The incidence of thoracic trauma in dogs with skeletal injury

One hundred dogs with skeletal injury were evaluated for co-existing thoracic abnormalities. Parameters used to assess thoracic trauma were physical examination, thoracic radiographs, electrocardiograms and arterial blood gas PaO₂. Thoracic abnormalities were found in 57 per cent of the dogs. Within this group, 77 per cent had abnormal thoracic radiographs, 44 per cent had abnormal low PaO₂, and 30 per cent had cardiac arrhythmias. No clinical signs suggestive of thoracic injury were found on physical examination in 79 per cent of the dogs with thoracic lesions.     

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.     

USE OF RADIOGRAPHY IN COMBINATION WITH COMPUTED TOMOGRAPHY FOR THE ASSESSMENT OF NONCARDIAC THORACIC DISEASE IN THE DOG AND CAT

Computed tomography (CT) of the thorax was performed in 28 dogs and five cats and findings were compared with previous thoracic radiographs. The sample population included all animals that had thoracic radiographs and a CT study within 5 days of each other, where the complete imaging studies were available for review. Thoracic radiographs were considered indeterminate in 31 patients and CT examinations were done to acquire additional information. The presence of additional information from CT relating to presence of pathology, location of pathology, extent of pathology, and involvement of mediastinal structures was recorded. Whether there was a change in diagnosis based on the CT findings was also recorded. In only 4/33 animals (all dogs) did CT fail to provide any new information for the parameters evaluated when compared with survey thoracic radiographs. Additional information about the pathology that was present was gained by CT in 5/5 cats and 21/ 28 dogs. New information on compartmental location of pathology was seen in 4/5 cats and 19/28 dogs. New information on pathology extent was noted in 5/5 cats and 20/28 dogs. Additional information regarding involvement of mediastinal structures was obtained in 2/5 cats and 10/28 dogs. A change in diagnosis was made in 3/5 cats and 13/28 dogs. In conclusion, CT is a valuable tool for evaluating intrathoracic disease. CT provides additional cross-sectional anatomic information that can aid in anatomic localization and evaluation of the extent of the pathology in question.     

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.     

Prediction of clinically important acquired cardiac disease without an echocardiogram in large breed dogs using a combination of clinical,radiographic and electrocardiographic variables

IntroductionLarge breed (LB) dogs develop dilated cardiomyopathy (DCM) and myxomatous mitral valve disease (MMVD). Echocardiography is required for a definitive diagnosis but is not always available. Our objective was to assess the clinical utility of thoracic radiographs alone and in combination with physical examination and electrocardiography findings for the prediction of clinically important DCM or MMVD in LB dogs.AnimalsFour hundred fifty-five client-owned dogs ≥20 kg with concurrent thoracic radiographs and echocardiogram.Materials and methodsMedical records were reviewed and stored thoracic radiographs and echocardiographic images were measured to classify dogs as normal heart size (NHS), preclinical DCM, clinical DCM, preclinical MMVD (with cardiomegaly), clinical MMVD, or equivocal. Dogs with preclinical MMVD, without cardiomegaly, were classified as NHS. Vertebral heart size (VHS) and vertebral left atrial size (VLAS) were measured. Receiver operating characteristic curves and prediction models were derived.ResultsPrevalence of MMVD (39.3%) was higher than the prevalence of DCM (24.8%), though most MMVD dogs (67.0%) lacked cardiomegaly and were classified as NHS for analysis. The area under the curve for VHS to discriminate between NHS and clinical DCM/MMVD or preclinical DCM/MMVD was 0.861 and 0.712, respectively, while for VLAS, it was 0.891 and 0.722, respectively. Predictive models incorporating physical examination and electrocardiography findings in addition to VHS/VLAS increased area under the curve to 0.978 (NHS vs. clinical DCM/MMVD) and 0.829 (NHS vs. preclinical DCM/MMVD).ConclusionsThoracic radiographs were useful for predicting clinically important DCM or MMVD in LB dogs, with improved discriminatory ability when physical examination abnormalities and arrhythmias were accounted for.     

