diameter and age, with increasing pancreatic duct diameter with increasing age. There was no correlation of pancreatic width with age, and no correlation of pancreatic echogenicity with age or body weight. Based on this study, feline pancreatic size and echogenicity do not change with age. Pancreatic duct diameter increases slightly with age and should not be used as a sole indicator of pancreatitis in the geriatric cat.     

NON-INVASIVE DIAGNOSIS OF ISCHEMIC BRAIN DAMAGE AFTER CARDIOPULMONARY RESUSCITATION IN DOGS BY USING TRANSCRANIAL DOPPLER ULTRASONOGRAPHY

We have attempted to identify whether it is possible to utilize transcranial Doppler ultrasonography to evaluate the brain damage that occurs after resuscitation from 3 min (control group) and 12 min (damage group) of cardiac arrest in dogs. In this study we used transcranial Doppler ultrasonography to follow the basilar arterial flow and middle cerebral arterial flow for 180 min following the induction of cardiac arrests. Two abnormal waveform patterns (the "to-and-fro" and "diastolic no-flow" patterns) were found in all dogs in the damage group whereas abnormal waveforms were not detected in the control group. Pathological diagnosis revealed that, compared with the control group, the damage group recognized ischemic alteration at the level of the hippocampus and caudate nucleus. In conclusion, this study shows that the basilar arterial flow of observed with transcranial Doppler ultrasonography may be use for the prediction of outcome and the diagnosis of brain damage in the dog.     

BIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN THE NORMAL CAT

Eight healthy, adult cats were examined with biplane transesophageal echocardiography (TEE). Cats were sedated with a combination of diazepam and propofol and were examined using a 5 mm x 80 cm pediatric biplane TEE probe. Consistent images were obtained at three imaging depths within the esophagus. The middle position porvided the best short-axis images of the left ventricle andheart base. The middle position provided the best long-axis views of the left atrium, left ventricle, and aorta satisfactory imaging of the aorta and pumonary artery and allowed Doppler examination of right ventricular and left ventricular outflow. Biplane TEE provides and additional method of imaging the feline heart which is complimentary to other imaging techniques and the images obtained were similar to those reported for dogs. Although TEE offers a slight advantage over transthoracic imaging for Doppler examination, the quality of the images of heart base structures was not as consistently superior to transthoracic images in cats as reported in dogs.     

ULTRASONOGRAPHIC IMAGING OF THE LATERAL CEREBRAL VENTRICLES IN THE DOG

Ultrasonography was effectively used to evaluate lateral cerebral ventricles in 28 dogs with persistent fontanelles. There was a significant incidence of ventriculomegaly in miniature and brachycephalic breeds. No relationship was found between the size and the fontanelle and the presence or size of ventriculomegaly. A significant relationship was found between the presence of a fontanelle and the presence of ventriculomegaly. There was no statistically significant relationship found between the presence of clinical signs and ventricular size.