Ultrasonographic diagnosis of septic arthritis secondary to porcupine quill migration in a dog

A 7-year-old castrated male German Shepherd Dog was evaluated for lethargy, icterus, and sepsis. Porcupine quills had been removed from the dog's face 1 month prior to examination; progressive right forelimb lameness had developed soon after removal of the quills. Septic arthritis of the right elbow joint was diagnosed and was unresponsive to antimicrobial and anti-inflammatory treatments. At the time of referral, the dog had developed endocarditis, septicemia, and disseminated intravascular coagulation. Via ultrasonography, a foreign body consistent with a porcupine quill was detected in the medial portion of the right humeroradial joint. The dog did not respond to initial supportive treatment and died as a result of cardiac arrest. Postmortem examination confirmed the presence of a quill in the medial compartment of the right elbow joint and severe acute endocarditis with septic emboli to the kidneys and spleen. Ultrasonographic examination should be considered as a diagnostic tool when septic arthritis secondary to a foreign body is suspected in dogs.     

Identification of an intra-cranial intra-axial porcupine quill foreign body with computed tomography in a canine patient

An intra-cranial intra-axial foreign body was diagnosed in a golden retriever dog through the use of computed tomography (CT). Confirmed by necropsy, a porcupine quill had migrated to the patient's left cerebral hemisphere, likely through the oval foramen. This case study demonstrates the efficacy of CT in visualizing a quill in the canine brain.     

IMAGING DIAGNOSIS—VERTEBRAL CANAL PORCUPINE QUILL WITH PRESUMPTIVE SECONDARY ARACHNOID DIVERTICULUM

A 3‐year‐old Gordon Setter developed cervical hyperesthesia and a stiff gait. Upon magnetic resonance (MR) imaging, an arachnoid diverticulum was detected at the C1 level. Upon surgical resection, a porcupine quill was identified within the vertebral canal in the area of the cyst. At a retrospective review of the MR images, the quill appeared as a circular well‐demarcated T2‐hypointense lesion. Porcupine quill migrations are common in the dog but migration into the central nervous system is rare.     

Gerbode type defect and third degree atrioventricular block in association with bacterial endocarditis in a dog

Gerbode type defects are rare left ventricular outflow tract–right atrial communications in people that may be congenital or acquired; they have been reported only once previously in dogs. Acquired forms in humans have been reported secondary to bacterial endocarditis, trauma, and valve replacement surgery, among other causes. We report a case of left ventricular outflow tract to right atrium and right ventricle communications (Gerbode type defect) in association with aortic and tricuspid valve bacterial endocarditis in a geriatric dog. The dog also developed third degree atrioventricular block and had underlying subaortic stenosis. The authors hypothesize that the Gerbode type defect in this case was acquired secondary to invasion and destruction of the membranous interventricular septum due to bacterial endocarditis.     

Hypertrophic osteopathy associated with a bronchial foreign body and lobar pneumonia in a dog

Hypertrophic osteopathy was diagnosed in a dog with a bronchial foreign body and lobar pneumonia. Hypertrophic osteopathy is generally associated with primary or secondary neoplasms of the lungs and rarely associated with nonneoplastic thoracic lesions. The foreign body and affected lung lobe were removed by pneumonectomy, resulting in recovery of the dog and resolution of the hypertrophic osteopathy lesions.     

Porcupine quill injuries in dogs: a retrospective of 296 cases (1998-2002)

The purpose of this retrospective study was to identify factors associated with quill injury in dogs. A second objective was to determine the risk of complications and any factors that would predict the likelihood of complications. Hospital records of 296 porcupine quill injuries in dogs from 1998 to 2002 were studied. There was an increased occurrence of porcupine encounters in the spring and fall months; Siberian huskies, rottweilers, and German shepherd crosses were significantly overrepresented for quill injuries. There was no association between risk of complications and either number of quills or antimicrobial use. Increasing time between quill injury and presentation was associated with an increased risk of complications. Because of the increased frequency of complication with a longer interval until presentation, clients should be strongly encouraged to bring the dog in as soon as the quill injury is discovered. Patients presented after 24 hours should be monitored closely during the first 3 weeks after injury, as most complications occurred during this time.     

Fatal aortic endocarditis associated with community-acquired Serratia marcescens infection in a dog

A 12 yr old Dalmatian was referred for evaluation of acute lethargy, fever, neurologic signs, and a recently ausculted heart murmur. Echocardiography in combination with blood cultures resulted in a diagnosis of nonhospital-acquired Serratia marcescens bacteremia and aortic valve endocarditis. Despite early diagnosis and aggressive therapy, the dog failed to respond to antimicrobials and died within 6 hr after admission. Necropsy findings included aortic valve endocarditis, septicemia, and diffuse thromboembolic disease. There was no history of pre-existing underlying disease or immunosuppressive therapy, and the dog had not been hospitalized before referral.     

