Abdominal and thoracic radiography in the neonate.

Plain and contrast radiographic techniques are used infrequently in the diagnostic evaluation of abdominal or thoracic disease in the adult horse because of the animal's large body size and the limited availability and expense of suitable equipment. The importance of radiography as a critical tool has also been lessened through the accessibility of ultrasound, although this technique is limited by depth and offers only a superficial window. Traditional radiographic techniques can be readily used in young foals because of their small body size, and radiography frequently provides critical information that aids in decision making. The ability to physically restrain a foal allows not only standing lateral images, but laterally recumbent and ventrodorsal views without the necessity for general anesthesia.     

Long-term survival of 23 dogs with pericardial effusions

Twenty-three dogs with pericardial effusions were identified from case records made between 1992 and 2000. Fourteen of the 23 were diagnosed with idiopathic pericardial effusions, and three of these were treated successfully by one pericardiocentesis. In the remaining 11 cases the pericardial effusion recurred; six cases were managed long-term by either two (three cases), three (two cases), or 11 repeated pericardiocenteses, and the remaining five were treated by pericardiectomy. The median survival time of the six dogs treated by repeated pericardiocentesis was five years and nine days.     

Echocardiographic,thoracic ultrasonographic,and CTA diagnosis of pericardial neoplasia in a dog

A 12-year-old male neutered Yorkshire Terrier presented for coughing and respiratory distress. Transthoracic echocardiography initially misdiagnosed the patient with pericardial effusion; repeat echocardiography increased suspicion for neoplasia. A definitive diagnosis was not apparent. Findings on thoracic computed tomography and thoracic ultrasound were consistent with a diffusely thickened, heterogenous, hypoechoic soft tissue structure surrounding the heart. Fine needle aspirates were obtained using ultrasound guidance and routine cytology of the intrapericardial mass was consistent with neoplasia, with pericardial mesothelioma most likely. These novel findings highlight the importance of thoracic ultrasound and potential limitations of echocardiography in diagnosis of pericardial neoplasia.     

Use of pericardial fluid pH to distinguish between idiopathic and neoplastic effusions

Pericardial effusion (PE) resulting from neoplasia usually is associated with a poor prognosis, whereas idiopathic PE frequently has a good prognosis. This study examined the utility of pH measurement to distinguish between these 2 etiologies. Dogs were classified as having idiopathic PE (n = 12) if pericarditis was diagnosed on histopathology (n = 4) or if no historical, physical, or echocardiographic evidence of recurrent PE was present for at least 6 months after pericardiocentesis (n = 8). Dogs were classified as having neoplastic PE (n = 25) if pericardial or myocardial neoplasia was detected on histopathology (n = 11) or a discrete mass associated with the right atrium, right ventricle, or the aorta was visualized on echocardiography (n = 14). Samples of PE were centrifuged and the supernatant pH was measured with a portable pH meter. The lowest pH (6.40) was found in a dog with idiopathic PE and the highest pH (7.85) was found in a dog with neoplastic PE. However, data from the 2 groups overlapped in 33 out of 37 (89%) instances, and median pH from the idiopathic and neoplastic groups was not significantly different (7.40 and 7.47, respectively; P = 0.28; difference in medians = -0.7; 95% CI, -0.26-0.06). Because of the degree of overlap, our data provide little justification for the use of pH measurement as a diagnostic test in cases of PE.     

Abdominal and thoracic focused assessment with sonography for trauma,triage, and monitoring in small animals

