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.     

Hypoxemia in the Acutely Traumatized Canine Patient

One hundred acutely traumatized dogs were evaluated for the presence of cardiopulmonary abnormalities with thoracic radiographs, electrocardiography and arterial blood gas analysis. Fifty-seven dogs were found to have concurrent appendicular fracture(s) and thoracic injury as defined by an abnormality in one or more of the variables evaluated. Thoracic radiographs were abnormal in 44 dogs. Ventricular arrhythmias were identified in 17 dogs. Hypoxemia (PaO₂ < 80 mmHg) was detected in 25 dogs. Hypoxemia was noted with increased frequency in dogs with abnormal thoracic radiographs. Ventricular arrhythmias occurred more frequently in the hypoxemic group of dogs.
Although a relationship was noted between the presence of hypoxemia, radiographic changes of the thorax and ECG abnormalities, all three examinations provided important information for assessing the cardiopulmonary status of each patient.     

Detection of comorbidities and synchronous primary tumours via thoracic radiography and abdominal ultrasonography and their influence on treatment outcome in dogs with soft tissue sarcomas,primary brain tumours and intranasal tumours

Canine soft tissue sarcomas (STS), primary brain tumours and intranasal tumours are commonly treated with radiotherapy (RT). Given the low metastatic potential of these tumours, recommendations regarding imaging tests as staging are variable among institutions. The purpose of our study was to describe thoracic radiographic and abdominal ultrasonographic findings in dogs with these neoplasms and to investigate association of abnormal findings with alterations in recommended treatment. Medical records from 101 dogs, each having thoracic radiographs and abdominal ultrasound performed as part of their staging, were reviewed. In 98 of 101 (97%), imaging abnormalities were detected, 27% of which were further investigated with fine needle aspiration cytology or biopsy. Nine percent of the detected abnormalities were considered serious comorbidities that altered treatment recommendations, including 3 (3%) which were confirmed as synchronous primary neoplasms. These findings may influence recommendations regarding the decision to perform thoracic radiographs and abdominal ultrasound prior to initiation of RT.     

Risk factors and prognostic variables for survival of foals with radiographic evidence of pulmonary disease

The medical records of 163 neonatal foals that had thoracic radiographs taken within 48 hours of admission to a referral hospital were reviewed. The objectives of this study were (1) to identify risk factors for the development of thoracic radiographic changes and (2) to identify prognostic indicators for survival in foals with radiographic evidence of pulmonary disease. Failure of transfer of passive immunity (IgG concentration < or = 400 mg/dL) was the only risk factor for radiographic evidence of respiratory disease identified by multivariate analysis. Hypoxemic patients (PaO2 < or = 60 mm Hg) were 4.9 times more likely to reveal radiographic abnormalities in a subset of foals for which arterial blood gas results were available. Foals with a serum creatinine concentration > 1.7 mg/dL upon presentation, dyspnea, and a history of dystocia were significantly more likely to die based on the multivariate statistical outcome analysis. An anion gap > or = 20 mEq/dL was strongly associated with nonsurvival in a subset of foals with arterial blood gas results. These hematologic and biochemical variables can be readily obtained during the initial evaluation of sick foals. The presence of a high anion gap appeared to have the greatest clinical impact and may be a useful prognostic indicator in foals with radiographic evidence of respiratory disease. In contrast, the majority of physical examination variables, including evaluation of tachypnea, abnormal respiratory sounds, fever, weakness, and milk reflux from the nares, which are usually obtained during the general respiratory evaluation of foals, were unrelated to outcome.     

