ANATOMIC MODELS AND PHANTOMS FOR DIAGNOSTIC ULTRASOUND INSTRUCTION

The preparation and application of anatomic models and phantoms to facilitate learning diagnostic ultrasound is described. Imaging with diagnostic ultrasound requires mastery of many skills, along with knowledge of sound-tissue interactions which contribute to the formation of diagnostic images and artifacts. Understanding the genesis of artifacts encountered during ultrasound scanning can avoid misinterpretation and aid diagnosis. In addition, development of machine related knowledge and skills, including manipulation of the transducer and the selection of correct settings for variables such as gain, power, time-gain compensation, and transducer type, is dependent on an understanding of how these factors affect the image. The normal appearance of an organ relates to both its echogenicity and morphologic characteristics, and confirmation of the nature of an abnormality often requires ultrasound guided biopsy. The use of anatomic models and phantoms in ultrasound instruction allows principles to be demonstrated, knowledge acquired, and biopsy procedures practiced and mastered in a controlled setting. This can minimize live animal use, and enhance the knowledge base and skills of the clinician prior to applying this diagnostic technique to the clinical patient.     

SCINTIGRAPHIC EVALUATION OF THE THORACIC SPINE IN THE ASYMPTOMATIC RIDING HORSE

Scintigraphic evaluation of the spinous processes of the equine spine has been done by subjective evaluation of radiotracer uptake in clinically abnormal horses. To determine the range of variation in asymptomatic riding horses, 33 normal horses were examined. Two 60 degrees oblique views of the thoracic and lumbar spine were evaluated subjectively, and a semi quantitative method based on standardized regions of interest in each spinous process in T10-L3 was also applied. A ratio between each spinous process and a reference area (Rib 15 or 16) was calculated. The effects of two different color displays and a smoothing filter were assessed. The results of the subjective evaluation was compared to the calculated ratios, and the associations between age, gender, weight, height, use and increased radiotracer uptake, and ratios were analyzed. No significant association was found between age, gender, weight, height, use and increased radiotracer uptake, or ratio. One or more areas of increased radiotracer uptake between T13 and T18 were common in the asymptomatic riding horse, which may have implications for the interpretation of clinical patients. The blue, green and red color display had a higher sensitivity for detecting increased radiotracer uptake compared to the continuous grayscale. The smoothing filter used in this study had no effect on the detection of areas with increased radiotracer uptake. The association between the results of the subjective evaluation and the semi quantitative method was apparent when analyzed in T13-17. To evaluate if the semi quantitative method can replace the subjective evaluation, studies on clinically affected horses are necessary.     

DIAGNOSTIC VALUE OF ULTRASONOGRAPHY IN DIFFERENTIATING ENTERITIS FROM INTESTINAL NEOPLASIA IN DOGS

One hundred and fifty dogs with histopathologically confirmed intestinal disease were evaluated retrospectively. Sixty-one dogs had enteritis and 89 dogs had intestinal neoplasia. Ultrasonographic findings including the thickness and distribution of the intestinal lesion, the integrity of intestinal wall layering, regional lymph node thickness, the location of the intestinal segment involved, and regional motility were evaluated. Dogs with intestinal tumor had wall thickness (1.5 cm) significantly greater than dogs with NSE lesions (0.6 cm; p < 0.001). Ninety-nine percent of dogs with intestinal tumor had loss of wall layering while 88% of dogs with NSE had normal or altered wall layering (p < 0.001). Dogs with NSE were significantly more likely to have diffuse lesion (72%) than dogs with intestinal tumor (2%; p < 0.001). Lymph node median thickness in 24/61 dogs with NSE was 1.00 cm. The median thickness of the lymph nodes in 56/89 dogs with intestinal tumors was 1.9 cm. A multivariate analysis showed that loss of wall layering alone was an excellent predictive factor in differentiating intestinal tumor from NSE. In our population, dogs with loss of intestinal wall layering were 50.9 times more likely to have a tumor than enteritis.     

