Magnetic Resonance Imaging Findings in Dogs with Confirmed Shoulder Pathology

Objective— To evaluate the diagnostic potential of magnetic resonance imaging (MRI) compared with a reference standard, arthroscopic and/or open surgery, in dogs with soft tissue shoulder pathology. Study Design— Retrospective study. Animals— Dogs (n=21). Methods— Magnetic resonance (MR) images were retrospectively evaluated in 21 dogs that had surgically identified soft tissue shoulder pathology. The musculotendinous units of the biceps, infraspinatus, teres minor, supraspinatus, subscapularis, and the medial and lateral glenohumeral ligaments (MGHL and LGHL) were graded as either normal or abnormal. Abnormal structures were further classified as being either inflamed, partially torn, or fully torn. Impingement of the biceps tendon was also evaluated. Results were reported in terms of agreement and concordance between MRI findings and surgical findings. Agreement was defined as the percentage of times MRI findings concurred with surgical findings with respect to a structure being either normal or abnormal. Concordance was defined as the percentage of times MRI concurred with the exact surgically assessed pathology when abnormality was identified. Results— The findings were biceps tendon: 90% agreement with 100% concordance; subscapularis: 95% agreement with 62% concordance; MGHL: 84% agreement with 83% concordance; LGHL: 88% agreement with 100% concordance; infraspinatus: 100% both agreement and concordance; biceps tendon impingement: 90% agreement with 100% concordance. Conclusions— Soft tissue abnormalities of the canine shoulder were readily identified on preoperative MR images. Clinical Relevance— MRI shows great potential as a diagnostic tool in the evaluation of canine shoulder disease.     

Necrotizing Meningoencephalitis in Atypical Dog Breeds: A Case Series and Literature Review

Background

Canine necrotizing meningoencephalitis (NME) is a fatal, noninfectious inflammatory disease of unknown etiology. NME has been reported only in a small number of dog breeds, which has led to the presumption that it is a breed‐restricted disorder.

Hypothesis/Objectives

Our objective was to describe histopathologically confirmed NME in dog breeds in which the condition has not been reported previously and to provide preliminary evidence that NME affects a wider spectrum of dog breeds than previously reported.

Animals

Four dogs with NME.

Methods

Archives from 3 institutions and from 1 author''s (BS) collection were reviewed to identify histopathologically confirmed cases of NME in breeds in which the disease has not been reported previously. Age, sex, breed, survival from onset of clinical signs, and histopathologic findings were evaluated.

Results

Necrotizing meningoencephalitis was identified in 4 small dog breeds (Papillon, Shih Tzu, Coton de Tulear, and Brussels Griffon). Median age at clinical evaluation was 2.5 years. Histopathologic abnormalities included 2 or more of the following: lymphoplasmacytic or histiocytic meningoencephalitis or encephalitis, moderate‐to‐severe cerebrocortical necrosis, variable involvement of other anatomic locations within the brain (cerebellum, brainstem), and absence of detectable infectious agents.

Conclusions and Clinical Importance

Until now, NME has only been described in 5 small dog breeds. We document an additional 4 small breeds previously not shown to develop NME. Our cases further illustrate that NME is not a breed‐restricted disorder and should be considered in the differential diagnosis for dogs with signalment and clinical signs consistent with inflammatory brain disease.     

Magnetic Resonance Imaging in the Diagnosis of Degenerative Lumbosacral Stenosis in Four Dogs

Magnetic resonance imaging was used to diagnose degenerative lumbosacral stenosis in four dogs that had physical and neurologic signs consistent with a cauda equina lesion. Nerve root displacement by protruding disc material and loss of epidural fat were identified. In all dogs, the diagnosis was confirmed by dorsal laminectomy of the lumbosacral area.     

Surgical Anatomical Landmarks of the Thoracolumbar Vertebral Column on Magnetic Resonance Imaging in Dogs

Magnetic resonance imaging (MRI) in veterinary medicine profoundly improved spinal cord disease investigation in canine patients. We aimed to further describe the anatomical landmarks of the thoracolumbar junction in sagittal MRI sequences. MRI studies from 90 dogs were reviewed retrospectively, representing a broad cross section of breeds and body weights. The ratio of the distance from the dorsal aspect of the vertebral canal to the dorsal aspect of the transverse process or rib articulation relative to the length of L2 vertebra was determined for T12, T13, L1 and L2 vertebrae. A statistically significant difference was noted with the transverse processes being more ventrally located than the cranial fovea costalis. The lumbar transverse processes and rib articulations dramatically varied in shape, being oval or round, respectively. The sagittal image at the level of the lateral margin of the articular facet joint proved to be the most consistent for review of these structures.     

