Results of Transsphenoidal Hypophysectomy in 52 Dogs With Pituitary-Dependent Hyperadrenocorticism

Objective —To evaluate microsurgical transsphenoidal hypophysectomy in dogs with pituitary-dependent hyperadrenocorticism (PDH). Study Design —Prospective study to evaluate the results (survival and disease-free interval, remission, recurrence) and complications of microsurgical transsphenoidal hypophysectomy by clinical follow-up, computed tomography (CT), and urinary corticoid-to-creatinine (C/C) ratios in dogs with PDH. The effect of surgical experience was investigated by comparing results of hypophysectomy cases 1 through 26 and 27 through 52. Animals or Sample Population—52 dogs with PDH. Results —Preoperative CT enabled accurate assessment of pituitary size (24 nonenlarged and 28 enlarged) and localization relative to intraoperative anatomic landmarks. Treatment failures included procedure-related mortalities (five dogs) and incomplete hypophysectomies (four dogs). The 1-year estimated survival rate was 84% (95% confidence interval [CI], 71% to 92%). The 2-year estimated survival rate was 80% (95% CI, 65% to 90%). In 43 dogs, the hyperadrenocorticism went into remission. Hyperadrenocorticism recurred in five dogs. The 1-year estimated relapse-free fraction was 92% (95% CI, 76% to 97%). The main complications were transient, mild, postoperative hypernatremia; transient reduction or cessation of tear production (25 eyes in 18 dogs); permanent (five dogs) or prolonged (nine dogs) diabetes insipidus; and secondary hypothyroidism. Normal tear production had resumed in all but one case after a median period of 10 weeks. In the second case series (27 through 52), the hospitalization period was shorter, the number of dry eyes fewer, the survival fraction greater, and the postoperative mortality lower than in the first series. In 15 dogs in which remission was obtained, postoperative CT images suggested the presence of small pituitary remnants; in 1 of these, hyperadrenocorticism recurred. In 46 dogs, the histological diagnosis was pituitary adenoma. Conclusions —Microsurgical transsphenoidal hypophysectomy in dogs with PDH is an effective method of treatment in specialized veterinary institutions having access to advanced pituitary imaging techniques. Postoperative CT findings do not correlate well with remission or subsequent recurrence of hyperadrenocorticism. Clinical Relevance —The neurosurgeon performing hypophysectomies must master a learning curve and must be familiar with the most frequent complications of the operation to recognize them as early as possible and to treat them immediately and effectively. Urinary C/C ratios are sensitive indicators for the assessment of remission and recurrence of hyperadrenocorticism.     

Vitiligo in a Quarter Horse Filly: Clinicopathologic, Ultrastructural, and Nutritional Study

Vitiligo is an autoimmune disorder characterized clinically by depigmentation of the skin—both epidermis and hairs—caused by destruction of melanocytes. Vitiliginous skin shows a T-lymphocyte inflammatory infiltrate, proliferation of Langerhans cells, epidermal vacuoles, and degenerative changes in the cutaneous nerve fibrils. Increased autoantibodies against melanin, tyrosinase, and various tissues are frequently present in vitiligo patients. Vitiligo is often associated with systemic abnormalities or nutritional deficiencies. A 2-year-old Quarter Horse filly developed facial vitiligo with depigmented areas that was strikingly similar to human vitiligo. Several innocuous small biopsies provided cutaneous specimens that were processed for light and electron microscopic studies. Many of the clinical and microscopic changes observed in human vitiligo were present in this equine patient. Marginal anemia was detected. Strengthening of the filly's nutritional and feeding conditions led to rapid and complete repigmentation. Equine practitioners as well as horse owners should be aware that vitiligo may not be simply a cosmetic problem; thus, a complete evaluation of horses affected by this condition should be performed.     

