THE SONOGRAPHIC APPEARANCE OF INTESTINAL MUCOSAL FIBROSIS IN CATS

The medical records of 11 cats with full‐thickness intestinal biopsies and histopathologic confirmation of segmental mucosal fibrosis were reviewed. All cats received an abdominal ultrasonographic evaluation. The sonographic feature of a small intestinal mucosal hyperechoic band paralleling the submucosa was present in all cats. Other intestinal sonographic findings included wall thickening, and altered wall layering (increased mucosal echogenicity, thickened submucosa, and/or muscularis layer). None of the cats had complete loss of wall stratification. All cats had clinical signs related to the gastrointestinal (GI) tract at the time of presentation. Three of the 11 cats had palpably thickened small intestinal loops, 3/11 abdominal pain, and 2/11 abdominal fluid. Histopathologically, mucosal fibrosis was associated with inflammatory cell infiltrates in all cats. In those cats with histopathologic evidence of mural fibrosis, all cats had a visible hyperechoic band through several intestinal segments. We speculate that the hyperechoic mucosal band represents the zone of mucosal fibrosis. Independently and prospectively, we reviewed the clinical presentation of 35 cats having this visible hyperechoic mucosal band on ultrasound. Twenty‐four of these 35 cats had clinical signs related to the digestive system at the time of record. Our study suggests that the hyperechoic mucosal band represents fibrosis, and in presence of concurrent GI signs, further diagnostic tests may be warranted.     

Transrectal ultrasonography of the cranial mesenteric artery of the horse

Transrectal ultrasonography was performed on the cranial mesenteric artery and its major branches in 23 conscious adult horses. Ultrasonographically, 25 arterial segments were classified as either normal or abnormal. These ultrasonographic classifications were later compared with the gross and histologic evaluations of each artery following necropsy of each horse. In this study, transrectal ultrasonography as a diagnostic test for verminous arteritis had a 90% sensitivity for detecting normal arteries and an 86% specificity for detecting abnormal arteries, suggesting that ultrasonography may be useful in the antemortem diagnosis of verminous arteritis.     

COMPARISON OF CLINICAL, ULTRASONOGRAPHIC, AND POSTOPERATIVE MACROSCOPIC FINDINGS IN COWS WITH BURSITIS

Clinical, ultrasonographic, and macroscopic findings of bursitis in cows were compared to assess the contribution of diagnosis and therapy planning. Sixteen dairy cows with swelling at the carpal (n = 12) or tarsal (n = 4) region were examined clinically and ultrasonographically and the findings were compared. In 10 patients the bursae were removed in toto. According to the duration of the disease (history) and clinical findings nine and seven patients had acute and chronic bursitis, respectively. Six had fluctuation and in 10 the bursa was firm. Contents were serous (n = 3), serofibrinous (n = 4), serohemorrhagic (n = 2), or purulent (n = 1). Sonographically there was fluid in all bursa except one. Capsule echogenicity varied between hypoechoic and hyperechoic and mean capsule thickness was 9.2 +/- 4.1 mm. Fourteen of the bursae contained free-floating particles. The hyperechoic capsules represented fibrous tissue, and the echogenic/hyperechoic free-floating particles were erythrocytes, purulent exudate, or fibrin masses. Capsule thickness and large free-floating particles could not be detected by clinical examination/centesis alone. However, capsule thickness, bursa contents, and the extent of inflammation could be determined ultrasonographically and this made the decision for different invasive/ operative procedures easier.     

Arteriography in ponies with Strongylus vulgaris arteritis.

Radiographs of the aorta and abdominal arteries were obtained from a normal anesthetized pony following catheterization of a femoral artery for nonselective, semiselective or selective arteriography. The arteries had smooth borders and regular diameters and the branches of the cranial mesenteric artery could be followed distally on the angiogram through to the smaller branches proximal to the bowel wall. Following arteriography, the pony walked normally and there were minimal alterations of the levels of serum muscle enzymes and blood lactate. The procedures for arteriography were repeated in three days. At that time the femoral artery was patent and satisfactory angiograms were obtained. Similiarly, radiographs were obtained from two ponies artificially infected with Strongylus vulgaris. The cranial msenteric artery and some of its branches, the right renal artery and segments of the aorta had irregular borders and were enlarged. Branches of the cranial mesenteric artery could not be followed distally because the flow of the contrast material was blocked. Following the above procedures, euthanasia of all ponies was expedited and the findings of arteritis, thrombosis and dilatation of arteries at necropsy compared favorably with interpretations from the radiographs. At least in the pony, arteriography can be a valuable research and diagnostic tool for the demonstration of lesions associated with verminous arteritis.     