Stage migration in dogs with lymphoma

BACKGROUND: Various diagnostic tests have been used to assign a clinical stage to dogs with lymphoma. As more sensitive staging methods are introduced, dogs are reclassified as having a higher disease stage, thereby affecting comparisons of dogs across differently staged clinical trials, and possibly, prognosis. HYPOTHESIS: The addition of more sensitive staging tests causes stage migration in dogs with lymphoma. ANIMALS: Fifty-nine client-owned dogs with previously untreated cytologically or histologically confirmed lymphoma METHODS: For every dog, the World Health Organization stage classification (I-V) was based on 5 groupings of various diagnostic tests: A (physical examination [PE] and quantitative blood count [QBC]), B (PE, QBC, thoracic and abdominal radiographs), C (PE, complete blood count with blood-smear evaluation [CBC], thoracic and abdominal radiographs), D (PE, CBC, thoracic radiographs, abdominal ultrasound), and E (PE, CBC, thoracic radiographs, abdominal ultrasound, and bone-marrow cytology). Dogs were treated with doxorubicin-based protocols. RESULTS: There was migration between all of the staging methods except D to E. However, the stage was not a predictor of remission rate, remission duration, or survival, regardless of staging method used. CONCLUSIONS AND CLINICAL IMPORTANCE: These data emphasized the need for standardized methods to determine the clinical stage in dogs with lymphoma.     

Clinical and prognostic significance of radiographic pattern, distribution, and severity of thoracic radiographic changes in neonatal foals

A total of 207 thoracic radiographs obtained from 128 foals were evaluated to assess the impact of pulmonary radiographic pattern, distribution, and severity of pulmonary changes on short-term survival of neonatal foals. The association between selected clinical variables and the radiographic manifestation of neonatal respiratory disease was also investigated. The evaluation of interstitial and alveolar-interstitial radiographic patterns within the caudodorsal, caudoventral, and cranioventral lung regions proved to be highly reliable between viewers in the study. A diagnosis of systemic inflammatory response syndrome was related to increased pulmonary infiltrates within the caudodorsal lung region. Dyspneic foals had more extensive pulmonary infiltrates within the cranioventral lung, advanced respiratory disease, and lower survival rates. A fibrinogen concentration >400 mg/dL was associated with increased cranioventral radiographic abnormalities. In addition, tachypnea most consistently related to diffuse (caudodorsal, caudoventral, and cranioventral) pulmonary changes. Neutropenia, milk reflux from the nares, upper airway pathology, abnormal respiratory sounds, failure of transfer of passive immunity (IgG concentration <400 mg/dL), immaturity, or fever, however, were not related to radiographic pattern, distribution, or severity of radiographic changes. Sixty-five percent of foals with radiographic pulmonary disease were discharged alive from our referral hospital. Concurrent caudodorsal and caudoventral radiographic disease was most frequently observed in this foal population. Increased caudodorsal radiographic scores retained statistical significance as a prognostic indicator for nonsurvival in a multiple stepwise logistic regression analysis.     

Influence of pre-anaesthetic thoracic radiographs on ASA physical status classification and anaesthetic protocols in traumatized dogs and cats

The purpose of this study was to evaluate if pre-anaesthetic thoracic radiographs contribute to the anaesthetic management of trauma patients by comparing American Society of Anesthesiologists Physical Status Classification (ASA grade) with and without information from thoracic radiography findings. Case records of 157 dogs and cats being anaesthetized with or without post-traumatic, pre-anaesthetic chest radiographs were retrospectively evaluated for clinical parameters, radiographic abnormalities and anaesthetic protocol. Animals were retrospectively assigned an ASA grade. ASA grades, clinical signs of respiratory abnormalities and anaesthesia protocols were compared between animals with and without chest radiographs. The group of animals without pre-anaesthetic radiographs was anaesthetized earlier after trauma and showed less respiratory abnormalities at presentation. The retrospectively evaluated ASA grade significantly increased with the information from thoracic radiography. Animals with a higher ASA grade were less frequently mechanically ventilated. Pre-anaesthetic radiographs may provide important information to assess the ASA grade in traumatized patients and may therefore influence the anesthesia protocol.     

