TRANSSPLENIC PORTAL SCINTIGRAPHY USING 99MTC-MEBROFENIN IN NORMAL DOGS

Transsplenic portal scintigraphy using sodium pertechnetate is superior to per-rectal portal scintigraphy due to improved visualization of the portal vasculature with decreased patient and personnel exposure. The purpose of this study was to describe the use of 99mTc-mebrofenin, the radiopharmaceutical of choice for the evaluation of hepatic function, in place of pertechnetate for transsplenic portal scintigraphy in normal dogs. Sixteen juvenile dogs underwent transsplenic portal scintigraphy using 37-130 MBq 99mTc-mebrofenin in a 0.2-0.5 ml volume. After the initial dynamic acquisition obtained at 4 frames/s in right lateral recumbency, static right lateral, and ventral views were obtained at 5, 10, 15, 20, 25, 30, 40, 50, and 60 min. A nuclear angiogram of the splenic and portal veins was visible in all dogs, followed by rapid distribution of the radiopharmaceutical in the liver. Hepatic morphology was more easily defined than with pertechnetate. Transit time could not be calculated due to the high hepatic extraction of 99mTc-mebrofenin. Mean +/- SD shunt fraction was 0.8 +/- 0.8%. Time to peak liver activity was 3.1 +/- 1.1 min, and hepatic excretion T1/2 was 19.4 +/- 6.3 min. No visible blood pool and cardiac activity was seen after 5 min. The mean +/- SD time to visualization of defined biliary activity was 8.8 +/- 2.9 min. Absorption from the spleen was significantly higher than that reported for pertechnetate (87.9 +/- 8.2%, vs. 52.5 +/- 19.1%). 99mTc-mebrofenin can be used in place of pertechnetate for transsplenic portal scintigraphy, with the advantage of combining quantitative parameters of liver function with the already known advantage of transsplenic portal scintigraphy.     

REPEATABILITY OF DOPPLER ULTRASONOGRAPHIC MEASUREMENT OF EQUINE DIGITAL BLOOD FLOW

The repeatability and sensitivity of Doppler ultrasonographic measurement of lateral digital arterial and venous blood flow has not been previously determined. Doppler ultrasonography was used to measure blood flow within the forelimb lateral digital vessels in one normal adult Thoroughbred horse on six occasions and in six normal adult Thoroughbred horses on three occasions, each occasion being at least 1 h apart, to determine the within- and between-horse variation. The values obtained from the right and left lateral digital vessels did not differ significantly. The within-horse coefficients of variation (CV) for arterial and venous measurements were all acceptable (< 11%); the between-horse CV were acceptable (< 7%) for all parameters except TaVa (average velocity of first peak of arterial waveform) and TaVb (average velocity of remainder of arterial waveform). The within-horse intraclass correlation coefficients (ICC) demonstrated excellent repeatability (> or = 0.71) for all parameters except venous diameter; the between-horse ICC demonstrated good to excellent repeatability (> or = 0.67) for all parameters except TaVb. Doppler ultrasonography can detect differences of 0.005 and 0.01 ml/ min in digital arterial and venous flow, respectively, using measurements from six horses on three occasions (80% power; P < 0.05). Thus, the technique is sufficiently repeatable and sensitive to be able to detect changes in flow during different physiological or pathological states or following pharmacologic intervention.     

Laparoscopic Removal of a Large Abdominal Testicular Teratoma in a Standing Horse

Objective— To describe laparoscopic removal of a large testicular teratoma in a standing horse.
Study Design— Clinical report.
Animals— Thoroughbred horse (11 months) with a testicular teratoma.
Methods— A unilateral cryptorchid testicle could not be removed by an inguinal approach under general anesthesia because of it s large size. After recovery from general anesthesia, ultrasound evaluation revealed a 24 × 19 cm fluid-filled testicular mass. The mass was removed by paralumbar fossa laparoscopy with the horse in a standing position. After fluid aspiration of the mass, the mesorchium and ductus deferens were ligated with extracorporeal knots and the mass retrieved inside a laparoscopic specimen pouch. Morphologic features were consistent with a teratoma.
Results— Laparoscopic-guided aspiration of fluid from the teratoma decreased mass size and increased ease of manipulation and retrieval. Retrieval of the teratoma in a laparoscopic specimen pouch prevented loss of abdominal insufflation, helped reduce fluid leakage, and potential seeding of neoplastic cells.
Conclusion— Use of laparoscopy for removal of neoplastic cryptorchid testicles offers many advantages including minimal invasiveness and increased safety associated with good visibility of structures.
Clinical Relevance— Standing laparoscopic surgery should be considered for removal of testicular neoplasms in horses.     

