Ultrasonographic diagnosis and surgical management of double intestinal intussusception in 3 dogs

The diagnosis and treatment of double intestinal intussusception in 3 pups with persistent vomiting, diarrhea, dehydration, anemia, leucocytosis, and electrolyte imbalance are described. Ultrasonography confirmed intussusception and laparotomy revealed double intussusceptions. Intussusceptions were corrected by manual reduction in 1 pup and intestinal resection and anastomosis in 2 pups. Two pups survived and 1 pup died on the 4th day after surgery.     

Ultrasonographic findings of intestinal intussusception in seven cats

The medical records of seven cats with intestinal intussusception that were diagnosed by abdominal ultrasonography and exploratory laparotomy were reviewed. In transverse ultrasonographic sections the intussusception appeared as a target-like mass consisting of one, two or more hyperechoic and hypoechoic concentric rings surrounding a C-shaped, circular or non-specific shaped hyperechoic centre. Part of the intestine representing the inner intussusceptum, located close to the hyperechoic centre and surrounded by concentric rings, was also detected. In longitudinal sections the intussusception appeared as multiple hyperechoic and hypoechoic parallel lines in four cases and as an ovoid mass in three cases. In one case the ovoid mass had a ‘kidney’ configuration. Additional ultrasonographic findings associated with intestinal intussusception included an intestinal neoplasm in one cat. The results of the present study demonstrate that the ultrasonographic findings of intestinal intussusception in cats bear some similarities to those described in dogs and humans, are relatively consistent, and facilitate a specific diagnosis.     

Ultrasonographic signs of intestinal intussusception associated with acute enteritis or gastroenteritis in 19 young dogs

The ultrasonographic pattern of intestinal intussusception was studied in 19 young dogs with acute enteritis or gastroenteritis. The intussusception was observed to be a target-like mass consisting of a hyperechoic or anechoic center surrounded by multiple hyperechoic and hypoechoic concentric rings in transverse sections. In longitudinal sections, the intussusception appeared as multiple hyperechoic and hypoechoic parallel lines, as a tumor-like or pseudokidney mass, and as a trident-like configuration. Ultrasonography may provide a sensitive, specific, and accurate method of diagnosing intestinal intussusception in young dogs.     

Spontaneous reduction of intestinal intussusception in five young dogs

Five, 3- to 8-month-old dogs had clinical and ultrasonographic findings consistent with intestinal intussusception, but findings were negative on exploratory celiotomy. Ultrasonography had revealed a target-like mass (median maximal diameter 25 mm) on transverse section and multiple hyperechoic or hypoechoic parallel lines (median length 36.8 mm) on longitudinal section. Blood flow in the intussuscepted bowel was detected in most of the cases. In dogs with similar findings, the authors recommend ultrasonographic reexamination of the abdomen after general anesthesia (but before surgery) to exclude spontaneous reduction of the intussusception.     

Ultrasonographic diagnosis of small-intestinal intussusception in three foals

Small-intestinal intussusceptions were diagnosed in 3 foals. Cross-sectional ultrasonography through the apex of the intussusceptum revealed a target-like pattern with a thick hypoechoic rim. The thick hypoechoic rim was caused by severe edema of the entering and returning walls of the intussusceptum. At the more proximal portion of the intestines, where parietal edema was less severe, the image appeared as 2 concentric rings and an inner circular area. The outer ring and inner circular area were hypoechoic and represented the returning and the entering wall of the intussusceptum. An additional cross-sectional pattern can be described as double concentric rings, with the inner lumen represented by a central echogenic core. Longitudinal scannings of the involved intestinal section revealed a different view of the same anatomic situation, with 2 hyperechoic areas delineated by 3 stripes of hypoechoic intestine. Ultrasonography of a foal's abdomen provides a clinician with a rapid noninvasive technique that may aid in the differential that may aid in the differential diagnosis of colic. The ultrasonographic diagnosis of intussusception may improve the recognition of a surgical lesion and improve the potential for successful treatment.     