Evaluation of thoracic radiographs as a screening test for dogs and cats admitted to a tertiary‐care veterinary hospital for noncardiopulmonary disease

Thoracic radiographs are used as a screening tool for dogs and cats with a variety of disorders that have no clinical signs associated with thoracic structures. However, this practice has never been supported by an evidence‐based study. The objective of this retrospective observational study was to determine if certain canine and feline populations have a higher proportion of radiographic abnormalities, and whether any of these abnormalities are associated with patient hospitalization and outcome. Patients were excluded if current or previous examinations revealed evidence of primary respiratory or cardiac disease, malignant neoplasia, or an abnormal breathing pattern consistent with pulmonary pathology. Any notable thoracic change in the radiology report was considered important and evaluated in this study. One hundred and sixty‐six of these included patients were dogs and 65 were cats. Of the 166 dog radiographs evaluated, 120 (72.3%) had normal thoracic radiographs, while 46 (27.7%) had radiographic abnormalities. Of the sixty‐five cats included, 36 (55.4%) had normal radiographs, while 29 (44.6%) had abnormal radiographs. Canine patients with abnormal radiographs had a significantly higher lactate level (P‐value 0.0348) and feline patients with abnormal radiographs had a significantly lower packed cell volume (P‐value 0.012). A large proportion of patients that had screening thoracic radiographs (32.5%) had documented abnormalities, but a relatively low percentage (6.5%) of our total population had their clinical plan changed as a consequence of detection of these abnormalities. Findings indicated that abnormal screening thoracic radiographs are more likely in dogs with an elevated lactate and cats with anemia, or a low normal hematocrit.     

Tracheal narrowing secondary to airway obstruction in two cats

Tracheal narrowing is described in two cats. In both cases, inspiratory radiographs demonstrated tracheal narrowing just cranial to the thoracic inlet; no narrowing was seen on expiratory radiographs. Magnetic resonance imaging revealed suspected nasal tumours in both cases, but no abnormalities were identified in the region of the narrowed trachea. Nasal biopsy confirmed intranasal lymphoma in one cat and nasal adenocarcinoma in the other. The former cat was treated with chemotherapy. The owner of the latter cat declined further treatment. The tracheal narrowing disappeared after the initiation of chemotherapy in the cat with intranasal lymphoma and it is suggested that the narrowing might have been associated with the nasal tumour. A careful evaluation of the airway, especially cranial to the narrowing, is recommended in cases of tracheal narrowing in cats.     

Radiographic, high detail radiographic, microangiographic and histological findings of the distal portion of the tarsus in weanling, young and adult horses.

Clinical radiographic (LM and D35L-P1MO views), high detail radiographic, microangiographic and histological findings of the distal portion of the tarsus of 16 horses (five weanling, four young and six adult), without known clinical histories, were evaluated to determine the sensitivity of clinical radiographs for the detection of abnormalities in the distal tarsus and the prevalence of abnormalities in this population. Clinical radiographic and high detail radiographic abnormalities were observed in at least 30 per cent of the tarsi examined. Statistical agreement between observations from clinical radiographs and corresponding post mortem high detail radiographs was not good for subchondral bone plate irregularities and joint margin changes. Three patterns of sclerosis of the medullary spongiosa were visualised on high detail radiographs: thickening of the subchondral bone plate was seen commonly in the weanling group, whereas arching and bridging patterns were more prevalent in the young and adult groups. Bone production on the dorsal cortex of the central and third tarsal bones did not increase with age. Abnormalities in vascular perfusion and articular cartilage histology were observed in association with subchondral bone plate irregularities and focal regions of osteopenia observed on high detail radiographs.     

Doppler echocardiographic diagnosis and surgical therapy of constrictive pericarditis in a cat

A 4-year-old Ragdoll cat presented for dyspnea secondary to chylous pleural effusion to the University of Georgia Veterinary Teaching Hospital. Physical examination, complete blood count, serum chemistries, urinalysis, thoracic radiographs, abdominal radiographs, and thoracic fluid cytology and culture failed to identify an etiology for the chylous effusion. The patient tested negative for feline leukemia virus, feline immunodeficiency virus and heartworm disease. Respiration phasic influences on early diastolic trans-mitral, trans-tricuspid and pulmonary vein blood flow velocities during Doppler echocardiography were consistent with constrictive pericarditis. The cat underwent subtotal pericardectomy. The patient recovered without complication and is overtly healthy without radiographic or echocardiographic abnormalities 6-months post-surgery. Constrictive pericarditis should be considered in cats with idiopathic pleural effusion, with or without ascites, in which standard echocardiographic assessment is not suggestive of structural heart disease. If constrictive pericarditis is present, the Doppler characteristics outlined here may allow for this diagnosis to be made. Pericardectomy may be highly rewarding, although the specific etiology of the constrictive pericarditis may remain unknown.     

