Cholesterol granuloma as long-term complication of total ear canal ablation in a dog

A 13-year-old cocker spaniel presented with pain on opening the mouth. History of a previous left total ear canal ablation with lateral bulla osteotomy, left intermittent facial palsy and left intermittent head tilt suggested progression of a total ear canal ablation with lateral bulla osteotomy complication. Magnetic resonance imaging revealed a large mass arising from the tympanic bulla. Cytology of aspirates revealed a chronic suppurative inflammatory reaction and numerous cholesterol crystals. The mass was removed by surgical excision and an active drainage system was placed for a few days. The head tilt, facial palsy and apparent pain were resolved by the surgery. Physical examination was unremarkable nine months postoperatively. Bacterial cultures of the collected fluid were negative and histological examination confirmed the diagnosis of a cholesterol granuloma.     

Massive haemorrhage associated with inadvertent incision of a suspected carotid artery pseudoaneurysm in a cat

A 12‐year‐old, castrated male, domestic long‐haired cat experienced massive haemorrhage associated with an incision of a swelling on the neck 2 weeks after right‐sided ventral bulla osteotomy. Emergent control of haemorrhage was gained through unilateral carotid artery ligation. Cardiopulmonary resuscitation was provided in conjunction with massive blood transfusion. The cat made an unremarkable recovery. Carotid artery pseudoaneurysm due to surgical disruption of the carotid artery during ventral bulla osteotomy, specifically through the use of self‐retaining retractors, was suspected. This case highlights the development of pseudoaneurysm as a potential complication of head and neck surgery, and additionally describes a case of massive transfusion in a cat.     

RADIOGRAPHIC IMAGING OF OTITIS MEDIA AND INTERNA IN PIGS

Middle and inner ear infections have been reported as a clinical entity in swine, other animal species and humans. In pigs, the anatomical-pathological and microbiological findings have been described. In this report, we describe radiographic findings in affected pigs. A total of 25 pigs with a head tilt and circling, as clinical signs of otitis media and interna, were examined. The majority were weaner-pigs with dyspnea or rhinitis. In radiographs, there was an increased opacity of the bulla tympanica, often accompanied by marginal destruction or thickening of the bulla wall. The radiographic findings confirmed the clinical diagnosis in each affected pig, but there were 5 false positive interpretations.     

Endogenous endophthalmitis caused by Enterococcus faecalis in a cat

A three‐year‐old male neutered domestic shorthair cat was presented for loss of vision associated with hyperthermia, lethargy and anorexia. Ophthalmic examination revealed a bilateral panuveitis. Cytological examination of aqueous and vitreous humours was performed and revealed a suppurative inflammation associated with numerous cocci. Enterococcus faecalis was identified by bacterial culture from aqueous and vitreous humour. No primary infection site was identified. Active uveitis resolved after systemic antibiotic therapy, but the vision loss was permanent. To the authors’ knowledge, this is the first reported case of endogenous bacterial endophthalmitis secondary to E. faecalis infection in a cat.     

Cholesterol granuloma associated with otitis media and destruction of the tympanic bulla in a dog

An 8-year-old, male neutered Irish Setter was presented with a 2-week history of pain upon opening the mouth and chronic otitis externa. Computed tomography examination revealed destruction of the left tympanic bulla with a soft-tissue density within the remains of the tympanic cavity. Cytology of aspirates collected from tissue adjacent to the tympanic bulla revealed suppurative inflammation and bacteria. A ventral bulla osteotomy was performed. Histopathology of granulation tissue within the remains of the tympanic cavity was diagnostic of cholesterol granuloma.     

COMPUTED TOMOGRAPHY-GUIDED PERCUTANEOUS BIOPSY IN THE DOG AND CAT: DESCRIPTION OF TECHNIQUE AND PRELIMINARY EVALUATION IN 14 PATIENTS

