Clinical, radiographic, and pathologic features of bronchiectasis in cats: 12 cases (1987-1999)

OBJECTIVE: To determine clinical, radiographic, and pathologic features of bronchiectasis in cats. DESIGN: Retrospective study. ANIMALS: 12 cats with histologic evidence of bronchiectasis. PROCEDURE: Information on signalment, body weight, clinical signs of respiratory disease, concurrent diseases, method by which lung tissue specimens were obtained (surgical biopsy or necropsy), and histopathologic findings was obtained by reviewing medical records from January 1987 to June 1999 for cats with confirmation of bronchiectasis by histologic examination. Available thoracic radiographs were reviewed by a board-certified radiologist. RESULTS: Bronchiectasis was most commonly identified in older male cats. Clinical signs referable to the lower portion of the respiratory tract were detected in only 5 cats but, when evident, were usually chronic (duration > 1 year). Radiographic pattern of bronchiectasis was cylindrical in 4 cats, and in 1 of these cats, a saccular pattern was also identified. For most cats, bronchiectasis was detected in a single lung lobe. Radiographic evidence of bronchiectasis was not detected in 2 cats. Concurrent respiratory diseases included chronic bronchitis and bronchiolitis, neoplasia, bronchopneumonia, endogenous lipid pneumonia, and emphysema. CONCLUSIONS AND CLINICAL RELEVANCE: Bronchiectasis appears to be an uncommon respiratory tract disorder that predominantly affects older male cats. Thoracic radiography may not be sensitive for the diagnosis of bronchiectasis in cats. Bronchiectasis in cats appears to be a sequela of chronic inflammatory bronchopulmonary diseases, especially chronic bronchitis, neoplasia, and bronchopneumonia.     

Clinical,clinicopathologic, and radiographic findings in dogs with coccidioidomycosis: 24 cases (1995-2000)

OBJECTIVE: To determine clinical, clinicopathologic, and radiographic abnormalities in dogs with coccidioidomycosis. DESIGN: Retrospective case series. ANIMALS: 24 dogs. PROCEDURE: Clinical information and results of clinicopathologic testing were obtained from medical records. Thoracic radiographs were reviewed to characterize abnormalities. RESULTS: Dogs ranged from 1 to 10 years old at the time of diagnosis, with 12 dogs being between 1 and 3 years old. Historical complaints included cough, lameness, signs of head or neck pain, and difficulty breathing. Mild anemia, neutrophilia, and monocytosis were common. All dogs had hypoalbuminemia, and 8 of 15 had hyperglobulinemia. Thoracic radiographs of 19 dogs were reviewed. Pulmonary infiltrates were seen in 13 dogs, with an interstitial pattern of infiltration being most common. Hilar lymphadenopathy was seen radiographically in 10 dogs. Serum from 20 dogs was tested for antibodies against Coccidioides immitis. One dog was positive for IgM antibodies, 5 were positive for IgM and IgG antibodies, and 14 were positive for IgG antibodies. Quantitative IgG titers measured in 14 dogs ranged from 1:2 to 1:128 (median and mode, 1:32). In 6 dogs, histologic examination of biopsy samples revealed fungal spherules ranging from 8 to 70 microm in diameter. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that in dogs, coccidioidomycosis may be associated with a wide spectrum of nonspecific respiratory and musculoskeletal abnormalities. The chronic nature of the disease makes diagnosis difficult, even in regions in which the organism is endemic.     

Ultrasonographic features of testicular neoplasia in dogs: 16 cases (1980-1988)

For 16 dogs with testicular neoplasia (n = 19 tumors), ultrasonography was performed to determine whether a correlation exists between ultrasonographic features of testicular tumors and cell type. The echogenicity of the tumors varied depending on the size of the tumor and whether the tumor had focal or diffuse distribution within the testis. The ultrasonographic characteristics of Sertoli cell tumors were variable, with no predominant pattern. This variation may be related to tumor size, because 6 of 7 Sertoli cell tumors were greater than 5 cm in diameter. Focal seminomas and interstitial cell tumors less than 3 cm in diameter had hypoechoic texture. Focal seminomas and interstitial cell tumors greater than 3 cm in diameter had mixed echogenicity. Tumors of multiple cell types were greater than 5 cm in diameter and had mixed echogenicity. In valuable breeding dogs with a small (less than 3 cm) focal intrascrotal lesion, testicular ultrasonography would be of benefit for localization of the mass to the testis or epididymis for subsequent biopsy. In dogs with intraabdominal neoplastic testes, ultrasonography may be of benefit in determining intra-abdominal metastases and invasion of contiguous structures.     