Objectives – To review the nonradiologist use of ultrasound (US) in the setting of emergency and critical care, the development, clinical applications, and standardization of veterinary abdominal and thoracic focused assessment with sonography for trauma (FAST) techniques. Etiology – Since the 1990s, the 4‐point FAST US technique has been used for injury surveillance in people with blunt and penetrating trauma. FAST screens for free fluid in the abdominal, pleural, and pericardial cavities with high sensitivity and specificity. More recently, an extended FAST scan was developed for the rapid detection of pneumothorax. These techniques and newly created scans have been applied to other critically ill, nontraumatized, subsets of human patients. As a result, the terminology related to this field, eg, extended FAST, HHFAST, FFAST, FAFF, BOAST, SLOH, bedside US, ‘$ Approach,’ protocols, and objectives have become convoluted despite having similar goals. Diagnosis – The importance of US in the setting of emergency medicine is highlighted by the fact that this diagnostic modality has become an integral part of the core curriculum for nonradiologists including the American College of Surgeons, American College of Emergency Physicians, American Board of Emergency Medicine, Society of Academic Emergency Medicine, and all United States Accreditation Council for Graduate Medical Education Emergency Medicine residency programs. Therapy – Veterinary applications of FAST techniques include an abdominal FAST technique with an abdominal FAST applied fluid scoring system, and a thoracic FAST technique. In an attempt to avoid the creation of numerous acronyms, veterinarians would be well served by making the ‘T’ in ‘FAST’ stand for ‘Trauma,’‘Triage,’ and ‘Tracking.’ Prognosis – These veterinary FAST techniques provide an extension of the physical examination for the emergency and critical care veterinarian potentially expediting diagnosis, prompting life‐saving maneuvers, and guiding patient management. Further clinical research to determine sensitivity, specificity, and accuracy for specific conditions is warranted.     

Thoracic, Abdominal and Vertebral Actinomycosis

The clinical, laboratory, radiographic, and histologic features and the response to therapy in three dogs with actinomycosis are reported. One dog (dog 1) had a 12-cm nonresectable mass extending from the ventrolateral chest wall into the left ventricular myocardium. Another dog (dog 2) had a diffuse peritonitis with "sulfur granules" and two large masses. One of these masses was nonresectable involving adjacent abdominal structures. A third dog (dog 3) had a subvertebral mass at T1-3 producing quadraplegia. Two dogs had periosteal reactions involving adjacent sternebrae (dog 1) or ribs and vertebral bodies (dog 3) that are characteristic of Actinomyces spp infections. In dogs 1 and 2 the diagnosis was based on the morphologic and tinctorial properties of free sulfur granules and/or tissue granules. Culture results were variable. Tissue from dog 1 yielded no growth, while polymicrobial infections, which included Actinomyces spp, were identified in dogs 2 and 3. Actinomyces odontolyticus was isolated from dog 3. Although the actinomycotic granulomas were either not excised or only partially excised from dogs 1 and 2, both animals were cured by the oral administration of high doses of penicillin G for 19 and 6 months, respectively. Dog 3 responded dramatically to the same antibiotic therapy given for 5 months. However, within 4 months of discontinuing treatment an abscess and draining fistulous tracts developed in the left axillary region. Two surgical fistulectomies and additional penicillin therapy were required to cure this animal. These cases and the current veterinary and human literature on actinomycosis are used to propose a rational approach to the treatment of actinomycosis in the dog.     

Abdominal surgery in ferrets.

Surgical procedures in ferrets share similarities with those performed in other species, but attention must be paid to important anatomic and physiologic differences. As the numbers of these endearing animals kept as pets is steadily increasing, veterinary practices are presented with more requests for a greater variety of surgical procedures.     

Septic pericardial effusion associated with pulmonary and pericardial botryomycosis in a dog

The authors report a case of septic pericardial effusion resulting in cardiac tamponade associated with intrathoracic botryomycosis in a dog. Septic pericarditis and a pulmonary mass were diagnosed, and subtotal pericardiectomy and lobectomy of the affected pulmonary areas were carried out. Histopathology of the excised tissue showed changes supportive of botryomycosis--namely a pyogranulomatous inflammation with neutrophils centred around amorphous homogeneous eosinophilic material and club-like bodies containing Gram-positive bacterial cocci present in the centre. The patient recovered well following surgery and antibiotic therapy. To the authors' knowledge, this is the first report of pulmonary botryomycosis in the dog and the first report of this condition presented with pericardial involvement and cardiac tamponade in any species.     

Biochemical analysis of pericardial fluid and whole blood in dogs with pericardial effusion

