Percutaneous endovascular retrieval of an intravascular foreign body in five dogs, a goat, and a horse

CASE DESCRIPTION-5 Dogs, 1 goat, and 1 horse underwent percutaneous endovascular retrieval of intravascular foreign bodies between 2002 and 2007. CLINICAL FINDINGS-Foreign bodies were IV catheters in 4 dogs, the horse, and the goat and a piece of a balloon valvuloplasty catheter in 1 dog. Location of the foreign bodies included the main pulmonary artery (1 dog), a branch of a pulmonary artery (4 dogs), the right ventricle (the goat), and a jugular vein (the horse). TREATMENT AND OUTCOME-The procedure of percutaneous endovascular retrieval of the foreign body was easy to perform in all instances. One dog was euthanized 41 days after retrieval because of worsening of another disease process, and 1 dog had abnormal neurologic signs secondary to a brain mass. All other animals were clinically normal during the follow-up period (follow-up duration, 3 to 57 months). None of the animals developed long-term complications secondary to the foreign body retrieval procedure. CLINICAL RELEVANCE-Intravascular foreign bodies that result from catheters or devices used during minimally invasive techniques are rare but may cause substantial morbidity. Percutaneous endovascular retrieval of intravascular foreign bodies was easily and safely performed in the 7 animals reported here. Use of percutaneous endovascular retrieval techniques should be considered for treatment of animals with intravascular foreign bodies because morbidity can be substantially decreased; however, proper selection of patients for the procedure is necessary.     

RESULTS OF COMPUTED TOMOGRAPHY IN DOGS WITH SUSPECTED WOODEN FOREIGN BODIES

Detection of wooden foreign bodies in dogs can be challenging. A retrospective, cross‐sectional study was done to describe computed tomographic (CT) signs associated with wooden foreign bodies, and to estimate the accuracy of CT for detection of wooden foreign bodies. Patient records and CT images were reviewed for 72 dogs that had a history of suspected stick injury and CT of the affected body part, or possible wooden foreign object reported on CT, and had surgical exploration during the same period of hospitalization. Duration of clinical signs was acute in 48 (67%) dogs and chronic in 24 (33%). Wood was removed from 55 dogs, including a piece of a tree or shrub in 33 (60%) instances, kebab stick in 8 (15%), piece of bamboo garden cane in 2 (4%), cocktail stick in 2 (4%), thorn in 1 (2%), and unidentified wood in the remaining nine instances. Based on review of CT images with knowledge of the surgical findings, sensitivity of CT for wooden foreign bodies was 79% (95% CI 65%–89%), specificity 93% (78%–98%), positive likelihood ratio 11.5 (2.9–44.1), and negative likelihood ratio 0.23 (0.13–0.41). Wooden foreign bodies were predominantly rectangular or linear, with median length 48 mm (range 2–270 mm), median thickness 3 mm (range 1–22 mm), and median attenuation 111 HU (range ?344 to +640 HU). A CT finding of gas in soft tissues was significantly associated with acute cases, whereas suspected foreign material, cavitary lesions, fat stranding, and periosteal reaction on adjacent bones were associated with chronic cases.     

Computed tomographic diagnosis of nongastrointestinal foreign bodies in dogs

Clinical data and computed tomography (CT) studies were reviewed for 13 dogs with confirmed nongastrointestinal foreign bodies. Locations of foreign bodies were the nasal cavity, thoracic wall, retropharyngeal region, and cerebellum. Types of foreign bodies included small plant components, blades of grass, wooden sticks, cloth fibers, and a needle. Foreign bodies in five dogs were not identified on CT, and secondary reactions resembled neoplastic or fungal disease. In eight dogs, foreign bodies were recognized by their shape and/or internal architecture. In two dogs, three-dimensional reformatting helped demonstrate foreign bodies in relation to palpable bony landmarks.     