Ischemic Postconditioning Does Not AttenuateIschemia–Reperfusion Injury of Rabbit Small Intestine

Objective— To determine whether ischemic postconditioning can attenuate intestinal ischemia–reperfusion (I–R) injury and has a beneficial effect on tissue blood flow during reperfusion. Study Design— In vivo experimental study. Animals— New Zealand White rabbits (n=6). Methods— Rabbits were anesthetized with pentobarbital, to avoid the preconditioning effects of volatile anesthetics, and ventilated with room air. Rectal temperature, hemodynamics, and normocapnia were maintained. After celiotomy, 3 jejunal segments were isolated in each rabbit for the following groups: (1) control, (2) I–R, and (3) I–R with postconditioning. I–R was induced by a 45‐minute occlusion of the segment jejunal artery followed by 2‐hour reperfusion. The postconditioning segment had 4 cycles of 30‐second reperfusion and 30‐second reocclusion during the initial 4 minutes of reperfusion. Stable isotope‐labeled microspheres were used to measure intestinal blood flow at baseline, end occlusion, and end reperfusion. At the end of reperfusion, intestine segments were harvested and the rabbits euthanatized. A semiquantitative histopathologic evaluation (0–5) was conducted by a single, blinded observer. Wet‐to‐dry weight ratios were calculated to assess intestinal edema. Results— There was no significant difference in grade of necrosis, tissue wet‐to‐dry weight ratios, or blood flow at any time point between ischemic and postconditioning groups. Conclusions— Ischemic postconditioning was ineffective in this model of intestinal I–R. Clinical Relevance— Further experimental studies will need to be performed before clinical application of postconditioning for intestinal ischemia.     

Spinal Epidural Abscess in Two Calves

Objective— To report clinical signs, diagnostic and surgical or necropsy findings, and outcome in 2 calves with spinal epidural abscess (SEA). Study Design— Clinical report. Animals— Calves (n=2). Methods— Calves had neurologic examination, analysis and antimicrobial culture of cerebrospinal fluid (CSF), vertebral column radiographs, myelography, and in 1 calf, magnetic resonance imaging (MRI). A definitive diagnosis of SEA was confirmed by necropsy in 1 calf and during surgery and histologic examination of vertebral canal tissue in 1 calf. Results— Clinical signs were difficulty in rising, ataxia, fever, apparent spinal pain, hypoesthesia, and paresis/plegia which appeared 15 days before admission. Calf 1 had pelvic limb weakness and difficulty standing and calf 2 had severe ataxia involving both thoracic and pelvic limbs. Extradural spinal cord compression was identified by myelography. SEA suspected in calf 1 with discospondylitis was confirmed at necropsy whereas calf 2 had MRI identification of the lesion and was successfully decompressed by laminectomy and SEA excision. Both calves had peripheral neutrophilia and calf 2 had neutrophilic pleocytosis in CSF. Bacteria were not isolated from CSF, from the surgical site or during necropsy. Calf 2 improved neurologically and had a good long‐term outcome. Conclusion— Good outcome in a calf with SEA was obtained after adequate surgical decompression and antibiotic administration. Clinical Relevance— SEA should be included in the list of possible causes of fever, apparent spinal pain, and signs of myelopathy in calves.     

In Vitro and In Vivo Evaluation of Ferric-Hyaluronate Implants for Delivery of Amikacin Sulfate to the Tarsocrural Joint of Horses