Ultrasonographic and histopathological features in 8 cats with fibrotic small intestinal stricture

Benign stricture is an uncommon cause of chronic small intestinal obstruction in the cat. The purpose of this retrospective case series was to describe the ultrasonographic features, histopathological findings, and clinical presentation in a group of cats with benign small intestinal stricture. Inclusion criteria were cats presenting during the period 2010‐2017, and that had ultrasonography and small intestinal stricture confirmed at surgery. For each cat, clinical data and ultrasonographic findings were retrieved from the medical record, and histopathology, where available, was reviewed. Eight cats met the inclusion criteria. The location of strictures was duodenum (1/8), mid‐ to distal jejunum (4/8), and ileum (3/8). Ultrasonographic findings included gastric distension (8/8) and generalized (3/8) or segmental (5/8) intestinal dilation consistent with mechanical obstruction. Ingesta did not propagate beyond the strictured segment. Wall thickening was mild to moderate (3‐6 mm). Normal wall layering was disrupted in all cats. Strictures were predominantly hypoechoic (7/8) and associated with hyperechoic peri‐intestinal mesentery (6/8). Annular strictures (5/8) were less than 15 mm in length whereas long‐segment strictures (3/8) were greater than 15 mm in length. Histopathology showed transmural disease with fibrosis and inflammation (8/8), often (6/8) extending into the bordering mesentery. The mucosa was the most severely affected layer and epithelial injury accompanied the mucosal fibrosis/inflammation. Clinical presentation reflected delayed diagnosis of chronic bowel obstruction with debilitation (8/8), marked weight loss (8/8), and prerenal azotemia (5/8). Benign fibrostenotic stricture should be considered a differential diagnosis in debilitated young cats presenting with chronic bowel disease and ultrasonographic features of intestinal obstruction.     

Ultrasonographic and computed tomographic features of a true gastro-gastric intussusception with concurrent foreign bodies in a dog

A 2-year-old intact male Cane Corso dog was presented for acute weakness, vomiting, and diarrhea. Abdominal ultrasound revealed the stomach had severe wall edema and a target appearance. Computed tomography was consistent with a gastro-gastric intussusception and concurrent mineral-like gastric foreign bodies. After reduction of the intussusception, bilateral incisional gastropexy was performed to prevent recurrence. True gastrogastric intussusception is a rare condition and should be considered if the stomach has severe wall edema with a target sign on abdominal ultrasound. Computed tomography was useful to confirm this rare diagnosis and screen the entire abdomen for concurrent lesions.Key clinical message:This case highlights the usefulness of a CT examination to confirm this rare diagnosis, to determine the position of gastric compartments, and to detect potential concurrent lesions prior to surgery.     

Chronic intestinal intussusception in two horses

In 2 cases of chronic intestinal intussusception in horses, one involved jejunum and the other, ileum. The only clinical signs observed were intermittent colic. Surgery was performed on both horses, with successful outcomes.     

Ultrasonographic features of testicular neoplasia in dogs: 16 cases (1980-1988)

For 16 dogs with testicular neoplasia (n = 19 tumors), ultrasonography was performed to determine whether a correlation exists between ultrasonographic features of testicular tumors and cell type. The echogenicity of the tumors varied depending on the size of the tumor and whether the tumor had focal or diffuse distribution within the testis. The ultrasonographic characteristics of Sertoli cell tumors were variable, with no predominant pattern. This variation may be related to tumor size, because 6 of 7 Sertoli cell tumors were greater than 5 cm in diameter. Focal seminomas and interstitial cell tumors less than 3 cm in diameter had hypoechoic texture. Focal seminomas and interstitial cell tumors greater than 3 cm in diameter had mixed echogenicity. Tumors of multiple cell types were greater than 5 cm in diameter and had mixed echogenicity. In valuable breeding dogs with a small (less than 3 cm) focal intrascrotal lesion, testicular ultrasonography would be of benefit for localization of the mass to the testis or epididymis for subsequent biopsy. In dogs with intraabdominal neoplastic testes, ultrasonography may be of benefit in determining intra-abdominal metastases and invasion of contiguous structures.     