Magnetic Resonance Imaging (MRI) Spinal Cord and Canal Measurements in Normal Dogs

The goal of this study was to establish Magnetic resonance imaging (MRI) reference ranges for spinal measurements in normal dogs. Forty dogs (1–10 kg, 11–20 kg, 21–30 kg, > 30 kg; 10 dogs per category) underwent spinal MRI. Measurements were performed on sagittal T2‐W images at the level of the 4th thoracic vertebra (T4), the 9th thoracic vertebra (T9) and the 3rd lumbar vertebra (L3). Spinal canal diameter (mm) ranged from 6.07 ± 0.63 (1–10 kg) to 8.27 ± 1.15 (> 30 kg) at the level of T4; 6.55 ± 0.61 (1–10 kg) to 9.04 ± 1.26 (> 30 kg) at the level of T9; and 6.80 (6.47–7.00; 1–10 kg) to 9.00 (7.90–9.73; > 30 kg) at the level of L3. There were significant differences (P < 0.05) in spinal canal diameter between groups. Mean spinal cord diameter (mm) ranged from 4.46 ± 0.51 (11–20 kg) to 4.70 ± 0.35 (1–10 kg) at the level of T4; 4.41 ± 0.50 (> 30 kg) to 4.85 ± 0.57 (1–10 kg) at the level of T9; and 4.52 ± 0.51 (> 30 kg) to 5.14 ± 0.68 (1–10 kg) at the level of L3. There were no significant differences in spinal cord diameter between groups. Spinal cord‐to‐spinal canal ratio varied significantly, ranging from 0.51 ± 0.08 (> 30 kg at L3) to 0.78 (0.69–0.80; 1–10 kg at T4) (P < 0.05). These findings are important when using MRI to evaluate patients with suspected diffuse spinal cord disease.     

Clinical Features and Magnetic Resonance Imaging Findings in 7 Dogs with Central Nervous System Aspergillosis

Background

Systemic aspergillosis is a manifestation of Aspergillus sp. infection that can result in central nervous system (CNS) involvement with marked alterations in CNS function. Information regarding the clinical presentation and magnetic resonance imaging (MRI) findings in cases of aspergillosis with CNS involvement is lacking, resulting in a need for better understanding of this disease.

Hypothesis/Objectives

The primary objectives were to describe the clinical features and MRI findings in dogs with CNS aspergillosis. The secondary objectives were to describe clinicopathologic findings and case outcome.

Animals

Seven dogs with CNS aspergillosis.

Methods

Archived records from 6 institutions were reviewed to identify cases with MRI of CNS aspergillosis confirmed with serum galactomannan enzyme immunoassay (EIA) testing, culture, or supported by histopathology. Signalment, clinical, MRI, clinicopathologic, histopathologic, and microbiologic findings were recorded and evaluated.

Results

Aspergillosis of the CNS was identified in 7 dogs from 3 institutions. The median age was 3 years and six were German Shepherd dogs. Five dogs had signs of vestibular dysfunction as a component of multifocal neurological abnormalities. The MRI findings ranged from normal to abnormal, including hemorrhagic infarction and mass lesions.

Conclusions and Clinical Importance

Until now, all reported MRI findings in dogs with CNS aspergillosis have been abnormal. We document that CNS aspergillosis in dogs, particularly German Shepherd dogs, can be suspected based on neurologic signs, whether MRI findings are normal or abnormal. Confirmatory testing with galactomannan EIA, urine, cerebrospinal fluid (CSF) or tissue culture should be performed in cases where aspergillosis is a differential diagnosis.     

Prognostic Value of Early Magnetic Resonance Imaging in Dogs after Traumatic Brain Injury: 50 Cases

Background

The prognostic value of early magnetic resonance imaging (MRI) in dogs after traumatic brain injury (TBI) remains unclear.

Objectives

Determine whether MRI findings are associated with prognosis after TBI in dogs.

Animals

Fifty client‐owned dogs.

Methods

Retrospective study of dogs with TBI that underwent 1.5T MRI within 14 days after head trauma. MRI evaluators were blinded to the clinical presentation, and all images were scored based on an MRI grading system (Grade I [normal brain parenchyma] to Grade VI [bilateral lesions affecting the brainstem with or without any lesions of lesser grade]). Skull fractures, percentage of intraparenchymal lesions, degree of midline shift, and type of brain herniation were evaluated. MGCS was assessed at presentation. The presence of seizures was recorded. Outcome was assessed at 48 h (alive or dead) and at 3, 6, 12, and 24 months after TBI.