Exercise Induced Alterations in the Serum Muscle Enzymes, Erythrocyte Potassium and Plasma Constituents Following Feed Withdrawal or Furosemide and Sodium Bicarbonate Administration in the Horse

Six thoroughbreds were used in each of three trials to examine the effect of potassium depletion on exercise-associated muscle damage. Horses were exercised after a control period (Treatment 1), a 72-hour fast (Treatment 2), and furosemide and sodium bicarbonate (Treatment 3). During the preexercise period, feed withdrawal for 72 hours caused decreases in body weight, plasma sodium, chloride, and serum calcium. There were no changes in plasma potassium, erythrocyte potassium, or serum creatine phosphokinase (CK) activity. Furosemide and sodium bicarbonate administration resulted in a decrease in plasma potassium, chloride, serum calcium, and magnesium in the pre-exercise period. Erythrocyte potassium and serum CK activity were unchanged. Body weight initially decreased following furosemide and sodium bicarbonate and then increased upon access to water. In all three treatment groups plasma sodium, potassium, L-lactate, serum calcium, and magnesium were increased immediately following exercise. There was a significant increase (P less than 0.05) in serum CK activity in the furosemide and sodium bicarbonate-treated horses compared to control and withholding feed treatment groups by 30 minutes following exercise. Erythrocyte potassium was decreased immediately following exercise in the furosemide and sodium bicarbonate group but not in the other treatment groups. Potassium depletion may play a role in exercise-induced muscle damage but could not be implicated as the sole cause of the serum CK activity increase in this study.     

Biomechanics of Cranial Cruciate Ligament Reconstruction in the Dog II. Mechanical Properties

A biomechanical analysis of the results of an over-the-top procedure for replacement of the cranial cruciate ligament (CCL) in the dog is presented. Using 15 adult mongrel dogs, the CCL in one stifle joint was reconstructed using fascia lata and the lateral one-third of the patellar ligament. The opposite CCL served as the control. Animals were sacrificed at 0, 4, 12 and 26 weeks postoperation and axial failure tests were performed. Stiffness, maximum load, and elastic modulus of the replacement increased over time, while elongation to maximum load continually decreased as compared to controls. Other parameters showed less consistent trends.
The results are encouraging given the reduction in joint laxity and the increases in tissue stiffness and strength. However, the ligament substitute was still unable to replicate the mechanical properties of the normal cruciate ligament. Longer studies therefore are required to determine if this replacement is capable of completely restoring joint stability and normal function.     

The Immediate Effect of Colposuspension on Resting and Stressed Urethral Pressure Profiles in Anaesthetized Incontinent Bitches

The aim of this study was to document what changes in the resting and stressed urethral pressure profile occur in the incontinent bitch with urethral sphincter mechanism incompetence (SMI) immediately after colposuspension. Resting and stressed subtracted simultaneous urethral pressure profilometry was performed immediately pre- and postcolposuspension in 26 bitches diagnosed with SMI. All of the urethral pressure profiles were measured in anaesthetized bitches using a standard technique and two orientations of the catheter transducers (dorsal and left). Readable pre- and postoperative urethral pressure profiles were obtained in 20 of the 26 bitches. Subjective and objective evaluation of the profiles showed significant differences in the profiles pre- and postcolposuspension. Immediately postoperatively there were significant ( P < .05) increases in functional profile length, maximum urethral closure pressure (MUCP), and distance between the bladder neck and the first negative respiratory peak and stressed spike. There was a significant ( P < .001) decrease in the percentage of negative spikes extending below the resting intravesical pressure on the subtracted profile. The pressure transmission profiles were significantly ( P < .001) altered by surgery. The findings presented support the hypothesis that colposuspension may restore continence by increasing pressure transmission to the proximal urethra and bladder neck. The results also suggest that immediately after surgery functional urethral length and urethral resistance are increased.     

Hemodynamic Effects of Atropine, Dobutamine, Nitroprusside, Phenylephrine, and Propranolol in Conscious Horses

The authors investigated the cardiovascular effects of low doses of nitroprusside, dobutamine, and phenylephrine and a beta-adrenergic blocking dose of propranolol in conscious, healthy horses with and without prior atropine administration. A parasympathetic blocking dose of atropine produced significant increases in heart rate and arterial pressures, and decreased stroke volume, ejection fraction, pulse pressure, and right-ventricular end-diastolic pressure and volume. Cardiac output was not changed by atropine administration. Nitroprusside reduced arterial pressures to a greater extent in atropinized horses but increased heart rate in both atropinized and non-atropinized horses. Dobutamine increased mean arterial pressure in both non-atropinized and atropinized horses but increased heart rate, diastolic arterial pressure, and systemic vascular resistance only in atropinized horses. Propranolol did not affect any of the hemodynamic variables that were measured. Phenylephrine, in the presence of beta-adrenergic blockade, increased mean arterial pressure and reduced cardiac output. This study showed that low doses of nitroprusside, dobutamine, and phenylephrine produce significant hemodynamic effects in conscious, healthy horses and that these effects are modified by prevailing parasympathetic tone.