Treatment of a malignant pheochromocytoma in a dog using 131I metaiodobenzylguanidine

A 12 yr old castrated male Yorkshire terrier was presented with a history of an inoperable pheochromocytoma. Physical examination revealed a large, midabdominal mass. Neurologic examination was normal at presentation. An abdominal computed tomography scan revealed a 215 cm(3) mass in the region of the right kidney. Forty-eight hours after IV injection of 370 megabecquerels (MBq, equivalent to10 millicuries [mCi]) of metaiodobenzylguanidine labeled with radioactive iodine ([(131)I]MIBG), standard planar scintigraphy was performed. A diffuse area of moderate uptake was noted in the midabdominal region. The dog experienced stable disease for 1.5 mo after injection based on a follow-up computed tomography (CT) scan; however, 5 mo after injection, repeat CT imaging revealed progression of the tumor, and a second IV injection of 370 MBq (10 mCi) of [(131)I]MIBG was administered. The dog died 3 wk after the second injection as a result of gastrointestinal blood loss that was believed to be caused by compression-induced bowel ischemia by the mass. A full necropsy was not performed, but the mass was removed for histologic evaluation, which confirmed the diagnosis of pheochromocytoma. This report is the first to document the treatment of canine pheochromocytoma using [(131)I]MIBG.     

Computertomographic characteristics of primary brain tumors in dogs and cats

Since computed tomography (CT) was introduced to veterinary medicine in the beginnings of the 80s, the CT of the skull has mainly been used for the diagnosis of brain tumors. The present study includes 18 dogs and five cats, all patients of the Clinic of Small Animals of the School of Veterinary Medicine Hannover. After a CT of their skull was made, a primary intracranial neoplasm was confirmed by a pathomorphological and -histogical examination post mortem. Four of the five cats had a meningioma, one cat an astrocytoma. With five cases the meningioma also predominated in the dogs, followed by primary lymphoma with four cases. An astrocytoma, an oligodendroglioma and a choroid plexus papilloma were diagnosed respectively in two dogs. A pituitary gland tumor, a germ cell tumor and a medulloblastoma represented individual cases. Based on the pathomorphologically and -histologically confirmed diagnosis, characteristics of these primary brain neoplasms can be found in their CT image. However, changes are not pathognomonic for a certain type of tumor; a definitive diagnosis cannot be made from the CT image.     

Spontaneous complex pheochromocytoma in a Fischer 344 rat

A spontaneous complex pheochromocytoma was diagnosed in the adrenal gland of an aged female Fischer 344 rat. This expansile neoplasm consisted of pheochromocytoma and areas of ganglioneuroma. The supporting stroma of both neoplastic components contained spindle-shaped cells, which also formed large fascicles. Immunohistochemically, pheochromocytoma cells stained for synaptophysin and chromogranin, scattered ganglioneuroma cells stained for neurofilament protein, and the spindle-shaped stromal cells were positive for S-100 protein. Special stains demonstrated Nissl substance in the ganglioneuroma cells and nerve fibers in the fascicles.     

Primary osseous melanoma in the tibia of a dog

An 18-month-old, female Cane Corso dog was presented with a suspected primary tumor of the tibia. Plain radiographs and computed tomography (CT) of the tibia were highly suggestive of a primary bone neoplasm. A diagnosis of malignant melanoma was made by cytology. Total body survey radiographs, CT scan of the thorax, and abdominal ultrasound excluded the presence of neoplastic lesions other than in the tibia. Limb amputation was performed. Histology and immunohistochemical analysis of the tibial neoplasm confirmed the diagnosis of a melanoma with secondary metastasis to the popliteal lymph node. The dog was alive and in good physical condition 43 months after surgery.     

Pleomorphic sarcoma with giant cells infiltrating the infraorbital canal in an aged Thoroughbred mare

A 27-year-old Thoroughbred mare presented for computed tomography (CT) of the head following a 3-month history of facial swelling at the infraorbital foramen, unilateral self-mutilation and head-shaking. Standing CT imaging showed soft tissue attenuation surrounding the infraorbital canal, with extensive bony lysis of the canal and maxillary bone at the infraorbital foramen. The mare was subjected to euthanasia, and post-mortem examination revealed a proliferative tan soft tissue mass overlying the infraorbital nerve. A histopathological diagnosis of pleomorphic sarcoma with giant cells was made. Immunohistochemical analysis failed to fully elucidate the mesenchymal cell of origin of the sarcoma. Pleomorphic sarcoma with giant cells involving the infraorbital canal of the horse has not been previously described. This case highlights chronic subtle behavioural changes attributable to this neoplasm prior to the development of clinical signs and the utility of advanced imaging in the diagnosis.     

