ADRENAL ULTRASONOGRAPHY IN THE DOG

The ultrasonographic appearance of the normal canine adrenal gland has not been described. This is due to the small size and shape of the canine adrenal glands, overlying abdominal viscera, similar acoustic texture to that of the surrounding tissue, frequent abundant perirenal fat, and the lack of patient compliance. Adrenal enlargement in association with hyperadrenocorticism, secondary to hyperplasia or neoplasia, can sometimes be identified by finding a distinct structure cranial and/or medial to the cranial pole of either kidney. Case history reports are used to characterize the appearance of adrenal enlargement from hyperplasia and adrenocortical adenocarcinoma. Additional case history reports are included to illustrate possible interpretation problems. Lack of ultrasonographic visualization of the adrenal gland does not rule out the possibility of enlargement, particularly if the enlargement in mild.     

QUANTITATIVE HEPATIC SCINTIGRAPHY IN THE DOG

Quantitative hepatic scintigraphy is a noninvasive test for measurement of relative arterial and portal blood flow to the liver. This technique has been used to evaluate human patients with known or suspected liver tumors or diffuse hepatocellular disease. A computer program to assess the hepatic perfusion index (HPI) in the normal dog is described. Factors affecting study quality and accuracy include injection technique, cardiac function, patient position, respiration, gross patient motion, and user intervention during data processing. HPI for a group of 12 normal dogs was 0.9±0.4 (X±SD). Quantitative scintigraphy could be used to evaluate dogs with primary or secondary liver tumors, portacaval shunts, or chronic liver disease     

ENDOSCOPIC ULTRASONOGRAPHY OF THE PANCREAS IN THE DOG

Endoscopic ultrasonography was done in 12 normal adult dogs to investigate its efficacy in visualization of the pancreas. The endoscopic ultrasonographic device used in the present study had a curved-array ultrasound transducer mounted in front of the objective lens. The tip of the ultrasonic endoscope was inserted into the stomach, and all examinations of the pancreas were performed from within the stomach. Endoscopic ultrasonography provided good images of most parts of the pancreas except for the ends of each lobe. Useful information about the pancreatic parenchyma, including pancreatic lobular structure, pancreatic duct, and vessels of the pancreas was obtained by endoscopic ultrasonography. Blood flow within vessels was detected using color Doppler and pulsed-wave Doppler examination. These results suggest that endoscopic ultrasonography is available as an effective diagnostic modality in small animal practice.     

RENAL SONOGRAPHIC MEASUREMENTS IN THE DOG PRECEDING AND FOLLOWING UNILATERAL NEPHRECTOMY

The purpose of this study was to establish sonographic baseline values for normal kidneys initu and to document sonographic changes following unilateral nephrectomy. Normal canine renal measurements were determined sonographically prior to and following unilateral nephrectomy. These included: cortical thickness (cranial, caudal, dorsal, ventral, lateral and medial), medullary measurements (cranial and caudal) and measurements of the renal silhouette (length, height and width). The latter group of measurements was obtained to determine renal volume. Normal parameters were obtained from sixteen healthy dogs prior to nephrectomy; the unilateral nephrectomy group was comprised of eight of these animals, the remaining eight dogs were part of an allo-transplant study.¹ The mean sonographic value for the length of the kidney was 60.3 mm ± 6.4 (n = 26) while the widths and heights were 34.7 ± 3.8 (n = 27) and 27.8 mm ± 3.3 (n = 26) respectively. Renal cortical measurements were found to be smallest dorsally and ventrally on sagittal and transverse sonograms. The largest volumes were the cranial pole on sagittal scans and the lateral pole on the transverse scans. Pearson correlation coefficient for volume resulted in r values of 0.88, 0.78 and 0.72 for length, height and width (n = 25, dif = 24) respectively.     

SONOGRAPHIC APPEARANCE OF RENAL NEOPLASIA IN THE DOG

Eight dogs with renal neoplasia were radiographically and sonographically examined. An enlarged, nonopacified kidney was seen on the excretory urogram in four dogs, but differentiation between a solid mass or severe hydronephrosis was not possible. The excretory urogram suggested an avascular lesion in one kidney, but differentiation between solid or cystic disease was not possible. Renal neoplasia was diagnosed in two dogs by excretory urography. Radiographic examination suggested splenic neoplasia in one dog. Solid masses were sonographically diagnosed in all dogs. A metastatic lesion was sonographically diagnosed in the opposite kidney of one dog that was missed on the radiographic examination. Ultrasonography com-plemented radiography as a diagnostic modality in eliciting additional information on renal disease. Sonograms did not allow determination of tumor cell type or whether the tumor was benign or malignant.     