ULTRASONOGRAPHIC APPEARANCE OF CANINE PARVOVIRAL ENTERITIS IN PUPPIES

The ultrasonographic appearance of the gastrointestinal tract of puppies suffering from parvoviral enteritis was characterized. Forty puppies between 6 and 24 weeks of age with confirmed canine parvoviral enteritis were examined ultrasonographically within 24 h of admission. Sonographic findings included fluid‐filled small intestines in 92.5% of subjects, and stomach and colon in 80% and 62.5% of subjects, respectively. Generalized atony was present in 30 subjects and weak peristaltic contractions indicative of functional ileus observed in the remaining 10 subjects. The duodenal and jejunal mucosal layer thicknesses were significantly reduced when compared with normal puppies with mean duodenal mucosal layer measuring 1.7 mm and jejunal mucosal layer 1.0 mm. Additionally, a mucosal layer with diffuse hyperechoic speckles was seen in the duodenum (15% of subjects) and the jejunum (50% of subjects). The luminal surface of the duodenal mucosa was irregular in 22.5% of subjects and the jejunal mucosa in 42.5% of subjects. In all of these subjects, changes were accompanied by generalized indistinct wall layering. Small intestinal corrugations were seen within the duodenum in 35% of subjects and within the jejunum in 7.5%. A mild amount of anechoic free peritoneal fluid was observed in 26 subjects and was considered within normal limits and a moderate amount of anechoic free peritoneal fluid was observed in six subjects. The jejunal lymph node size was within normal limits. None of the above changes are pathognomonic for canine parvoviral enteritis but finding them in combination is highly suggestive.     

Ultrasonography of Diffuse Liver Disease A Review

Radiographically, the liver may appear normal even if severely diseased. Ultrasonography can be an important adjunct in the evaluation of diffuse parenchymal hepatic disease. Diffuse liver disease appears ultrasonographically as a change in liver echogenicity from normal when compared with the renal cortex or spleen. Diffuse liver disease can be characterized as either hyperechoic due to fatty change, steroid hepatopathy, and cirrhosis or hypoechoic due to congestion, suppurative hepatitis, and lymphoma. Ultrasonographic diagnosis of diffuse liver disease should be substantiated by biopsy and histopathologic evaluation.     

Comparison of ultrasonographic characteristics of the thyroid gland in healthy small-, medium-, and large-breed dogs

OBJECTIVE: To determine ultrasonographic characteristics of the thyroid gland in healthy small-, medium-, and large-breed dogs and evaluate the relationships of thyroid gland size and volume with body weight and body surface area (BSA). ANIMALS: 72 dogs of small (6 Toy and 6 Miniature Poodles), medium (12 Beagles), and large breeds (12 Akitas and 36 Golden Retrievers). PROCEDURE: Each dog's thyroid gland was examined ultrasonographically with a 10- to 5-MHz multifrequency linear-array transducer. Size, shape, echogenicity, and homogeneity of thyroid lobes were evaluated on longitudinal and transverse images. Thyroid lobe volume was estimated by use of the equation for an ellipsoid (pi/6 [length x height x width]). RESULTS: Thyroid lobes appeared fusiform or elliptical on longitudinal images and triangular or round to oval on transverse images. In most dogs, thyroid lobes were hyperechoic or isoechoic, compared with surrounding musculature, and had a homogeneous echogenic pattern. Mean length, width, height, and volume of thyroid lobes were significantly greater in Akitas and Golden Retrievers, compared with findings in Beagles or Poodles; mean length, width, and height were significantly greater in Beagles, compared with findings in Poodles. Total thyroid gland volume correlated with body weight (r = 0.73) and BSA (r = 0.74). CONCLUSIONS AND CLINICAL RELEVANCE: Among the dog breeds examined ultrasonographically, thyroid lobe size and volume were more variable than shape, echogenicity, and homogeneity. The correlation of thyroid gland volume with BSA suggests that size of the dog, rather than breed, should be considered when assessing thyroid glands ultrasonographically.     

