Diagnosis of Congenital Cardiac Right-to-left Shunts with 99mTc-macroaggregated Albumin

Diagnosing right-to-left congenital cardiac shunts can be difficult. Cardiac catheterization and angiocardiography represent the traditional gold standard for diagnosis, but they are invasive. Nuclear scintigraphy using 99mTc-macroaggregated albumin (MAA) has been employed in humans as an alternate method of diagnosis. This study reviews eight dogs presented for evaluation of a suspect right-to-left cardiac shunt that were examined using 99mTc-MAA. In all, 2-4 mCi (74-148 MBq) of reduced particle 99mTc-MAA were injected IV in a cephalic vein and static images of the whole body, including right and left lateral, dorsal, and ventral views, were acquired for 60 s and stored into a 256 x 256 x 16 matrix. Shunt fractions were calculated. One dog with radiopharmaceutical distribution limited to the lungs did not have a shunt. Seven dogs had distribution of the radiopharmaceutical outside the pulmonary capillary bed, indicating bypassing of the pulmonary capillary circulation due to a right-to-left shunt. Four dogs had 99mTc-MAA within the brain. Three dogs that did not have brain uptake, but instead had a sharp cutoff of radioactivity at the level of the front limbs and neck, were diagnosed with reverse patent ductus arteriosus (PDA). The asymmetric distribution of the radiopharmaceutical is due to the location of the shunt, distal to the brachiocephalic trunk and left subclavian artery. Shunt fractions of dogs with extrapulmonary radioactivity ranged from 40% to 59%. Nuclear scintigraphy with 99mTc-MAA is a quick alternative method of diagnosing right-to-left cardiac shunts that permits quantification of shunt fraction. Distinguishing between reverse PDA and other right-to-left shunts may be possible based on the radiopharmaceutical distribution.     

Computed tomography dacryocystography evaluation of the nasolacrimal apparatus

Computed tomography-dacryocystography (CT-DCG) was used to evaluate the nasolacrimal system in four patients (three dogs and one horse) that were admitted for evaluation of chronic epiphora, facial swelling, or facial trauma. The four patients are reviewed and the technique for performing CT-DCG is described. Additionally, the indications for this procedure are discussed. CT-DCG is advantageous because cross-sectional imaging provides superior resolution of the nasolacrimal apparatus and the relatively long, small-diameter, bony nasolacrimal canal in most veterinary patients.     

Hypernatremia secondary to homemade play dough ingestion in dogs: a review of 14 cases from 1998 to 2001

Objective: To correlate the sodium chloride dosage and the serum sodium concentration to clinical signs, to determine if the dosage of homemade play dough (and, therefore, sodium chloride) is the most reliable way to predict clinical signs and prognosis, and to review previously reported treatment options. Design: Retrospective case series. Animals: Fourteen dogs with a history of homemade play dough ingestion. Procedure: Cases were examined for each animal's signalment including body weight, age, approximate amount of play dough ingested, the estimated sodium chloride dosage, clinical signs, serum sodium concentration, and outcome when available. The literature was reviewed to determine pathophysiology and treatment regimens. Results: Twelve of 14 dogs (86%) that ingested homemade play dough showed clinical signs. Vomiting (9 of 14, 64%), polydipsia, and seizures (4 of 14 each, 29%) were the most common signs followed by polyuria, tremors (3 of 14 each, 21%), and hyperthermia (2 of 14, 14%). The lowest calculated dosage associated with objective clinical signs was 1.9 g/kg. Seizures were reported in all animals with serum sodium levels greater than 180 mEq/L. Conclusions and clinical relevance: Homemade play dough ingestion can be a serious and life‐threatening problem. Many factors can contribute to the toxicity of homemade play dough. This study indicates that the serum sodium concentration is a more reliable indicator of the clinical course of the toxicity rather than the amount of play dough and, therefore, the dosage of sodium chloride ingested. Treatment should be based on a clinical evaluation of the patient and laboratory results, and consists of controlling seizures, reducing serum sodium concentrations slowly, and supportive care.     

Computed tomographic anatomy of the canine cervical vertebral venous system

Computed tomographic (CT) venography of the cervical vertebral canal was performed in six, clinically normal, adult mixed-breed dogs from 14 to 23 kg. After dogs were euthanized and saline perfused, a gelatin and iothalamate mixture was injected into the right external jugular vein. Contiguous, 4-mm-thick CT images were obtained with dogs in sternal recumbency. Dogs were kept in the same position as for the CT scan and frozen to approximately -8 degrees C. All post-contrast CT images were analyzed using similar bone window and level settings. Additional multiplanar reformatted dorsal images were obtained in all dogs. The frozen cadavers were sectioned through the cervical region extending from the occiput to T1 at approximately 8-mm intervals. The frozen sections were then compared with the CT images. The CT appearance of the normal cervical vertebral venous system was described and illustrated. Components such as the internal vertebral venous plexus, interarcuate veins, intervertebral veins, and vertebral veins were clearly identified on the CT images.