TRANSABDOMINAL SONOGRAPHIC EVALUATION OF THE CANINE PROSTATE

The present study sought to determine the accuracy of ultrasonographic measurement of the prostate; to observe the ultrasonographic appearance of the normal prostate; and to compare these observations with those in prostates affected by cystic hyperplasia, benign hyperplasia, land neoplasia. Trassabdominal ultrasonography of the canine prostate was performed in eight normal dogs to establish criteria for evaluating enlarged prostates. Marginal boundries, size, and ultrasonographic architecture were compared with dissection findings to assess the accuracy of ultrasonography. Four enlarged prostates were evaluated ultrasonographically, and the findings were correlated with results of needle aspiration and urethral wash and with surgical and histopathologic findings. Differentiation between cystic and solid prostatic enlargement by ultrasonography proved efective. Transducer frequency and gain manipulation were important factors in describing the nature of the fluid within a cyst. Assenssment of the nature of solid prostatic enlargement and accurate size determination proved to be areas in which ultrasonography should by used in conjunction with other diagnostic techniques.     

COMPUTED TOMOGRAPHIC ANATOMY OF THE CANINE PANCREAS

Barium sulfate was administered into the coeliac artery of 5 canine cadavers to allow for contrast computed tomography of the pancreas. Contiguous, 2-mm-thick slices were acquired. Multiplanar and three-dimensional reformatting were performed to clarify the anatomic relationship. After imaging, the cadavers were frozen, cross sections obtained, and plastinated. These were compared to the computed tomography images. Five plain and contrast enhanced computed tomographic series of normal live controls were acquired and evaluated retrospectively. In the study of the canine cadavers the pancreas became opacified and appeared homogenous with irregular contour. In normal live controls, acquiring an image at the end of expiration allowed a detailed view of the pancreatic parenchyma in the non-alterated pancreas, but pancreatic and bile ducts could not be seen. Adjacent to the hepatic hilus the pancreatic body appeared as a dorsoventrally flattened structure bordering on the ventral surface of the portal vein, both in cadavers and normal live controls. The right lobe extended caudodorsally to the right abdominal wall and aligned with the cranial part of the duodenum. The left lobe was adjacent to the gastric body in all dogs although it was separated from the gastric fundus by the dorsal extremity of the spleen in normal live controls. Neither kidney was suitable as an anatomic marker for localization of the pancreas, unlike traditional references in textbooks. We recommended using the portal vein to localize the pancreatic body, the descending duodenum for the right lobe, and the dorsal extremity of the spleen as well as the gastric fundus for the left lobe.     

DEVELOPING A TECHNIQUE FOR ULTRASOUND‐GUIDED INJECTION OF THE ADULT CANINE HIP

An accurate method for guiding injections into the canine hip would facilitate diagnostic localization of lameness and targeted treatments. Ultrasound‐guided hip injections are commonly used in humans and large animals. Aims of this prospective study were to describe ultrasound (US) anatomy of the adult canine hip and determine the feasibility and accuracy of intra‐articular placement of injectate using US‐guidance. Seven adult dogs were used to describe US anatomy, five dog cadavers were used to assess the feasibility of the injection technique and 11 dog cadavers were used to assess accuracy of injections. For the accuracy test, 22 joints were injected with iodinated contrast medium by three operators with different experience. With dogs in lateral recumbency, the hyperechoic femoral head surface was identified by following the femoral neck from the greater trochanter or the acetabular rim was localized by following caudally the ilium from the iliac wing.  An anechoic gap between the femoral head and acetabular surface represented the joint. The capsule was visible as a triangular echoic structure and the femoral head articular cartilage appeared as an anechoic band. The needle was inserted axial to the greater trochanter and directed in a dorsolateral–ventromedial direction toward the joint space and then pushed through the capsule. Based on postinjection radiography, accuracy was 81.8% at first attempt and 100% at second attempt. This study indicated that US‐guided injection is a feasible and accurate technique for injecting the adult canine hip. Future studies in live dogs are needed to assess safety and efficacy.     