DYNAMIC HELICAL COMPUTED TOMOGRAPHY OF THE PITUITARY GLAND IN HEALTHY DOGS

Dynamic helical computed tomography (CT) of the pituitary gland can be used to image the three-dimensional shape and dimensions of abnormalities within the pituitary gland. The aim of this study was to develop a protocol for dynamic helical CT of the pituitary gland in healthy dogs as a future reference study for patients with pituitary disease. Dynamic helical series of nine scans of the pituitary gland during and following contrast medium injection were performed in six healthy dogs using the following protocols: a series with 1 mm collimation and a table feed per X-ray tube rotation of 2 mm (pitch of 2) in six dogs, a series with 2 mm collimation and pitch of 2 in three dogs, and a series with 1 mm collimation and pitch of 1 in three other dogs. Multiplanar reconstructions of the images were made using a reconstruction index of 0.5. Images of all series were assessed visually for enhancement of the arteries, the neurohypophysis, and the adenohypophysis. The enhancement pattern of the neurohypophysis was distinguished adequately from that of the adenohypophysis in five dogs that were scanned with 1 mm collimation and pitch of 2, but the difference was less discernable when the other protocols were used. The carotid artery, its trifurcation, and the arterial cerebral circle were best visualized in dorsal reconstructions. Dynamic helical CT of the pituitary gland in healthy dogs can be performed with 1 mm collimation and pitch of 2, and a scan length that includes the entire pituitary region. Using this protocol, with the specific scanner used, the neurohypophysis, the adenohypophysis, and the surrounding vascular structures are adequately visualized.     

Prevalence, spread and control of caprine arthritis-encephalitis virus in dairy goat herds in New South Wales

SUMMARY A study of the prevalence, spread and control of caprine arthritis-encephalitis virus (CAEV) in dairy goat herds in New South Wales (NSW) during 1986–1988 found that 56.8% of 1484 goats in 14 dairy herds were infected with CAEV. The prevalence of CAEV infection within most herds not implementing control measures increased during the study. At the end of the study, 59.7% of 1322 goats were infected. The prevalence of CAEV increased with age. Differences between breeds were less apparent. Within seven herds with a high standard of identification of goats, 149 of 812 goats seroconverted in an ELISA. Of these newly infected goats, 142 (95.3%) were > 1 yr of age and 96 (64.4%) were > 2 yr suggesting lateral spread of the virus. Most of the goats > 2 yr of age had been in the milking herd for a minimum of 3 to 6 months. The high seroconversion rate within the milking herd suggested that factors other than the ingestion of infected colostrum and milk before weaning were important for the spread of CAEV. Observations indicated that behaviour of goats, particularly reproductive behaviour among lactating does, and milking herd management practices are important in the spread of CAEV. A high density of livestock, poor livestock control and contamination of feed, water, equipment and personnel were implicated in transmission. Poorly functioning milking machines may also be involved. CAEV was eradicated from 3 herds by the implementation of strict control measures.     

Transsphenoidal Hypophysectomy in Beagle Dogs: Evaluation of a Microsurgical Technique

Objective — Assessment of a microsurgical technique for transsphenoidal hypophysectomy in dogs.
Study Design — Prospective study using physical examination, pituitary function testing, computed tomography (CT), and histological examination at autopsy.
Animals or Sample Population — Eight laboratory beagle dogs.
Methods — Pituitary function was assessed before and at 10 weeks after hypophysectomy by combined administration of four releasing hormones (anterior pituitary), administration of haloperidol (pars intermedia), and infusion of hypertonic saline (posterior pituitary).
Results — CT imaging enabled accurate preoperative localization of the pituitary. Appropriate positioning and surgical technique facilitated exposure of the pituitary and its extraction without hemorrhage. Postoperative recovery was generally uncomplicated. None of die eight dogs had somatotropic, gonadotropic, lactotropic, melanotropic, or posterior pituitary responses to stimulation at 10 weeks after hypophysectomy. Four dogs (ACTH nonresponders) also had no cortico-tropic response and four (ACTH responders) had small but significant responses in the combined anterior pituitary function test. Adrenocortical atrophy was more pronounced in the ACTH nonresponders man in the responders. No residual pituitary tissue was found along the ventral hypothalamic diencephalon but nests of pituitary cells were found embedded in fibrous tissue in the sella turcica.
Conclusions — The surgical technique proved to be safe and effective. Microscopic nests of pituitary cells in the sella turcica may be responsible for residual corticotropic response to hypophysiotropic stimulation after hypophysectomy.
Clinical Relevance — The surgical technique may be used in the treatment of dogs with pituitary-dependent hyperadrenocorticism. The corticotropic response is the most sensitive criterion in assessing completeness of hypophysectomy in dogs.