一例母犬胃内异物合并绝育手术的诊疗

文章研究治愈母犬胃内异物的同时做绝育手术的效果.对病犬采用临床检查、血常规检查、血清生化检查、影像学检查等方法确诊胃内有异物,并通过手术取出胃内异物的同时进行绝育.结果 表明:从母犬胃内取出一块大小为2 cm×1 cm×1 cm的石子,并成功给母犬做绝育,术后恢复效果较好.该病例的诊疗经验为临床上犬胃内异物的诊治和绝育...     

Results of adrenalectomy in 36 dogs with hyperadrenocorticism caused by adrenocortical tumour

Summary

A total of 38 adrenocortical tumours were removed from 36 dogs with hyperadrenocorticism. The surgical approach was by way of a unilateral flank laparotomy (32 dogs; 14 left and 18 right), a bilateral flank laparotomy (3 dogs) or a midline celiotomy (1 dog).

Two dogs were euthanized during surgery because their tumours could not be resected. Eight dogs died from post‐operative complications. Pancreatic necrosis with peritonitis was the most common cause of death. Eight of the 26 dogs that survived had signs of recurrence of hyperadrenocorticism. Unsuppressible hyperadrenocorticism was found in four dogs; one dog had probably pre‐existent pituitary‐dependent hyperadrenocorticism, and adrenocortical function could not be re‐examined in the remaining three dogs.

Among the 37 tumours examined microscopically expansion of neoplastic tissue into blood vessels was found in 22 of them. Four adrenal glands with adrenocortical tumours also contained phaeochromocytomas. Necropsy was performed in eight dogs. Metastases were found in the lungs of two dogs and in the lungs and liver in one dog.

In combination with the data of previous reports, it is suggested that histological findings in surgery specimens are not good predictors for the clinical outcome.     

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.     

Rabies-like inclusions in dogs

Inclusion bodies, indistinguishable from rabies inclusion bodies (Negri bodies), were found in the brains of 8 nonrabid dogs. The inclusions were compared to Negri bodies present in neurons of rabies-positive animals and examined for the presence of rabies virus by a combination of immunoperoxidase staining (7 cases), fluorescent antibody (FA) staining (1 case), and transmission electron microscopy (4 cases). Positive immunoperoxidase staining for rabies was obtained in brain tissues from FA rabies-positive animals. All brain tissues from the 7 dogs stained by the immunoperoxidase method and the brain from the 1 dog stained by the FA method were negative for rabies. Rabies virus was not found in inclusion-containing neurons in the cases examined by transmission electron microscopy. These results emphasize the importance of FA testing and mouse inoculation for the diagnosis of rabies.     

Experimental studies of intrabronchial foreign bodies in the dog

Results obtained from clinical, endoscopic, bacteriological, and roentgenological investigations, following artificial introduction of foreign bodies into the tracheobronchial system of dogs, are reported in this paper. The foreign bodies included gauze pads, plastic halma pieces, larch, alder, and wood cones. Twenty of the 22 foreign bodies artificially placed into the bronchial tree of the experimental dogs were spontaneously coughed up, 16 of them between the 1st and 14th days from introduction. The cause underlying such high spontaneous healing rate of tracheobronchial foreign bodies in dog is discussed in some detail.     

Spirocerca lupi esophageal granulomas in 7 dogs: resolution after treatment with doramectin

Seven dogs with Spirocerca lupi esophageal granulomas were identified based on the site of involvement (ie, distal esophagus) and characteristic endoscopic appearance. Six dogs presented with signs of esophageal disease and 1 dog was asymptomatic. Ova were only identified in the feces of 2 dogs. On thoracic radiographs, 4 dogs had evidence of a caudodorsal mediastinal mass, and 2 of these dogs had spondylitis of midthoracic vertebrae. On endoscopy, single esophageal nodules were observed in 5 dogs, 1 dog had 3 nodules, and 1 dog had 6 nodules. All 7 dogs were treated with doramectin at a dosage of 200 microg/kg SC at 14-day intervals for 3 treatments. Dogs had physical and endoscopic examinations at 2, 4, and 6 weeks after treatment. By 6 weeks, clinical signs had resolved in 6 dogs (1 dog was asymptomatic), and the esophageal nodules had completely resolved in 4 dogs, and incompletely resolved in 3 dogs. Two dogs with incomplete resolution were treated again with doramectin at 500 microg/kg PO daily for an additional 6 weeks. Complete resolution of the esophageal nodules was confirmed by endoscopy in all dogs. Nodules had resolved in 4 dogs by 6 weeks, in 2 dogs by 12 weeks (after 6 weeks additional daily oral therapy), and in 1 dog 22 months after the initial 200 microg/kg treatment regimen. No dog experienced adverse effects to the drug, and all symptomatic dogs have been free of disease for periods ranging from 3 to 4 years.     