ANGIOGRAPHY OF THE HEPATIC AND PORTAL VENOUS SYSTEM IN THE DOG AND CAT: AN INVESTIGATIVE METHOD*

The investigators studied the hepatic angiographic technics used in human medicine with respect to their applicability for the investigation of circulatory liver diseases in the dog and cat. The technics were performed in 11 normal dogs and 2 normal cats, and the normal radiographic anatomy of the hepatic portal system and its tributaries was described. The potential indications for the angiographic technics were defined and their respective advantages and disadvantages discussed. Splenoportography was a valuable method for outlining the intrahepatic portal vein branches and for percutaneous prehepatic portal vein pressure determination. Percutaneous transhepatic portography was more difficult to perform, but it provided better detail of the intrahepatic portal veins than splenoportography. Transjugular transhepatic portography was the most versatile but also the most cumbersome of all technics tested. Percutaneous kinetic hepatography proved impractical in dogs and cats. The mesenteric tributaries to the hepatic portal system were best outlined by cranial mesenteric arterial portography or by operative mesenteric venous portography. Operative mesenteric venous portography, in contrast to cranial mesenteric arterial portography, was also useful for prehe-patic portal vein pressure determination. Free and wedged hepatic venography provided an opportunity for the functional and morphologic investigation of the hepatic sinusoid circula-tion.     

ULTRASONOGRAPHY AS AN AID IN THE DIAGNOSIS OF RENAL CELL CARCINOMA IN A HORSE

Clinical diagnosis of renal tumors in the horse has been difficult because the traditional diagnostic techniques are inadequate. Because of this shortcoming, early publications rarely reported antemortem diagnosis of primary renal tumors. Conventional radiographic techniques cannot effectively outline kidneys in the adult horse. With the advent of ultrasonography, a new dimension to the evaluation of the large-animal kidney has been introduced. Percutaneous diagnostic ultrasonography provides a noninvasive method of examining both kidneys. This report describes a 15 year-old Tennessee Walking Horse mare presented for evaluation of a mass in the sublumbar region, polyuria and polydipsia. Clinical examination and laboratory test results suggested intra-abdominal neoplasia. Two-dimensional ultrasonographic images of the mass were consistent with renal neoplasia. Histologic diagnosis of ultrasound-guided renal biopsy was renal tubular cell carcinoma.     

EXPERIMENTAL ISOLATED RENAL ARTERY PERFORATION IN THE DOG: ITS NATURAL HISTORY*

Three 25- to 30-kg adult mongrel dogs had nonsurgical experimentally induced unilateral renal artery perforations produced by a rotating guide wire tip. The guide wire was introduced via a percutaneous femoral artery puncture. Baseline arteriograms were compared with serial postperforation arteriograms made over a three-month peirod, and the natural history and healing rate of these lesions were assessed. In the three-dog study, the renal artery perforations were self-limiting. The dogs'healing processes alone seemed adequate in preserving both renal and renal artery function.     

EQUINE RENAL ULTRASONOGRAPHY: NORMAL AND ABNORMAL

The kidneys of three clinically normal horses were evaluated ultrasonographically, utilizing a standardized approach. The normal renal architecture, including cortex, medulla, pyramids, renal sinus fat, collecting system, and intrarenal vessels, was evaluated.
A horse with hematuria was examined in the same manner and a mass was found in the right renal pelvis.
Ultrasonographic determinations were correlated with gross anatomy, clinical signs, and pathologic findings of a renal pelvic adenoma.     

ULTRASONOGRAPHY OF GASTRIC ULCERATION IN THE DOG

The clinical, ultrasonographic and, when available, histopathologic findings of gastric ulceration in 7 dogs were reviewed. The most common clinical signs were vomiting, hematemesis, melena, weight loss and anemia. Ultrasonographic features of gastric ulcer included local thickening of the gastric wall, possible loss of the 5-layer structure, the presence of a wall defect or "crater", fluid accumulation in the stomach and diminished gastric motility.The localized gastric thickening varied from 9 to 16 mm. The ulcer crater was often located in the center of the thickened site and appeared as a mucosal defect associated with persistent accumulation of small echoes, most likely representing microbubbles. In this preliminary study, there was no definitive ultrasonographic distinction between benign and malignant ulcers.     

