Eosinophilic pulmonary granulomatosis in a young dog with prolonged remission after treatment

A two‐year‐old Jack Russell terrier was presented for evaluation of chronic cough and exercise intolerance. Previous treatment with antibiotics and glucocorticoids had only partially ameliorated the clinical signs. During investigation, hypoxaemia, peripheral eosinophilia and an eosinophilic bronchoalveolar lavage fluid were noted. Thoracic radiographs revealed two ovoid clearly delineated soft‐tissue opacities, one in the caudal segment of the left cranial lung lobe (diameter 26 mm) and the other in the right cranial lung lobe (diameter 20 mm). These findings were verified by computed tomography, which identified an additional smaller lesion (diameter 16 mm) dorsally in the right caudal lobe. Ultrasound‐guided fine‐needle aspiration samples confirmed the diagnosis of eosinophilic pulmonary granulomatosis and treatment with prednisolone and azathioprine was initiated. Within 1 month, granulomas were no longer detectable radiographically. All medication was discontinued after 7 months and currently, after 2·5 years, the dog remains free of clinical signs. To the authors’ knowledge this is the first case report to describe prolonged remission from idiopathic canine eosinophilic pulmonary granulomatosis.     

Macroscopic Anatomy of the Lower Respiratory System in Mole rats (Spalax leucodon)

The morphologic and morphometric features of the lower respiratory system in mole rats were examined. It was seen that the low respiratory system of this species leading a special life under highly hypoxic/hypercapnic conditions underground is structurally similar to other mammals living on land in terms of the parts examined; trachea was formed by 29.5 ± 4 oval‐formed cartilaginous tracheals arranged backwards and became gradually more stenotic diameter from cranial to the caudal of the neck. The trachea was separated in two principal bronchus at the fourth thoracal intercostal spatium level. The angle between the two main principal bronchi was 60.5 ± 2.35°. The lung constituted 1.29 ± 0.03% of the body weight and the right lung was heavier than the left lung. Fissura inter‐lobaris was deep and separated the lung lobes wholly, and the right lung was separated in four lobes, whereas the left lung was not separated into the lobes. Also, the medial lobe of the left lung was the lightest lobe.     

RADIOGRAPHIC CHARACTERIZATION OF PRIMARY LUNG TUMORS IN 74 DOGS

Primary pulmonary neoplasia is well recognized in dogs and prognosis depends upon the tumor type. The purpose of this retrospective study was to characterize the radiographic appearance of different primary lung tumors with the goal of establishing imaging criteria to separate the different types. Three‐view thoracic radiographs of 74 dogs with histologically confirmed pulmonary anaplastic carcinoma (n = 2), adenocarcinoma (n = 31), bronchioalveolar carcinoma (n = 19), histiocytic sarcoma (n = 21), and squamous cell carcinoma (n = 1) were evaluated. Radiographs were assessed for tumor volume, affected lobe, location within lobe, overall pulmonary pattern, presence of cavitation, mineralization, air bronchograms, lymphadenomegaly, and pleural fluid. Histiocytic sarcomas were significantly larger than other tumor types (271 cm³; P = 0.009) and most likely to be found in the left cranial (38%; 8/21) and right middle (43%; 9/21) lung lobes, whereas adenocarcinomas were most likely to be found in the left caudal (29%; 9/31) lung lobe. Fifty‐seven percent (12/21) of histiocytic sarcomas had an internal air bronchogram. Findings indicate that a large mass in the periphery or affecting the whole lobe of the right middle or left cranial lung lobe with an internal air bronchogram is likely to be an histiocytic sarcoma.     