Disseminated pheochromocytoma in a North American river otter (Lontra canadensis)

A 21-yr-old male North American river otter (Lontra canadensis) with a chronic history of degenerative osteoarthritis was evaluated for acute posterior paralysis. Because no definitive cause was identified and a poor prognosis was expected, the otter was euthanatized. A malignant neoplasm of adrenal gland origin with disseminated metastases to the central nervous system, lymph nodes, diaphragm, pancreas, spleen, and liver was diagnosed on postmortem examination. No clinical signs of disseminated neoplasia had been noted throughout the otter's history. The adrenal neoplasm was composed of nests of epithelial cells surrounded by a fine fibrovascular stroma. Neoplastic cells were immunohistochemically positive for chromogranin A, PGP9.5, metencephalin, and endorphin and negative for melan A and inhibin, confirming a diagnosis of a malignant pheochromocytoma. On the basis of the necropsy finding, metastasis of the pheochromocytoma might have contributed to the observed clinical signs.     

Prognosis of canine patients with nasal tumors according to modified clinical stages based on computed tomography: a retrospective study

To evaluate the efficacy of clinical staging based on computed tomography (CT) imaging over the World Health Organization (WHO) staging system based on radiography for nasal tumors in dogs, a retrospective study was conducted. This study used 112 dogs that had nasal tumors; they had undergone radiography and CT and had been histologically confirmed as having nasal tumors. Among 112 dogs, 85 (75.9%) were diagnosed as adenocarcinoma. Then they were analyzed for survival time according to each staging system. More than 70% of the patients with adenocarcinoma were classified as having WHO stage III. The patients classified under WHO stage II tended to survive longer than those classified under WHO stage III. Dogs classified under WHO stage III were further grouped into CT stages III and IV, and CT stage III patients had a significantly longer survival time than CT stage IV patients. In addition, patients treated with a combination of surgery and radiation had a significantly longer survival time than the patients who did not receive any treatment in CT stage III. On the other hand, different treatment modalities did not show a significant difference in the survival time of CT stage IV dogs. The results suggest that WHO stage III dogs may have various levels of tumor progression, indicating that the CT staging system may be more accurate than the WHO staging system.     

Feasibility of computed tomography in awake dogs with traumatic pelvic fracture

In veterinary medicine, general anesthesia or sedation is generally required to immobilize patients during computed tomography (CT) scanning. This may not be suitable in all patients because of risks of anesthesia. We evaluated the feasibility of pelvic CT examination in 14 awake animals with pelvic trauma. Physical restraint was applied by wrapping the patient in a towel and then taping to the CT table or by directly taping the patient to the CT table. The effect of patient positioning, cooperation on the CT table, preparation time for scanning, scanning time, frequency of repeat scans, image quality, and complications related to physical restraint were evaluated. Fractures were recorded and compared between radiography and CT. Ten of 14 dogs were scanned in lateral recumbency and four in sternal recumbency. All patients were cooperative with the exception of one that moved slightly during the scan. Both physical restraint methods were adequate for CT scanning. Patient preparation took less than 5 min while the scan time was typically less than 1 min. No repeat scans were required in any patient. The transverse CT image quality was good (10/14) or fair (4/14) for interpretation. When comparing the CT images to radiographs, more pelvic fractures were identified with CT than with radiography and a few patients were overdiagnosed based on radiographs. No complications or additional injuries associated with physical restraint were noticed.     

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.     

Immunohistochemical evaluation of a malignant phecochromocytoma in a wolfdog

A malignant pheochromocytoma with multiple metastases was diagnosed in a 7-year-old male wolfdog that resulted from a cross between an eastern timber wolf (Canis lupus lycaon) and an Alaskan malamute. A yellowish white neoplastic mass approximately 10 cm diameter was found in the right adrenal gland. The neoplasm penetrated through the wall of the caudal vena cava. A diagnosis of pheochromocytoma was established by histopathologic and immunohistochemical procedures. Immunohistochemically, the neoplastic cells expressed chromogranin A, substance P, synaptophysin, Leu-7, protein gene product 9.5, methionine-enkephalin, S100 protein, and galanin. Multiple metastatic tumors were found in the kidneys, spleen, lungs, heart, and liver.     

The use of computed tomography to assist orthopaedic surgery in 86 horses (2002–2010)