Ultrasonographic evaluation of the thickness of the small intestinal wall in dogs with inflammatory bowel disease

OBJECTIVES: To establish whether the intestinal wall thickness, as measured ultrasonographically, is significantly increased in dogs with inflammatory bowel disease (IBD). The results would provide the information necessary to decide whether measurement of ultrasonographic wall thickness can predict IBD in dogs. METHODS: The intestinal wall thickness of 75 dogs with idiopathic IBD, as measured by ultrasonography, was compared with recently published normal values. IBD was either confirmed histologically (n = 54) or suspected (n = 21). In all cases there was a positive response to immunosuppressive treatment. RESULTS: A positive association between intestinal wall thickness in dogs and either the histological diagnosis or the response to treatment was not found. Ultrasonographic intestinal wall measurements do not appear to be able to establish a diagnosis of intestinal inflammation and may result in a false negative diagnosis in cases of IBD. CLINICAL SIGNIFICANCE: The same 'grey zone' of between 4 and 6 mm used in humans can be used in the canine duodenum to distinguish the normal range, reserving the term 'abnormal' for an intestinal measurement greater than 6 mm in the duodenum and greater than 4.7 mm in the jejunum.     

Ultrasonographic features of splenic hemangiosarcoma in dogs: 18 cases (1980-1986)

The medical records of 18 dogs in which ultrasonography was useful in making a diagnosis of splenic hemangiosarcoma were reviewed. Splenic ultrasonography revealed masses with echo patterns that ranged from anechoic fluid to hyperechoic tissue. In 7 dogs, metastasis was detected ultrasonographically as anechoic to hypoechoic lesions in the liver.     

Ultrasonographic features of splenic lymphosarcoma in dogs: 12 cases (1980-1986)

The ultrasonographic appearance of the spleen and adjacent organs in 12 dogs with splenic lymphosarcoma was reviewed. Poorly marginated hypoechoic to anechoic nodules (4 mm to 3 cm in diameter) were found in all dogs. The anechoic nodules did not result in reflective shadowing or acoustic enhancement of the underlying tissues. The remainder of the splenic parenchyma appeared relatively hypoechoic when compared with the liver or renal cortices in 9 dogs. Recognition of this ultrasonographic pattern appears to be a useful diagnostic tool. Needle aspiration guided ultrasonographically will then enable histologic confirmation of lymphosarcoma.     

Ultrasonographic evaluation of tracheal collapse in dogs

Tracheal ultrasonography was performed to measure the width of the tracheal ring shadow and to assess the clinical relevance of these measurements for identifying tracheal collapse. The first tracheal ring width (FTRW) and thoracic inlet tracheal ring width (TITRW) were measured on both expiration and inspiration. The mean of the FTRW width (129 dogs) was greater in expiration (10.97 ± 1.02 mm, p = 0.001) than that in inspiration (9.86 ± 1.03 mm). For 51 normal dogs, the mean of the TITRW width was greater in expiration (9.05 ± 1.52 mm, p = 0.001) than in inspiration (8.02 ± 1.43 mm). For 78 tracheal collapse dogs, the mean of the TITRW width was greater in expiration (15.89 ± 1.01 mm, p = 0.001) than in inspiration (14.85 ± 1.17 mm). The TITRW/FTRW ratio of the normal dogs was higher (p = 0.001) in expiration (0.81 ± 0.09) than that in inspiration (0.79 ± 0.10). When compared between the normal and tracheal collapse dogs, the TITRW/FTRW ratio was also increased (p = 0.001) both in expiration (1.54 ± 0.09) and inspiration (1.47 ± 0.08), respectively. Based on these results, the cutoff level of the TITRW/FTRW ratio was statistically analyzed according to the receiver operating characteristic curve and it could be set at 1.16 in expiration and at 1.13 in inspiration. We have demonstrated that tracheal ultrasonography is a useful technique for the evaluation of tracheal collapse and it can be a supportive tool together with the radiographic findings for making the correct diagnosis.     