Fatal acute lung injury after balloon valvuloplasty in a dog with pulmonary stenosis

A one-year-old French Bulldog was referred for the management of a severe form of pulmonary valve stenosis (PS) complicated by right-sided congestive heart failure.Echocardiography showed severe valvular PS with right ventricular concentric hypertrophy, dilatation and severe right atrial enlargement. A pulmonary balloon valvuloplasty (PBV) was performed with a balloon-to-pulmonary annulus ratio of 1.36. Echocardiography immediately after PBV showed a significant reduction in right atrial and ventricular size, improved opening and mobility of the pulmonary valve leaflets, and a 75% reduction in the pulmonary pressure gradient from 158 mmHg pre-operative to 40 mmHg post-operative. The dog recovered well from anesthesia, but 2 h later, it suddenly showed severe respiratory distress. Focus cardiac ultrasound showed increased left cardiac size with echocardiographic signs of high left ventricular filling pressure. Bedside lung ultrasound showed diffuse numerous-to-confluent B lines, compatible with a severe alveolar-interstitial syndrome. The dog was treated with furosemide, helmet continuous positive airway pressure, and then mechanical ventilation but without success.At post-mortem evaluation, histological examination of the lung showed diffuse, severe broncho-alveolar edema with mixed leukocyte, fibrin, and red blood cell infiltrate. Moreover, severe congestion and multifocal alveolar hemorrhages were evident. All findings were compatible with fatal acute lung injury after PBV secondary to pulmonary reperfusion-ischemia injury and increased pulmonary capillary hydrostatic pressure. Based on the present case, acute lung injury should be considered as a rare but serious complication of PBV.     

Treatment of coxofemoral luxation in a mature Welsh pony by femoral head ostectomy: Long‐term outcome

A 233 kg, 4‐year‐old Welsh pony stallion presented with a unilateral coxofemoral luxation and a history of previous upward fixation of the patella. This condition was surgically managed by femoral head ostectomy using a craniodorsal approach to the luxated coxofemoral joint, without greater trochanteric osteotomy. Immediate improvement in weightbearing was observed after surgery and primary intention healing was recorded. Long‐term outcome, 4 years after surgery, was assessed by radiographic, ultrasonographic and lameness examination. The pony was in good body condition and the initial weight of this patient was restored. Despite fetlock hyperlaxity of the contralateral hindlimb, amyotrophy and mechanical lameness of the affected hindlimb, the pony showed evident comfort without apparent signs of pain and was able to trot and gallop. Bone callus was observed at imaging examination.     

Pyogenic granuloma of the cornea in a pony: Uncommon complication of corneal wound healing

A 6-year-old miniature Shetland pony mare was referred for evaluation of a left corneal mass, which developed from the healing tissue of a corneal traumatic ulceration that had occurred 4 weeks previously. On gross examination, a spherical, smooth-surfaced, and pink-colored lesion of about 1 cm in diameter was protruding from the left palpebral fissure. Ophthalmic examination revealed that it was attached to the scar tissue of the cornea, and that one corpora nigra was adherent to the posterior face of corneal wounded area, without sign of uveitis. The remainder of the ophthalmic examination was unremarkable. The mass was excised, and cryotherapy was used as an adjunctive therapy. Histopathology of the resected mass was consistent with a pyogenic granuloma on the basis of radially oriented proliferating capillaries, embedded in immature granulation tissue containing an infiltrate of neutrophils, plasma cells and eosinophils. There were no histological features of malignancy. 2 months after surgery, the ventral part of the fibrotic corneal scar was slightly raised by a pink tissue, suggesting possible recurrence of the initial lesion. A second cryotherapy was performed over the leukoma area. No recurrence has been noted for a follow-up period of more than 25 months. Pyogenic granuloma is a benign proliferative fibrovascular response that typically develops after trauma or surgery. Corneal involvement is rare in humans, and to the authors' knowledge has never been documented in veterinary ophthalmology.     

Use of computed tomography and minimum intensity projection in the detection of lobar pneumonia mimicking lung lobe torsion in a dog

A 10‐year‐old female spayed Dachshund was referred with progressive coughing for 1 month. The dog was tentatively diagnosed with right middle lung torsion based on pleural effusion, vesicular emphysema, abruptly ending bronchus in consolidated right middle lung, and no contrast enhancement of the affected lobe on radiography and computed tomography (CT). There was no evidence of torsion upon thoracotomy, and histological examination confirmed lobar pneumonia. The CT images were reevaluated using minimum intensity projection and revealed normal bronchial courses. The minimum intensity projection technique can be to assist in evaluation of the bronchial tree for dogs with suspected lung lobe torsion and other pulmonary diseases.     