EFFECTS OF CORN OIL ADMINISTERED ORALLY ON CONSPICUITY OF ULTRASONOGRAPHIC SMALL INTESTINAL LESIONS IN DOGS WITH LYMPHANGIECTASIA

Lymphangiectasia is one of the causes of protein‐losing enteropathy in dogs and characteristic ultrasonographic small intestinal lesions have been previously described. The purpose of this study was to determine whether corn oil administered orally (COAO) would result in increased conspicuity of these characteristic small intestinal ultrasonographic lesions in dogs with lymphangiectasia. Affected dogs were included if they underwent corn oil administered orally and had a surgical full‐thickness intestinal biopsy diagnosis of lymphangiectasia. Control dogs had normal clinical examination and standard laboratory test findings. Ultrasound images of duodenum, jejunum, and ileum were obtained prior to and 30, 60, 90, and 120 min after corn oil administered orally for all dogs. Parameters recorded for each ultrasound study were intestinal wall thickness, mucosal echogenicity, and presence or absence of hyperechoic mucosal striations (HMS) and a parallel hyperechoic mucosal line (PHML). Nine affected and five controls dogs were included in the study. Seven of the nine dogs with lymphangiectasia had hyperechoic mucosal striations prior to corn oil administered orally. Jejunal hyperechoic mucosal striations were significantly associated with lymphangiectasia at multiple time points (P < 0.05) and were best identified in dogs with lymphangiectasia 60 or 90 min after corn oil administered orally. Increased mucosal echogenicity was observed in all dogs at multiple time points after corn oil administered orally. A parallel hyperechoic mucosal line was present in the jejunum in 4/5 healthy and 6/9 dogs with lymphangiectasia at one or more time points after corn oil administered orally. Findings indicated that corn oil administered orally improves conspicuity of characteristic ultrasonographic lesions in dogs with lymphangiectasia, however some of these lesions may also be present in healthy dogs that recently received a fatty meal.     

Ultrasound as a diagnostic tool in the investigation of a pony with intestinal lymphoma

A 21‐year‐old New Forest pony presented for evaluation of lethargy and colic. Transcutaneous abdominal ultrasonography revealed a cavitary, thick walled, mass‐like lesion that appeared continuous with the small intestine. The thick walls of the mass‐like lesion were of heterogeneous echogenicity with hyperechoic foci extending from the hyperechoic luminal surface to within the wall and there was loss of normal wall layering. These findings were confirmed grossly at exploratory celiotomy and histopathological examination of affected tissues confirmed lymphoma. The ultrasound findings facilitated a preoperative presumptive diagnosis that allowed informed decision‐making and aided case management.     

Ultrasonographic evaluation of induced testicular lesions in male goats

To study testicular ultrasonographic features, unilateral testicular artery ligation was performed in 12 bucks to induce predictable ischemic necrosis of the testis. Both scrotal testes then were scanned subsequently on days 1, 3, 5, 7, 15, and 30. On each of the designated days, 2 bucks each were castrated and the excised testes were rescanned outside the scrotum before gross and histologic examinations. In each goat, the testis without the ligated artery served as a control. Gross and histopathologic findings in the testis were compared with ultrasonographic observations. As the study progressed from day 0 to day 15, visually and microscopically, the testis involved in the testicular artery ligation had edema that changed to areas of peripheral necrosis with thickening of the testicular capsule. On day 30, the affected testis had granulation tissue in the areas that previously had been necrotic. Ultrasonographically, the testicular changes were consistent with the gross and histopathologic findings. There were areas of decreased echogenicity that corresponded to the necrotic areas and foci of high echogenicity that corresponded to areas of tubular mineralization. On day 30, the granulation tissue was difficult to differentiate ultrasonographically from normal testicular parenchyma. Between days 3 and 15, hydrocele was seen ultrasonographically in several goats. The excellent association between ultrasonographic findings and gross and histologic changes suggested that testicular ultrasonography might be a valuable diagnostic tool for assessing testicular disease in domestic animals.     