Juvenile cellulitis in dogs: 15 cases (1979-1988)

The records of 15 dogs diagnosed as having juvenile cellulitis (juvenile pyoderma, puppy strangles) were evaluated for clinical, laboratory, and therapeutic results. Mandibular lymphadenopathy was observed in 14 dogs, and was not associated with skin lesions in 5 dogs. Edema, pustules, papules, or crusts were noticed periorally, periocularly, on the chin or muzzle, or in the ears of those dogs with skin lesions. Eight dogs were lethargic; fever and anorexia were inconsistent findings. Four dogs had signs of pain on manipulation of their joints. Complete blood counts revealed leukocytosis with neutrophilia in 4 dogs, and normocytic, normochromic anemia in 6 dogs. Three dogs had suppurative lymphadenitis with many neutrophils. Cytology of the aspirate of pustules or abscesses in 6 dogs revealed many neutrophils without bacteria. Coagulase-positive Staphylococcus spp were isolated from draining lesions in 2 dogs. Intact abscesses and lymph nodes were negative for bacterial growth in 4 dogs. Three of these dogs were being administered antibiotics at the time of bacterial culturing. Cytology of the aspirates of joints in 3 of the 4 dogs with joint pain revealed suppurative arthritis with no bacteria, and the aspirates were negative for bacterial growth on culturing, although all 3 dogs were being administered antibiotics at the time of culturing. Of 12 dogs initially treated with antibiotics, only 4 (33%) responded favorably; the other 8 dogs were then given antibiotics and corticosteroids. Three dogs were initially given antibiotics and corticosteroids. All dogs treated concurrently with antibiotics and corticosteroids responded favorably. One of these dogs had a relapse after treatment was discontinued. The concurrent arthritis in 4 of the dogs resolved with treatment of the juvenile cellulitis and did not redevelop once the medication was discontinued. Concurrent treatment with antibiotics (cephalosporins) and prednisone (2.2 mg/kg of body weight/day) was the most consistently effective treatment in the dogs in this study.     

Dysautonomia in dogs: 65 cases (1993-2000)

OBJECTIVE: To determine signalment, history, clinical findings, results of autonomic function testing and other antemortem diagnostic tests, and pathologic findings in dogs with dysautonomia. DESIGN: Retrospective study. ANIMALS: 65 dogs with dysautonomia. PROCEDURE: Case records of 68 dogs with a diagnosis of dysautonomia were reviewed; inclusion criteria included histologic confirmation of dysautonomia or clinical signs and results of pharmacologic testing consistent with dysautonomia. RESULTS: 65 dogs fulfilled all criteria for dysautonomia. Dogs from rural environments were overrepresented, and cases of dysautonomia were reported for every month, although the highest number of cases was reported in February and March. Vomiting was the most common clinical sign, followed by diarrhea, signs of anorexia and depression, weight loss, and dysuria. The most common physical examination finding was decreased or absent anal tone, followed by absent pupillary light reflexes and elevated nictitating membrane. Results of pharmacologic testing were consistent with dysautonomia, although no single test was 100% sensitive. Histologic lesions consistent with dysautonomia were found in the autonomic ganglia, brainstem nuclei, and ventral horns of the spinal cord. CONCLUSIONS AND CLINICAL RELEVANCE: Dysautonomia is an endemic disease in Kansas, and a high index of suspicion of the disease can be made by combining clinical signs, physical examination findings, and results of pharmacologic testing.     

Liposarcomas in dogs: 56 cases (1989-2000)

OBJECTIVE: To determine the biological behavior of liposarcomas in dogs and identify clinical signs, the effect of treatment on survival time, and potential prognostic factors. DESIGN: Retrospective study. ANIMALS: 56 dogs with histologically confirmed liposarcoma. PROCEDURE: Information was obtained on signalment, tumor size, location of the tumor, stage of disease, remission duration, overall survival time, cause of death, type of surgery (incisional biopsy, marginal excision, or wide excision), and any additional treatments given. RESULTS: Surgery consisted of incisional biopsy in 6 dogs, marginal excision in 34, and wide excision in 16. Twenty-five dogs had histologic evidence of tumor cells at the surgical margins and 28 did not (status of the margins was unknown in 3 dogs). Twelve of 43 dogs had local recurrence. Median survival time was 694 days, and the only factor significantly associated with survival time was type of surgery performed. Median survival times were 1,188, 649, and 183 days, respectively, for dogs that underwent wide excision, marginal excision, and incisional biopsy. Factors that were not found to be significantly associated with survival time included tumor size, status of the margins, tumor location, and histologic subtype. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that in dogs, liposarcomas are locally invasive neoplasms that rarely metastasize and occur primarily in appendicular or axial locations and that wide excision is preferred to marginal excision when feasible.     