Frequency of pulmonary mineralization and hypoxemia in 21 dogs with pituitary-dependent hyperadrenocorticism

The purpose of this study was to determine the frequency of hypoxemia and pulmonary mineralization using ^99mTc-methylene diphosphonate (^99mTc-MDP) in dogs with pituitary-dependent hyperadrenocorticism (PDH). Twenty-one dogs with PDH were pro-spectively evaluated using thoracic radiography, arterial blood gas analysis, and bone phase and pulmonary perfusion scintigraphy (using ^99mTc-macro-aggregated albumin [^99mTc-MAA]). The radiographs and bone and perfusion studies were evaluated subjectively. An averaged quantitative count density ratio was calculated between the thorax and cranial thoraco-lumbar vertebrae from lateral thoracic ^99mTc-MDP images. Thoracic: vertebral ratios were calculated using ^99mTc-MDP studies from 21 control dogs. The thoracic: vertebral ratios were compared between the 2 groups (PDH and control). The mean age (±SD) of the 21 PDH dogs was 10.2 (±3) years, whereas the mean age of the control group was 9.8 (±3) years. Seven of the 21 dogs with PDH were hypoxemic (denned as an arterial partial pressure of oxygen [PaO₂] <80 mm Hg) with an average PaO₂ (±SD) of 62 (±15) mm Hg. Of the 7 hypoxemic dogs, 2 were found to have pulmonary mineralization based on bone scintigraphic images. Pulmonary perfusion abnormalities were not identified using ^99mTc-MAA in any of the 21 PDH dogs. Six PDH dogs had an abnormal interstitial pulmonary pattern and 5 of these dogs were hypoxemic. The average quantitative thoracic: vertebral ratio was not significantly different between the PDH and control dogs (0.5 ± 0.4 versus 0.4 ± 0.1, P = .16). Causes of hypoxemia other than pulmonary thromboembolism should be considered in dogs with PDH. Pulmonary mineralization may contribute to hypoxemia in dogs with PDH.     

Ventricular Arrhythmias in Dogs With Splenic Masses

The records of 73 dogs with splenic masses were evaluated retrospectively to determine whether ventricular arrhythmias, in the absence of clinically apparent underlying heart disease, were a common clinical finding. Associated clinical, laboratory, and pathologic findings were evaluated to search for clinical predictors of ventricular arrhythmias. Age, breed, weight, sex, coagulation abnormalities, electrolyte abnormalities, and hemoabdomen were unrelated to the development of arrhythmias (p > 0.05). Anemia was associated with the presence of arrhythmias (p = 0.005). Myocardial necrosis (10/18) and metastatic hemangiosarcoma (3/18) were common myocardial histopathologic findings. Proposed causes for arrhythmias in dogs with splenic masses include myocardial metastases, tissue hypoxia secondary to anemia or hypovolemia, and local or systemic catecholamine release.     

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.     

THE EFFECT OF POSITIONING ON THE APPEARANCE OF SELECTED CRANIAL THORACIC STRUCTURES IN THE DOG

In this retrospective study the effect of thoracic positioning on the visibility and size of selected cranial thoracic structures in dogs was investigated. Dorsoventral (DV), ventrodorsal (VD) as well as left lateral recumbent (LLR) and right lateral recumbent (RLR) thoracic radiographs of 17 large, 15 medium, and 10 small skeletally mature dogs were evaluated. The craniodorsal and cranioventral mediastinum, the cupula pleura and sternal lymph nodes were examined. The effect of obesity was also evaluated. The craniodorsal mediastinum was better delineated on DV radiographs and was wider on VD radiographs. The craniodorsal mediastinal width: width of T2 cranial end-plate on VD radiographs was 2.41 for all groups combined and obesity significantly influenced this value. The cranioventral mediastinum was more visible in RLR and VD radiographs. A normal sternal lymph node soft tissue opacity was seen most commonly in RLR in large breed dogs and had a mean length of 30 mm. The pulmonary cupula extended beyond the first rib on all views and extended more cranially and was better visualised on VD than DV views.     

THE EFFECT OF DORSAL VERSUS VENTRAL RECUMBENCY ON THE RADIOGRAPHIC APPEARANCE OF THE CANINE THORAX

The thorax of nine dogs was radiographed with a vertical beam in both dorsal (VD) and ventral (DV) recumbency. The radiographs were evaluated subjectively and objectively for differences in appearance. To help explain appearance differences, lateral thoracic radiographs were made with the dogs in dorsal and ventral recumbency using a horizontally (laterally) directed x-ray beam. The appearance of thoracic viscera in VD and DV vertical beam radiographs differed. In VD vertical beam radiographs the craniocaudal axis of the heart appeared longer, the heart had a more consistent positional relationship to the thoracic spine, a larger area of the accessory lung lobe was visible, and a greater length of the caudal vena cava was visible. In DV radiographs the caudal lobar pulmonary arteries were more easily identified. The selection of dorsal versus ventral recumbency for thoracic radiography should be based on the clinical status of the patient and the reason(s) for which the radiograph is being made.     