Ultrasonographic features of insulinoma in six ferrets

Insulinoma is a functional, insulin‐secreting tumor, arising from the beta islet cells of the pancreas. It is one of the most common neoplasms in ferrets and has been associated with clinical signs of hypoglycemia, such as ptyalism, pawing at the mouth, seizures, lethargy, and coma. The ultrasonographic features of insulinoma in ferrets have not been previously reported. The purpose of this retrospective case series study was to describe the ultrasonographic features of confirmed insulinoma in a group of ferrets. Inclusion criteria were abdominal ultrasound examination and histological confirmed insulinoma by surgical biopsy. Six ferrets met the inclusion criteria, all of which had multiple hypoglycemic episodes. Ultrasonographic images were reviewed and the characteristics of the pancreatic nodules were recorded. Twenty‐eight pancreatic nodules were observed in the six ferrets and were primarily hypoechoic (89.3%, 25/28) and homogenous (46.4%, 13/28) with a smooth margin (78.6%, 22/28). The distribution of the pancreatic nodules was 46.4% in the left lobe, 50% in the right lobe, and 3.6% in the body of the pancreas. The sizes of the pancreatic nodules varied from 1.5 × 1.5 to 4.1 × 5.6 mm. All of the pancreatic nodules removed from surgery were histopathologically confirmed as insulinoma. The findings indicated that insulinoma in ferrets could be detected through ultrasonography, which may facilitate diagnosis and preoperative surgical planning.     

Ultrasonographic examination of the carpal canal in dogs

The aim of this study was to determine the course of the median nerve and its adjacent structures in the carpal canals of 8 healthy dogs by using high-frequency transducers. Before performing ultrasonography, the transverse and posteroanterior diameters as well as the perimeter of the carpus were measured at just proximal to the side of the carpal pad. The anatomical structures were then determined at two levels of the carpal canal, which were named the proximal and distal levels, on the transverse sonograms. The cross-sectional areas, perimeters and the transverse and posteroanterior diameters of the median nerve were measured at these levels. Although all the measurements were larger at the proximal level, significant differences between the proximal and distal levels were determined for the cross-sectional area, the perimeter and the transverse diameter of the median nerve. On the transverse sonogram, the deep digital flexor tendon was seen in almost the center of the carpal canal like a comma shape and also it had a small concavity on the caudal side. The superficial digital flexor tendon was seen as an ovoid shape on the transverse sonograms and it was located nearly at the posterior side of the carpal canal. Both tendons were seen as intermediate-grade echogenic structures. The median artery was located inside of the concavity of the deep digital flexor tendon. Also, the median nerve was seen at the posteromedial side of the median artery. As a result of this study, the cross-sectional areas of the median nerve ranged between 1.01-2.68 mm² at the proximal level and between 0.93-1.91 mm² at the distal level.     

Ultrasonographic diagnosis of portacaval shunts in young dogs

Ultrasonography was performed on 21 young dogs with portacaval shunts. Initial ultrasonography revealed a small hypovascular liver in all dogs. Eight portacaval shunts (4 intrahepatic, 4 extrahepatic) were detected. Supplementary ultrasonography of dogs under general anesthesia and subjected to positive-pressure ventilation identified 6 additional intrahepatic portacaval shunts.     

Ultrasonographic characteristics of soft tissue tumours in dogs

Objective   To identify and describe the ultrasonographic features of soft tissue tumours in dogs.
Procedure   Superficial soft tissue tumours of various histological types, including mast cell tumours (MCTs) and soft tissue sarcomas (STSs), were evaluated. Ultrasound was used to visualise internal characteristics of the tumour, including vascularity. Tumours were categorised according to size, shape, margin definition, tissue plane mobility, echogenicity, echotexture, acoustic shadowing or enhancement and vessel distribution. Objective measurements of intratumoural blood flow included velocities and maximal perfused cross-sectional area (fractional area). Logistic regression models incorporating a variety of data were used in an attempt to predict the histopathological type of tumours.
Results   The logistic regression model defined by the parameters echotexture, margin definition and presence of subcapsular vessels was highly predictive of MCTs (> 73%; P = 0.024). Several other trends, including a larger size for STSs and less vascularity for both MCTs and STSs, were observed, but did not reach statistical significance.
Conclusion   This preliminary study has shown the potential diagnostic value of ultrasound in differentiating soft tissue tumours. However, at present, ultrasound cannot replace biopsy and histopathological evaluation for tumour diagnosis.