Prevalence, clinical features, and causes of epistaxis in dogs: 176 cases (1996-2001)

OBJECTIVE: To determine prevalence, clinical features, and causes of epistaxis in dogs. DESIGN: Retrospective case series. ANIMALS: 176 dogs with epistaxis. PROCEDURES: Medical records were reviewed for information related to signalment, clinical features, diagnosis, and outcome. RESULTS: 132 (75%) dogs were initially examined by the hospital's emergency service; prevalence of epistaxis was 0.3%. Dogs with epistaxis were more likely to be old (> or = 6 years), male, and large (> or = 26 kg [58.5 lb]) than were dogs in a reference population. In 109 (62%) dogs with epistaxis, an underlying cause was identified; 115 underlying disorders were identified, with 90 classified as local and 25 classified as systemic. Local causes of epistaxis included nasal neoplasia (n = 35), trauma (33), idiopathic rhinitis (20), and periapical abscess (2). Systemic causes included thrombocytopenia (12), thrombocytopathia (7), coagulopathy (3), hypertension (2), and vasculitis (1). Dogs with local causes were more likely to have unilateral than bilateral epistaxis, but 11 of 21 (52%) dogs with systemic disorders also had unilateral epistaxis. Dogs with systemic disorders were more likely to have clinical signs of systemic disease. Duration of epistaxis (acute vs chronic), severity, and duration of hospitalization were similar for dogs with local versus systemic disorders. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that epistaxis was a common disorder in dogs and frequently regarded as an emergency. Local causes of epistaxis were predominant, but clinical features traditionally thought to be helpful in distinguishing local versus systemic causes could not be reliably used for this purpose.     

Signalment and clinical features of diskospondylitis in dogs: 513 cases (1980-2001)

OBJECTIVE: To determine signalment, clinical features of the disease, and treatment in dogs with diskospondylitis. DESIGN: Case-control study. ANIMALS: 513 dogs with diskospondylitis (cases) and 236,109 canine hospital accessions (controls) from 12 veterinary teaching hospitals. PROCEDURE: Information retrieved from the medical records of 123 dogs with diskospondylitis at the Louisiana State University veterinary teaching hospital between 1980 and 2001 included sex, age, breed, primary complaint, neurologic status, location of lesions, causative organism, treatment, and outcome. The signalment of 390 additional cases from 11 other veterinary teaching hospitals was accessed from the Veterinary Medical Database. Comparisons were made with controls from the same time periods. RESULTS: Male dogs were twice as likely as female dogs to be affected (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.7 to 2.4). Dogs were significantly more likely to be affected as age increased. Purebred dogs, especially Great Danes, were more likely than mixed-breed dogs to be affected (OR, 73; CI, 4.3 to 12.6). For dogs from Louisiana State University, Staphylococcus spp, Brucella spp, Streptococcus spp, and Escherichia coli were isolated most often; multiple organisms were detected via microbial culture in 11 dogs. The mean duration of treatment was 53.7 weeks. CONCLUSIONS AND CLINICAL RELEVANCE: Male dogs, older dogs, and Great Danes appeared more likely to be affected with diskospondylitis than female dogs, dogs < 1 year of age, and mixed-breed dogs, respectively. Long-term administration of antimicrobial drugs for treatment of diskospondylitis may be expected. Identification of the causative organism and early treatment are recommended.     

Drug-associated aplastic anemia in dogs: eight cases (1984-1988)

Records of 8 dogs with drug-associated aplastic anemia were reviewed. Drugs suspected as being causative included estradiol cyclopentylpropionate (3 dogs), phenylbutazone (2 dogs), meclofenamic acid (1 dog), trimethoprim-sulfadiazine and fenbendazole (1 dog), and quinidine (1 dog). Five of the dogs died or were euthanatized. One dog with estrogen-associated aplasia recovered after prolonged treatment. The dogs with trimethoprim-sulfadiazine and quinidine-associated marrow aplasia recovered promptly after treatment was discontinued.     