Electrocardiographic findings in dogs with motor vehicle-related trauma

Motor vehicle-related injury is the most common form of trauma incurred by dogs, and cardiac arrhythmias are a well-recognized complication. Although posttraumatic arrhythmias are often observed, little is known regarding their frequency. This study utilized continuous ambulatory electrocardiography (i.e., Holter monitoring) to describe the cardiac rhythm disturbances in 30 dogs sustaining trauma in motor vehicle accidents. Ventricular ectopy was identified by Holter monitoring in 29 of 30 dogs, although the initial electrocardiogram (EKG) only documented ventricular ectopic complexes (VECs) in four dogs. Ventricular ectopy was infrequent in most dogs (i.e., 62% of the dogs had less than 100 VECs per day for the entire study), but 16% developed frequent arrhythmias (greater than 4,000 VECs per day). In all cases, the VECs were observed within 24 hours of injury. Forty-three percent of dogs had at least one episode of ventricular tachycardia, including several dogs that had an overall infrequent rate of VECs (i.e., less than 100 or 100 to 1,000 VECs per day). Although baseline EKGs are useful in identifying arrhythmias in most dogs, the length of the recording should be increased to improve the likelihood of observing an abnormal EKG event. Most importantly, additional EKGs should be obtained or continuous EKG monitoring should be performed in dogs that display clinical signs that could be attributed to ventricular arrhythmias.     

Clinical findings and diagnostic value of post-traumatic thoracic radiographs in dogs and cats with blunt trauma

Objective: To characterize the clinical findings in dogs and cats that sustained blunt trauma and to compare clinical respiratory examination results with post‐traumatic thoracic radiography findings. Design: Retrospective clinical study. Setting: University small animal teaching hospital. Animals, interventions and measurements: Case records of 63 dogs and 96 cats presenting with a history of blunt trauma and thoracic radiographs between September 2001 and May 2003 were examined. Clinical signs of respiratory distress (respiratory rate (RR), pulmonary auscultation) and outcome were compared with radiographic signs of blunt trauma. Results: Forty‐nine percent of dogs and 63.5% of cats had radiographic signs attributed to thoracic trauma. Twenty‐two percent of dogs and 28% of cats had normal radiographs. Abnormal auscultation results were significantly associated with radiographic signs of thoracic trauma, radiography score and presence and degree of contusions. Seventy‐two percent of animals with no other injuries showed signs of thoracic trauma on chest radiographs. No correlation was found between the radiographic findings and outcome, whereas the trauma score at presentation was significantly associated with outcome and with signs of chest trauma but not with the radiography score. Conclusion: Thoracic trauma is encountered in many blunt trauma patients. The RR of animals with blunt trauma is not useful in predicting thoracic injury, whereas abnormal chest auscultation results are indicative of chest abnormalities. Thorough chest auscultation is, therefore, mandatory in all trauma animals and might help in the assessment of necessity of chest radiographs.     

Ventricular Tachyarrhythmias in 106 Cats: Associated Structural Cardiac Disorders

Background: Ventricular tachyarrhythmias occur in association with cardiac and extracardiac disorders in many species of animals, but information identifying concurrent disorders in cats with such arrhythmias is scarce. Methods: We investigated coexisting diseases by retrospectively evaluating medical records of cats with ventricular tachyarrhythmias seen during a 51‐month period at 1 institution. For comparative purposes, we evaluated records of dogs with similar arrhythmias during the same time period. All cats and dogs had premature ventricular complexes, accelerated idioventricular rhythm, ventricular tachycardia, or some combination of these arrhythmias, and all had undergone echocardiography during the same visit that led to the diagnosis of ventricular tachyarrhythmia. Results and Conclusions: Most (102/106; 96%) cats had at least 1 echocardiographically apparent abnormality concurrent with ventricular tachyarrhythmias. Ventricular tachyarrhythmias in cats were most commonly associated with myocardial disease (eg, left ventricular concentric hypertrophy [n = 66], restrictive or unclassified cardiomyopathy [n = 17], and dilated cardiomyopathy [n = 6]). When comparing dogs and cats that had ventricular tachyarrhythmias and were diagnosed on the same clinical service of the same institution, an echocardiographically apparent cardiac lesion was seen more often in cats (102/106, 96%) than in dogs (95/138, 69%) (P < .001).     