Migration of wooden skewer foreign bodies from the gastrointestinal tract in eight dogs

Wooden skewer foreign bodies were found in eight dogs. Five presented for evaluation of draining sinuses and two for inflammatory disease referrable to the thorax, abdomen or pelvic region. In an additional case, pneumothorax resulted from perforation of the stomach and diaphragm. Ingestion was considered the most likely mode of access of the foreign body in all cases. Although the wooden foreign bodies were seen radiographically in only two dogs, identification of soft tissue or bony changes, or the results of contrast sinography assisted diagnosis. Surgical retrieval led to resolution of signs in all cases.     

MAGNETIC RESONANCE IMAGING OF THE CERVICAL SPINE IN 27 DOGS

The cervical spine of 27 dogs with cervical pain or cervical myelopathy was evaluated using magnetic resonance imaging (MRI). Spin echo T1, T2, and post-contrast T1 weighted imaging sequences were obtained with a 0.5 Tesla magnet in 5 dogs and a 1.5 Tesla magnet in the remaining 22 dogs. MRI provided for visualization of the entire cervical spine including the vertebral bodies, intervertebral discs, vertebral canal, and spinal cord. Disorders noted included intervertebral disc degeneration and/or protrusion (12 dogs), intradural extramedullary mass lesions (3 dogs), intradural and extradural nerve root tumors (3 dogs), hydromyelia/syringomyelia (1 dog), intramedullary ring enhancing lesions (1 dog), extradural synovial cysts (1 dog), and extradural compressive lesions (3 dogs). The MRI findings were consistent with surgical findings in 18 dogs that underwent surgery. Magnetic resonance imaging provided a safe, useful non-invasive method of evaluating the cervical spinal cord.     

IMAGING DIAGNOSIS: MAGNETIC RESONANCE IMAGING OF A CERVICAL WOODEN FOREIGN BODY IN A DOG

This article describes the discovery of a chronic cervical wooden foreign body ventral to the left transverse processes of the cranial cervical spine using magnetic resonance imaging (MRI) in a dog that presented with chronic neck pain and lameness. The dog did not exhibit dysphagia or chronic draining tracts, the most common signs of the presumed cause, that of a penetrating oropharyngeal foreign body. The foreign body itself was represented on MR images as an oval straight-edged core within an inflammatory tissue reaction. The wood was slightly hyperintense on T2- and isointense on T1-weighted images relative to muscle. Surrounding this was a more conspicuous contrast-enhancing reactive tissue rim that was hyperintense on all pulse sequences. Adjacent musculature also exhibited diffuse edema and contrast enhancement that extended around the left cervical vertebral transverse processes and local intervertebral nerve roots. The foreign body was found to be a wooden stick upon surgical removal. MRI is an excellent method for visualizing the inflammatory tissue reactions associated with soft-tissue foreign bodies because of its contrast resolution and depiction of anatomy in multiple imaging planes.     

Nontraumatic rupture of an adrenal gland tumor causing intra-abdominal or retroperitoneal hemorrhage in four dogs

Diagnosis and surgical management of intra-abdominal or retroperitoneal hemorrhage in 4 dogs with rupture of an adrenal gland tumor were determined. All 4 dogs were lethargic and weak with pale mucous membranes on initial examination. Three dogs did not have any history of clinical signs of hyperadrenocorticism or pheochromocytoma prior to examination. In 3 of the dogs, a mass in the area of the adrenal gland was identified with ultrasonography prior to surgery. All dogs developed ventricular premature contractions before or during anesthesia. Three dogs survived adrenalectomy; 1 dog was euthanatized during surgery because of an inability to achieve adequate hemostasis. The remaining 3 dogs all survived more than 5 months after surgery; 1 was euthanatized 9 months after surgery because of rupture of a hepatic mass. On the basis of these results, we suggest that hemodynamic stabilization followed by adrenalectomy is the treatment of choice for dogs with nontraumatic rupture of an adrenal gland tumor and resulting life-threatening hemorrhage.     