HEPATIC ABSCESSES IN 13 DOGS: A REVIEW OF THE ULTRASONOGRAPHIC FINDINGS, CLINICAL DATA AND THERAPEUTIC OPTIONS

Historical, physical examination, clinicopathologic, radiographic and ultrasonographic findings of 13 dogs with hepatic abscesses were reviewed. Liver abscessation was characterized by number, size, shape, echogenicity and location. Solitary lesions greater than 3 cm were more common than multiple ones. The abscesses were mainly poorly echogenic lesions, often with central cavitation. The shape of the lesion ranged from round to oval or irregular. Enhancement artifact, abdominal effusion, regional lymphadenopathy and hyperechoic perihepatic fat, were identified in several dogs. Ultrasound-guided aspiration was performed in 10 of 13 dogs, and confirmed abscessation with cytologic and microbiologic evaluation. Ultrasound-guided percutaneous drainage of abscesses was performed as an adjunct to medical management in four dogs.     

ULTRASONOGRAPHIC APPEARANCE OF CANINE GASTRIC POLYPS

Benign gastric polyps are uncommon in dogs and most are discovered incidentally. Polyps protruding into the pyloric antrum can cause gastric outflow obstruction. Clinical and ultrasonographic findings in seven dogs with histologically confirmed benign mucosal gastric polyps were reviewed. Sonographic findings such as shape, size, echogenicity, location, evidence of gastric wall thickening, wall layering, and size of regional lymph nodes were recorded. Five sessile and two pedunculated masses of different sizes (range 7–60 mm) and echogenicities were found. They primarily arose from the mucosal layer and protruded into the gastric lumen. Only one dog had a large inhomogeneous mass with a poorly visualized gastric wall layering. The polyps were all single, and were located in the pyloric antrum in six out of seven dogs. Although the ultrasonographic appearance allowed a presumptive diagnosis of mucosal gastric polyp, the final diagnosis was determined from histopathologic examination.     

Statistical relevance of ultrasonographic criteria in the assessment of diffuse liver disease in dogs and cats

OBJECTIVE: To determine whether objectively applied ultrasonographic interpretive criteria are statistically useful in differentiating among 7 defined categories of diffuse liver disease in dogs and cats. SAMPLE POPULATION: Ultrasonographic images of 229 dogs and 104 cats. PROCEDURES: Liver parenchymal or related sonographic criteria established by the authors were retrospectively and independently applied by 3 radiologists who were not aware of patient status or patient laboratory data. Seven histologic or cytologic categories of diffuse (infiltrative but not nodular) liver diseases were jointly established by the authors and included normal liver; inflammation; round-cell neoplasia; non-round-cell infiltrative, prenodular (early) metastatic neoplasia; lipidosis; vacuolar hepatopathy; and other. Liver parenchymal sonographic criteria included parenchymal sound attenuation with increasing depth, comparative organ echogenicity (liver, spleen, and kidneys), diffuse or patchy hyperechoic or hypoechoic echotexture, uniform or coarse echotexture, portal venous clarity, and liver lobe geometry. Related extrahepatic criteria included gallbladder wall thickness, bile duct diameter, amount and character of gallbladder precipitate, nondependent shadowing in the gallbladder, hepatic vein diameter versus caudal vena cava diameter, peritoneal fluid, spleen echotexture (normal vs abnormal [characterized]), and kidney echotexture. Ultrasonographic criteria were statistically compared to the 7 categories of diffuse liver disease in search of clinically exploitable relationships. RESULTS: Statistical evaluation of the applied ultrasonographic criteria did not yield clinically acceptable accuracy for discrimination among the 7 categories of diffuse liver diseases (including normal liver) in either species. CONCLUSIONS AND CLINICAL RELEVANCE: Criterion-based ultrasonographic appearance was insufficient to discriminate among canine and feline diffuse infiltrative liver diseases.     