Objective— To assess the antimicrobial elution characteristics, toxicity, and antimicrobial activity of amikacin‐impregnated ferric‐hyaluronate implants (AI‐FeHAI) for amikacin delivery to the tarsocrural joint of horses. Study Design— Experimental study. Sample Population— AI‐FeHAI implants, equine cartilage, and synovium, and horses (n=6). Methods— In vitro study: Five AI‐FeHAI were placed in saline solution with daily replacement until implant degradation. Eluent was tested for amikacin concentration and bioactivity. Synovial and cartilage explants were incubated in the presence or absence of AI‐FeHAI for 72 hours and subsequently assessed for morphology, viability, and composition. Synovial explants were incubated with Staphylococcus aureus in the presence or absence of AI‐FeHAI. Spent medium was cultured daily and explants were assessed for morphology and viability after 96 hours. In vivo study: AI‐FeHAI were placed in 6 tarsocrural joints. Standard cytologic analysis and amikacin concentration (SFAC) were determined in synovia obtained regularly for 28 days thereafter. Similar analyses were conducted after a single intra‐articular injection of amikacin 6 months later. Results— In vitro study: Amikacin concentrations exceeded 16 μg/mL and inhibited S. aureus growth for 8 days. AI‐FeHAI had no effect on cartilage explants. AI‐FeHAI eliminated bacteria from synovial explants. In vitro study: After AI‐FeHAI placement, SFAC was highest (140.78+63.81 μg/mL) at first sampling time. By 24 hours SFAC was <16 μg/mL. After intra‐articular injection, SFAC was the highest (377.91 ± 40.15 μg/mL) at first sampling time. By 48 hours SFAC was <16 μg/mL. Conclusions— A single intra‐articular amikacin injection demonstrated superior pharmacokinetics than AI‐FeHAI prepared as described. Clinical Relevance— AI‐FeHAI cannot be recommended for clinical use.     

Emerging zoonoses

The food-borne zoonoses are the most important zoonoses in England and Wales measured in terms of human morbidity and mortality and they include the most important emerging infections. Over the past decade there were over 100,000 laboratory reported cases of salmonellosis, about 1–5 per cent with serious extra-intestinal complications with 427 registered deaths; there were nearly 90,000 Campylobacter infections. In salmonellosis the sources and modes of spread of infection are largely known, but veterinary and human public health measures have so far failed to control the disease. In Campylobacter enteritis however, the source and spread in most of the reported cases are unknown and control is not yet possible. Amongst the remaining less common food-borne zoonoses, listeriosis and yersiniosis are most prominent. Both are increasing with food-borne outbreaks of both infections having been reported, but the origin of infection of most cases recorded in England and Wales is not known. Of the new food-borne or water-borne diseases the most common are giardiasis and cryptosporidiosis but in neither is it clear whether the infections are predominantly of human or animal origin. The place of haemorrhagic colitis and of S. zooepidemicus infection is not yet apparent, both may emerge as important zoonoses. Streptobacillary fever, on the other hand, seems unlikely to recur with normal hygienic standards of water and milk supply. Of the occupational zoonoses Q fever and leptospirosis are the most important. Although only 1,330 cases of Q fever were reported in 10 years, it is a severe disease; 123 of them had endocarditis. Leptospirosis probably increased in incidence and emerged as a new disease of farmers and others working with cattle. S. suis type 2, a ‘new’ disease, remained a rarity. Zoonoses acquired from pets made up only a small proportion of human zoonotic infections and the only apparent change was an increase in psittacosis, the reason for which is unknown. Lastly, among the zoonoses acquired from wild and captive animals the viral haemorrhagic fevers have emerged as an important hazard in hospitals and laboratories.     

IMAGING DIAGNOSIS—CANINE THORACIC MESOTHELIOMA

A 12-year-old neutered female Pembroke Welsh Corgi had a 2-month history of a progressive, productive cough nonresponsive to therapy. Mild pleural effusion, right middle lung lobe collapse, and multiple subpleural nodular lesions were detected in thoracic radiographs and computed tomography (CT) images. Histopathologic diagnosis of the pleural nodules was mesothelioma. Mesothelioma should be considered in patients where pleural masses are detected in radiographs or CT images.     

IMAGING DIAGNOSIS—BILATERAL ADRENAL ADENOMAS AND MYELOLIPOMAS IN A DOG

A 10-year-old neutered female Pug was evaluated for a left adrenal mass detected previously by ultrasonography. Using computed tomography, a fat-attenuating, rim-enhancing left adrenal mass and a homogeneous, soft-tissue attenuating, intensely enhancing right adrenal mass were found. A left adrenalectomy and right adrenal biopsy were performed and the final diagnosis was bilateral adrenal adenomas and myelolipomas. Myelolipomas are rare, benign, endocrinologically inactive tumors composed of well-differentiated adipose tissue and a variable amount of hematopoietic cells of both lymphatic and myeloid lineages, which may account for the different appearance on tomographic images.