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.     

Accuracy of Ultrasonographic Measurements of Adrenal Glands in Dogs: Comparison with Necroscopic Findings

Ultrasonographic evaluation of the adrenal glands was performed in 85 dogs, followed by macroscopic and histopathological examination either post‐mortem or after adrenalectomy. This retrospective cross‐sectional study evaluated the difference between gross and ultrasonographic measurements to determine the diagnostic accuracy of ultrasonography in the evaluation of canine adrenal gland size. The differences were assessed for gland length, thickness at cranial, middle and caudal regions, and surface area. In our sample, ultrasound error accuracy ranged between 0% in measurement of the right adrenal gland surface area and 25.21% for left cranial pole thickness. The parameters with minor errors were caudal pole thickness (3.64% right side and 3.49% left side) and length (5.75% right side and 2.19% left side). The ultrasonographic measurements generally underestimated the actual size of the adrenal glands. No statistically significant differences were observed for measurement errors between normal and pathological adrenal glands. This study confirmed that the caudal pole of both glands is the best parameter for ultrasonographic evaluation of normal and pathological adrenal glands size in dog. Furthermore, the surface area could be considered as a dimensional parameter for better assessment of the complex shape and the global aspect of the adrenal glands, while standardize ultrasonographic projections are needed to measure the cranial pole of both adrenal glands.     

Canine prostatic disease--comparison of ultrasonographic appearance with morphologic and microbiologic findings: 30 cases (1981-1985)

A retrospective analysis was made of 30 cases of canine prostatic disease, with the objective of identifying (via a prepubic approach) the 2-dimensional, gray-scale ultrasonographic appearance most often associated with the various spontaneous prostatic diseases. Ultrasonography was of value in characterizing the parenchymal architecture as normal vs focally hyperechoic and diffusely hyperechoic (associated with chronic inflammation and neoplasia) or focally hypoechoic or anechoic (either accompanied by distant enhancement), which was associated with retention cyst or abscess. Further specificity based only on abnormal echotexture was not possible. Ultrasonography facilitated the differentiation of radiographically identifiable prostatomegaly attributable to abscess or neoplasia from apparent prostatomegaly attributable to paraprostatic cyst. An imaging protocol consisting of distention retrograde urethrocystography and prepubic ultrasonography was recommended, as a distended bladder aided ultrasonographic identification of the prostate gland. In addition, the combination of urethral morphologic features and urethroprostatic reflux appearance complemented the ultrasonographic appearance for differentiation of prostatic abscess from prostatic carcinoma. A classification scheme for spontaneous canine prostatic disease combining germane imaging morphologic features with microscopic and microbiologic findings was proposed.     

CONTRAST‐ENHANCED ULTRASOUND OF THE NORMAL CANINE PROSTATE GLAND

Canine prostate gland abnormalities affect a large number of adult male dogs. In veterinary medicine, the commonly used methods to diagnose canine prostate gland disease are digital rectal examination and abdominal ultrasound. We evaluated the ability of ultrasound contrast agent to provide additional information about the vascularity of the canine prostate gland; such information could be useful in detecting early prostate gland disease and in staging disease known to be present. We characterized the ultrasonographic appearance of prostate gland vascularity in 10 healthy dogs before and after the injection of an ultrasound contrast agent (Levovist^?). Before injecting Levovist^?, the prostate gland blood flow was classified as poor in all dogs, whereas after contrast agent injection blood flow was classified as moderate or good, in 3 and 7 dogs respectively. Knowledge of the status of prostate gland vascularity could be useful for the characterization, diagnosis and therapeutic monitoring of canine prostate gland lesions.     

