Delayed asymptomatic progressive intraventricular pneumocephalus in a dog following craniotomy

Delayed pneumocephalus developed in a 9-year-old dog following transfrontal craniotomy and implantation of an experimental local chemotherapy into a partially resected oligodendroglioma, but the animal appeared to be asymptomatic. MRI evidence of increasing intracranial pressure, including progressive ventricular dilatation and compression of periventricular parenchyma, led to the recommendation for exploratory craniotomy. The barrier between the intracranial cavity and frontal sinus was enhanced, and pneumocephalus resolved on MRI at both 1 and 3 months following the repair.     

Intraventricular tension pneumocephalus as a complication of transfrontal craniectomy: a case report

OBJECTIVE: To report the diagnosis and surgical treatment of a case of intraventricular tension pneumocephalus in a dog after a transfrontal craniectomy for removal of a falx cerebri meningioma. STUDY DESIGN: Case report. ANIMAL: A 12-year-old spayed English springer spaniel. RESULTS: Intraventricular air and a fistula between the craniectomy site and ventricular system were identified by magnetic resonance imaging. Prompt repair of the dural defect using prosthetic dura mater resulted in immediate regression of the neurological signs and cerebral spinal fluid rhinorrhea. Magnetic resonance imaging repeated 8 weeks after surgery showed complete resolution of pneumocephalus. CONCLUSIONS AND CLINICAL RELEVANCE: Tension pneumocephalus is an uncommon but life-threatening complication of craniectomy that requires urgent diagnosis and treatment.     

Magnetic resonance imaging in the diagnosis and surgical management of sacral osteochondrosis in a mastiff dog

The clinical, radiographic, magnetic resonance imaging (MRI), surgical and pathological findings related to an osteochondral lesion of the sacrum in a mastiff dog are described. The dog showed chronic signs of pain in its pelvic limbs. Radiography revealed a triangular mineralised opacity at the craniodorsal aspect of the sacrum consistent with sacral osteochondrosis. A T2-weighted spin-echo MRI revealed dorsal and lateral compression of the cauda equina. The osteochondral fragment was removed via a dorsal laminectomy, and the clinical signs resolved. Histological abnormalities in the fragment were consistent with a diagnosis of osteochondrosis.     

Ventricular pneumocephalus and septic meningoencephalitis secondary to dorsal rhinotomy and nasal polypectomy in a dog

CASE DESCRIPTION: A 4-year-old sexually intact female French Bulldog was evaluated because of lethargy, anorexia, and chronic rhinitis-sinusitis. The dog had nasal discharge of 18 months' duration; dorsal rhinotomies were performed 3 months and 2 weeks prior to referral. CLINICAL FINDINGS: On initial evaluation, intraventricular pneumocephalus and sinusitis were diagnosed; CSF analysis revealed high total protein concentration and mononuclear pleocytosis. The dog's condition improved with treatment. Two weeks after discharge, it was treated by a local veterinarian because of upper airway obstruction; 3 days later, the dog was referred because of seizures. Computed tomography revealed a large fluid-filled, left lateral ventricle and a soft tissue mass protruding through a cribriform plate defect. The mass was histologically consistent with brain tissue. Findings of clinicopathologic analyses were unremarkable. Results of cytologic examination of a CSF sample were indicative of septic, suppurative inflammation, and bacteriologic culture of CSF yielded Escherichia coli. TREATMENT AND OUTCOME: Amputation of the herniated olfactory bulb and antimicrobial treatment resolved the septic meningoencephalitis, but neurologic deficits recurred 6 weeks later. Definitive correction of the cribriform plate defect with bone and fascial grafts was attempted. Postoperative rotation of the bone graft resulted in cerebral laceration and hemorrhage, and the dog was euthanized. CLINICAL RELEVANCE: Findings suggest that following dorsal rhinotomy and nasal polypectomy surgery, the dog developed herniation of the left olfactory bulb, intra-ventricular pneumocephalus, and septic meningo-encephalitis because of a cribriform plate defect. Care must be taken to prevent rotation of bone grafts used in cribriform defect repair.     