RADIOGRAPHY OF THE EQUINE THORAX: ANATOMY AND TECHNIC

Radiographic evaluation of the entire adult equine thorax in the standing position requires a minimum of four overlapping lateral radiographs. Small horses could often be studied with fewer radiographs. This basic examination provided the optimal radiographic opportunity for detecting lung diseases in the horse. An understanding of normal gross and radiographic anatomy is an absolute necessity if one is to avoid the potential diagnostic pitfalls inherent in radiographic interpretation of the equine thorax. Of equal importance is an appreciation for the technic required to produce thoracic radiographs. The advent of rare-earth intensifying screen and highspeed film systems has enhanced the opportunity for obtaining diagnostic standing lateral equine thoracic radiographs.     

FAT IS RESPONSIBLE FOR AN INTRAMURAL RADIOLUCENT BAND IN THE FELINE STOMACH WALL

An intramural radiolucent band in the stomach wall can be seen on abdominal radiographs of cats without concurrent clinical gastrointestinal signs. A retrospective study of cats with normal abdominal radiographs and computed tomography (CT) was performed to determine the prevalence of this finding. This gastric radiolucent band was seen in 13 of 37 (35%) radiographs. There was no relationship between age, weight and relative obesity and the presence of this radiolucent band. Using CT, an intramural hypoattenuating layer was detected in the stomach wall of four of 15 (27%) cats. The intramural radiolucent band was visible on the radiographs in all four of those cats. This radiographic and CT finding was histologically determined to be normal fat in the gastric submucosa in one cat cadaver.     

Feline large granular lymphocyte lymphoma: An Italian Society of Veterinary Oncology (SIONCOV) retrospective study

Feline large granular lymphocyte (LGL) lymphoma is an uncommon subtype of lymphoma characterized by a grave prognosis and scarce response to chemotherapy. There are limited reports on clinico‐pathological and prognostic factors. One‐hundred and 9 cats with newly diagnosed LGL lymphoma that underwent initial staging (including hematology, serum biochemistry, thoracic radiographs and abdominal ultrasound), and followed‐up were retrospectively evaluated. LGL lymphoma was localized within the gastrointestinal tract with or without extra‐intestinal involvement in 91.7% of the cases, and at extra‐gastrointestinal sites in 8.3%. Symptoms were frequent. Anemia (31.2%) and neutrophilia (26.6%) were commonly observed, and 14 (12.8%) cats had neoplastic circulating cells. Frequent biochemistry abnormalities included elevated ALT (39.4%) and hypoalbuminemia (28.4%). Twenty (54.1%) of 37 cats had elevated serum LDH. Treatment varied among cats, and included surgery (11%), chemotherapy (23%), corticosteroids (38.5%) and no treatment (27.5%). Median time to progression (MTTP) was 5 days, and median survival time (MST) 21 days. MST was significantly shorter in the case of substage b, circulating neoplastic cells, lack of chemotherapy administration, and lack of treatment response. A small subset of cats (7.3%) survived more than 6 months, suggesting that a more favorable clinical course can be found among LGL lymphoma patients.     

Age-related thoracic radiographic changes in golden and labrador retriever muscular dystrophy

Golden retriever and Labrador retriever muscular dystrophy are inherited progressive degenerative myopathies that are used as models of Duchenne muscular dystrophy in man. Thoracic lesions were reported to be the most consistent radiographic finding in golden retriever dogs in a study where radiographs were performed at a single-time point. Muscular dystrophy worsens clinically over time and longitudinal studies in dogs are lacking. Thus our goal was to describe the thoracic abnormalities of golden retriever and Labrador retriever dogs, to determine the timing of first expression and their evolution with time. To this purpose, we retrospectively reviewed 390 monthly radiographic studies of 38 golden retrievers and six Labrador retrievers with muscular dystrophy. The same thoracic lesions were found in both golden and Labrador retrievers. They included, in decreasing frequency, flattened and/or scalloped diaphragmatic shape (43/44), pulmonary hyperinflation (34/44), hiatal hernia (34/44), cranial pectus excavatum (23/44), bronchopneumonia (22/44), and megaesophagus (14/44). The last three lesions were not reported in a previous radiographic study in golden retriever dogs. In all but two dogs the thoracic changes were detected between 4 and 10 months and were persistent or worsened over time. Clinically, muscular dystrophy should be included in the differential diagnosis of dogs with a combination of these thoracic radiographic findings.     