Ultrasonographic Characteristics of the Adrenal Glands in Dogs With Pituitary-Dependent Hyperadrenocorticism: Comparison With Normal Dogs

Ultrasonographic evaluation of the adrenal glands was performed in 10 dogs with pituitary-dependent hyperadrenocorticism (PDH) and in 10 age- and weight-matched healthy control dogs. Thickness, shape, and echogenicity were determined for each adrenal gland. Adrenal thickness in dogs with PDH (median, 10 mm-left; 8.5 mm-right) was significantly greater than thickness in control dogs (median, 6 mm-left; 6 mm-right). Other ultrasonographic characteristics associated with PDH included bilaterally symmetrical adrenomegaly and maintenance of normal adrenal shape. Adrenal echogenicity was homogeneous and less than that of the adjacent renal cortex in 8 of 10 dogs with PDH and in 10 of 10 control dogs. Heterogenous echogenicity was present in 2 of 10 dogs with PDH, and was associated with nodular cortical hyperplasia in one of those dogs. Results of this study confirm the difference in sonographic appearance between PDH-induced bilateral cortical hyperplasia and functional adrenocortical neoplasia, and show a difference in so-nographically determined adrenal size between healthy dogs and dogs with PDH. J Vet Intern Med 1996; 10:110–115. Copyright © 1996 by the American College of Veterinary Internal Medicine .     

Quantification of the effect of various patient and image factors on ultrasonographic detection of select canine abdominal organs.

We assessed factors that affected ultrasonographic visualization of the pylorus, duodenal papilla, pancreas, adrenal glands, and jejunal and medial iliac lymph nodes in the dog. An abdominal ultrasonographic examination was performed on 100 canine patients, equally divided between two facilities. The pylorus was visible in 64% of the dogs, the major duodenal papilla in 42%, the left pancreatic lobe in 56%, the body of the pancreas in 60%, the right pancreatic lobe in 87%, the left adrenal gland in 91%, the right adrenal gland in 86%, the medial iliac lymph nodes in 54%, and the jejunal lymph nodes in 51%. The parameters that negatively influenced the visibility of these organs were the presence of air or food in the gastrointestinal tract (pancreas, duodenal papilla), age (lymph nodes), and body weight (pancreas, duodenal papilla). The parameters that positively influenced their visibility were the presence of air or food in the gastrointestinal tract (lymph nodes), body weight (lymph nodes), body condition score (right adrenal gland), and inherent image quality (left pancreatic lobe). There was a significant difference between the two institutes for the visualization of the pylorus, pancreas, and lymph nodes, which was probably related to different body positions used for scanning in each institution.     

Ultrasonography Criteria for Differentiating ACTH Dependency from ACTH Independency in 47 Dogs with Hyperadrenocorticism and Equivocal Adrenal Asymmetry

Background: Adrenal ultrasonography (US) in dogs with hyperadrenocorticism (HAC) is commonly used to distinguish adrenocorticotropic hormone (ACTH)‐independent (AIHAC) and ACTH‐dependent hyperadrenocorticism (ADHAC). To date, no cut‐off values for defining adrenal atrophy in cases of adrenal asymmetry have been determined. Given that asymmetrical hyperplasia is sometimes observed in ADHAC, adrenal asymmetry without ultrasonographic proof of adrenocortical tumor such as vascular invasion or metastasis can be equivocal. Objective: The purpose of this study was to compare adrenal US findings between cases of ADHAC and AIHAC in dogs with equivocal adrenal asymmetry (EAA), and to identify useful criteria for their distinction. Animals: Forty dogs with EAA were included. Methods: Ultrasound reports of HAC dogs with adrenal asymmetry without obvious vascular invasion or metastases were reviewed. Dogs were classified as cases of ADHAC (n = 28) or AIHAC (n = 19), determined by plasma ACTH concentration. The thickness, shape, and echogenicity of both adrenal glands and presence of adjacent vascular compression were compared between AIHAC and ADHAC groups. Results: The maximal dorsoventral thickness of the smaller gland (SDV) ranged from 2.0 to 5.0 mm in AIHAC and from 5.0 to 15.0 mm in ADHAC. The 95% confidence intervals for estimated sensitivity and specificity of a SDV cut‐off set at 5.0 mm in the diagnosis of AIHAC were 82–100 and 82–99%, respectively. Other tested US criteria were found to overlap extensively between the 2 groups, precluding their usefulness for distinction. Conclusion and Clinical Importance: In EAA cases, an SDV ≤5.0 mm is an appropriate cut‐off for AIHAC ultrasonographic diagnosis.     

Concurrent mammary gland hyperplasia and adrenocortical carcinoma in a domestic ferret.