Paratracheal cervical mass in a dog

A 14-year-old female Welsh Terrier was presented for evaluation of multiple skin masses. Two of them were diagnosed as a follicular (epidermal) cyst and a sebaceous epithelioma by cytology and histopathology. The third mass was located in the subcutis adjacent to the cervical trachea. Clinical findings, thoracic radiography, and laboratory results were otherwise unremarkable. Cytologically, the cervical mass was characterized by the presence of round to polygonal cells with distinct cell borders, mild to moderate anisocytosis, round to oval eccentric nuclei with prominent nucleoli, and a variable amount of finely granular, eosinophilic cytoplasm. Differential diagnoses included endocrine/neuroendocrine tumors such as thyroid adenocarcinoma, medullary thyroid carcinoma, carotid body chemodectoma, and parathyroid carcinoma. The mass was removed surgically and submitted for histopathologic and immunohistochemical examination. Histologically, the mass was composed of rows and nests of densely packed cells separated by thin fibrovascular stroma. Neoplastic cells had moderate to large amounts of pale eosinophilic dusty or finely vacuolated cytoplasm and round to oval nuclei with finely dispersed chromatin and 1 or 2 small nucleoli. On immunohistochemistry, neoplastic cells were positive for chromogranin A, calcitonin, and neuron-specific enolase, and were negative for cytokeratin and thyroglobulin. The final diagnosis was medullary thyroid carcinoma, an uncommon endocrine tumor of dogs that has cytologic and histopathologic features similar to other endocrine and neuroendocrine tumors. Immunohistochemistry or immunocytochemistry should be performed to differentiate medullary thyroid carcinoma from other endocrine/neuroendocrine tumors of dogs.     

Congenital lobar emphysema and tension pneumothorax in a dog.

Congenital lobar emphysema (CLE) and tension pneumothorax (TPT) are rarely reported in dogs. A case of CLE of the right middle lung lobe predisposing to air trapping, alveolar hyperinflation, and pleural rupture resulting in fatal spontaneous TPT in a 6-month-old mixed breed dog is described. The unique alteration of "bloat line" was observed in this case in addition to compressive atelectasis of all other lung lobes and lack of negative pressure within the thoracic cavity, signifying markedly elevated intrathoracic pressure. Bronchial cartilage hypoplasia and bronchiectasis were confirmed microscopically, which likely led to abnormal dynamic collapse of bronchi during expiration, consequentially leading to increased intrapulmonary pressure, bullous emphysema, and pleural rupture resulting in TPT. TPT consequent to CLE may therefore be considered one of the potential causes of sudden death in young dogs without overt clinical illness.     

Myoclonus and urinary retention following subarachnoid morphine injection in a dog

A 5-year-old German Shepherd dog which presented for total hip replacement developed myoclonus and urinary retention after the subarachnoid injection of preservative-free morphine. Myoclonus was resistant to treatment, except pentobarbital anesthesia. Urinary retention was treated with bethanechol and subsided within a few days. Involuntary muscular activity can result from the epidural, subarachnoid or systemic injection of various opioid drugs, or as a result of the toxic or irritant effect of preservatives or autologous blood. The latter were not causative factors in this case. Opioid agonist inhibition of central inhibitory neurotransmitter action may have explained the myoclonus. Postoperative urinary retention was attributed to the spinal action of morphine inhibiting efferent parasympathetic nervous activity.     

Transpelvic urethrostomy in a Staffordshire bull terrier: a new technique in the dog

An eight-year-old male Staffordshire bull terrier was presented with a bleeding mass in the urethral mucosa 1.5 cm distal to the ischial arch. After cytological findings suggestive of a squamous cell carcinoma and confirmation of the mass with urethroscopy, total penile amputation followed by transpelvic urethrostomy using an ischial symphyseal ostectomy was performed. The procedure successfully produced a tension-free anastomosis of the urethra to the skin in the scrotal position and no major complications were observed in the postoperative period. Histologically, the lesion was reported as a ruptured vascular structure with thrombosis and repair tissue. Seven months after surgery the dog is free of clinical signs.     

Ectopic cervical thymic carcinoma in a dog

A 10-year-old male German shepherd dog was referred for evaluation of a cranial cervical mass causing progressively worsening respiratory distress. A fine-needle aspirate of the mass was obtained and the cytology results were compatible with a carcinoma. The dog underwent chemotherapy without clinical improvement and was ultimately euthanased because of clinical deterioration. At post-mortem examination, an irregular multi-lobated mass in the cranial cervical region was observed causing ventro-lateral tracheal deviation. Histopathology and immunohistochemistry revealed a mixed population of CD3 lymphocytes and macrophages in an exuberant fibrous stroma, associated with dispersed cytokeratin-positive epithelial cells with marked eosinophilic cytoplasm. Some of the epithelial cells were arranged in concentric clusters that were interpreted as Hassall's corpuscles. Histopathological examination of the thyroid gland revealed several neoplastic emboli composed of epithelial cells similar to those observed in the cervical mass. To the authors' knowledge, this is the first report of an ectopic cervical thymic carcinoma in a dog.     