Comparison of ultrasound, computed tomography, and magnetic resonance imaging in detection of acute wooden foreign bodies in the canine manus

We evaluated the diagnostic sensitivity of ultrasound, nonenhanced computed tomography (CT) and nonenhanced magnetic resonance (MR) imaging in detecting wooden foreign bodies in the canine manus. Identical wooden splinters were manually inserted into 30 cadaver canine manus, and the limbs were evaluated using ultrasound, CT, and MR imaging by independent observers. All sites were rated as positive or negative for the presence of a foreign body, and observer certainty was scored on a 1-10 scale. Using receiver operating characteristic analysis, CT was the most accurate modality for detection of wooden foreign bodies overall and within each of the three individual regions, followed by ultrasound and MR imaging, respectively. Ultrasound evaluations were most limited in the metacarpal pad, where distal acoustic shadowing from the pad surface hindered evaluation of the tissues in some specimens.     

Surgical excision of ectopic thyroid carcinoma involving the base of the tongue in dogs: three cases (1980-1987)

Localized thyroid carcinoma involving the base of the tongue was diagnosed in 3 dogs examined because of a midline cervical mass rostroventral to the larynx. These masses had been present for 4 to 12 months and were firm, nonsensitive, and fixed in position. One dog had progressive dysphagia and dyspnea. Masses were surgically excised together with the base of the tongue and portions of the hyoid apparatus. Severe dyspnea that developed immediately after surgery in 1 dog was managed by tracheostomy intubation for 4 days. Transient dysphagia developed in all dogs. Hydration was maintained by IV fluid administration until water and food of gruel consistency could be swallowed 1 to 6 days after surgery. Consistency of food was gradually thickened to normal, as swallowing improved 6 days to 2 months after surgery. One dog developed aspiration pneumonia that resolved after antimicrobial administration and improved swallowing that prevented further aspiration. After 9 months, 3 years, and 6 years, the dogs were clinically normal.     

Rectal strictures in 19 dogs: 1997-2005

The etiologies for nonneoplastic rectal strictures in dogs included foreign bodies, postoperative formation, inflammatory disease, and congenital malformation. Sixteen of 19 dogs underwent balloon dilatation therapy, and 14 of these 16 dogs received intralesional triamcinolone injections. Following dilatation, clinical signs persisted in one dog, improved with continued medical therapy in five dogs, and resolved in nine dogs for the duration of their follow-up period (mean 18 months; median 12 months); one dog was lost to follow-up. Balloon dilatation and triamcinolone were parts of a treatment regimen that improved clinical signs in the majority of dogs diagnosed with nonneoplastic rectal strictures.     

ULTRASONOGRAPHIC DIAGNOSIS OF FOREIGN BODIES ASSOCIATED WITH CHRONIC DRAINING TRACTS AND ABSCESSES IN DOGS

This is a retrospective study that describes the historical, physical exam, radiographic, fistulographic, ultrasonographic, and surgical findings associated with non-gastrointestinal and extrathoracic foreign bodies in six dogs. All dogs had a chronic draining tract or abscess. Although radiographs were obtained in five of the six dogs, no foreign bodies were identified with this modality. Fistulography was performed in four of the six dogs, and a filling defect consistent with a foreign body was found in two of four dogs. A foreign body was identified in five of the six dogs with ultrasound. Foreign bodies were removed surgically in five of six dogs. This report clarifies the importance of ultrasound in the evaluation of chronic draining tracts and abscesses in dogs.     

