Urinary and Plasma Catecholamines and Metanephrines in Dogs with Pheochromocytoma,Hypercortisolism, Nonadrenal Disease and in Healthy Dogs

Background

Diagnosis of pheochromocytoma (PC) is based on a combination of clinical suspicion, finding an adrenal mass, increased plasma, and urine concentrations of catecholamine metabolites and is finally confirmed with histopathology. In human medicine, it is controversial whether biochemically testing plasma is superior to testing urine.

Objectives

To measure urinary and plasma catecholamines and metanephrines in healthy dogs, dogs with PC, hypercortisolism (HC), and nonadrenal diseases (NAD) and to determine the test with the best diagnostic performance for dogs with PC.

Animals

Seven PC dogs, 10 dogs with HC, 14 dogs with NAD, 10 healthy dogs.

Methods

Prospective diagnostic clinical study. Urine and heparin plasma samples were collected and stored at −80°C before analysis using high‐pressure liquid chromatography (HPLC) coupled to electrochemical detection or tandem mass spectrometry were performed. Urinary variables were expressed as ratios to urinary creatinine concentration.

Results

Dogs with PC had significantly higher urinary normetanephrine and metanephrine : creatinine ratios and significantly higher plasma‐total and free normetanephrine and plasma‐free metanephrine concentrations compared to the 3 other groups. There were no overlapping results of urinary normetanephrine concentrations between PC and all other groups, and only one PC dog with a plasma normetanephrine concentration in the range of the dogs with HC and NAD disease. Performances of total and free plasma variables were similar. Overlap of epinephrine and norepinephrine results between the groups was large with both urine and plasma.

Conclusion and clinical importance

Measurement of normetanephrine is the preferred biochemical test for PC and urine was superior to plasma.     

3 TESLA MAGNETIC RESONANCE IMAGING OF THE OCCIPITOATLANTOAXIAL REGION IN THE NORMAL HORSE

The aim of this study was to describe the appearance of the ligamentous structures of the occipitoatlantoaxial (OAA) region in the normal horse by 3 tesla (3T) magnetic resonance imaging (MRI). The MRI images of the longitudinal odontoid ligament, tectorial membrane, dorsal and ventral atlantoaxial ligaments, dorsal atlantooccipital membrane with its reinforcing ligaments, and the lateral atlantooccipital ligaments of 10 horse cadavers were evaluated. All ligaments and membranes were identified in all planes, except for the lateral atlantooccipital ligament in the sagittal plane due to its cranioventrolateral course. All were iso to mildly hypointense to musculature of the neck in T1W with the exception of the tectorial membrane that was moderately hypointense; moderately hypointense in PD‐SPIR, and markedly hypointense (isointense to cortical bone) in T2W. The PD‐SPIR was the best sequence to identify all ligaments and membranes from their cranial and caudal attachments. The longitudinal odontoid ligament, ventral atlantoaxial ligament, and reinforcing bands of the dorsal atlantooccipital membrane presented a characteristic striped heterogeneous signal behavior thought to be due to fibrocartilaginous content. The remaining ligaments and membranes showed homogeneous signal intensity. Special anatomical features in this species such as the fan‐shaped longitudinal odontoid ligament, absence of the transverse ligament and presence of the ventral atlantoaxial ligament were documented. Ligamentous structures that stabilize the equine OAA region were described with MRI in this study and these findings could serve as an anatomic reference for those cases where instability of this region is suspected.     