Marked pleural effusion causing right atrial collapse simulating cardiac tamponade in a dog

A 16-month-old, female German shepherd dog was presented with severe bicavitary effusions. A diaphragmatic hernia was diagnosed by thoracic radiography. An echocardiogram performed prior to surgical repair of the hernia revealed signs of cardiac tamponade, with right atrial collapse, in the absence of pericardial effusion. Right atrial collapse was presumed to be secondary to severe pleural effusion. At surgery, no pericardial disease was identified. Surgical correction of the diaphragmatic hernia resulted in resolution of the pleural and peritoneal effusions. Follow-up echocardiography demonstrated resolution of the signs of cardiac tamponade.     

Left ventricular outflow tract to left atrial fistula associated with endocarditis in a dog

A one-year-old, intact male, 28-kg, mixed-breed dog developed neurological episodes consistent with emboli. An acquired III/VI holosystolic heart murmur was ausculted in the mitral area, and valvular endocarditis with pulmonic and aortic insufficiency were noted at echocardiographic examination. An abnormal communication (i.e., fistula) between the left ventricular outflow tract (LVOT) and the left atrium adjacent to the mitral valve annulus was noted with Doppler imaging and confirmed with angiography. Infective valvular endocarditis was confirmed based on two of three blood cultures being positive for Staphylococcus intermedius. In humans, a sequela to infective endocarditis of the aortic or mitral valve, or both, is rupture of the mitral-aortic intervalvular fibrosa, resulting in a communication between the LVOT and the left atrium. This is the first report of this sequela in the dog.     

Septic pericarditis in a Yorkshire Terrier

Objective: To describe a novel case management strategy for a small breed dog diagnosed with septic pericarditis. Case summary: An 8‐year‐old spayed female Yorkshire Terrier presented for evaluation of pericardial effusion and persistent hypoglycemia. The dog had been hospitalized at a primary care facility for acute onset of vomiting, lethargy, inappetance, and painful abdominal distension. Pericardial effusion was detected and upon referral, cytologic examination revealed a suppurative exudate with Gram‐positive and Gram‐negative bacteria. The dog was treated with pericardiocentesis and placement of an indwelling pericardial catheter. Subtotal pericardiectomy was performed and a thoracotomy tube was utilized postoperatively. A penicillin‐susceptible Bacteroides species was cultured from the pericardial fluid and was treated with a 6‐week course of antibiotics. The dog was discharged from the hospital and clinical signs have not recurred in over 2 years. New or unique information provided: Septic pericarditis, an uncommon cause of canine pericardial effusion, has been described primarily in large breed dogs and in association with bacterial infection secondary to Hordeum grass (foxtail) awn migration. This case was unique in that the dog was a small breed with no evidence of foreign body penetration or other precipitating cause for the pericarditis. In a novel management plan, an indwelling pericardial catheter was employed to stabilize the dog before subtotal pericardiectomy.     

Idiopathic primary chylopericardium in a dog

CASE DESCRIPTION: A 7-year-old spayed female Labrador Retriever was evaluated because of pericardial effusion. CLINICAL FINDINGS: The dog had a history of decreased appetite and exercise intolerance of 3 days' duration. Thoracic radiography performed by the referring veterinarian revealed a large cardiac silhouette. Heart sounds were muffled. Echocardiographic findings were indicative of severe pericardial effusion with cardiac tamponade; no pleural effusion was identified. Pericardiocentesis yielded a considerable amount of chylous fluid. A diagnosis of chylopericardium in the absence of pleural effusion was made. TREATMENT AND OUTCOME: Conservative management was not effective, and subtotal pericardectomy and thoracic duct ligation were recommended. Surgery was postponed by the owners for 25 days, at which time the dog had both chylopericardium and chylothorax. The dog underwent subtotal pericardectomy and thoracic duct ligation; to delineate the thoracic duct, intraoperative lymphangiography was performed by injection of a radiopaque contrast agent directly into a mesenteric lymph node and subsequent injection of methylene blue solution into another mesenteric lymph node. Surgical treatment resulted in complete resolution of the clinical signs and pleural effusion. CLINICAL RELEVANCE: To the authors' knowledge, this is the first report of the development of chylopericardium prior to development of chylothorax in a dog. Treatment with thoracic duct ligation and pericardectomy resulted in complete resolution of the effusion and clinical signs.     

Echocardiography and Surgery in a Dog With Left Atrial Rupture and Hemopericardium

Endocardial splitting and left atrial rupture were diagnosed in a dog with mitral regurgitation that experienced the sudden onset of collapsing episodes, weakness, depression, labored breathing, and weak pulses. Thoracic radiographs showed a rounded cardiac silhouette with prominent left atrium consistent with hemopericardium due to left atrial rupture. Two-dimensional echocardiography confirmed the presence of severe mitral valve disease, pericardial fluid, and a laminated blood clot caudal to the left ventricle. A sterile emergency thoracotomy was performed, the hemopericardium and blood clot were removed, and the rupture site in the left atrium was repaired with reinforced sutures. The dog recovered from surgery but died the next day, presumably from a ventricular arrhythmia.     