MOST DOGS WITH MEDULLARY RIM SIGN ON ULTRASONOGRAPHY HAVE NO DEMONSTRABLE RENAL DYSFUNCTION

The medullary rim sign is a distinct hyperechoic line in the renal medulla parallel to the corticomedullary junction that has been reported in dogs with a variety of renal diseases. To examine the association between medullary rim sign and renal disease, the medical records of thirty-two dogs that had medullary rim sign were reviewed retrospectively. Eighteen dogs (56%) had no evidence of renal dysfunction; 14 (44%) had clinicopathological evidence of renal disease, including 6 (19%) that had hypercalcemic nephropathy. Most dogs (72%) in which medullary rim sign was the only ultrasonographic finding affecting the kidneys had no evidence of renal dysfunction. In contrast, 78% dogs that had medullary rim sign and other renal signs (reduced size, increased medullary echogenicity, and pyelectasia) had renal disease. On the basis of this study, the medullary rim sign appears to be a non-specific ultrasonographic sign; however, the possibility cannot be excluded that is a sentinel sign of subclinical renal disease.     

ULTRASONOGRAPHIC DETERMINATION OF RENAL VOLUME IN THE DOG

Ultrasonographic linear and area measurements were performed on both kidneys of 15 clinically healthy dogs. Renal volumes were calculated from linear and area data applying three prolate ellipsoid models. Ultrasonographic volumes were then compared using linear regression analysis with kidney volumes measured in vitro by water displacement. In vivo ultrasonographic volumes had a statistically significant relationship with the in vitro volume. The highest correlation was provided by the single plane area method. There was also a correlation between body weight and ultrasonographically detected renal volume, suggesting that ultrasound imaging may be a useful method for assessment of renal volume changes in dogs with renal disease.     

ANATOMY OF THE PORTAL AND HEPATIC VEINS OF THE DOG: A BASIS FOR SYSTEMATIC EVALUATION OF THE LIVER BY ULTRASONOGRAPHY

The objective of this study was to define, in detail, the anatomy of the portal and hepatic veins in the dog in order to establish a procedure for the systematic evaluation of the liver by ultrasonography. Anatomical details were obtained from the formalin fixed livers of ten dogs. The hepatic and portal veins were removed intact from these livers so that a detailed pattern of distribution could be established and the numbers of branches could be counted. Silastic casts were also made of the hepatic and portal veins of two livers, one in situ and one in which it had been removed. The former was to enable the relationship of the portal to the hepatic veins to be established as closely as possible within the animal and the other to provide a model of the distribution of each venous system within the liver. Contrast medium was infused into two other livers and radiographs taken to establish the relationship of each branch to each lobe. It was found that there was a consistent pattern of venous branching to each lobe of the liver in the dog with little variation between individual specimens. All liver lobes contained definite venous branches so that the left lateral and medial, quadrate, right medial and lateral, caudate and papillary veins could be distinguished in each venous system. We believe that an appreciation of this venous distribution will aid in the systematic evaluation of the liver during ultrasonography by enabling identification of each liver lobe. It should be of value for differentiating portal from hepatic veins and veins from dilated bile ducts.     

ULTRASONIC DETERMINATION OF KIDNEY VOLUME IN THE DOG

Canine kidney measurements were obtained in vivo using ultrasound before and after anesthesia and were compared with direct caliper measurements at laparotomy. Following excision, the kidney dimensions were also measured ultrasonically in a water bath and the results were used to calculate kidney -volume by a modified parallel planimetric method and three variations of a prolate ellipsoid method. The calculated volume was compared with actual kidney volume determined by volume displacement. All methods were found to underestimate actual volume so that a linear correction of ultrasonically calculated volume was required to predict actual volume. The modified parallel planimetric method and a prolate ellipsoid method using height and width determinations cranial and caudal to the renal pelvis were the best models. The prolate ellipsoid model was chosen for subsequent kidney volume calculations because of its simplicity. The noninvasive calculation of kidney volume using ultrasound was sufficiently accurate to be clinically useful, particularly when serially evaluating kidney size changes in the same dog.     