A technique for computed tomography (CT)-guided percutaneous biopsy described for use in humans was adapted to the dog and cat and is evaluated in 14 patients. Nine retrobulbar, 1 cranial mediastinal and 4 pulmonary masses and 1 hilar lymph node were biopsied in 13 dogs and 1 cat. Tissue samples sufficient for diagnosis were obtained in 12 of the 15 lesions. Diagnoses were made following cytologic (3/12) or histopathologic (3/12) evaluation or both (6/12) and included retrobulbar lymphoma, carcinoma, spindle cell sarcoma and suppurative inflammation; pulmonary carcinoma, granuloma and eosinophilic/histiocytic inflammation; nasal carcinoma, thymoma and metastatic carcinoma of a hilar lymph node. In each patient, the needle tip was identified within the lesion on the CT image. The primary limitation was non-diagnostic samples in 3 of 15 lesions due to necrosis or insufficient tissue. Complications were minor. In addition to biopsy guidance, CT imaging provided information not obtainable with fluoroscopy or ultrasonography which assisted in tumor staging and therapy planning. Although a larger number of patients and biopsy locations would be required for a thorough assessment, the free-hand technique described in this preliminary report appeared to be a safe and useful option of biopsy guidance in the dog and cat.     

Computed tomographic evidence of bulla effusion in cats with sinonasal disease: 2001-2004

BACKGROUND: Sinonasal disease is common in cats; chronic inflammatory disease and neoplasia are diagnosed most frequently. Radiographic and computed tomographic (CT) findings in nasal disease have been reported, although involvement of other cranial structures has not been fully described to our knowledge. HYPOTHESIS: We hypothesized that neoplastic or inflammatory obstruction of the auditory tube associated with sinonasal disease could result in CT evidence of effusive bulla disease in affected cats. ANIMALS: 46 cats with sinonasal disease, 18 control cats. METHODS: CT images acquired in cats with (n = 46) and without (n = 18) sinonasal disease were reviewed for evidence of concurrent bulla effusion. CT findings of soft tissue or fluid opacity within the tympanic bulla or thickening of the bone of the bullae were considered evidence of effusive bulla disease. RESULTS: The prevalence of bulla effusion in cats with sinonasal disease was 28% (13/46) and was significantly higher than that observed in cats without sinonasal disease (1/18, P = .043). CT findings that were found in association with effusive bulla disease included imaging features of sinusitis and nasopharyngeal disease. The most common neoplasm associated with bulla effusion was nasopharyngeal lymphoma. Bulla effusion was not observed in any cat with nasal carcinoma. CONCLUSIONS AND CLINICAL IMPORTANCE: Findings of this study suggest that auditory canal dysfunction may play a larger role in feline sinonasal disease than was previously recognized. The implications of these findings for management of cats with chronic inflammatory or neoplastic sinonasal disease require further investigation.     

Middle ear tumours with brainstem extension treated by ventral bulla osteotomy and craniectomy in two cats

Two geriatric domestic shorthaired cats (DSH) were treated surgically with a ventral bulla osteotomy and craniectomy for middle ear tumours that invaded the calvarium. Both cats had a history of vestibular disease. One cat had a normal neurological examination. Both cats underwent computed tomographic imaging of the head. After intravenous injection of an iodinated contrast material, one cat had a ring‐enhancing intracranial lesion and the other had a uniform contrast‐enhancing intracranial lesion, which either communicated with the bulla or was associated with bulla osseous lysis/production. One cat had a papillary adenoma and the other had an adenocarcinoma. Both cats had prolonged survivals (630 days; alive and lost to follow‐up at 840 days), which is longer than reported in cats with middle ear neoplasia. Craniectomy, in addition to ventral bulla osteotomy, may be part of the treatment plan for middle ear tumours that invade the calvarium.     

ASSESSMENT OF THREE RADIOGRAPHIC PROJECTIONS FOR DETECTION OF FLUID IN THE RABBIT TYMPANIC BULLA

Otitis media in the rabbit commonly results in fluid accumulation in the tympanic bulla. Radiographic detection of fluid in the tympanic bulla is only moderately sensitive in the dog and cat. The purpose of this study was to investigate the accuracy of radiographic detection of fluid in the rabbit tympanic bulla for three different radiographic projections. Forty rabbit cadavers were used. Half of the tympanic bullae were randomly allocated to be filled with soft tissue material. Following this procedure, each specimen was radiographed in three projections: dorsoventral (DV), rostro 40° ventral-caudodorsal (R40°V-CdDO), and left and right latero 40° ventral-laterodorsal (Lat40°V-LatDO). After imaging, each specimen was frozen and sectioned to determine the content of the tympanic bullae. Images were interpreted and scored independently by two board-certified radiologists. There was no significant difference in sensitivity or specificity between the three projections when compared with the gross findings following sectioning, but observer confidence was highest for the DV projection. Accuracy of radiographic fluid detection was similar to that reported in the dog and cat. The DV and R40°V-CdDO allow comparison of both tympanic bullae on a single radiograph, but the DV was subjectively easier to position, while the Lat40°V-LatDO requires two radiographs for comparison.     