Imaging‐assisted orthopaedic surgery is becoming part of routine orthopaedic practice in horses and several techniques have been reported. However, there are no published reports describing the use of intraoperative computed tomography (CT) for surgical guidance and immediate post operative control in the horse. This use of CT in equine orthopaedics is currently limited because of the logistic problems associated with availability of CT scans in surgical theatres as well as concerns over radiation safety. The aim of this report was retrospectively to report CT assisted orthopaedic surgical cases in our practice through identifying the types of surgery where it was used, to list the technical problems that were encountered, to describe solutions to these, and to discuss the applications of the technique. All surgical procedures were performed with the assistance of a peripheral quantitative computed tomography (pQCT) scanner. CT assisted orthopaedic surgery in 86 patients during the study period. Reasons for CT included: 1) use of CT at the beginning of the surgical procedure to document the lesion and identify surgical landmarks (n = 75); 2) pre, intra‐ and post operative use of CT in comminuted fractures of the middle or proximal phalanx to guide and control internal fixation (n = 7); and 3) post operative use of CT to monitor the results of the surgical procedure (n = 4). Proper planning in both the draping steps and the use of polyvinyl splints to stabilise the limb allowed for movements of the gantry around the limb. The time required to obtain one slice was not dissimilar to the time that is necessary to take and process a single digital radiograph. The radiation dose with the pQCT described here is <0.5 µSv and its acquisition time should be balanced against radiation risks of conventional CT systems.     

RADIOGRAPHIC AND COMPUTED TOMOGRAPHIC EVALUATION OF OTITIS MEDIA IN THE DOG

The purpose of this study was to compare computed tomography (CT) and radiography in the identification of canine middle ear disease. Fourteen canine patients underwent a radiographic "bullae series" and CT examination of the tympanic bullae. Confirmation of otitis media was based on surgery. The overall diagnostic accuracy of CT and radiographs regarding the diagnosis of otitis media was similar. Although a marked difference was not detected between radiographs and CT for detecting otitis media using Youden's index values, CT was a more sensitive test for the detection of otitis media.     

Computed tomography (CT) of the lungs of the dog using a helical CT scanner, intravenous iodine contrast medium and different CT windows

The aim of this study was to determine the accuracy of helical computed tomography (CT) for visualizing pulmonary parenchyma and associated formations in normal dogs. CT scan was performed by using intravenous contrast medium and by applying different types of CT windows: soft tissue and lung windows, and high-resolution computed tomography of the lung. This technique allowed, especially with lung window types, a good view of the parenchyma, bronchial tree, vascular structures and pleural cavity. The selected images, with high anatomical quality and tissue contrast, may be a reference for future clinical studies of this organ. Thus, helical CT is a promising non-invasive method of diagnosing a wide variety of pulmonary diseases in dogs.     

Pheochromocytoma in dogs: 13 cases (1980-1985)

Thirteen cases of canine pheochromocytoma seen at the University of Minnesota Veterinary Teaching Hospital between 1981 and 1985 were reviewed. In 8 cases, the neoplasms were locally invasive; in the remaining cases, they were confined to the adrenal gland. Clinical signs compatible with fatal cardiovascular collapse secondary to a hypertensive or arrythmic episode were observed in 6 of 8 dogs with invasive neoplasms that died during examination or shortly thereafter. The remaining 2 dogs with invasive neoplasms had antemortem diagnoses of adrenal gland neoplasm with metastases and were euthanatized. Invasion or encroachment of the caudal vena cava in 6 dogs and encroachment of the aorta and other regional vasculature in 2 dogs were discovered at necropsy. In 5 dogs, the noninvasive pheochromocytoma was found incidentally during necropsy.     

Prediction of vascular invasion using a 7‐point scale computed tomography grading system in adrenal tumors in dogs

BackgroundPrevious studies evaluating the accuracy of computed tomography (CT) in detecting caudal vena cava (CVC) invasion by adrenal tumors (AT) used a binary system and did not evaluate for other vessels.ObjectiveTest a 7‐point scale CT grading system for accuracy in predicting vascular invasion and for repeatability among radiologists. Build a decision tree based on CT criteria to predict tumor type.MethodsRetrospective observational cross‐sectional case study. Abdominal CT studies were analyzed by 3 radiologists using a 7‐point CT grading scale for vascular invasion and by 1 radiologist for CT features of AT.AnimalsDogs with AT that underwent adrenalectomy and had pre‐ and postcontrast CT.ResultsNinety‐one dogs; 45 adrenocortical carcinomas (50%), 36 pheochromocytomas (40%), 9 adrenocortical adenomas (10%) and 1 unknown tumor. Carcinoma and pheochromocytoma differed in pre‐ and postcontrast attenuation, contralateral adrenal size, tumor thrombus short‐ and long‐axis, and tumor and thrombus mineralization. A decision tree was built based on these differences. Adenoma and malignant tumors differed in contour irregularity. Probability of vascular invasion was dependent on CT grading scale, and a large equivocal zone existed between 3 and 6 scores, lowering CT accuracy to detect vascular invasion. Radiologists'' agreement for detecting abnormalities (evaluated by chance‐corrected weighted kappa statistics) was excellent for CVC and good to moderate for other vessels. The quality of postcontrast CT study had a negative impact on radiologists'' performance and agreement.Conclusions and Clinical ImportanceFeatures of CT may help radiologists predict AT type and provide probabilistic information on vascular invasion.     