Combined surgical and radiotherapy treatment of a mandibular ameloblastic carcinoma in a pony

A 9‐year‐old Welsh Section D gelding was referred to an equine hospital for evaluation and computed tomographic (CT) imaging of a left mandibular swelling. An expansile mass, found within the left mandible at the level of the caudal 2 cheek teeth, was surgically debulked and histology of the lesion identified it as an ameloblastic carcinoma. Radiotherapy using 4 fractions of 800 cGy, 7 days apart, was subsequently undertaken. The pony made excellent clinical progression following treatment. Repeat CT imaging at 7.5 and 19.5 months post surgery showed no apparent recurrence of the lesion and marked improvement in the remodelling of the mandible. In conclusion, radiotherapy in conjunction with surgical debulking appears to have been successful in treating an ameloblastic carcinoma in this pony and could be considered for similar tumours in other cases.     

Increased left lung consolidation in turkey cholera related to larger left pulmonary artery

After necropsy of the surviving turkeys in a comparative vaccine study for fowl cholera, in the turkeys with only one lung lobe consolidated, a significantly (P < 0.01, chi square test) higher number of turkeys were found with a consolidation of the left lung lobe than with the right lung lobe. When the circumferences of the left and right pulmonary arteries 0.5 cm rostral from the bifurcation were measured and converted to cross-sectional area, the left pulmonary artery had an average area of 29.6 +/- 2.8 mm2, and the right pulmonary artery had an average area of only 22.9 +/- 2.8 mm2, which was nearly one-fourth smaller. This finding suggests that the left lung lobe receives more blood than the right lobe and that, during an acute Pasteurella multocida septicemia, it would receive more of this organism than the right lung lobe.     

Hypertrophic osteopathy secondary to pulmonary sarcoma in a cat

A case of hypertrophic osteopathy secondary to a pulmonary spindle cell sarcoma is described. The 9‐year‐old male cat presented with a 1‐month history of decreased appetite, decreased activity and progressive lameness with swelling and pain of all four limbs. Thoracic radiographs showed a soft tissue opaque mass in the left caudal lung lobe. Radiographs of all limbs showed extensive periosteal new bone formation of uniform opacity demonstrating a ‘palisading’ pattern. The lung mass was removed at exploratory thoracotomy; histopathological examination diagnosed a low‐grade spindle cell sarcoma. Prior to surgery, the cat had a non‐specific conjunctivitis that resolved spontaneously following lobectomy raising the possibility of a paraneoplastic association. The lameness also resolved; six months after surgery, the periosteal palisading of new bone on the long bones had remodelled, and there was no evidence of pulmonary metastases.     

Use of computed tomography and silicon endocasts to identify pulmonary veins with echocardiography

The pulmonary veins were identified from the silicone endocast heart models of 19 dogs. Although variation in the number of the more peripheral veins on each specimen existed, all of the casts had a consistency with regards to the most proximal coalescence of the pulmonary veins as they entered the body of the left atrium. That is, the confluence of the veins formed three ostia at the atrial entry point that consisted of 1) right cranial and right middle pulmonary lobe veins; 2) right caudal, accessory, and left caudal pulmonary lobe veins; and 3) both the left cranial and left caudal pulmonary lobe veins of the left cranial lung lobe. The location of these structures identified by the 3-dimensional endocasts were then used to assist in the identification of the pulmonary veins using computed tomography of 2 dogs. Slices were made that approximated those commonly performed during echocardiographic examination. Understanding which pulmonary veins are seen by echocardiography in the different imaging planes will permit prospective evaluations of pulmonary vein size and abnormal flow patterns.     