Mammary gland hyperplasia associated with adrenocortical carcinoma in a domestic ferret had a histologic appearance similar to that observed in cats. It is important to consider this hyperplastic condition in the differential diagnosis of mammary gland enlargement in the ferret.     

Effects of mitotane therapy in dogs with pituitary dependent Cushing syndrome on the adrenal gland size--an ultrasonographic study]

The effect of mitotane therapy on adrenal gland size was evaluated in 13 dogs with pituitary dependent hyperadrenocorticism. Ultrasonographic measurements were obtained before and during mitotane therapy. During therapy both adrenal glands were shorter and thinner (median during therapy: left adrenal gland 19.4 mm long, 5.4 mm thick, right adrenal gland 18.1 mm long, 6.1 mm thick) than before mitotane therapy (median before therapy: left adrenal gland 23.6 mm long, 8.3 mm thick, right adrenal gland 21.6 mm long, 8.1 mm thick). Statistical evaluation showed a significant reduction in size. But ultrasonographic measurement of adrenal gland size is not useful in the evaluation of adrenal reserve during mitotane therapy. Inadequate adrenal reserve was not identified and adrenal size measurement by ultrasonography was not helpful to differentiate adequate and inadequate control of adrenal cortisol secretion during mitotane therapy.     

Evaluating the correlation between adrenal gland dimensions and aortic diameter in healthy dogs

In the present study, the relationship of normal adrenal dimensions with weight, aortic diameter, age and sex was evaluated. Moreover, a formula for estimating the normal dimensions of adrenal gland was provided. Thirty‐two intact adult dogs that were considered healthy based on history, physical examination, routine blood works and specific adrenal tests as well as absence of any abnormal ultrasonographic findings were included. Adrenal glands and abdominal aorta were imaged in the sagittal plane by ultrasound. Length, maximal height of the cranial and caudal poles, area and circumference of the left and right adrenal glands and also the internal diameter of the abdominal aorta were measured. Analysis showed that there is a positive correlation between the adrenal gland dimensions and weight and aortic diameter. The ratio of adrenal gland dimensions and the aortic diameter was calculated, but this ratio showed a great amount of variability in tandem with a significant correlation to the weight; Meaning that the ratio of the adrenal gland dimensions to the aortic diameter was not a reliable index for evaluating the size of the normal adrenal gland in animals with different weights. Therefore, we used the weight along with adrenal measurements in a linear regression model, and then, we were able to estimate the adrenal gland dimensions in different weights. Knowing the relationship of normal adrenal dimensions with the indices such as weight, age, sex and diameter of abdominal aorta can help the clinicians to diagnose the adrenal gland diseases.     

Computed tomography in the diagnosis of canine hyperadrenocorticism not suppressible by dexamethasone

Computed tomography (CT) was performed in 10 dogs with hyperadrenocorticism not suppressible by dexamethasone. In 6 of these dogs, a unilateral adrenal mass was found on CT images. Specimens of the masses were obtained via retroperitoneal laparotomy; histologic examination revealed 4 carcinomas, 1 adenoma, and 1 nodular hyperplasia. In the 4 other dogs, CT revealed symmetric bilateral adrenal gland enlargement. In 2 of these dogs, contrast-enhanced CT revealed a mass in the pituitary fossa, which could be identified at necropsy as a pituitary tumor. The other 2 dogs were successfully treated with mitotane.     

Hepatic ultrasonography in the dog

Ultrasonography may be used to evaluate noninvasively a wide variety of diseases affecting the canine liver. Hepatic mass lesions, parenchymal pathology, gallbladder and biliary disease, and vascular abnormalities may be detected and characterized by ultrasonography. Ultrasonically guided percutaneous liver biopsy can improve the succes and safety of obtaining diagnostic cytologic material. The response of liver disorders to treatment may be effectively monitored by serial ultrasonographic examination. The ultrasonographic diagnosis of canine liver disease is described and illustrated with 11 case history reports.     