Differences between µCT‐imaging and conventional CT for the diagnosis of possible diseases of the middle and inner cat ear

The aim of this study was to check the relevance of using in‐vivo micro computed tomography (µCT) for the diagnosis of possible diseases of the middle and inner ear of the cat. Therefore, on the one hand, differences of the detail detectability between the two imaging methods conventional computed tomography (cCT) and in‐vivo µCT were analyzed. Six healthy cat ears were dissected and scanned several times and the obtained images were compared with each other. On the other hand, histological slices of all ears were prepared and pictures of defined anatomical structures were taken and compared with the identical sectional plane of the µCT‐images. This way it was possible to evaluate the quality and clinical limitations of the in‐vivo µCT. The results show that an in‐vivo µCT is suitable to analyze even the smallest osseous structures, such as the semicircular ducts, the spiral osseous lamina or the ossicles whereas with the help of cCT it is not possible to identify such small osseous structures because of their blurred and less detailed representation. Delicate soft tissue structures as the membranous labyrinth including hearing and vestibular organ cannot be differentiated with as well in‐vivo µCT‐ as with cCT‐images. In‐vivo µCT represent a good possibility for more detailed diagnosis of extremely fine structures which cannot be detected with cCT. Histological slices can nonetheless not be replaced by in‐vivo µCT due to a too low spatial resolution and the limitations of the in‐vivo µCT with regard to the evaluation of soft tissue dense structures.     

Computed tomography in small animals--basic principles and state of the art applications

Since its clinical introduction, computed tomography (CT) has revolutionized veterinary medicine and is considered to be one of the most valuable tools for the imaging work-up of neurological, oncological and orthopaedic canine and feline patients. In small animals with acute trauma, particularly those involving complex anatomic areas such as the head, spine or pelvis, CT has been established as a standard imaging method. With the increasing availability of radiation therapy in veterinary medicine, CT has also become the principal tool to stage a tumour, assess response, and guide radiation therapy. The increasing availability of helical CT in veterinary medicine has allowed novel techniques such as spiral CT angiography and high-resolution CT. This review provides a brief overview of the historical and technical development of CT and literature reviews of the major clinical CT applications in small animals such as intracranial and extracranial lesions, the spine, the appendicular skeleton, and abdominal and thoracic diseases.     

Multiple endocrine neoplasias in a dog: Corticotrophic tumour,bilateral adrenocortical tumours,and pheochromocytoma

Summary

In a 10‐year‐old ovariohysterectomized standard Schnauzer, the finding of dexamethasone‐resistant hypersecretion of cortisol, the results of computed tomography, and elevated plasma concentrations of ACTH suggested the presence of both adrenocortical tumour and pituitary‐dependent hyperadrenocorticism. The dog made an uneventful recovery after bilateral adrenalectomy and remained in good health for 31/2 years with substitution for the induced hypoadrenocorticism. Then the enlarged pituitary caused neurological signs and eventually euthanasia was performed. The surgically excised right adrenal contained a well‐circumscribed tumour of differentiated adrenocortical tissue and in the left adrenal there were two adrenocortical tumours and a pheochromocytoma. The unaffected parts of the adrenal cortices were well developed and without regressive transformation. At necropsy there were no metastatic lesions. The cells of the pituitary tumour were immunopositive for ACTH and had characteristics of malignancy.

The present combination of corticotrophic tumour, adrenocortical tumours, and pheochromocytoma may be called ‘multiple endocrine neoplasia’ (MEN), but does not correspond to the inherited combinations of diseases known in humans as the MEN‐1 and the MEN‐2 syndromes. It is suggested that the co‐existence of hyperadrenocorticism and pheochromocytoma may be related to the vascular supply of the adrenals. Some chromaffin cells of the adrenal medulla are directly exposed to cortical venous blood, and intra‐adrenal cortisol is known to stimulate catecholamine synthesis and may promote adrenal medullary hyperplasia or neoplasia.     

Comparison of concurrent imaging modalities for staging of dogs with appendicular primary bone tumours

This study assessed the use of whole body computed tomography (CT) for the evaluation of metastasis in dogs with primary appendicular bone tumours compared to long bone survey radiography, bone scintigraphy and thoracic radiographs. Fifteen dogs were included in this pilot study. A construct reference standard was used for detection of bone metastasis, and negative thoracic radiographs were compared against CT. Definitive lesions were only identified on bone scintigraphy. Not all lesions agreed with the construct reference standard. No definitive lesions were identified on survey radiographs or CT. Lesions were identified on thoracic CT that were not visible radiographically. Equivocal ground glass pulmonary lesions progressed in three of four cases. Whole body CT was not a suitable alternative to bone scintigraphy; however, it was useful as an adjunctive diagnostic modality. Pulmonary lesions were visible on CT that were not seen radiographically and ground glass pulmonary lesions in dogs should be considered suspicious for metastasis.