SONOGRAPHIC ESTIMATION OF PLEURAL FLUID VOLUME IN DOGS

The aim of this study was to find an ultrasonographic method to estimate pleural fluid volume in dogs. Nine canine cadavers of mixed breed were studied. Using a transsternal view, linear measurements from the pleural surface of the midline of the sternebra at the center of the heart to the furthest ventrolateral point of both right and left lung edges were recorded. Isotonic saline was injected using ultrasound guidance into both right and left pleural spaces and the measurements were repeated using standard increments until 1000 ml total volume was reached. No relationship was identified between mean distance and injected volume up to 100 ml. Thereafter, the mean distance increased in an approximately linear relationship with the cube root of fluid volume. There was a high correlation ( r ≥0.899) between the ultrasonographic measurement and fluid volume within individual dogs, but it was not possible to produce a useful equation to calculate absolute pleural fluid volume for new subjects. Nevertheless, ultrasonography may be used to semiquantitatively monitor pleural fluid volume, so that a decrease in the mean linear measurement obtained reflects a decrease in the total fluid volume.     

ENDOSCOPIC ULTRASONOGRAPHY OF THE PANCREAS IN THE DOG

Endoscopic ultrasonography was done in 12 normal adult dogs to investigate its efficacy in visualization of the pancreas. The endoscopic ultrasonographic device used in the present study had a curved-array ultrasound transducer mounted in front of the objective lens. The tip of the ultrasonic endoscope was inserted into the stomach, and all examinations of the pancreas were performed from within the stomach. Endoscopic ultrasonography provided good images of most parts of the pancreas except for the ends of each lobe. Useful information about the pancreatic parenchyma, including pancreatic lobular structure, pancreatic duct, and vessels of the pancreas was obtained by endoscopic ultrasonography. Blood flow within vessels was detected using color Doppler and pulsed-wave Doppler examination. These results suggest that endoscopic ultrasonography is available as an effective diagnostic modality in small animal practice.     

ENDOSCOPIC ULTRASOUND OF THE CANINE ABDOMEN

The aim of this study was to develop a standardized procedure for examination of the canine abdomen using endoscopic ultrasound and to describe the organs and structures that could be identified transgastrically. The abdomen of four healthy dogs and two cadavers were examined with endoscopic ultrasound. Five anatomic landmarks were used for standardized imaging of the cranial abdomen. These were the portal vein, splenic head and body, duodenum, left kidney, and aorta. High-resolution images of the following organs and structures could be made: distal esophagus, gastric wall from the cardia to the pylorus, liver, caudal vena cava, hepatic lymph nodes, liver hilus, and associated vessels, trifurcation of the celiac artery as well as the path of its branches and the left pancreatic limb and body. Structures that were more difficult to image were the distal duodenum and right pancreatic limb, the entire jejunum, ileum, and cecum as well as the tail of the spleen. Endoscopic ultrasound allowed excellent visualization of the gastric wall and regional structures without interference with gas artefacts. Centrally located organs such as the pancreas could be well examined transgastrically with endoscopic ultrasound without interference by overlying intestinal segments as is common with transabdominal ultrasound.     

SONOGRAPHIC EVALUATION OF CANINE TESTICULAR AND SCROTAL ABNORMALITIES: A REVIEW OF 26 CASE HISTORIES

The ultrasonographic and medical records of 26 dogs examined for testicular/scrotal abnormalities were reviewed. Fifteen dogs were diagnosed with testicular neoplasia that included one or more of the following tumor cell types: Sertoli cell, seminoma and interstitial cell. Ultrasound was highly sensitive to detection of testicular neoplasia including one nonpalpable tumor. Tumor type specificity was not readily apparent in this study, although the three nondescended Sertoli cell tumors displayed similar characteristic sonographic patterns. Six dogs were reviewed with nonneoplastic, noninfectious disorders that included: vascular compromise, atrophy, scrotal edema and intestinal hernia. Five dogs with infectious diseases were reviewed. Ultrasound was sensitive and relatively specific for the nonneoplastic conditions.     