Gallbladder mucocele in dogs: 30 cases (2000-2002)

OBJECTIVE: To determine long-term outcome of dogs with gallbladder mucocele. DESIGN: Retrospective study. ANIMALS: 30 dogs with gallbladder mucocele, including 23 that underwent cholecystectomy. PROCEDURE: Medical records were reviewed for signalment, history, and clinical, ultrasonographic, and surgical findings. Follow-up information was obtained for all dogs that survived the perioperative hospitalization period. RESULTS: 23 dogs had signs of systemic illness; 7 had no clinical signs. Median values for serum activities of alanine aminotransferase and alkaline phosphatase, serum total bilirubin concentration, and total WBC count were significantly higher among dogs with gallbladder rupture than among dogs without rupture. Sensitivity of sonography for detection of rupture was 85.7%. Overall perioperative mortality rate for dogs that underwent cholecystectomy was 21.7%; mortality rate was not significantly greater for dogs with rupture. Aerobic bacteria were isolated from the bile or gallbladder wall in 8.7% of dogs. All 18 dogs discharged from the hospital had complete resolution of clinical signs. In dogs that underwent in-hospital reexamination, serum liver enzyme activities were significantly decreased, compared with preoperative activities. Persistent increases in serum activities of 1 or more liver enzymes were detected in 9 of 12 dogs; 6 of 12 dogs had persistent abnormalities in hepatic echogenicity. Mean follow-up period was 13.9 months. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that cholecystectomy is an effective treatment for gallbladder mucocele. Although perioperative mortality rate is high, prognosis after discharge from the hospital is excellent. Rupture of the gallbladder warrants emergency surgical intervention but does not preclude a positive outcome.     

Clinical features and outcome in dogs and cats with obsessive-compulsive disorder: 126 cases (1989-2000)

OBJECTIVE: To determine clinical features and outcome in dogs and cats with obsessive-compulsive disorder (OCD). DESIGN: Retrospective study. ANIMALS: 103 dogs and 23 cats. PROCEDURES: Records of patients with OCD were analyzed for clinical features, medication used, extent of behavior modification, and outcome. RESULTS: Most dogs affected with OCD had been obtained from breeders. Male dogs significantly outnumbered females (2:1). Female cats outnumbered male cats by 2:1 in a small sample. Most affected dogs lived in households with 2 or more humans and other dogs or cats, and had some formal training. Client compliance with behavior modification was high. A combination of behavior modification and medication resulted in a large decrease in intensity and frequency of OCD in most animals. Clomipramine was significantly more efficacious for treatment in dogs than was amitriptyline. Only 1 dog and 1 cat were euthanatized because of OCD during the study. CONCLUSIONS AND CLINICAL RELEVANCE: OCD in dogs does not appear to be associated with lack of training, lack of household stimulation, or social confinement. In cats, OCD may be associated with environmental and social stress. Obsessive-compulsive disorder appears at the time of social maturity and may have sporadic and heritable forms. With appropriate treatment (consistent behavior modification and treatment with clomipramine), frequency and intensity of clinical signs in most dogs and cats may decrease by > 50%. Success appears to depend on client understanding and compliance and the reasonable expectation that OCD cannot be cured, but can be well controlled.     

Leiomyosarcoma in dogs: 44 cases (1983-1988).

During a 5-year period, leiomyosarcoma was diagnosed in 57 dogs. Forty-four dogs were included in the study on the basis of completeness of medical records. All dogs underwent exploratory laparotomy, and dogs were allotted to 4 groups according to primary site of tumor: spleen (16 dogs, median age 10.3 years), stomach/small intestine (13 dogs, median age 10.3 years), cecum (10 dogs, median age 11.8 years), and liver (5 dogs, median age 9 years). All dogs with leiomyosarcoma of the liver had visible metastasis and were euthanatized at surgery. In the other 3 groups, 79% of the dogs had no gross evidence of metastasis at surgery, and 64% survived greater than 2 weeks. Median survival in these 3 groups was 10 months (range, 1 month to 7 years); 48% died of metastasis, 32% died of unrelated causes, and 16% died of unknown causes. The prognosis in dogs with leiomyosarcoma of the spleen, stomach, small intestine, and especially the cecum is good to excellent if surgery is performed. In dogs with leiomyosarcoma of the liver, the prognosis is poor.     