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 FEATURES OF CANINE ABDOMINAL MALIGNANT HISTIOCYTOSIS

Ultrasonographic features of canine abdominal malignant histiocytosis (MH) of 16 dogs are reported. The most common finding was the presence of hypoechoic nodules in the spleen, some of which caused distortion of the splenic margin. The liver was the second-most commonly affected organ. Hepatic ultrasonographic features were highly variable, including hypoechoic, hyperechoic, or mixed echogenic lesions. Other common ultrasonographic abnormalities included hypoechoic nodules in the kidneys and mesenteric and medial iliac lymphadenopathy. The results of this study suggest that the ultrasonographic appearance of canine abdominal MH is nonspecific, and definitive diagnosis requires cytologic or histologic examination.     

Use of x-ray-computed tomography as an aid in localization of adrenal masses in the dog

Four dogs with clinical evidence of hyperadrenocorticism were evaluated by use of x-ray-computed tomography (CT). Adrenal masses were identified accurately and localized. Unilateral adrenal masses were diagnosed accurately in dogs 1, 2, and 3 and were removed surgically via a paracostal retroperitoneal approach to the adrenal gland. Using CT and IV contrast medium, the adrenal mass in dog 3 also was accurately diagnosed as being highly vascular. The histopathologic diagnosis was adrenal adenoma in dogs 1, 2, and 3. In dog 4, the CT-roentgen diagnosis was asymmetric bilateral adrenal enlargement. Necropsy examination of dog 4 indicated moderate enlargement of the left adrenal gland and severe enlargement of the right adrenal gland. Results of microscopic examination indicated chronic inflammation of the left adrenal gland and adenocarcinoma of the right adrenal gland. Use of CT facilitated localization of adrenal masses and fulfilled the needs of a localizing technique. A unilateral mass can be removed surgically via a limited exposure, retroperitoneal incision on the affected side of the animal instead of removal via abdominal laparotomy, which is more invasive. Advantages of CT can reduce the needs of other imaging modalities for the localization of adrenal masses.     

Surgical treatment and long-term outcome of ferrets with bilateral adrenal tumors or adrenal hyperplasia: 56 cases (1994-1997).

OBJECTIVE: To determine signalment, clinical signs, concurrent diseases, response to surgical treatment, and long-term outcome of ferrets with bilateral adrenal tumors or adrenal hyperplasia. DESIGN: Retrospective study. ANIMALS: 56 ferrets with bilateral adrenal tumors or adrenal hyperplasia confirmed histologically following subtotal bilateral adrenalectomy. PROCEDURE: Medical records of all ferrets with bilateral adrenal tumors or hyperplasia examined between 1994 and 1997 were reviewed. Ferrets underwent a subtotal bilateral adrenalectomy or a unilateral adrenalectomy initially, followed by a unilateral subtotal adrenalectomy when tumors or hyperplasia later developed on the contralateral adrenal gland. A long-term follow-up of a minimum of 18 months after final adrenal gland surgery was obtained by examination of medical records and follow-up telephone conversations. RESULTS: Clinical signs of hyperadrenocorticism included bilaterally symmetric alopecia, return to male sexual behavior in castrated male ferrets, or swollen vulva in spayed female ferrets. Surgical treatment of bilateral adrenal disease by subtotal bilateral adrenalectomy (or unilateral adrenalectomy followed by contralateral unilateral subtotal adrenalectomy) was effective with a mortality rate of < 2%. Only 3 (5%) ferrets required glucocorticoid or mineralocorticoid replacement following subtotal bilateral adrenalectomy. Recurrence after bilateral adrenalectomy was 15% with a mean long-term follow-up period of 30 months. CONCLUSIONS AND CLINICAL RELEVANCE: Bilaterally symmetric alopecia, return to male sexual behavior in castrated male ferrets, or swollen vulva in spayed female ferrets are indicative of adrenal tumors or adrenal hyperplasia in ferrets. Surgical treatment of bilateral adrenal disease by subtotal bilateral adrenalectomy is effective, with a low rate of complications and postoperative recurrence rate.     