INITIAL INFLUENCE OF RIGHT VERSUS LEFT LATERAL RECUMBENCY ON THE RADIOGRAPHIC FINDING OF DUODENAL GAS ON SUBSEQUENT SURVEY VENTRODORSAL PROJECTIONS OF THE CANINE ABDOMEN

Identification of the duodenum and potential abnormalities on survey abdominal radiographs is often difficult unless it contains gas. This study investigated the effect of patient positioning on the presence of duodenal gas in survey abdominal radiographs. One hundred dogs receiving a three‐view survey abdominal radiographic study were enrolled in a prospective, randomized study where all dogs were divided into two groups. Group A (n = 51) dogs had a left lateral projection first, followed by a ventrodorsal projection, ending with a right lateral projection. Group B (n = 49) dogs had a right lateral projection first, followed by a ventrodorsal projection, ending with a left lateral projection. The presence of gas within the duodenum and level of distribution of gas throughout the duodenum were recorded for all three projections. In addition, the presence or absence of duodenal pseudoulcers was evaluated on all three projections for each dog. The results for the two groups were compared using Chi‐square analysis with a P‐value of less than 0.05 being considered significant. Results showed that dogs first placed in left lateral recumbency were significantly more likely to have duodenal gas on the subsequent ventrodorsal and right lateral radiographic projections compared to dogs first placed in right lateral recumbency (P‐value < 0.0001). Pseudoulcers were seen in 11 dogs that had duodenal gas making the visualization of pseudoulcers on survey abdominal radiographs somewhat commonplace. This study emphasizes the benefit of using initial left lateral abdominal projections prior to other views for subsequent evaluation of the duodenum.     

Studies of oesophageal function

Lesions of the sympathetic nervous system have been associated with grass sickness for many years (Obel, 1955). Dysphagia is also an accepted clinical feature of subacute or chronic cases. Megaoesophagus has been reported in horses with grass sickness, but it was uncertain whether oesophageal dilation was a primary condition, or a sequel to gastric distension (Greet, 1982). Robertson and others, (1948) suggested that dysphagia was alleviated in affected horses after drainage of gastric contents. It is interesting to note that dysphagia was present in less than half the cases in this study although radiological abnormalities of the oesophagus were similar in all cases. Consistent radiological abnormalities of the oesophagus occurred in 12 out of the 14 horses examined (this consisted of incoordination or atony of the thoracic oesophagus). In the two suspected cases of grass sickness which made a clinical recovery, the radiological abnormalities were slightly different. Contrast material was transferred slowly through the cervical oesophagus and pooled at the thoracic inlet as well as at several sites in the cervical oesophagus. Eventually the contrast material passed through the distal oesophagus into the stomach. Although gastric distension was present in many of the cases examined it was not possible to identify this by radiographic means. It is unlikely that the signs of oesophageal incoordination and dilation were related only to gastric distension, as in most of the cases, contrast material pooled in the oesophagus at the thoracic inlet rather than just cranial to the diaphragm. It seems reasonable to suggest that these radiological abnormalities resulted from neurological impairment of the oesophagus. It would be of particular value to examine horses with obstructive lesions of the stomach or duodenum to evaluate the effect of upper gastro-intestinal obstruction on oesophageal motility. A number of horses with other conditions of the upper alimentary tract have been examined radiographically at these clinics. Two horses suspected of suffering from grass sickness were found to have primary oesophageal abnormalities. One had a diverticulum and the other a localized area of dilation; both showed regurgitation of food and weight loss. Barium swallows in both horses defined the sites of their localized lesions but there was no evidence of either Type I or Type II oesophageal malfunction, and at post-mortem examination the ganglionic changes associated with grass sickness were absent. Examination of one horse with ileocaecal intussusception did not show radiological features of the oesophagus typical of those shown by cases of grass sickness. However, contrast material passed slowly through the upper oesophagus of a foal with congenital megaoesophagus in a manner similar to the Type II oesophageal malfunction described above. It also demonstrated dilation and gross inco-ordination of the thoracic oesophagus with pooling of contrast material at the thoracic inlet and oscillation between the thoracic inlet and diaphragm as seen in Type I malfunction in proven grass sickness. It is recognized that the radiological findings of oesophageal dilation and inco-ordination merely demonstrate the presence of neuromuscular impairment of oesophageal movement. Until more cases of upper gastro-intestinal disease can be examined, the specificity of these functional abnormalities for grass sickness cannot be accurately assessed. However the results assume considerable diagnostic significance when demonstrated in an adult horse which is exhibiting signs of grass sickness, particularly those of colonic impaction. The need for sophisticated equipment and thus the necessity of transport to centres so equipped, is clearly a drawback to the technique but this is often outweighed by the advantage of being able to avoid unnecessary laparotomy. As there is at present no cure for grass sickness, the improved diagnostic capability will allow severely ill horses to be destroyed without delay. It may also identify horses which on rare occasions appear to be making a slow recovery.     