THORACIC RADIOGRAPHIC FINDINGS IN DOGS INFECTED WITH RICKETTSIA RICKETTSII

Sixteen beagle dogs were injected intradermally with Rickettsia rickettsii. The dogs were divided into four groups (n=4):1) infected, non-treated withdoxycycline;3) infected, treated with doxycycline and an anti-inflammatory dose of corticosteroid;4) infected, treated with ocular fluoresein angiograhphy was performed on days 6, 10, 17 post-inoculatin.A mild interstitial lung opacitywas noted in4/16 dogs on day 6, 5/16 on day 10 and 17 post-inculatin. Increased retinal vascular permeability was noted n 8/16 dogs on day 6,3/16 on day 10 and 1/16 on day 17 post-inoculation. Correlatin between the presence of radiographic and retinal lesions was not signigicant (p=0.08). Elevan, naturally infected, dogs with thoracic radiographs and an final diagnosis of RMSF were also evluated. Four of the 11 dogs had an unstructu4red inteerstitial pattern. Dogs with acute, experimentally-infected or naturally-occurring RMSF may have subtle pulmonary changes characterized by an unstructured interstitial patteern.     

Primary renal neoplasia of dogs

BACKGROUND: Primary renal tumors are diagnosed uncommonly in dogs. HYPOTHESIS: Signs and survival will differ among different categories of primary renal tumors. ANIMALS: Data were collected from the medical records of 82 dogs with primary renal tumors diagnosed by examination of tissue obtained by ultrasound-guided biopsy, needle aspiration, surgery, or at postmortem examination. METHODS: This was a multi-institutional, retrospective study. RESULTS: Forty-nine dogs had carcinomas, 28 had sarcomas, and 5 had nephroblastomas. The dogs were geriatric (mean 8.1 years; range: 1-17) with a weight of 24.9 kg (range: 4.5-80). Tumors occurred with equal frequency in each kidney with 4% occurring bilaterally. Initial signs included one or more of hematuria, inappetance, lethargy. weight loss, or a palpable abdominal mass. Pain was reported more frequently in dogs with sarcomas (5/28). The most common hematologic abnormalities were neutrophilia (22/63), anemia (21/64), and thrombocytopenia (6/68). Polycythemia was present in 3 dogs and resolved with treatment. Hematuria (28/49), pyuria (26/49), proteinuria (24/50), and isosthenuria (20/56) were the most frequently observed abnormalities on urinalysis. Pulmonary metastases were noted on thoracic radiographs in 16% of dogs at diagnosis. Seventy-seven percent of dogs had metastatic disease at the time of death. Median survival for dogs with carcinomas was 16 months (range 0-59 months), for dogs with sarcomas 9 months (range 0-70 months), and for dogs with nephroblastomas 6 months (range 0-6 months). CONCLUSIONS AND CLINICAL IMPORTANCE: Primary renal tumors in dogs are generally highly malignant with surgery being the only treatment that improves survival.     

THORACIC METASTASES OF CANINE MAMMARY GLAND TUMORS

The absence or presence of metastases on thoracic radiographs in 55 female dogs with mammary gland tumors was assessed by comparing the results of a single radiographic examination, using dorsoventral and left lateral views, with clinical and histologic follow-up data. Radiographic abnormalities found in dogs with thoracic metastases were classified as well-defined pulmonary nodules, ill-defined pulmonary nodules, and involvement of pleural effusion. No obvious difference in the effect on the right or left lung lobes was found. The sensitivity, specificity and accuracy for the detection of thoracic metastases were 65%, 97%, and 87%, respectively.     