ULTRASONIC FEATURES OF EXPERIMENTALLY INDUCED, ACUTE PANCREATITIS IN THE DOG

Acute, necrotizing pancreatitis was experimentally produced in three dogs by injection of oleic acid into the accessory pancreatic duct. The ultrasonic features of acute pancreatitis were compared with the radiographic and gross pathologic findings. It was concluded that ultrasonography was very useful for the detection and characterization of experimental pancreatitis. The results must be carefully compared with the ultrasonic abnormalities found in naturally occurring, acute canine pancreatitis before the usefulness of pancreatic sonography can be determined for this disease in the dog     

ULTRASONOGRAPHIC FEATURES OF GRASS AWN MIGRATION IN THE DOG

The aim of this study was to describe the ultrasonographic features of grass awns in soft tissue. A 10 MHz linear transducer was used. Ultrasound images from 25 dogs (27 awns) were collected and compared with the results from water bath studies using wild oat seeds (Avena spp.) collected in the field. Wild oat seeds were the most common grass awn found in soft tissue of dogs. Ultrasonographically grass awns appeared as a double/triple spindle-shaped echogenic interface within soft tissue. The same appearance was observed in water bath studies. In four dogs, the grass awn was removed surgically with a clamp introduced into a fistulous tract, using sonographic guidance. The grass awn was not found surgically in only three dogs, suggesting more attention during surgery. Ultrasonography is a useful diagnostic imaging technique to identify grass awns within soft tissue.     

SONOGRAPHIC AND RADIOGRAPHIC CHANGES ASSOCIATED WITH SPLENIC TORSION IN THE DOG

The clinical, radiographic, and sonographic signs in three dogs with splenic torsion are presented. AH dogs exhibited weight loss, anorexia, and lethargy. Splenomegaly was consistent radiographic finding in two dogs and large ill-defined midabdominal mass was seen in one dog. The spleen was easily imaged sonographically in all dogs. Splenic sonography in two dogs showed diffuse, hypoechoic pattern consistent with splenic congestion. Hilar splenic vessels were enlarged on the sonograms of two dogs.     

ULTRASONGRAPHIC FINDINGS IN HEPATIC AND SPLENIC LYMPHOSARCOMA IN DOGS AND CATS

In a survey of patients with histologically-confirmed hepatic lymphosarcoma at Tufts University, abnormal ultrasound findings were detected in 3 of 14; two had diffuse hepatic hypoechogenicity, one had a focal hypoechoic lesion. In contrast, 5 of 6 patients with spleic lymphosarcoma had an abnormality on ultrasongraphy; two had diffuse hypoechogenicity, one had multiple hypoechoic foci, one had a large, cavitated-appearing mass, and one had an irregular border. In our experience, ultrasonography is an insensitive means of detecting hepatic lymphosarcoma but appears more sensitive for detection of splenic lymphosarcoma.     

OSSEOUS METAPLASIA IN THE RENAL PELVIS OF A DOG WITH HYDRONEPHROSIS

A 3-year-old male Sheltie dog was presented with abdominal distension, diarrhea, and vomiting. Hematologic and blood chemistry studies revealed a mild anemia and a few leukocytes in the urine. Radiographic examination was made, and a large mass with calcified trabeculae was present in the ventral right cranial quadrant of the abdomen. Exploratory celiotomy was performed, and a mass identified as the right kidney was removed. The excised kidney was cystic and multiloculated, and contained areas of bone and cartilage. This mass weighed 1120 g and was in excess of ten percent of the dog's body weight. Transitional epithelium can stimulate osseous metaplasia. The presence of both tissues in a biopsy specimen might indicate urinary tract disease.     

CELLULAR FEATURES OF SONOGRAPHIC TARGET LESIONS OF THE LIVER AND SPLEEN IN 21 DOGS AND A CAT

Target lesions are seen in ultrasound images of the liver or spleen as nodules or masses with a hypoechoic rim and a hyperechoic or isoechoic center. To assess the diagnostic significance of finding a target lesion, the cytologic and/or histopathologic findings were reviewed in a series of 21 dogs and a cat that had hepatic and/or splenic target lesions noted during abdominal ultrasonography. Twelve of 16 hepatic target lesions and 5 of 7 splenic target lesions were malignant. In this series, the finding of one or more target lesions in the liver or spleen had a positive predictive value for malignancy of 74%; for the finding of multiple target lesions in one organ, the positive predictive value for malignancy was 81%. Benign lesions associated with target lesions were nodular hyperplasia of the liver and spleen, pyogranulomatous hepatitis, cirrhosis, and chronic active hepatitis.