HELICAL COMPUTED TOMOGRAPHIC ANGIOGRAPHY OF THE NORMAL CANINE PANCREAS

Helical abdominal computed tomography (CT) was performed in nine normal beagle-mix dogs. Following cephalic vein injection of ionic iodinated contrast medium via power injector (rate 5 ml/s) dual-phase CT was performed in all dogs. A delayed scan was performed in five dogs between 5 and 13 min after the contrast medium injection. The median time of appearance of contrast medium in the aorta and gastroduodenal artery was 6.3 and 7 s, post start injection and 12 and 12.2 s in the gastroduodenal and portal vein, resulting in a purely arterial pancreatic time window of 5-6s. Pancreatic veins and parenchyma remained enhanced until the end of the dynamic scan (40s). The pancreatic parenchyma showed heterogeneous arterial and homogenous venous contrast enhancement which was slightly hypoattenuating compared to the liver. Delayed scans provided best delineation of the pancreas from the liver. The common bile duct could be identified ventral and to the right of the portal vein joining the dorsomedial aspect of proximal duodenum. Because of the very short time window and variable onset of pure arterial enhancement careful planning of dual-phase studies with previous dynamic CT is recommended. Dual-phase CT angiography enables assessment of the arterial supply, parenchymal perfusion and venous drainage of the canine pancreas.     

A BOOST TECHNIQUE FOR IRRADIATION OF MALIGNANT CANINE NASAL TUMORS

Eighteen dogs with malignant nasal cavity tumors were treated with radiation therapy, including a boost technique. Three 3:0 Gy boost doses were added to a treatment protocol consisting of sixteen 3.0 Gy daily fractions, bringing the total dose to 57 Gy. This boost technique was implemented without an associated increase in overall treatment time by giving the boost doses on a twice-a-day basis. Boost doses were given during the first half of the radiation therapy period. The treatment was completed as planned in 16 of the 18 dogs; two dogs received lower doses (51 and 54 Gy). Median survival was 177 days, poorer than in some other reported studies of nasal tumor irradiation. Acute effects were unacceptable, with 11 of the 18 dogs developing severe mucositis, desquamation, edema, swelling, and pruritus. The extensive nature of the acute reactions compromised assessment of the effect of the increased radiation dose on the tumor. Although there is justification for assessing more aggressive radiation protocols in canine nasal tumor patients, total doses approximating 60 Gy can not be given as described because of the inability of acutely responding normal tissues to compensate.     

SONOGRAPHIC APPLICATION IN THE DIAGNOSIS OF INTRAABDOMINAL ABSCESS IN THE DOG

The sonographic appearance of intraabdominal abscess, excluding prostatic abscess, is presented. The most common sonographic pattern identified for intraabdominal abscess is an irregularly defined, hypoechoic mass with minimal to no through transmission. Definitive diagnosis of intraabdominal abscess using only sonography is not possible, as variations of this common sonographic pattern are imaged. Sonography is best utilized to scan an animal when there is a high suspicion of intraabdominal abscess with no overt physical or radiographic evidence, and to better characterize intraabdominal masses. Sonography can be used to assist in percutaneous aspiration, catheterization, and intraoperative localization of abscessation.     

SONOGRAPHIC APPEARANCE OF RENAL NEOPLASIA IN THE DOG

Eight dogs with renal neoplasia were radiographically and sonographically examined. An enlarged, nonopacified kidney was seen on the excretory urogram in four dogs, but differentiation between a solid mass or severe hydronephrosis was not possible. The excretory urogram suggested an avascular lesion in one kidney, but differentiation between solid or cystic disease was not possible. Renal neoplasia was diagnosed in two dogs by excretory urography. Radiographic examination suggested splenic neoplasia in one dog. Solid masses were sonographically diagnosed in all dogs. A metastatic lesion was sonographically diagnosed in the opposite kidney of one dog that was missed on the radiographic examination. Ultrasonography com-plemented radiography as a diagnostic modality in eliciting additional information on renal disease. Sonograms did not allow determination of tumor cell type or whether the tumor was benign or malignant.     

ULTRASONOGRAPHIC ANATOMY OF THE NORMAL CANINE KIDNEY*

Radiographic and ultrasonic examinations were performed in 12 normal dogs. Initial ultrasound examinations were performed in normally hydrated dogs. The ultrasonic appearance of the diuresed kidney was evaluated after excretory urography and intramuscular administration of furosemide. The dogs were euthanized for anatomic correlation with the sonographic appearance of the kidneys. Renal cortex, medulla, pelvic diverticula, intrarenal vessels, renal pelvis, and renal sinus fat were identified sonographically. Kidney enlargement during diuresis was due to increase renal medullary size. Veterinary Radiology, Vol. 25, No. 4, 1984; pp 173–178.     