Use of a rivet-like titanium clamp closure system to replace an external frontal bone flap after transfrontal craniotomy in a dog

A 10-year-old spayed female dog was referred for surgical removal of a brain tumor that had been identified following an acute onset of seizure activity 2 weeks earlier. A computed tomographic evaluation involving contrast agent revealed the presence of a contrast-enhanced mass within the left olfactory lobe of the brain. After removal of the mass via a transfrontal craniotomy, the overlying frontal bone flap was replaced and secured by use of a biologically inert rivet-like titanium clamp closure system and 3 titanium alloy craniotomy line clamps. On reevaluation 4 weeks after tumor removal, the dog was free of seizure activity and had no proprioceptive deficits; according to the owner, the dog had marked improvement in its overall behavior and attitude. The titanium clamp closure system appears to offer an effective and rapid technique for the secure replacement of craniotomy bone flaps in dogs.     

Infiltrative lipoma in cervical bones in a dog

A 4-year-old, neutered male Maltese presented with a 2-month history of right hemiparesis. The radiographic findings revealed bone lysis, and sclerotic changes in the right section of the fifth and sixth cervical bones with a mild radiolucent mass around the lesion. The magnetic resonance imaging revealed a hyperintense mass located in the region extending from the muscles to the bones and compressing the spinal cord. The mass was removed via a hemilaminectomy in the cervical area using the ventral and dorsal approach, and a histological examination confirmed that it was adipose tissue. An infiltrative lipoma was diagnosed based on these findings. The dog has ambulated normally for 24 months since undergoing surgery.     

Metaplastic ossification of a cervical sialocoele in a dog

Metaplastic ossification of a long-standing cervical sialocoele was identified in a 2-year-old male Hellenic Hound dog. Diagnosis was based upon history, clinical findings, paracentesis and histopathology. Trauma or chronic inflammation of the mandibular gland/duct complex were the most probable causes of the ossification. Surgical excision of the ossified mass, as well as of mandibular and sublingual salivary glands/ducts of the affected side, resulted in clinical remission.     

Long-term survival after surgical excision of a schwannoma of the sixth cervical spinal nerve in a dog

A schwannoma of the sixth cervical spinal nerve in a 5-year-old Shetland Sheepdog was surgically excised, sparing the thoracic limb and resulting in long-term survival. The dog had been referred because of slowly progressive left thoracic limb lameness. The lesion was localized to the left suprascapular and musculocutaneous nerves or the C6 and C7 spinal nerves on the basis of neurologic examination, electrodiagnostic examination, and myelography. Surgical exploration revealed a mass, which was excised and identified histologically as a schwannoma. Three and a half years later, the dog was normal except for mild gait abnormality, focal muscle atrophy, and a focal area of decreased cutaneous sensation of the left thoracic limb.     

Teratoma in the cervical spinal cord of a dog

An 11-year-old, spayed female giant schnauzer was presented for evaluation of chronic, progressive tetraparesis. Diagnostic imaging was consistent with intervertebral disk protrusion, and surgical decompression and stabilization were performed. Postoperatively the dog did not improve, and further imaging suggested an intramedullary mass at the level of the sixth cervical vertebra. The dog was euthanized 7 days after surgery, and a teratoma was found postmortem.     

Successful conservative treatment of cervical discospondylitis in a dog

A discospondylitis between C₆ and C₇ was treated with trimethoprim* for two months. Spontaneous fusion of the involved vertebrae was observed within 6 months. Neurological symptoms disappeared completely at that time.     

Postoperative complication of cervical fracture repair in a dog

Fracture and luxation of the second cervical vertebra of a dog were repaired with braided polyester sutures. After 28 months, the dog became ataxic. Compression of the spinal cord at C1-2 was seen on a myelogram. Surgical exploration of the area revealed a granuloma associated with the sutures and compressing the spinal cord. After the granuloma was removed, the dog recovered and has remained neurologically normal for 21 months. The abnormal tissue was determined histologically to be a pyogranuloma.     

Oligodendroglioma in the cervical spinal cord of a dog

A 7-year-old male castrated Yorkshire Terrier dog developed slowly progressive neurologic disturbances consisting of difficulties in moving the neck, lack of proprioception, and tetraparesis 4 months prior its death. Neurologic examination, computer tomography, and myelography resulted in the tentative diagnosis of intramedullary cervicothoracic spinal cord lesion. At necropsy, an intramedullary cervical spinal cord mass between C5 and C6 was noticed. Histologically, cells of this well-demarcated, nonencapsulated neoplasm were arranged in sheaths or cords separated by a fine fibrovascular stroma. The polygonal to round tumor cells were characterized by moderate pale, basophilic, and vacuolar cytoplasm and round to slightly oval, centrally located nuclei with fine-stippled heterochromatin, a single nucleolus, and a very low mitotic activity. Tumor cells lacked glial fibrillary acidic protein, vimentin, factor VIII-related, and cytokeratin antigen expression. Histologic and immunohistochemical findings led to the diagnosis of a cervical spinal cord oligodendroglioma.