Traumatic tympanic bulla fracture

A Pekingese dog was presented for evaluation of head trauma with ventral head and neck swelling, puncture wounds, palpable mandibular fractures, and loss of menace, severe miosis, and loss of palpebral reflex of the right eye. Computed tomography confirmed multiple mandibular and zygomatic fractures, a right ear canal avulsion, and a complete right tympanic bulla fracture with ventral displacement. The tympanic bulla fracture was managed conservatively. Topical lubrication and antibiotic ointment was prescribed for the right eye. A subtotal hemimandibulectomy was performed to address the mandibular fractures. A temporary oesophagostomy feeding tube was placed. No short‐term complications developed as a result of the fractured bulla and avulsed ear canal being left in situ, and no complications were reported 18 months after the injury. To the authors’ knowledge this is the first report of a traumatic tympanic bulla fracture in the dog.     

Squamous cell carcinoma causing blindness and ophthalmoplegia in a cat

Ophthalmoplegia and blindness caused by squamous cell carcinoma were reported in a cat. Unilateral functional deficits of cranial nerves II, III, IV, and VI and of the sympathetic nerve supply caused blindness, complete ophthalmoplegia, and Horner syndrome. Radiography and computed tomography revealed a proliferating bony lesion associated with the right tympanic bulla, right temporal bone, right side of the mandible, and left frontal bone. A focal area of bony destruction involved the right sphenoid bone. The cat was euthanatized and necropsied. Squamous cell carcinoma was identified invading the bones and rostral part of the right side of the skull. The tumor had extended through the sphenoid bones into the region of the cavernous sinus and had surrounded the cranial nerves passing through this region. It also had invested connective tissue surrounding the optic nerves and had invaded the right globe through the lamina cribrosa. This represents an unusual distribution for ocular cranial squamous cell carcinoma in a cat.     

COMPUTED TOMOGRAPHIC APPEARANCE OF INFLAMMATORY POLYPS IN THREE CATS

This report describes the use of computed tomography (CT) to evaluate the inner ear, tympanic bullae, nasopharyngeal area, and external ear canals of three cats. All cats presented for evaluation of upper respiratory signs or chronic ear infection. Nasopharyngeal masses were present in two cats, and a mass in the external ear canal was present in the third cat. In all three cats, CT was able to define the extent of osseous bulla involvement, which was confirmed at surgery. Computed tomography also defined the extent of the polyp in the nasopharyngeal area in two cats, and in the external ear canal in one cat. Surgical removal of the polyps was accomplished with a combined oral approach and ventral bulla osteotomy in cats 1 and 2. The polyp was removed from cat 3 using a combination of ventral bulla osteotomy and excision of the mass through the external ear canal. Microscopic examination confirmed all masses as nasopharyngeal (inflammatory) polyps.     

Meningoencephalomyelitis in a foal due to Salmonella agona infection

CASE HISTORY: A neonatal Thoroughbred foal was presented with rib fractures and left forelimb lameness secondary to dystocia. CLINICAL FINDINGS: The foal developed a head tilt, seizures and watery diarrhoea during hospitalisation and died at 7 days of age. Histological examination of the brain and spinal cord revealed a suppurative meningoencephalomyelitis with vasculitis, and numerous intralesional, gram-negative bacilli. Similar microscopic lesions were noted in the lungs, renal medullary interstitium, and umbilicus. Bacilli in the brain, spinal cord and umbilicus were identified immunohistochemically as Salmonella group B. Salmonella agona was isolated in pure culture from the brain, lung, liver, kidney, and intestine. CONCLUSION: This is the first report of meningoencephalomyelitis and septicaemia due to Salmonella infection in an equine neonate.     