Cavitary pulmonary lesion associated with Aspergillus fumigatus infection in a German shepherd dog

A two-year-old female German shepherd dog was presented with chronic cough and haemoptysis. Thoracic radiographs revealed a thin-walled cavitary lesion within a consolidated left cranial lung lobe. Bronchoalveolar lavage confirmed a concurrent bacterial infection; however, despite antibiotic and anthelmintic therapy the clinical signs failed to resolve. A left cranial lung lobectomy was performed. Histopathology and fungal culture confirmed the presence of Aspergillus fumigatus. The necrotic cavity had features compatible with a bronchial origin, possibly a form of cystic bronchiectasis, arising either as a congenital anomaly or acquired secondary to infection. Surgery provided resolution of clinical signs for just over a year before the dog deteriorated again and was subsequently euthanised. Necropsy was declined by the owners. This case report presents a unique presentation in which the predominant clinical sign was coughing due to pulmonary involvement. Aspergillus fumigatus was isolated from the left cranial lung lobe.     

Hypertrophic osteopathy associated with pulmonary Eikenella corrodens infection in a dog

CASE DESCRIPTION: A 4-year-old English Pointer was examined because of chronic, progressive signs of pulmonary disease and failure to respond to medical treatment. CLINICAL FINDINGS: At examination, radiography of the thorax revealed increased pulmonary opacity and air bronchograms in the right caudal lung lobe, and radiography of the forelimbs revealed periosteal bone production typical of hypertrophic osteopathy. Attempts to isolate a causative organism included bacterial culture of bronchoalveolar lavage fluid and a lung tissue specimen obtained via fine-needle aspiration. Despite a cytologic diagnosis of septic suppurative inflammation in the lavage fluid, those specimens did not yield bacterial growth. However, a biopsy specimen obtained during a lung lobectomy procedure yielded growth of Eikenella corrodens. TREATMENT AND OUTCOME: Despite successful surgical removal of the consolidated lung lobe and initiation of antimicrobial treatment, the dog died 6 days after surgery. CLINICAL RELEVANCE: The authors are not aware of reports of pulmonary infection with E. corrodens in animals. Infection with the organism is rare, but it is possible that infections are underreported given that the organism is difficult to culture and biopsy may be necessary to obtain enough tissue to yield a diagnosis.     

Splenectomy in a dressage pony: end of sports career?

A 14-year-old Arabian cross-bred gelding was referred to the University Clinic because of mild, recurrent signs of colic for 5 days. The pony showed icteric mucous membranes, haemolytic blood, and dark coloured urine. Internal examination did not give a clear diagnosis. Unidentified intra-abdominal strands were found and haemorrhagic abdominocentesis led to the decision to perform an exploratory laparatomy. An extremely enlarged spleen was the sole finding. A splenal biopsy sample was taken and surgery was completed. The pony remained colicky, so the spleen was examined by ultrasonography. After this examination, the tentative diagnosis 'tumour of the spleen' was made and splenectomy was performed. Pathological examination of the spleen revealed splenomegaly caused by infarctions of unknown origin. Eight weeks after surgery, the pony started again in dressage competition. Six months after splenectomy, the pony won the provincial dressage competition.     

Chronic Atlantoaxial Luxation Imaging Features in a Pony with Intermittent Neck Stiffness

A 17-year-old mixed breed pony was presented with intermittent neck stiffness during regular training rides in the six months preceding its admission. All parameters were within the normal range, except for an increase in heart rate (48 bpm) during the examination. Concave areas were observed at the level between the atlas and axis vertebrae (C1-C2) on both the left and right sides of the neck. Radiographs were taken of the laterolateral, left ventrodorsal oblique, and right ventrodorsal oblique projections in the cranial cervical region. The images revealed severe structural disorders, including trauma with luxation of the atlantoaxial joint, a fusion of the atlas and axis vertebrae, and evidence of a false joint in the axis bone. Subsequent ultrasonography showed hyperechoic areas in the rectus capitis caudalis and obliquus capitis caudalis muscles. Neck mobility was improved after two weeks of stall rest, administration of oral phenylbutazone (4.4 mg/kg), and topical cold gel treatment. The overstretching of surrounding soft tissues accompanying chronic injury of cranial cervical area may result in neck stiffness in the aging pony. Radiographic and ultrasonographic findings were consistent with the presence of cranial cervical trauma leading to neck stiffness. These findings emphasized the essential role of imaging diagnostics in treating a pony with intermittent neck stiffness.     