Radiographic abnormalities in canine multicentric lymphoma: A review of 84 cases

The thoracic and abdominal radiographs of 84 dogs with multlcentric lymphoma were examined to identlfy the radiological abnormalities. The frequency of occurrence of individual changes, role of radiography in diagnosis, relationship of radiographic changes to hypercalcaemla and prognostic relevance of radiographic flndlngs were assessed. Multiple abnormalities were more commonly seen than solitary changes. No radiographic abnormalities were seen In approximately one quarter of thoracic radiographs and one fifth of abdominal radiographs. Lymphoma could not be diagnosed on the basis of radiographs alone. Many of the features of lymphoma were non-speclflc, having numerous possible causes. Cranial mediastinai disease was neither a prerequisite for, nor a disproportionately common flnding in, hypercaicaemic patients. The absence of radiological abnormalities may be a positive prognostic indicator but, in general, radiology had no place as a prognostic Indicator for the Individual patient. The differential diagnoses for the radlographlc abnormalities seen in lymphoma are discussed.     

Canine Chronic Bronchitis

Eighteen dogs with chronic bronchitis were studied using physiologic, radiologic, microbiologic, and pathologic techniques. Twelve of these dogs were evaluated before and after two weeks of oral bronchodilator administration. Thoracic radiographs, tidal breathing flow-volume loops, radioaerosol ventilation scans, airway appearance at bronchoscopy, and airway pathology were abnormal in the majority of dogs studied. There was a significant relationship between abnormal ventilation scans and abnormal results for PaO2 and end-tidal airflow. Bronchoscopy revealed excessive mucus and inflammation of airway mucosa in all 16 dogs undergoing this procedure. Endoscopically obtained aerobic bacterial cultures grew mixed bacterial flora in only three dogs. Increased numbers of neutrophils in 14 dogs were detected by airway lavage cytology. A large number of eosinophils were seen in airway lavages obtained from two dogs; these two dogs also had evidence for eosinophilic bronchitis on endobronchial biopsy. Oral bronchodilator administration resulted in clinical and expiratory airflow improvements in most dogs, but had no effect on PaO2 or on the radioaerosol-scan abnormalities. The presence of both the physiologic and pathologic airway abnormalities of chronic bronchitis in dogs presented to a veterinary hospital with chronic unexplained cough was confirmed, suggesting that aerobic bacteria do not play an etiologic role in most cases.     

Cranial vena cava aneurysm in a dog

A 1.5-year-old mixed breed dog was presented for evaluation of arrhythmia and a cranial mediastinal density was noted on thoracic radiographs. The density was determined to be a cranial vena cava aneurysm based on ultrasonographic and angiographic testing. No treatment was initiated and the dog remains asymptomatic for the cranial vena cava aneurysm at 6 years of age. Although rare, cranial vena cava aneurysm should be a differential diagnosis for dogs with cranial mediastinal abnormalities on thoracic radiographs.     

Lymphography of the thoracic duct by percutaneous injection of iohexol into the popliteal lymph node of dogs: experimental study and clinical application

OBJECTIVE: To evaluate the efficacy of percutaneous administration of iohexol into the popliteal lymph node as a non-invasive technique for thoracic duct lymphangiography in dogs. STUDY DESIGN: Experimental study and clinical report. ANIMALS: Normal adult dogs (n=4) and 1 dog with recurrent chylothorax. METHODS: For the experimental study, 4 dogs (weight, 8.4-12.3 kg) had 5-10 mL iohexol injected percutaneously into 1 popliteal lymph node and then thoracic radiographs were taken. Popliteal lymph nodes were examined by histopathology 8 days later. One 25-kg dog with recurrent chylothorax had 25 mL iohexol injected into the right popliteal lymph node followed by thoracic radiography. RESULTS: In experimental dogs, the thoracic duct was best visualized on thoracic radiographs after administration of 10 mL iohexol. Clinically, no abnormalities were identified in the injected limb and except for 1 dog that had large numbers of siderocytes and erythrophagocytic macrophages in the injected lymph node, the histopathologic findings in the other injected popliteal lymph nodes were not different from contralateral nodes. In the clinical case, the thoracic duct was visualized, but there was leakage of iohexol around the node. CONCLUSION: The thoracic duct in dogs can be visualized by lymphography after percutaneous injection of iohexol (1 mL/kg at 2 mL/min) into the popliteal lymph node. CLINICAL RELEVANCE: Percutaneous popliteal lymph node administration of iohexol should be considered as an alternative to mesenteric lymph node injection for radiographic identification of the thoracic duct in dogs.