Primary central nervous system T-cell lymphoma mimicking meningoencephalomyelitis in a cat

A cat was presented with right head tilt and circling. The lack of expression of virus antigens did not support the postmortem diagnosis of encephalomyelitis pointing to a diffuse primary central nervous system T-cell lymphoma on the basis of CD3 and CD45R co-expression with absence of CD79α staining.     

Total Ear Canal Ablation Combined with Lateral Bulla Osteotomy for End-Stage Otitis in Dogs Results in Thirty Dogs

Thirty dogs with end-stage otitis were treated by either unilateral or bilateral total ear canal ablation and lateral bulla osteotomy. Otitis was considered end stage when the horizontal ear canal was collapsed, stenotic, or occluded in conjunction with chronic infection of the external and middle ear. The dogs were evaluated clinically and radiographically for 4 to 63 months. The frequency of scratching, head shaking, aural drainage, and para-aural fistulation was significantly decreased. Abnormal ear carriage and head tilt were not changed. The results in 23 dogs were graded as excellent or improved. One dog died of intraoperative hemorrhage. Complications during the period from suture removal to follow-up included para-aural fistulation (3 dogs), facial nerve paralysis (5 dogs), and head tilt (3 dogs).     

Salivary Gland Adenocarcinoma in a Domestic Rabbit (Oryctolagus cuniculus)

A 2.4 kg, 7-year-old, female Rex rabbit was presented with a 4-month history of a left-sided head tilt, difficulty in mastication, lethargy, and chronic wasting. Diagnostic testing of the patient revealed a severe heterophilic leukocytosis and radiographic images of the skull radiographs indicated irregularity of the left tympanic bulla. A computed tomographic scan highlighted a heterogeneously contrast-enhancing mass, ventral and rostral to the left tympanic bulla, with contrast enhancement of the meninges on the left, consistent with an aggressive neoplasm. The patient was euthanized and the mass was identified as a salivary gland adenocarcinoma. The gland of origin is suspected to be the left parotid, owing to its location and close association with normal parotid tissue. To the authors' knowledge, this is the first report of a salivary gland adenocarcinoma in a domestic rabbit. A computed tomography (CT) scan and histopathology examination were useful modalities for identifying the neoplasm in this case.     

Dysgonic strain of Microsporum canis pseudomycetoma in a Domestic Long-hair cat

A 4-year-old Domestic Long-hair cat was presented with two large non-painful, ulcerated and suppurative lesions over the flanks. Histopathology and cytology were consistent with fungal pyogranulomatous inflammation. Culture of tissue yielded a dysgonic strain of Microsporum canis. The cat was treated successfully by staged en bloc resections of the lesions, followed by oral ketoconazole, then oral terbinafine. This is the first reported case of dermatophytic pseudomycetoma in a Domestic Long-hair cat in Australia.     

Clinical and pathological features of a cerebellar oligodendroglioma in a cat

A cerebellar oligodendroglioma was responsible for the progressive development of neurological deficits in a six-year-old castrated male domestic longhaired cat. These abnormalities included a head tilt and loss of balance, nystagmus, proprioceptive deficits and eventually a fine head tremor and hypermetria of the forelimbs. The tumour was found to have destroyed most of the cerebellar grey matter, the flocculus, and the cerebellar roof nuclei on the right hand side. Increased peri-axonal space and axonal vacuolation were visible in fibre tracts which connected to the cerebellum. The clinical signs and location of the tumour are related to the functional anatomy of the cerebellum.     

Enterococcus hirae enteropathy with ascending cholangitis and pancreatitis in a kitten

A 2-month-old female Persian cat that had been showing episodes of anorexia and diarrhea for the previous 4 weeks was presented in shock and died 2 days later. Numerous Gram-positive cocci were located along the brush border of small intestinal villi, without significant inflammatory infiltration. Similar bacteria were present within hepatic bile ducts and pancreatic ducts and were associated with suppurative inflammation and exfoliation of epithelial cells. Culture of the liver and lung yielded bacteria identified as Enterococcus hirae. Fecal culture from an asymptomatic adult female from the same cattery also yielded large numbers of E. hirae. To our knowledge, this is the first report of E. hirae enteropathy in a cat and the first report of ascending cholangitis and ductal pancreatitis caused by an Enterococcus spp.