Partial anomalous pulmonary venous connection with portosystemic shunt in a cat

A nine-month-old castrated male domestic shorthair presented for evaluation with a three-month history of hematuria. Portosystemic shunts and calculi within the bladder were suspected, and computed tomography angiography was performed. Computed tomography angiography identified an extrahepatic portosystemic shunt and a partial anomalous pulmonary venous connection, with the lobar vein of the right caudal lobe draining into the caudal vena cava. After anesthesia was administered to the cat, tachypnea and wheezing respiratory sounds were observed, and thoracic radiography revealed the right middle lung lobe atelectasis and an unstructured interstitial pattern in the left cranial lobe. Echocardiography showed left and right atrial enlargement and slight interventricular septal flattening in diastole. Based on these findings, cardiogenic pulmonary edema was suspected, and the cat was treated with furosemide. The clinical symptoms were resolved the next day. Closure of the extrahepatic portosystemic shunt was performed on days 47 and 157. Left atrial enlargement and interventricular septal flattening were attenuated after the procedure. At the time of writing this report (seventeen months after diagnosis), the cat exhibited no clinical signs, but subjective right atrial enlargement remained at approximately the same level. This report represents the first case of a partial anomalous pulmonary venous connection and a portosystemic shunt in a cat.     

Presentation,stabilisation and contrast-enhanced computed tomographic (CT) diagnosis of a left gastrocaval portosystemic shunt in a pony foal

A 2-week-old pony foal was presented for recurrence of neurological dysfunction, obtunded-comatose mentation and collapse. Signalment, history, haematological and clinical chemical measurements and response to treatment prompted a presumptive diagnosis of hepatic encephalopathy secondary to a portosystemic shunt. This case differs from previous reported cases of  congenital portosystemic shunts in horses due to the early onset of clinical signs, which usually occur at 2–6 months of age. In addition, in comparison with previously reported cases, this foal stabilised rapidly with minimal intervention. Contrast-enhanced computed tomography (CT) confirmed a left gastrocaval extrahepatic portosystemic shunt. Surgical intervention was not attempted due to financial constraints, so the foal was subjected to euthanasia, and on post-mortem examination, the anomalous vascular connection could clearly be identified.     

Intracranial,extraneural ectopic lymph node in a bovine (Bos taurus)

The brain from a field necropsied 8‐month‐old feedlot heifer presenting with an acute history of depression, lethargy, dyspnoea and anorexia was evaluated grossly and by histopathology. The meninges overlying the left cerebral hemisphere contained a 12 × 26 × 32 mm, dark red, soft, ovoid mass. Histologic examination of this tissue revealed a well‐organized lymph node with normal architecture. Organization of reactive lymphoid tissue resembling normal lymph node architecture may occur under chronic stimulation. However, there are no known aggregates of lymphoid tissue present within the cranial vault in any veterinary species. This is the first reported case of an intracranial ectopic lymph node in any species.     

Partial Equine Lung Resection Using a Stapling Instrument

Four horses (aged 1 to 18 years) with no apparent respiratory or cardiovascular abnormalities underwent thoracotomy and partial resection of a cranial lung lobe. A stapling instrument was used. Pulmonary function testing prior to and 30 days following surgery showed no significant change in inspiratory or expiratory resistance, compliance, or work of breathing. Postoperative complications consisted of a mild pneumothorax in all horses and localized incisional infection in two horses. All horses displayed a temporary decrease in forward motion of the forelimb on the operated side. Postmortem examination was performed 30 days after surgery; pleural thickening and adhesions between the lung and thoracotomy site were found. The excisionai margin of each cranial lobe was straight with slight puckering due to multiple surgical wire staples. Adjacent tissue collapse and compression were confined to an area no greater than 1 cm from the staples. Beyond this compression, the remaining lung at the surgical site was histologically normal. Subsequently, one horse suffering from recurrent episodes of clinical signs attributed to pleuropneumonia underwent left thoracotomy and partial lung resection followed by a right thoracotomy 48 days later. The horse's condition improved postoperatively, and he was able to undergo normal conditioning and racing.