Chronic bronchocutaneous fistula caused by toothpick foreign body in a Maltese dog

A 7-year-old, 1.76 kg Maltese dog presented with a 4-year history of a chronic pustular lesion and a wet cough. Erosive lesions were seen at the left thoracic wall. Radiology and computed tomography (CT) revealed a bronchocutaneous fistula connecting from the left cranial bronchus to the skin. On definitive surgery, a long wooden toothpick was observed within this tract, and clinical signs resolved after retrieval of the foreign body. Three-dimensional CT was useful to identify the characteristics of the bronchocutaneous fistula. However, the wooden foreign body was not apparent on CT. Here, we report the clinical, clinicopathological and diagnostic imaging findings of a chronic bronchocutaneous fistula caused by a foreign body in a dog.     

Results of transthoracic esophagotomy retrieval of esophageal foreign body obstructions in dogs: 14 cases (2000-2004)

The records of 14 consecutive cases of esophageal foreign body obstruction in dogs that had undergone transthoracic esophagotomy for foreign body retrieval were reviewed. Clinical results were considered successful in 13 of 14 dogs. One dog was euthanized at surgery because of the severity of associated thoracic lesions. Clinical signs resolved in the remaining 13 dogs. Two dogs had postoperative complications. One dog developed a pyothorax, and one dog developed a subcutaneous seroma. The overall recovery rate was 93%.     

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.     

Extradural spinal liposarcoma in a dog.

An 8-year-old female Doberman Pinscher was examined because of progressive, asymmetric, ambulatory caudal paraparesis. Myelography revealed extradural left ventrolateral spinal cord compression over the first and second lumbar vertebral bodies. A left hemilaminectomy, extending from the thirteenth thoracic to the second lumbar vertebrae, was done, and an extradural mass was removed. The tumor was identified histologically as myxoid liposarcoma. The dog's neurologic function improved gradually after surgery; however, at 7 months after surgery, hind limb neurologic function deteriorated rapidly over a 5-week period, presumably because of local recurrence of the tumor. The dog was euthanatized; necropsy was not permitted.     

Migrating grass awn within the intraconal part of the retrobulbar space in a dog

A 1.5-year-old MC Cardigan Welsh Corgi was presented for a right oral fistula associated with left tonsil enlargement that responded to medical treatment. A first computed tomography scan was performed and showed no signs of a foreign body. Medical treatment was continued for 2 additional weeks and the dog was free of clinical signs for 3 months. The dog was presented again for a 3-day history of anorexia and marked pain when opening the jaw. The repeat computed tomography scan revealed a migrating foreign body near the optic canal of the right eye, and surgical exploration confirmed that it was trapped within the intraconal part of the retrobulbar space, abutting the optic nerve. The foreign body was surgically removed through an osteotomy of the zygomatic bone. The dog fully recovered with no vision loss. Based on the literature search, this is the first published report describing a migrating grass awn located in the intraconal part of the retrobulbar space, abutting the optic nerve.     

Osteomyelitis of the atlanto-occipital region as a sequela to a pharyngeal stick injury

An eight-year-old female Belgian shepherd dog was referred for investigation of chronic neck pain. The dog had sustained a pharyngeal injury 12 weeks previously while catching a stick. Radiographs of the cervical spine revealed signs consistent with a septic arthritis of the atlanto-occipital joint and osteomyelitis of both occipital condyles and the atlas. A foreign body was identified ultrasonographically in the retropharyngeal soft tissues, and a stick was surgically removed from a site ventral to the right side of the atlanto-occipital joint. The signs of neck pain started to resolve within a week of surgery.     

Migration of a Kirschner wire to the heart in a Yorkshire terrier

A 12-year-old, male Yorkshire terrier was presented for acute pulmonary oedema. Thoracic radiographs showed a linear metallic foreign body within the cardiac silhouette. Echocardiogram showed a hyperechoic line extending through the left ventricle, the mitral valve, leading into the left atrium. A 4 cm long Kirschner wire was surgically removed by left fourth thoracotomy. The dog died two days after surgery for acute pulmonary oedema. Necropsy showed thrombi on the mitral leaflets that impeded their movement.     

Iatrogenic brainstem injury during cerebellomedullary cistern puncture

Cerebrospinal fluid collection is fundamental to the investigation of central nervous system disorders although it carries potential risks. Herein we report the clinical signs and magnetic resonance (MR) imaging findings associated with needle injury to the brainstem during cerebellomedullary cistern puncture in four dogs. Three dogs were nonambulatory tetraparetic with cranial nerve deficits and one dog had unexplained left thoracic limb paresis. In MR images, there were conspicuous T2 hyperintensities in the myelencephalon in all dogs. In T2* gradient echo images, the lesions were hypointense in two dogs with multiple cranial nerve deficits, and hyperintense in another dog. One dog was euthanized due to sudden neurologic deterioration 12 days later, one died shortly after MR imaging, and a third was euthanized due to concurrent cervical spondylomyelopathy. The fourth dog recovered gradually. Diagnosis was confirmed histopathologically in one dog and was presumptive based on clinical signs and MR findings in three dogs. None of the dogs with cranial nerve deficits recovered, only the one dog with left thoracic limb paresis and concurrent syringomyelia.