Intra‐abdominal cystic lymphangiomatosis in a Thoroughbred foal

Cystic lymphangiomas are rare malformations of the lymphatics that result in the formation of a cystic mass. Where multiple cysts are seen, the condition is termed cystic lymphangiomatosis. This case describes the diagnosis and unique management of cystic lymphangiomatosis in a 10‐day‐old Thoroughbred foal. Ultrasonography, histopathology and laparoscopy were essential for diagnosis and appreciation of the extent of disease. Ultimately, the cystic lymphangiomatosis was so extensive in this foal that complete surgical excision was considered impossible and the presence of adhesions within the abdomen indicated a very poor long‐term prognosis; the owners elected for euthanasia at age 14 weeks. Although rare, lymphangioma and lymphangiomatosis should be considered as a differential diagnosis for an intra‐abdominal mass in a young horse.     

TRANSCUTANEOUS ULTRASONOGRAPHY OF THE ABDOMEN IN THE NORMAL COMMON MARMOSET (CALLITHRIX JACCHUS)

Ultrasonographic examinations were performed on 17 clinically healthy adult common marmosets to gain information about the normal abdominal echoanatomy. The marmosets were 1.5-9 years of age and weighed between 328 and 506g. Marked species-specific differences compared with the cat or dog were noted. Good images of the kidneys, bladder, spleen, adrenal glands, liver, and the gastrointestinal tract could be obtained. The pancreas, caecum, and abdominal lymph nodes were not seen. The spleen was the least echogenic organ, followed by the medium echogenic liver and the sometimes isoechoic, but mostly hyperechoic renal cortex. The kidneys had a poor corticomedullary distinction. The prominent right lobes of the liver extended caudally far beyond the costal arch. The gallbladder had a bi- to multi-lobed appearance with a wide, tortuous cystic duct. The pylorus was centrally positioned. The adrenal glands were readily seen, but should not be confused with the adjacent spleen. A statistically significant (P<0.05) difference between female and male kidney, and right adrenal gland length was present.     

FEASIBILITY FOR USING DUAL‐PHASE CONTRAST‐ENHANCED MULTI‐DETECTOR HELICAL COMPUTED TOMOGRAPHY TO EVALUATE AWAKE AND SEDATED DOGS WITH ACUTE ABDOMINAL SIGNS

Canine patients with acute abdominal signs are often clinically unstable and need a rapid and accurate diagnosis. Contrast‐enhanced multi‐detector computed tomography (CT) is the current modality of choice for evaluating acute abdominal pain in people. We hypothesized that contrast‐enhanced multi‐detector CT would be a feasible and safe technique for use in awake and lightly sedated dogs with acute abdominal signs. Eighteen client‐owned dogs were enrolled, all presenting with acute abdominal signs. Dogs were scanned using a dual‐phase protocol that included precontrast, arterial, and portal venous phases. Eight dogs were scanned awake and ten were given light sedation as chosen by the primary care clinician. Two observers who were unaware of clinical findings and sedation status scored image quality for each scan by consensus opinion. Mean serum creatinine in the sedated group was higher than in the awake group but was within the normal reference range. Other laboratory and physiologic measures did not differ between awake and sedated groups. No IV contrast‐related adverse reactions were seen. Median scan time for all patients was less than 10 min. Sixteen of 18 contrast‐enhanced multi‐detector CT scans were scored fair to excellent in diagnostic quality, with no statistical difference in diagnostic quality for awake vs. sedated patients. Causes for two poor quality diagnostic scans included severe beam hardening from previously administered barium contrast agent and severe motion artifacts. We conclude that dual‐phase contrast‐enhanced multi‐detector CT is a feasible and safe technique for evaluating awake and minimally sedated dogs presenting with acute abdominal signs.     