Effects of doxycycline on early infections of Dirofilaria immitis in dogs

The antifilarial effects of tetracycline drugs were first demonstrated when they were found to be highly effective against L(3) and L(4) of Brugia pahangi and Litomosoides sigmodontis in rodent models. Tetracyclines are also now known to have activity against microfilariae and adult Dirofilaria immitis, but assessment of their activity against larval and juvenile heartworms has not been reported previously. This study assessed the effects of doxycycline administered orally at 10mg/kg twice daily for 30-day periods at selected times during the early part of the life cycle of D. immitis in dogs with dual infections of D. immitis and B. pahangi. Twenty beagles were randomly allocated by weight to four groups of five dogs each. On Day 0, each dog was given 50 D. immitis L(3) and 200 B. pahangi L(3) by SC injection. Dogs received doxycycline on Days 0-29 (Group 1); Days 40-69 (Group 2); or Days 65-94 (Group 3). Group 4 served as untreated controls. Blood samples were collected for microfilariae counting and antigen testing. Necropsy for collection of adult heartworms and selected tissues were performed Days 218-222. Heartworms recovered were examined by immunohistology, conventional microscopy/transmission electron microscopy, and molecular biology techniques. No live heartworms were recovered from dogs in Group 1; dogs in Group 2 had 0 to 2 live worms (98.4% efficacy), and dogs in Group 3 had 0-36 live worms (69.6% efficacy). All control dogs had live adult heartworms (25-41). The live worms recovered from dogs in Groups 2 and 3 were less developed and smaller that worms from control dogs. Microfilariae were not detected in any dogs in Groups 1 and 2; one dog in Group 3 had 1 microfilariae/ml at necropsy. All control dogs had microfilariae at necropsy. One dog in Group 1 was antigen positive at one sampling (Day 166). One dog in Group 2 was antigen positive Days 196 and 218-222 and three dogs in Group 3 were antigen positive at one or more samplings All five control dogs were antigen positive at all three sampling times. These findings suggest that doxycycline at 10mg/kg orally twice daily for 30 days has efficacy against migrating tissue-phase larvae and juvenile worms and will delay or restrict microfilarial production.     

Volvulus of the colon in four dogs

Four dogs were examined because of vomiting of 7 to 48 hours' duration. Gas-distended segments of intestine were identified radiographically in all dogs, but the affected portion of the intestinal tract could not always be identified as the colon. Volvulus of the colon was diagnosed during surgery in all 4 dogs. Gastrocolopexy was performed following derotation of the colon in 3 of the dogs. In 1 dog, a colectomy and an ileorectal anastomosis were performed. All 4 dogs survived. Volvulus of the colon should be considered as a cause of vomiting of short duration in dogs for which there is radiographic evidence of intestinal dilatation.     

Computed tomography as an aid to management of chronic oropharyngeal stick injury in the dog

Objective : To describe the use of computed tomography scanning in the management of dogs with chronic signs after oropharyngeal stick injury. Methods : Dogs with a final diagnosis of chronic oropharyngeal stick injury that underwent a computed tomography scan during their investigation were selected retrospectively from case files at the Royal Veterinary College, London. Results : The six dogs were young (median age 3·1 years) and medium to large breed (19·0 to 42·0 kg). By the time of referral the most common clinical sign was cervical swelling (five dogs). Stick foreign bodies were apparent on the plain computed tomography images in all cases and appeared as well‐demarcated, linear abnormalities. A ventral mid‐line approach was used for foreign body retrieval, and the computed tomography findings corresponded well with the surgical findings, with stick foreign body length ranging from 1 to 7 cm. Closed suction drainage was used in five dogs, for two to four days. Clinical signs fully resolved postoperatively in all cases, although cervical swelling recurred three weeks after surgery in one case. This dog had the smallest foreign body, the greatest number of surgical interventions before referral (three) and the longest disease course before referral (eight months). Clinical Significance : Computed tomography scanning is accurate in identifying the presence and location of chronic stick foreign bodies. Recurrence of disease is possible despite successful retrieval of the wood fragments found by computed tomography scan.