Effectiveness of ivermectin against later 4th-stage Strongylus vulgaris in ponies

Twelve pony foals were reared worm-free and inoculated with Strongylus vulgaris. Approximately 8 weeks after they were inoculated, 6 foals were given ivermectin IM at a dosage rate of 200 micrograms/kg of body weight and 6 were given a placebo. All foals were necropsied 35 days after treatment. Ivermectin was 98.9% effective in eliminating later 4th-stage S vulgaris larvae located near the origin of major intestinal arteries and in reducing clinical signs and permitting resolution of lesions associated with verminous arteritis. One pony foal reared on pasture and with evidence of arteritis of the cranial mesenteric and ileocolic arteries on arteriography was treated with ivermectin at a dosage rate of 200 micrograms/kg of body weight. On arteriographs taken subsequently, there was evidence of regression of the lesion, and at necropsy 9 weeks after treatment, there was no arteritis or larvae in those arteries.     

Effects of repeated Strongylus vulgaris inoculations and concurrent ivermectin treatments on mesenteric arterial lesions in pony foals

Eight of 10 pony foals reared under helminth-free conditions were inoculated PO with 50 Strongylus vulgaris infective larvae/week for 4 weeks, at which time 1 foal died of acute verminous arteritis. Inoculation of 7 remaining foals continued at 2-week intervals for 20 weeks. Of the 7 foals, 3 were treated with ivermectin (0.2 mg/kg of body weight) in an oral paste formulation at experiment weeks 8, 16, 24; 4 foals were not treated. Two foals were not inoculated or treated and served as controls. After the first ivermectin treatment, ivermectin-treated foals had fewer days (12 +/- 2.9) with rectal temperatures greater than 38.6 C than did nontreated foals (23.3 +/- 3.8). Mean baseline rectal temperatures were 38 +/- 0.2 C. Adverse clinical reactions to ivermectin treatment were not observed in foals. Foals were euthanatized and necropsied 3 weeks after the last ivermectin treatment (week 24). Ivermectin was effective in reducing S vulgaris arterial larval and intestinal adult parasite numbers by 100% in 3 treated foals. Strongylus vulgaris arterial larvae and/or adults were recovered from all 4 nontreated inoculated foals. One nontreated inoculated foal lacked arterial larvae or active arterial lesions, indicating that protective resistance had developed in this individual. Marked gross and histopathologic lesions typical of chronic S vulgaris infection were observed in the 3 nontreated inoculated foals with arterial larvae. Repeated killing of intra-arterial S vulgaris fourth-stage larvae in ivermectin-treated foals did not exacerbate lesions associated with verminous arteritis or induce unique lesions associated with repeated destruction of arterial larvae.(ABSTRACT TRUNCATED AT 250 WORDS)     

Ultrasonographic appearance of primary gastric neoplasia in 21 dogs

The ultrasonographic findings in 21 dogs with histologically confirmed primary gastric neoplasia were reviewed. Location, shape of the gastric lesion, evidence of gastric wall thickening, wall layers affected, presence of ulceration, evidence of extension through the gastric wall and lymphadenopathy were recorded. Twelve dogs with carcinoma shared many ultrasonographic features with six dogs that had lymphoma, the majority having sessile masses that appeared to involve all layers of the gastric wall; many also had evidence of ulceration and lymphadenopathy. Signs of extension of the lesion through the serosal surface of the stomach were identified ultrasonographically only in dogs with carcinoma. In contrast, three dogs with leiomyoma or leiomyosarcoma each had a focal mass affecting the gastric antrum, and lymphadenopathy was not identified ultrasonographically in these dogs. Even without any specific patient preparation, ultrasonography enables a morphological assessment of gastric neoplasms that may prompt a tentative diagnosis of gastric neoplasia and stimulate further investigation.     