COMPUTED TOMOGRAPHIC CHARACTERISTICS OF PRESUMED NORMAL CANINE ABDOMINAL LYMPH NODES

Though identification of lymph nodes is essential in staging cancer patients, little has been reported about the CT features of canine abdominal lymph nodes. The purpose of this retrospective study was to describe the visibility, location, and characteristics of abdominal lymph nodes in abdominal CT studies of dogs considered unlikely to have lymphadenopathy. The relationship between the number of identified lymph nodes and intraabdominal fat ranking, body weight, and slice thickness was also investigated. A total of 19 dogs were included. At least two jejunal lymph nodes and both left and right medial iliac lymph nodes were identified in all dogs. Colic lymph nodes were not identified in any of the dogs. Visualization of all other lymph nodes varied. There were significantly more lymph nodes visible in dogs with more intraabdominal fat (P < 0.0001). No correlation between the number of identified lymph nodes and body weight (P = 0.64) or slice thickness (P = 0.76) was found. Though most of all identified lymph nodes had an elongated shape, a rounded shape was most common in splenic, pancreaticoduodenal, renal, ileocolic and caudal mesenteric lymph nodes. Most lymph nodes had a homogeneous structure before and following the intravenous administration of contrast medium. Some lymph nodes had a slightly irregular structure or were relatively more hyper attenuating in the periphery than centrally before and/or after contrast administration. Mean attenuation before contrast was 37 Hounsfield Units (HU) (range 20–52 HU), and 109 HU after contrast (range 36–223 HU). Findings indicated that the CT visibility, characteristics of different abdominal lymph nodes may be variable in dogs.     

Diagnostic imaging for the assessment of acquired abdominal vascular diseases in small animals: A pictorial review

Advances in interventional radiology and surgical techniques now allow complex abdominal diseases to be more successfully treated in small animals. Abdominal vascular alterations, acquired as individual process or as complication of other lesions such as neoplasia, can be life‐threatening or at least greatly limit curative interventions of underlying diseases. Computed tomography (CT) and high‐definition ultrasonography are now readily available in veterinary referral centers. Yet, there is little information currently available on the use of these modalities for the diagnosis and characterization of these vascular alterations. The purpose of this article is to review the CT and ultrasonographic findings of acquired vascular diseases in the abdomen of dogs and cats, using both the veterinary and human medicine literature as references, and highlighting essential concepts through figures.     

Utility of two‐view vs. three‐view abdominal radiography in canines presenting with acute abdominal signs

There are clear differences in the normal radiographic appearance of the abdominal organs between a left lateral vs. a right lateral view. While a few veterinary academic institutions have transitioned to a three‐view abdominal radiographic study protocol, obtaining only two views of the canine abdomen remains the current standard in veterinary medicine. In this combined retrospective and prospective, case‐controlled study, 48 canine patients presenting with signs of acute abdomen were recruited. Four board‐certified veterinary radiologists and four general practice veterinarians with greater than 3 years of experience in small animal practice were asked to determine if 10 predetermined findings were present within the set of images and if surgery was recommended based on those findings. Image readers were unaware of the clinical history. Three‐view studies did not yield statistically significantly greater accuracy than two‐view studies when evaluating all readers together. No statistically significant associations between the availability of the third view and increased accuracy or confidence were found in evaluations of general practitioners specifically. Evaluation of three‐view radiographic examination, as compared to two‐view examination, did not have perceived or statistically significantly increased diagnostic utility. Based on our findings, there is no statistically increased utility to justify a standard three‐view abdominal radiographic examination over a two‐view study for canines presenting with signs of acute abdomen.     

Small intestinal pseudodiverticulosis in a pony mare

A 14-y-old pony mare was referred after 30-d duration of intermittent pyrexia, anorexia, weight loss, and change in manure consistency. Physical examination revealed a palpable but reducible ventral abdominal mass. Transabdominal ultrasonography revealed multiple distended, hypomotile, and thickened small intestinal loops in close approximation with numerous, well-defined, hyperechoic masses. There was a large amount of echogenic peritoneal fluid; abdominocentesis revealed a neutrophilic and macrophagic inflammatory exudate, and a mixed bacterial population was cultured. Given the poor prognosis, the mare was euthanized. The autopsy findings included a large abdominal abscess, serosanguineous peritoneal fluid with fibrin strands, and ~50 outpouches communicating with the lumen and extending from the anti-mesenteric aspect of the duodenum, jejunum, and ileum. These structures were classified as pseudodiverticula based on the histologic absence of the tunica muscularis layer of the intestinal wall. Pseudodiverticula should be included as a differential etiology in horses when clinical signs consistent with colic, diarrhea, or weight loss are recognized and, when on examination, one or more organized masses are palpated or visualized on transabdominal ultrasound, as well as visualization of small intestinal loops with thickened walls.     

五步推拿法辅治小儿腹泻经验

运用五步推拿法加减辅助内服中药治疗小儿腹泻,据证之虚实运用相应的补泻手法,有促进药物吸收、增强疗效、缩短疗程的作用,而且无痛苦,无毒副作用,患儿容易接受,更宜于服药困难的小儿,并举验案五则以证之。