ENDOSCOPIC ULTRASOUND INSTRUMENTATION, APPLICATIONS IN HUMANS, AND POTENTIAL VETERINARY APPLICATIONS

Endoluminal scanning under endoscopic guidance, or endoscopic ultrasonography (EUS), has become the most significant advance for imaging the gastrointestinal (GI) tract wall and contiguous organs in the past 20 years. It was originally designed to overcome the limitations in humans to imaging the abdominal organs transabdominally, such as large penetration depths and GI air. This imaging modality provides detailed images of pathological processes both within and outside of the GI wall since a high-frequency transducer can be brought into close proximity with the target regions. It has found most success in humans for the staging of lung, gastric, and esophageal cancer, the detection of both lymphatic and hepatic metastases, and diagnosis of pancreatitis and pancreatic cancer, as well as achieving an important role in interventional and therapeutic procedures. The EUS examination can be performed to examine both the thorax and abdomen in animals when both conventional transthoracic or transabdominal ultrasound are inadequate due to intervening air, bone, large penetration depths, or obesity. The echoendoscope is similar to a conventional endoscope but has an ultrasound transducer at its tip. Both radial and linear multifrequency scanners are available. Linear scanners allow fine-needle aspiration (FNA) of the bowel wall or extraluminal structures. Transducer coupling is either by direct mucosal contact or by inflation of a water-filled balloon surrounding the transducer. Current thoracic applications for EUS in veterinary medicine include examination of the mediastinum, bronchial lymph nodes, esophagus, and pulmonary lesions as well as FNA of pulmonary masses. Abdominal applications include examination of both pancreatic limbs and the liver, including portosystemic shunts, detection of lymphadenomegaly, and examination of the gastric wall, duodenum, and jejunum. Other potential applications in dogs and cats include tumor staging and intrapelvic ultrasound.     

Extracutaneous viral inclusions in psittacine beak and feather disease

Thirty-five birds that died with naturally acquired psittacine beak and feather disease (PBFD) were necropsied to identify extracutaneous viral inclusions. Inclusions were found in various tissue sections from 34 of 35 birds. By immunoperoxidase staining, intranuclear and intracytoplasmic inclusion bodies were shown to contain PBFD viral antigen. Inclusion-bearing lesions were widely disseminated but often closely associated with the alimentary tract. Lesions within the palate, esophagus, crop, intestine, bursa of Fabricius, and liver probably serve as sources for viral shedding into the feces.     

Determination of chicken and turkey plasma and serum protein concentrations by refractometry and the biuret method

Plasma and serum protein concentrations were determined in chickens and turkeys by refractometry (with human and veterinary refractometers) and by the biuret method. Chicken and turkey serum protein values were significantly lower than respective plasma protein values according to both methods. Refractometer readings for both plasma and serum correlated closely with the results of the biuret test (r2 = 0.72 to 0.97). These findings indicate that plasma and serum protein values may be determined accurately in chickens and turkeys with a handheld refractometer.     

Congenital unilateral facial nerve paralysis in a Warmblood filly

A 17-month-old Warmblood filly was referred to our clinic for evaluation of congenital facial nerve (FN) paralysis. Clinical examination revealed a right-sided facial paralysis with mild masticatory muscle atrophy, mild dysphagia and exposure keratitis. Apart from the FN deficits, neurological examination of the remaining cranial nerves showed no abnormalities. Magnetic resonance imaging (MRI) examination using a 3.0 Tesla scanner showed that in comparison to the left FN, the intracranial section of the right FN between the pons and internal acoustic canal was thinner, whereas it appeared indistinct and thickened within the internal acoustic canal and facial canal. Signs of meningitis or encephalitis were not present on MRI. Cerebrospinal fluid analysis showed mild pleocytosis. The owner of the filly requested euthanasia due to the guarded prognosis. At necropsy, the intracranial section of the right FN was macroscopically thinner than the left side and within the facial canal, a 5 mm tissue stump could be identified with an absent extracranial part of the right FN. Histological examination of the brain stem showed different architecture of the left and right motor nuclei of the FN: in the left nucleus, motor neurons of a normal size and well stainable Nissl bodies were present, whereas in the right nucleus, neurons with Nissl bodies were decreased in number and size. Further, a cytoplasmic rich cell population with a nucleus size compatible with normal neurons was present. These cells were suspected to be atrophic neurons. The tissue stump within the facial canal was histologically identified as connective tissue. Unilateral malformation of the FN has not previously been described in the horse. This filly showed a right-sided, intracranial hypoplasia accompanied by an extracranial aplasia of the FN causing complete, congenital facial nerve paralysis, which corresponded to a difference in the architecture of the affected motor nucleus of the FN.     