RETROSPECTIVE ULTRASONOGRAPHIC EVALUATION OF ADRENAL LESIONS IN 26 DOGS

A review was performed of ultrasonographic findings in 26 dogs with confirmed adrenal lesions. Adrenal shape, size, echogenicity, laterality, and the presence of vascular invasion were evaluated. Histopathologic diagnoses were obtained in all dogs. Adrenal lesions were confirmed as pheochromocytomas (9), adenocarcinomas (6), a poorly differentiated blastoma (l), bilateral adrenal metastases of a carcinoma (l), adenomas-one of which was bilateral-(4) and hyperplasia (6). Size and shape were extremely variable and not specific to lesion type. There was a tendency for pheochromocytomas (7), adenocarcinomas (5) and poorly differentiated blastoma (1) to be rounded masses. Adenomas (4), hyperplasia (7) and adrenal metastases (2) presented predominantly as nodules. No specificity in echogenicity was noted. Mineralization and bilaterality were present in both benign and malignant lesions. Vascular extension or the presence of a thrombus were suggestive but not specific signs of malignancy. Based on our prelimiary study, ultrasonography is an effective method for localizing adrenal lesions and is helpful in assessing their extension. However, no definitive differentiation between benign and malignant lesions was possible using ultrasonographic criteria alone.     

Prostatic Perfusion in the Dog Using Contrast-Enhanced Doppler Ultrasound

Ultrasonography has become the imaging modality of choice for evaluation of the prostate gland in the dog. Unfortunately, despite providing excellent images, it may be difficult to differentiate the common canine prostatic diseases with ultrasound because many have a similar ultrasonographic appearance. Real-time contrast-enhanced ultrasound was used to monitor and characterise the normal perfusion pattern and perfusion dynamics of the canine prostate gland when using a micro bubble contrast agent. In all contrast studies, the prostatic artery, entered the prostate gland on the dorso-lateral surface then tunnelled into the prostatic capsule and branched into many small parenchymal arteries which were directed medially towards the urethra to supply the body of the prostate gland. The flow of the contrast medium into the prostatic parenchyma was visible after 15 s. During the wash-in phase, there was an homogenous enhancement of the prostatic parenchyma. During the wash-out phase, an homogenous decrease of the echogenicity was visible in all cases.     

Ultrasonographic characteristics of both adrenal glands in 15 dogs with functional adrenocortical tumors.

Ultrasonographic examination of both adrenal glands was performed in 15 dogs with functional adrenocortical tumors (FAT). Bilateral adrenal tumors were diagnosed in three of 15 dogs, and unilateral tumors were diagnosed in 12 of 15 dogs. Adrenal tumors were characterized by adrenal gland enlargement with loss of the normal shape and parenchymal structure. The contralateral adrenal gland could be imaged in all dogs with unilateral tumors. Based on size, shape, and parenchymal structure, the contralateral adrenal gland was similar to adrenal glands of normal dogs. The results of this study show that: 1) both adrenal glands should be imaged routinely in dogs with hyperadrenocorticism; 2) bilateral adrenocortical tumors seem to be more frequent than previously assumed; 3) one normal adrenal gland does not exclude the existence of a contralateral FAT; and 4) the functional atrophy of the contralateral adrenal gland in dogs with FAT may not be apparent ultrasonographically.     

Ultrasonographic evaluation of the adrenal glands in six dogs with hypoadrenocorticism.

The purpose of this study was to determine the value of ultrasonographic characterization of the adrenal glands in dogs with hypoadrenocorticism. Measurements of adrenal glands were obtained in six dogs with hypoadrenocorticism. The adrenal glands on both sides were shorter (range: left adrenal gland length, 10.0 to 19.7 mm; right adrenal gland length, 9.5 to 18.8 mm) and thinner (range: left adrenal gland thickness, 2.2 to 3.0 mm; right adrenal gland thickness, 2.2 to 3.4 mm) than in normal dogs (range: left adrenal gland length, 13.2 to 26.3 mm; right adrenal gland length, 12.4 to 22.6 mm; left adrenal gland thickness, 3.0 to 5.2 mm; right adrenal gland thickness, 3.1 to 6.0 mm). Statistical analysis revealed a significant reduction in size of the left adrenal gland (p less than 0.05) in dogs with hypoadrenocorticism compared to the left adrenal gland in normal dogs. The results of this study show that atrophy of the adrenal glands in dogs with hypoadrenocorticism seems to lead to an ultrasonographic-measurable reduction in size of the adrenal glands.