Results

Sixty‐six percent of the dogs had abnormal MRI findings. MRI grade was negatively correlated (P < .001) with MGCS. A significant negative correlation of MRI grade, degree of midline shift, and percentage of intraparenchymal lesions with follow‐up scores was identified. The MGCS was lower in dogs with brain herniation (P = .0191). Follow‐up scores were significantly lower in dogs that had brain herniation or skull fractures. The possibility of having seizures was associated with higher percentage of intraparenchymal lesions (P = 0.0054) and 10% developed PTE.

Conclusions and Clinical Importance

Significant associations exist between MRI findings and prognosis in dogs with TBI. MRI can help to predict prognosis in dogs with TBI.     

Epidemiology of necrotizing meningoencephalitis in Pug dogs

BACKGROUND: Although the histopathologic features of necrotizing meningoencephalitis (NME) have been described previously, little information is available concerning the signalment, geographic distribution, seasonal onset, treatment, and survival of affected dogs. ANIMALS: Sixty Pugs with NME and 14 contemporaneous control Pugs with other intracranial diseases (non-NME group). METHODS: Pugs that were euthanized or died because of intracranial disease were prospectively obtained. All dogs had necropsy, histopathology, and testing for various infectious diseases and were subsequently divided into NME and non-NME groups. Signalment, geographic distribution, seasonal onset, treatment, and survival were compared between groups. RESULTS: In Pugs with NME, median age at onset of clinical signs was 18 months (range, 4-113 months). A greater proportion of female dogs were present in the NME group (40/60) compared with the control group (6/14). Pugs with NME had a significantly lower mean weight (7.81 kg) than control Pugs (9.79 kg) (P= .012). Mean survival in Pugs with NME was 93 days (range, 1-680 days), with dogs receiving any form of treatment living significantly longer than those that were not treated (P= .003). Anticonvulsive drugs were the only treatment significantly associated with longer survival (P= .003). CONCLUSIONS AND CLINICAL IMPORTANCE: NME appears to be a common cause of intracranial signs in Pugs, based on the high proportion of NME dogs reported in this population. Pugs with NME are most commonly young adult female dogs. Although further investigation is needed to determine the optimal treatment of NME, anticonvulsive drugs appear to beneficially affect duration of survival.     

Magnetic Resonance Imaging of Right Ventricular Morphology and Function in Boxer Dogs with Arrhythmogenic Right Ventricular Cardiomyopathy

Background: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a myocardial disease characterized by fibrofatty replacement of the right ventricle and ventricular tachyarrhythmias, reported most commonly in the Boxer dog. Although ARVC is characterized as a myocardial disease, the impact of the disease on the function of the right ventricle has not been well studied.
Objective: To noninvasively evaluate the function and anatomy of the right ventricle in Boxer dogs with ARVC.
Animals: Five adult Boxer dogs with ARVC and 5 healthy size-matched hound dogs.
Methods: Magnetic resonance imaging was performed on an ECG-gated conventional 1.5-T scanner using dark blood imaging and cine acquisitions. Images were evaluated by delineation of endocardial right and left ventricular contours in the end-diastolic and end-systolic phases of each slice. Right and left end-systolic and end-diastolic volumes were generated using Simpson's rule and ejection fraction was calculated. Images were evaluated for right ventricular (RV) aneurysms and wall motion abnormalities. Spin echo images were reviewed for the presence of RV myocardial fatty replacement or scar.
Results: RV ejection fraction was significantly lower in Boxers with ARVC compared with the controls (ARVC 34%± 11 control 53%± 10, P < .01). There was an RV aneurysm in 1 dog with ARVC but not in any of the controls. RV myocardial gross fatty changes were not observed in dogs of either group.
Conclusions and Clinical Importance: These findings could be interpreted to suggest that arrhythmias and myocardial dysfunction precede the development of morphological abnormalities in dogs with ARVC.     