Studies evaluating pericardial fluid analysis in dogs to determine the etiology of pericardial effusions have yielded conflicting results. The purpose of this prospective study was to compare acid-base status, electrolyte concentrations, glucose, and lactate of pericardial fluid to peripheral blood from dogs with pericardial effusion and to compare these variables between dogs with neoplastic and nonneoplastic pericardial effusion. Acid-base status, electrolyte concentrations, glucose, hematocrit, urea nitrogen, and lactate concentrations were evaluated in peripheral blood samples and in pericardial effusion samples of 41 client-owned dogs with pericardial effusion. Common abnormal findings in the peripheral blood of dogs with pericardial effusion included hyperlactatemia (n = 38 [of 41]; 93%), hyponatremia (n = 25/41; 61%), hyperglycemia (n = 13/41; 32%), and hypermagnesemia (n = 13/41; 32%). Bicarbonate, sodium, ionized calcium, glucose, and hematocrit were all significantly lower in the pericardial fluid compared with peripheral blood, whereas lactate, chloride, and PCO2 were significantly higher in the pericardial fluid. When comparing the concentrations of variables in the pericardial fluid of dogs with neoplasia (n = 28) to those without neoplasia (n = 13), pH, bicarbonate, and chloride were significantly lower in dogs with neoplasia, whereas lactate, hematocrit, and urea nitrogen were significantly higher in the pericardial fluid of dogs with neoplasia. The difference between peripheral and pericardial glucose concentrations was significantly larger in dogs with neoplasia than in dogs without neoplasia. Although differences between variables in dogs with neoplastic and nonneoplastic pericardial effusion were documented, clinical relevance is likely limited by the degree of overlap between the 2 groups.     

Equine neonatal thoracic and abdominal ultrasonography.

Pathologic disorders of the equine neonate often develop shortly after foaling as a result of prematurity, dystocia, trauma, or septicemia. Recognition of these disorders requires routine patient assessment along with diagnostic aids, including abdominal and thoracic ultrasonography. Fortunately, modern technology affords today's equine practitioners the opportunity to use ultrasonography to advance their practice, and it is the authors' hope that this article might help in those efforts.     

Abdominal surgery in neonatal foals.

Abdominal surgery in foals under 30 days old has become more common with improved neonatal care. Early recognition of a foal at risk and better nursing care have increased the survival rates of foals that require neonatal care. The success of improved neonatal care also has increased the need for accurate diagnosis and treatment of gastrointestinal, umbilical, and bladder disorders in these foals. This chapter focuses on the early and accurate diagnosis of specific disorders that require abdominal exploratory surgery and the specific treatment considerations and prognosis for these disorders.     

Evaluation of pleural and peritoneal effusions

Certain diseases cause an increase in the amount of fluid present in the pleural and/or peritoneal cavity (an effusion). Uroperitoneum subsequent to kidney, ureter, bladder, or urethra rupture also can cause an increased amount of fluid in the abdomen. Evaluation of fluid samples often is helpful in identifying the mechanism causing the effusion and, occasionally, results in a specific diagnosis. The TP, TNCC, and general cytologic examination can be performed easily, quickly, and inexpensively in-house. The TP and TNCC are used to classify effusions as transudates, modified transudates, or exudates. Transudates usually are caused by hypoalbuminemia, but also can be caused by leakage of fluid from efferent intestinal lymphatics. Cytology and culture usually are not rewarding in the evaluation of transudates. Modified transudates usually are caused by increased vascular permeability or increased intrahepatic hydrostatic pressure. Cytologic and radiographic examinations often are helpful in evaluating patients with modified transudates, while cultures usually are unrewarding. The exudate class encompasses the inflammatory exudates (septic or nonseptic), neoplastic exudates, and chylous effusions. Inflammatory exudates have a high TP and predominantly contain inflammatory cells. They may be septic or nonseptic. When septic, degeneration neutrophils often, but not always, are found. Cultures often are needed to determine whether sepsis is present, to identify the specific organism, and to determine the best therapy. Neoplastic exudates may contain numerous neoplastic cells. If there is concern that the cells are dysplastic instead of neoplastic, the cytology preparation should be referred to a consultant. Chylous effusions usually contain many small lymphocytes with a variable number of neutrophils and macrophages. In chronic chylous effusions, however, neutrophils and/or macrophages may predominate. Chylous effusions usually are differentiated easily from pseudochylous effusions by cytology. Comparison of fluid and serum triglyceride and cholesterol concentrations can be used to differentiate chylous and pseudochylous effusions when differentiation cannot be accomplished by cytology.     

A review of the pathophysiology, classification, and analysis of canine and feline cavitary effusions

Effusion is the abnormal accumulation of fluid within a body cavity that can result from a variety of disease processes. This article reviews the normal production and resorption of body cavity fluid and the pathophysiology of abnormal fluid accumulation. In addition, classification schemes, differential diagnoses, and currently available diagnostic tests for evaluation of effusions are reviewed.