Radiography, computed tomography and virtual bronchoscopy in four dogs and two cats with lung lobe torsion

This report describes the imaging features of radiography, computed tomography and virtual bronchoscopy in dogs and cats with lung lobe torsions. The medical records, thoracic radiographs and computed tomography images of four dogs and two cats with confirmed lung lobe torsions were retrospectively reviewed. Computed tomography with virtual bronchoscopy showed bronchial narrowing, collapse or occlusion in all six animals, while this was only appreciated on one radiographic examination. A tapering terminating angle of the air-filled bronchus proximal or distal to the collapsed region was seen only on computed tomography and virtual bronchoscopy in all six animals. The vesicular emphysema pattern typical of lung lobe torsion was seen on three computed tomographies but only on one radiographic examination. The lung lobe torsion-specific findings of vesicular emphysema and a proximally narrowed or occluded bronchus were more easily recognised on computed tomography and virtual bronchoscopy than with radiographs. Computed tomography slices acquired through the bronchus and lung lobe of interest in a cat or dog with possible lung lobe torsion can be reformatted into virtual bronchoscopic images that can be utilised along with computed tomography to help make a more definitive preoperative diagnosis.     

Aortic foreign body (airgun pellet) embolism in a cat

A five-year-old female domestic shorthair cat presented with clinical signs typical of an aortic saddle thromboembolism. An echocardiogram and thoracic radiographs excluded cardiac disease as a source of the thrombus. Two heavy metal opacity, pellet-like objects were seen in the thoracic and abdominal radiographs. Abdominal ultrasound demonstrated occlusion of aortic blood flow by the abdominal pellet but could not indicate whether this was due to a penetrating aortic wound or pellet embolisation. A necropsy confirmed a penetrating left ventricular cardiac wound with subsequent embolisation of the pellet to the abdominal aorta.     

A COMPARISON OF NORMAL FELINE THORACIC RADIOGRAPHS MADE IN DORSAL VERSUS VENTRAL RECUMBENCY

Thoracic radiographs of 11 normal cats were made in dorsal (VD) and ventral (DV) recumbency with a vertically directed x-ray beam. These radiographs were compared subjectively and objectively with each other and with an additional pair of radiographs made with the cats in dorsal and ventral recumbency using a horizontally directed x-ray beam. Differences were found between VD and DV thoracic radiographs but they were minimal. In VD radiographs the caudal mediastinum and accessory lobe regïon of the lung were more clearly seen but cardiac shape varied somewhat. In DV radiographs, the appearance of the heart was more constant and caudal lobar pulmonary arteries more clearly seen. The results of this study indicated that both VD and DV radiographs are satisfactory for radiographic examination of the feline thorax