Comparison between magnetic resonance imaging,computed tomography,and arthrography to identify artificially induced cartilage defects of the equine carpal joints

While articular cartilage changes are considered to be one of the initial events in the pathological cascade leading to osteoarthritis, these changes remain difficult to detect using conventional diagnostic imaging modalities such as plain radiography. The aim of this prospective, experimental, methods comparison study was to compare the sensitivity of magnetic resonance imaging (MRI), magnetic resonance arthrography, computed tomography (CT), and CT arthrography in the detection of artificially induced articular cartilage defects in the equine carpal joints. Defects were created in the antebrachiocarpal and middle carpal joint using curettage by a board‐certified equine surgeon. Normal articular cartilage thickness varied from a maximum of 1.22 mm at the level of the distal aspect of the radius to a minimum of 0.17 mm in the proximal articular surface of the third carpal bone. Regarding cartilaginous defect measurements the remaining cartilaginous bed range from a maximum of 0.776 mm in the partial thickness defects, and 0 mm (defect reaches the subchondral bone) when total thickness defect were made. Computed tomography and magnetic resonance imaging were performed followed by CT arthrography and magnetic resonance arthrography after antebrachiocarpal and middle carpal intraarticular contrast administration. All images were reviewed by two board‐certified veterinary radiologists, both of whom were blinded to the location, presence of, and thickness of the cartilage defects. A total number of 72 lesions in nine limbs were created. Mean sensitivity for localizing cartilage defects varied between imaging modalities with CT arthrography showing the best sensitivity (69.9%), followed by magnetic resonance arthrography (53.5%), MRI (33.3%), and CT (18.1%) respectively. The addition of contrast arthrography in both magnetic resonance and CT improved the rate of cartilage lesion detection although no statistical significance was found. Computed tomographic arthrography displayed the best sensitivity for detecting articular cartilage defects in the equine antebrachiocarpal and middle‐carpal joints, compared to magnetic resonance arthrography, MRI, and CT.     

3 Tesla magnetic resonance imaging study of the normal canine femoral and sciatic nerves

Understanding the normal course and optimizing visualization of the canine peripheral nerves of the lumbar plexus, in particular the sciatic and the femoral nerves, is essential when interpreting images of patients with suspected peripheral neuropathies such as inflammatory or neoplastic conditions. The purpose of this prospective, anatomic study was to describe the magnetic resonance imaging (MRI) anatomy of the normal canine femoral and sciatic nerves and to define the sequences in which the nerves are best depicted. A preliminary postmortem cadaver study was performed to determine optimal sequences and imaging protocol. In a second step the optimized technique was implemented on 10 healthy Beagle dogs, included in the study. The applied protocol included the following sequences: T1‐weighted, T2‐weighted, T2‐Spectral Attenuated Inversion Recovery, T1‐weighted postcontrast and T1‐Spectral Presaturated Inversion Recovery postcontrast. All sequences had satisfactory signal‐to‐noise ratio and contrast resolution in all patients. The sciatic and femoral nerves were seen in all images. They were symmetric and of homogeneous signal intensity, being iso‐ to mildly hyperintense to muscle on T2‐weighted, mildly hyperintense in T2‐Spectral Attenuated Inversion Recovery, and iso‐ to mildly hypointense in T1‐weighted images. No evidence of contrast enhancement in T1‐weighted and T1‐Spectral Presaturated Inversion Recovery postcontrast sequences was observed. The anatomic landmarks helpful to identify the course of the femoral and sciatic nerves are described in detail. This study may be used as an anatomical reference, depicting the normal canine femoral and sciatic nerves at 3 Tesla MRI.