Causes of uveitis in dogs: 102 cases (1989-2000)

Uveitis is one of the most common ocular diseases and one of the most common causes of blindness in dogs. The purpose of this retrospective study was to correlate the signalment, history, clinical signs and ophthalmic findings of dogs with uveitis with the underlying etiology. We conducted a retrospective study of 102 dogs presented to the NCSU-VTH from 1989 to 2000 with clinical signs of uveitis. Medical records of dogs presented for uveitis were reviewed. Dogs were included in the study only if a complete diagnostic work-up database was collected, if sufficient follow-up was documented, and if the uveitis was not secondary to trauma or a hypermature cataract. The mean age +/- SD of all dogs in this study was 6.2 +/- 3.6 years. There were 33 intact and 16 castrated males, and 14 intact and 27 neutered females. Fourteen breeds were represented, with the Golden Retriever (n = 14) most common. Fifty-nine dogs (58%) were diagnosed with idiopathic/immune-mediated uveitis, neoplasia was diagnosed in 25 dogs (24.5%) and 18 dogs (17.6%) were diagnosed with infectious causes of uveitis. Aqueous flare was the most common clinical sign, occurring in 88 dogs (86%). The most common infectious organisms associated with uveitis in the dogs of this study were Ehrlichia canis (n = 7). Lymphosarcoma (n = 17) was the most common neoplasm. In approximately 60% of dogs presenting for uveitis an underlying cause was not found, and a diagnosis of immune-mediated or idiopathic uveitis was made. However, approximately 25% of dogs had ocular and/or systemic neoplasia (with 17% of cases having lymphosarcoma) and 18% with an underlying infectious cause for uveitis. Because of the high percentage of systemic disease associated with uveitis in dogs, extensive diagnostic testing is recommended before instituting symptomatic anti-inflammatory therapy.     

Salivary gland disease in dogs and cats: 245 cases (1985-1988)

Diagnostic pathology records spanning 41 months (July 1985 through November 1988) were searched for diagnoses of salivary gland disease in dogs and cats. Review of 87,392 records from that period revealed 245 cases (0.3%) in which salivary gland tissue had been evaluated. During that period, salivary gland tissue was submitted to the laboratory almost twice as often from dogs (160 cases) as from cats (85 cases). On the basis of histologic examination, 89% of salivary gland submissions from small animal practices were allotted to 1 of 5 major categories: malignant neoplasms (30%; 74/245), sialadenitis (26%; 64/245), normal salivary gland (16%; 40/245), sialocele (9%; 21/245), and salivary gland infarction (8%; 20/245). The remaining 11% of submissions included various degenerative or fibrotic lesions, ductal ectasia, sialolithiasis, edema, benign neoplasia, and secondary salivary involvement with systemic or cervical lymphosarcoma or with fibrosarcoma in the head and neck.     

Clinicopathologic and radiographic features and etiologic agents in cats with histologically confirmed infectious pneumonia: 39 cases (1991-2000)

OBJECTIVE: To determine clinicopathologic and radiographic features and etiologic agents in cats that died as a result of infectious pneumonia. DESIGN: Retrospective study. ANIMALS: 39 cats. PROCEDURE: Medical records of cats in which infectious pneumonia was confirmed by histologic examination of necropsy specimens were reviewed. Signalment, clinical signs, and results of a CBC, viral serologic tests, and thoracic radiography were evaluated. Infectious agents were classified as bacterial, viral, fungal, protozoal, or parasitic. Histologic features (severity, duration, anatomic location, and distribution) were analyzed. RESULTS: Clinical signs referable to the respiratory tract were not detected in 14 of 39 (36%) cats, and results of a CBC (4/18 cats) and radiography (3/13) were unremarkable. Sixteen of 39 (41%) cats lacked clinical signs of systemic illness. Etiologic agents identified included bacteria (n = 21), viruses (11), fungi (6), protozoa (2), and parasites (1). Cats with clinical signs related to the respiratory tract (19/24 [79%] cats) were more likely to have severe histologic changes than cats without signs related to the respiratory system (6/14). Twenty-nine of 38 (76%) cats had histologic evidence of systemic disease, whereas the remaining cats had lesions limited to the respiratory tract. CONCLUSIONS AND CLINICAL RELEVANCE: Infectious pneumonia is uncommon in cats. Cats with infectious pneumonia may lack clinical signs and have unremarkable results for a CBC and thoracic radiography, yet frequently have systemic infections. Therefore, clinicians should maintain an index of suspicion for pneumonia and evaluate the respiratory tract when infection is detected in other organ systems.     

Smoke exposure in dogs: 27 cases (1988-1997).