ULTRASONOGRAPHY VERSUS RADIOGRAPHY FOR DETECTION OF FLUID IN THE CANINE TYMPANIC BULLA

The tympanic bullae of 20 previously healthy cadaver animals were randomly filled with sterile saline or air. The heads were positioned using tape ties and a rostrocaudal open mouth radiograph taken. The resulting radiographs were assessed by a blinded ECVDI diplomate, with each tympanic bulla being recorded as being either air or fluid filled. Ultrasound examination of the bullae was performed, by a blinded assessor, using a B-mode 5 mHz sector probe (Sonotron-VingMed Sound A/S, PO Box 141, N3191, Horten, Norway) operating at 3 mHz. Each bulla was recorded as being either air or fluid filled. Results of radiography and ultrasonography were each compared to the actual status of the bulla in a chi square analysis. Sensitivity of radiography was 80%, with specificity of 65%. Ultrasonographic sensitivity was 100% and specificity 100%. Ultrasonography may in future provide a cheap, noninvasive, rapid and widely available method for diagnosing otitis media in clinical cases.     

A COMPARISON OF TWO-DIMENSIONAL ULTRASONOGRAPHY AND RADIOGRAPHY FOR THE DETECTION OF SMALL AMOUNTS OF FREE PERITONEAL FLUID IN THE DOG

The detection of small amounts of free peritoneal fluid in the canine patient can be a diagnostic dilemma. Ultrasonography and radiography have been advocated to detect intraabdominal fluid not detectable by physical exam. The purpose of this study was to determine the more sensitive method for detecting small amounts of free peritoneal fluid. Ultrasound examinations and radiographs were performed after increments (1 ml/lb body weight) of fluid were injected intraperitoneally. Ultrasonography detected fluid in one animal at 2 ml/lb. AH other animals had fluid detected at 3 ml/lb. With radiographs fluid could be detected with a high degree of accuracy at 4 ml/lb. The lateral view was more accurate than the ventrodorsal view in detecting fluid. The authors concluded that Ultrasonography is more sensitive than radiography and is the method of choice to detect small amounts of free peritoneal fluid.     

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.     

EVALUATION OF DIFFERENT COMPUTED TOMOGRAPHY TECHNIQUES AND MYELOGRAPHY FOR THE DIAGNOSIS OF ACUTE CANINE MYELOPATHY

Forty‐six dogs with either cervical (C1–C5 or C6–T2) or thoracolumbar (T3–L3) acute myelopathy underwent prospective conventional computed tomography (CT), angiographic CT, myelography, and CT myelography. Findings were confirmed at either surgery or necropsy. Seventy‐eight percent of lesions were extradural, 11% were extradural with an intramedullary abnormality, 7% were intramedullary, 2% were intradural–extramedullary, and 2% had nerve root compression without spinal cord compression. Intervertebral disc herniation was the most frequent abnormality regardless of signalment or neurolocalization. Twenty‐one of 23 Hansen type I disc extrusions but none of the Hansen type II disc protrusions were mineralized. Two chondrodystrophic dogs had acute myelopathy attributable to extradural hemorrhage and subarachnoid cyst. CT myelography had the highest interobserver agreement, was the most sensitive technique for identification of compression, demonstrating lesions in 8% of dogs interpreted as normal from myelography and enabling localization and lateralization in 8% of lesions incompletely localized on myelography due to concurrent spinal cord swelling. None of the imaging techniques evaluated permitted definitive diagnosis of spinal cord infarction or meningomyelitis but myelography and CT myelography did rule out a surgical lesion in those cases. While conventional CT was adequate for the diagnosis and localization of mineralized Hansen type I disc extrusions in chondrodystrophic breeds, if no lesion was identified, plegia was present due to concurrent extradural compression and spinal cord swelling, or the dog was nonchondrodystrophic, CT myelography was often necessary for correct diagnosis.     