Electrophysiologic Characteristics and Topographic Distribution of Focal Atrial Tachycardias in Dogs

Background: Focal atrial tachycardia (FAT) is a common supraventricular tachycardia in dogs. Objective: To evaluate electrophysiologic characteristics and topographic distribution of FAT. Animals: Sixteen dogs with symptomatic FAT. Methods: Retrospective case series. Electrophysiological studies were performed to test the inducibility of documented and no documented arrhythmias. Once induced for each dog, FAT was analyzed for electrogenic mechanism, endocardial electrogram, and location. Results: Nineteen FATs could be studied in 16 dogs, 12 were automatic, 4 nonautomatic, and 3 incessant. Two dogs had >1 focus. Mean atrial cycle length (CL) was 238.2 ± 69.2 (SD) milliseconds, mean ventricular CL of 292.7 ± 72.5 (SD) milliseconds, with atrioventricular block in 6 cases. Mean presystolic atrial activity recorded at the ectopic focus was –39.9 ± 17.7 (SD) milliseconds. Atrial potentials were fragmented in 11 dogs and were low amplitude in 6 dogs. Sixty‐three percent of ectopic foci were distributed within the right atrium (5 crista terminalis, 3 triangle of Koch, 2 tricuspid valve annulus, 1 interatrial septum, and 1 right auricle) and 37% in the pulmonary veins (PVs) (4 right superior PV, 2 left superior PV, and 1 right inferior PV). Persistent atrial fibrillation (AF) and paroxysmal AF were triggered by FATs in 7 dogs (2 with multiple ectopic foci and 4 with at least one PV focus). Conclusion and Clinical Relevance: According to our findings, dogs have a predominance of right‐sided FAT. The majority of FATs are automatic and can trigger AF, particularly in the case of PV location.     

Magnetic Resonance Imaging in Dogs with Neurologic Impairment Due to Acute Thoracic and Lumbar Intervertebral Disk Herniation

Background: Magnetic resonance imaging (MRI) is a correlate to physical examination in various myelopathies and a predictor of functional outcome.
Objectives: To describe associations among MRI features, neurological dysfunction before MRI, and functional outcome in dogs with disk herniation.
Animals: One hundred and fifty-nine dogs with acute thoracolumbar disk herniation.
Methods: Retrospective case series. Signalment, initial neurological function as assessed by a modified Frankel score (MFS), and ambulatory outcome at hospital discharge and >3 months (long-term) follow-up were recorded from medical records and telephone interview of owners. Associations were estimated between these parameters and MRI signal and morphometric data.
Results: Dogs with intramedullary T2W hyperintensity had more severe pre-MRI MFS (median 2, range 0–4) and lower ambulatory proportion at long-term follow-up (0.76) than those dogs lacking hyperintensity (median MFS 3, range 0–5; ambulatory proportion, 0.93) ( P =.001 and .013, respectively). Each unit of T2W length ratio was associated with a 1.9 times lower odds of long-term ambulation when adjusted for pre-MRI MFS (95% confidence interval 1.0–3.52, P =.05). Dogs with a compressive length ratio >1.31 (which was the median ratio within this population) had more severe pre-MRI MFS (median 3, range 0–5) compared with those with ratios ≤1.31 (median MFS 3, range 0–4; P =.006).
Conclusions and Clinical Importance: MRI features were associated with initial injury severity in dogs with thoracolumbar disk herniation. Based on results of this study, the T2W length ratio and presence of T2W intramedullary hyperintensity appear to be predictive of long-term ambulatory status.     

The Biologic Behavior of Mast Cell Tumors in Pug Dogs

Introduction:  The purpose of this study was to quantitate the risk and to describe the behavior of mast cell tumors (MCT) in Pugs.
Methods and Materials:  Using the Veterinary Medicine Database, the frequency of MCT in Pugs was compared to the frequency in other dogs using a Chi‐square test. To describe the biologic behavior of MCT in pugs, cases with histologically confirmed diagnosis were identified through the University of Minnesota (UMN) Diagnostic Laboratory and Veterinary Medical Center. Histology was reviewed by a single pathologist. Survival analysis was performed to determine the impact of clinical and histologic data on survival.
Results:  The frequency of MCT diagnosis in Pugs was significantly increased compared to other dogs (OR = 2.28, 95% CI = 1.81–2.86). Twenty‐five purebred Pugs with a diagnosis of MCT were identified through UMN. Multiple cutaneous tumors were documented in 14 (56%) of the dogs. Most tumors were low to intermediate grade. Only three dogs have died of their disease. Sixteen are still living (median follow‐up = 660 days). The only factors predicting survival were grade, mitotic index and tumor size.
Discussion:  Our data confirms MCT predisposition in Pugs and suggests that mast cell tumors in Pugs are relatively benign, despite the presence of multiple cutaneous tumors in most cases. Multiple tumors in breeds with predisposition to MCT may indicate separate primaries rather than advanced stage disease.
This work was supported in part by NCI grants R03‐CA101030 and K08‐CA89530.