Validation of a Rapid Parathyroid Hormone Assay and Intraoperative Measurement of Parathyroid Hormone in Dogs with Benign Naturally Occurring Primary Hyperparathyroidism

Objectives— To (1) validate a rapid chemiluminescent parathyroid hormone (PTH) assay, (2) determine it's usefulness locating a parathyroid nodule(s), and (3) determine if >50% decrease in PTH corresponds with excision of autonomously functioning parathyroid tissue. Study Design— Prospective cohort study. Animals— Dogs (n=12) with naturally occurring primary hyperparathyroidism and 25 healthy dogs. Methods— The assay was validated with linearity, precision, and intermethod comparison. Preoperative and postoperative systemic plasma PTH concentrations, measured from saphenous venous blood, were compared. Intraoperative local PTH concentrations were measured in right and left jugular venous blood before and after surgical excision of the grossly abnormal parathyroid gland(s). Results— Within run and day‐to‐day precisions were acceptable (coefficient of variation <15%). Dilutional parallelism was used to demonstrate high correlation between measured and calculated PTH concentrations (R²=0.99). The assay methods had good correlation but numerical results of the rapid assay were usually lower than the immunoradiometric assay. Seven of 12 dogs had uniglandular disease and five had multiglandular disease. Systemic and local PTH concentrations decreased >50% in all the dogs after excision of the parathyroid gland(s). Mean preoperative systemic plasma PTH concentrations were significantly higher than mean postoperative systemic concentrations. Local PTH concentrations could not be used reliably to differentiate the side of the autonomously functioning gland(s). Hypercalcemia resolved postoperatively in all the dogs. Conclusion— This assay measures PTH in dogs. Rapid PTH measurement provided documentation of decreased PTH concentration after removal of autonomously functioning parathyroid tissue. Clinical Relevance— Use of this assay allows documentation of a significant decrease in PTH concentration after excision of autonomously functioning parathyroid tissue.     

Bilateral Iliopsoas Muscle Contracture and Spinous Process Impingement in a German Shepherd Dog

Objective— To report diagnosis and treatment of bilateral iliopsoas muscle contracture in a dog with spinous process impingement. Study design— Case report. Animals— German Shepherd dog. Methods— A dog with chronic progressive lameness, flexion contracture of the coxofemoral joints, severe pain, and decreased femoral reflexes had severe spondylosis bridging the vertebral bodies from L1 to L4 and enlarged dorsal spinous processes from T8 to L6 with impingement and bony proliferation. Ultrasonographic and magnetic resonance imaging (MRI) findings were consistent with fibrosis, mineralization, and atrophy of the iliopsoas muscles bilaterally which was treated by staged tenectomy of the insertions of the iliopsoas muscles. Results— Because of severe perivascular fibrosis, the femoral vessels required ligation. Bilateral iliopsoas muscle tenectomy improved gait and provided pain relief. Histologic findings were consistent with fibrotic myopathy. Conclusions— Slow progression of severe clinical signs observed bilaterally in this dog differs from previous reports of iliopsoas myopathy. Findings were similar to the fibrotic myopathy of the gracilis or semitendinosus muscles described in dogs. Clinical Relevance— Iliopsoas muscle abnormalities should be considered in dogs with limited hip extension and pain. MRI is useful for diagnosing muscle fibrosis. Iliopsoas tenectomy may improve clinical function in dogs with fibrotic myopathy.     

Presumptive primary cardiac lymphoma in a cat causing pericardial effusion

We report a case of primary cardiac lymphoma in a cat, causing pericardial effusion. A 13-year-old castrated male Himalayan cat was evaluated for chronic weight loss and radiographic finding of cardiomegaly. Pericardial effusion and a heart mass were detected via echocardiography. Pericardiocentesis and ultrasound-guided fine needle aspirate of the heart mass were performed under sedation. Antemortem diagnosis of cardiac lymphoma was made based on cytology of pericardial fluid. Based on physical examination, laboratory tests and abdominal radiographs, primary cardiac lymphoma was established as the presumptive clinical diagnosis. Treatment with chemotherapeutic agents was initiated.     

In Vitro Pullout Strength of Screws Inserted in Adult Equine Third Metacarpal Bone After Overdrilling a 4.5-mm Threaded Insertion Hole

Objective—To determine and compare the in vitro pullout strength of 5.5-mm cortical versus 6.5-mm cancellous bone screws inserted in the diaphysis and metaphysis of adult equine third metacarpal (MCIII) bones, in threaded 4.5-mm cortical bone screw insertion holes that were then overdrilled with a 4.5-mm drill bit to provide information relevant to the selection of a replacement screw if a 4.5-mm cortical screw is stripped. Study Design—In vitro pullout tests of 5.5-mm cortical and 6.5-mm cancellous screws in equine MCIII bones. Sample Population—Two independent cadaver studies each consisting of 14 adult equine MCIII bones. Methods—Two 4.5-mm cortical screws were placed either in the middiaphysis (study 1) or distal metaphysis (study 2) of MCIII bones. The holes were then overdrilled with a 4.5-mm drill bit and had either a 5.5-mm cortical or a 6.5-mm cancellous screw inserted; screw pullout tests were performed at a rate of 0.04 mm/second until screw or bone failure occurred. Results—In diaphyseal bone, the screws failed in all tests. Tensile breaking strength for 5.5-mm cortical screws (997.5 ± 49.3 kg) and 6.5-mm cancellous screws (931.6 ± 19.5 kg) was not significantly different. In metaphyseal bone, the bone failed in all tests. The holding power for 6.5-mm cancellous screws (39.1 ± 4.9 kg/mm) was significantly greater than 5.5-mm cortical screws (23.5 ± 3.5 kg/mm) in the metaphysis. There was no difference in the tensile breaking strength of screws in the diaphysis between proximal and distal screw holes; however, the holding power was significantly greater in the distal, compared with the proximal, metaphyseal holes. Conclusions—Although tensile breaking strength was not different between 5.5-mm cortical and 6.5-mm cancellous screws in middiaphyseal cortical bone, holding power of 6.5-mm cancellous screws was greater than 5.5-mm cortical screws in metaphyseal bone of adult horses. Clinical Relevance—If a 4.5-mm cortical bone screw strips in MCIII diaphyseal bone of adult horses, either a 5.5-mm cortical or 6.5-mm cancellous screw, however, would have equivalent pullout strengths. A 6.5-mm cancellous screw, however, would provide greater holding power than a 5.5-mm cortical screw in metaphyseal bone.     

Surgical Management of Multiple Congenital Intrahepatic Shunts in Two Dogs

Objective —To present details of an unusual type of portosystemic shunt and its surgical management in two dogs.
Animals —Two young dogs that had a tentative diagnosis of a portosystemic shunt on the basis of clinical signs and serum biochemical abnormalities. Abdominal ultrasonography and contrast portography demonstrated multiple intrahepatic shunts. In both cases, the multiple shunts arose from a single branch of the portal vein.
Outcome—It was possible to locate and attenuate flow through the shunts via a transportal venotomy under conditions of hepatic vascular occlusion. Clinical and biochemical abnormalities resolved after surgery in both dogs. Postoperative sonography revealed complete obliteration of the shunt plexus in one of the dogs.