SONOGRAPHIC EVALUATION OF EXPERIMENTAL BILE DUCT LIGATION IN THE DOG

The common bile duct was surgically ligated in five normal adult dogs. Ultrasonographic examinations of the gallbladder and biliary system were performed after duct ligation at intervals of 24 hours. The sequence of biliary system dilation was from the common duct to the peripheral intrahepatic ducts. Common duct enlargement was evident in 24–48 hours, while peripheral biliary duct dilation was recognized by five to seven days after obstruction. When compared with hepatic and portal veins, dilated biliary ducts were more tortuous and had irregular branching patterns. Gross pathologic changes were correlated with ultrasonographic findings at seven, 14, 15, 18 and 21 days after obstruction.     

ENDOSCOPIC ULTRASONOGRAPHIC FINDINGS OF THE PANCREAS AFTER PANCREATIC DUCT LIGATION IN THE DOG

Endoscopic ultrasonographic evaluation and gray-scale histogram analysis of pancreatic atrophy after pancreatic duct ligation were performed in four normal adult dogs. Using endoscopic ultrasonography, markedly dilated pancreatic ducts were visualized, and the pancreas became gradually atrophied with a hyperechoic parenchyma. In gray-scale histogram analysis of the pancreas, mean brightness increased gradually until 8 weeks, then decreased temporally. Standard deviation of the histogram increased markedly and then fluctuated until the 4th week, after which the mean brightness and standard deviation became stable. At 4 weeks postoperatively, collapse of most pancreatic acinar structures were observed, and each atrophic lobule was associated with a significantly large amount of interstitial fibrous tissue at histopathology. At 12 weeks postoperatively, most exocrine tissue had decreased and was partly replaced by fibrous and fatty tissue. These changes of mean brightness and standard deviation reflected the histologic analysis. These findings indicated that endoscopic ultrasonography is a useful technique to image such atrophic disorders of the pancreas as chronic pancreatitis. Furthermore, gray-scale histogram analysis provides helpful information for ultrasonographic tissue characterization of the pancreas.     

ULTRASOUND EVALUATION OF THE COXOFEMORAL JOINTS OF THE CANINE NEONATE

The effectiveness of ultrasound in depicting the normal anatomy of the coxofemoral joint in puppies was evaluated. Ultrasound images were obtained from twenty Springer Spaniel puppies ranging from one day to twelve weeks of age. The anatomy of the hip joint could be identified up to eight weeks of age. By twelve weeks of age the degree of ossification prevented complete hip joint evaluation. Three different views were utilized. The longitudinal and dorsolateral views were the most useful. Motion of the femoral head within the acetabulum could be observed. Measurements of the acetabulum, femoral head and joint space could be obtained however these measurements were inconsistent. The technique appears to be useful for depicting the anatomy of the neonatal coxofemoral joint however, additional studies utilizing both normal and dysplastic puppies are recommended to determine if this examination will be useful in discriminating between normal and dysplastic puppies.     

CONTRAST HARMONIC IMAGING OF THE NORMAL CANINE SPLEEN

The purpose of this study was to assess the perfusion pattern and perfusion dynamics in the normal canine spleen using contrast harmonic imaging. Twenty-five dogs without clinical or ultrasonographic evidence of splenic disease were studied. Twenty-three dogs were scanned with only manual restraint; two dogs were sedated with buprenorphin. All dogs received an intravenous bolus of a microbubble contrast medium (SonoVue). The perfusion pattern during the blood pool phase represented a skewed bell-shaped curve. A tissue-specific late phase, similar to humans, was not observed. Time/intensity curves were generated for a selected region. Mean average-derived peak intensity (PI) was 6.6dB, mean time to peak intensity calculated from the initial rise (TTP) was 25.6 s and mean area under the curve (AUC) was 523.6 dBs. If dogs were divided into two body weight groups (< or =15 and >15 kg body weight), average derived peak intensity area, time to peak intensity, and area under the curve were lower for the smaller dogs than for the larger animals. However, differences were not statistically significant (P = 0.2, 0.05, and 0.08, respectively). No significant association was found between hematocrit, hemoglobin concentration, red blood cell count, blood pressure, heart rate, age, gender, and the perfusion variables. In conclusion, these baseline data may prove useful in the evaluation of dogs with diffuse or focal splenic disease.