ULTRASONOGRAPHIC FINDINGS IN CAIRN TERRIERS WITH PRECLINICAL RENAL DYSPLASIA

Renal dysplasia is a hereditary disease characterized by abnormal differentiation of renal tissue. The ultrasonographic appearance of dysplastic canine kidneys has been reported in the late stage of the disease where inflammatory and degenerative changes are already present and the dogs are in chronic renal failure. In this study, we describe the ultrasonographic appearance of the kidneys of five related Cairn Terriers affected with renal dysplasia before the onset of clinical or laboratory evidence of renal failure. Common findings included poor corticomedullary definition and multifocal hyperechoic speckles in the renal medulla, or a diffusely hyperechoic medulla. Severity of ultrasonographic changes was related to the severity of histopathologic findings. The ability to detect dysplastic changes before clinical signs develop makes ultrasound a potentially useful screening method for canine renal dysplasia.     

ULTRASONOGRAPHIC APPEARANCE OF URETHRAL TRANSITIONAL CELL CARCINOMA IN TEN DOGS

The mucosal margin of the urethra is best assessed by positive contrast urethrography, but ultrasonography offers complementary information such as urethral wall thickness and size of medial iliac lymph nodes. Ultrasonography of the urethra is quick, noninvasive and does not require sedation or general anesthesia. In patients with complete urethral obstruction, ultrasonography may be the only way to image the urethra. Twelve dogs which were presented to Tufts University School of Veterinary Medicine with clinical signs referable to the urinary bladder, urethra or vagina were examined ultrasonographically. Seven were neutered females and five were neutered males. Each dog had a hyperechoic, nonshadowing line at the epithelial surface of the proximal urethra. In the seven female patients and one of the males, the urethral wall was also thick and hypoechoic to surrounding tissue. In the other males, the urethral epithelial changes were at the level of the prostate, and the limits of the urethra were not visible. In six dogs, the urethral change was the only abnormality seen, while in six, bladder wall, bladder luminal and/or prostatic parenchymal changes were also detected. Three patients had hydronephrosis, and one had enlarged medial iliac lyumph nodes. Biopsies were obtained via suction with urinary catheterization (n = 6), exploratory celiotomy (n = 3), urethroscopy (n = 2), or at post-mortem (n = 1). A histopathologic diagnosis of urethral transitional cell carcinoma was obtained in ten dogs. The ultrasonographic appearance was not pathognomonic for transitional cell carcinoma, as one dog with transitional cell dysplasia and one dog with severe ulcerative and necrosupperative cystitis and urethral stricture had similar findings.     

RADIOGRAPHIC AND ULTRASONOGRAPHIC FEATURES OF HYPERTROPHIC FELINE MUSCULAR DYSTROPHY IN TWO CATS

Hypertrophic fellne musculer dystrophy has been reported as an X-linked inherited deficiency of a cytoskeletal myofiber protein called dystrophin. This report deserlbes the radiographic and ultrasonographic abnormalities of two male littermate domestic short-hair cats and reviews the previous reported findings assoclated with hypertrophic feline muscular dystrophy. The thoracic radiographic abnormalities included: progressive cardiomegaly, large convex, scalloped irregularities associated with the vetral aspect of the diaphragm, and variable degrees of esophageal dilation (megaesophagus) with associated cranioventral aspiration pneumonia. Echocardiographic features included: concentric left vetricular wall thickening, increased left ventricular and diastolic and systolic dimensions, and an increase in endocardial echogenicity. Abdominal radiographic abnormalities included: hepatosplenomegaly, peritoneal effusion, renomegaly, adrenal gland mineralization, and paralumbar and diaphragmatic musculature enlargement. Abdomlnal ultrasonographic abnormalities included: irregularly thickened muscular portion of the diaphragm; hypoechogenicity of the liver; peritoneal effusion; hepatosplenomegaly; renomegaly with hyperechoic cortex and medulla; and adrenal gland mineralization. The irregular scalloped appearance of the diaphragm (particularly along the ventral/sternal margin) was a consistenl radiographic abnormlity in the two cats with hypertrophic feline muscular dystrophy after the age of 7 months. This finding was confirmed by ultrasound as a thickened irregular, hyperechoic diaphragm. A diagnosis of hypertrophic feline muscular dystrophy should be strongly suspected if this abnormality is identified.