OBJECTIVE: To evaluate clinical findings, prognostic variables, and clinical course of dogs exposed to smoke. DESIGN: Retrospective study. ANIMALS: 27 dogs exposed to smoke in residential fires. PROCEDURE: Medical records were reviewed for 1988-1997. Time of year, signalment, interval from fire to arrival at veterinary hospital, duration of smoke exposure, clinical signs at the fire scene, physical examination findings, changes in respiratory tract signs, radiographic findings, hematologic and arterial blood gas analyses, initial treatment, clinical course, and outcome were recorded. RESULTS: 27 dogs (16 uncomplicated and 11 complicated cases) were identified. In the complicated group, 4 dogs died, 4 were euthanatized, and 3 had a complicated clinical course. Stupor or coma (8 of 17 dogs), coughing or gagging (6), and respiratory difficulty (6) were commonly observed at the fire scene. Substantial improvement was evident within 5 to 30 minutes after dogs were given supplemental oxygen at the fire scene. More severely affected dogs had a higher median PCV (58%) than less severely affected dogs (50%). Most common thoracic radiographic findings were an alveolar (10 dogs) or an interstitial (3) pattern. CONCLUSIONS AND CLINICAL RELEVANCE: Dogs exposed to smoke can develop respiratory or neurologic complications. Monitoring progression of respiratory problems on the day after the fire may provide clinicians with clues about the severity of each dog's condition.     

Ultrasonographic findings in dogs with hyperammonemia: 90 cases (2000-2002)

OBJECTIVE: To determine ultrasonographic abnormalities in dogs with hyperammonemia. DESIGN: Retrospective study. ANIMALS: 90 client-owned dogs with hyperammonemia. PROCEDURE: Ultrasonography of the abdominal vessels and organs was performed in a systematic way. Dogs in which the ultrasonographic diagnosis was a congenital portosystemic shunt were included only if they underwent laparotomy or necropsy. Dogs in which the abdominal vasculature appeared normal and dogs in which the ultrasonographic diagnosis was acquired portosystemic shunts and portal hypertension were included only if liver biopsy specimens were submitted for histologic examination. RESULTS: Ultrasonography excluded portosystemic shunting in 11 dogs. Acquired portosystemic shunts were found in 17 dogs, of which 3 had arterioportal fistulae and 14 had other hepatic abnormalities. Congenital portosystemic shunts were found in 61 dogs, of which 19 had intrahepatic shunts and 42 had extrahepatic shunts. Intrahepatic shunts originated from the left portal branch in 14 dogs and the right portal branch in 5. Extrahepatic shunts originated from the splenic vein, the right gastric vein, or both and entered the caudal vena cava or the thorax. Ultrasonography revealed splenic-caval shunts in 24 dogs, right gastric-caval shunts in 9 dogs, splenic-azygos shunts in 8 dogs, and a right gastric-azygos shunt in 1 dog. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that ultrasonography is a reliable diagnostic method to noninvasively characterize the underlying disease in dogs with hyperammonemia. A dilated left testicular or ovarian vein was a reliable indicator of acquired portosystemic shunts.     

Fluoroscopic and radiographic evaluation of tracheal collapse in dogs: 62 cases (2001-2006)

OBJECTIVE: To compare the use of radiography and fluoroscopy for detection and grading of tracheal collapse in dogs. DESIGN: Retrospective case series. Animals-62 dogs with tracheal collapse. PROCEDURES: For each dog, tracheal collapse was confirmed fluoroscopically and lateral cervical and thoracic radiographic views were reviewed. A board-certified radiologist (who was unaware of the dogs' clinical history) evaluated the cervical, thoracic inlet, thoracic, carinal, and main stem bronchial regions in all fluoroscopic videos and radiographic images for evidence of collapse. Cervical, thoracic inlet, thoracic, and carinal regions in both radio-graphic and fluoroscopic studies were graded for collapse (0%, 25%, 50%, 75%, or 100% decrease in diameter). RESULTS: Lateral cervical and thoracic radiographic images were available for 54 dogs, and inspiratory and expiratory lateral cervical and thoracic radiographic images were available for 8 dogs. For detection of tracheal collapse, assessment of radiographic views was sensitive and had the best negative predictive value in the cervical and thoracic inlet regions. Assessment of radiographic views was most specific and had the best positive predictive value in the thoracic inlet, thoracic, carina, and main stem bronchial regions. Radiography underestimated the degree of collapse in all areas. Review of inspiratory and expiratory views improved the accuracy of radiography for tracheal collapse diagnosis only slightly. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with fluoroscopy, radiography underestimated the frequency and degree of tracheal collapse. However, radiography appears to be useful for screening dogs with potential tracheal collapse.