Traumatic spinal cord injury caused by suspected hyperflexion of the atlantoaxial joint in a 10-year-old cat

Case summary: A 10-year-old cat presented 5 days after a traumatic event with acute recumbency followed by some clinical improvement. The neuroanatomical localisation was the C1–C5 spinal cord segments. Initial survey radiographs, including lateral flexed views, showed no convincing abnormalities. Magnetic resonance imaging (MRI) revealed a marked focal intramedullary lesion at the level of the dens and suspected oedema extending over C2–C3 vertebrae, suggesting early syrinx formation. The cat made an initial excellent recovery on restricted exercise without medical treatment. The MRI changes largely resolved on follow-up MRI 4 weeks later yet recurred following a relapse 4 months later. At this stage, a post-traumatic syrinx had developed. Moreover, the suspected atlantoaxial instability was finally diagnosed on radiography with fully flexed lateral views. A hyperflexion injury causing tearing of the atlantoaxial ligaments was considered most likely given the lack of malformations or fractures. The cat made a full recovery on conservative management. Relevance and novel information: This is the first report of sequential MRI findings in a cat with atlantoaxial instability. Moreover, post-traumatic syringomyelia formation following atlantoaxial injury has not been reported. Sequential MRI aids in the diagnosis of hyperflexion injury if survey radiographs fail to identify atlantoaxial instability

Ultrasonographic identification of the dorsal atlantoaxial ligament in dogs

Objective: To determine the ability to identify the dorsal atlantoaxial ligament during ultrasonographic examination of dogs. Study design: Canine cadaveric study. Sample population: Canine cervical spines (n = 35). Methods: Thirty-five canine cadavers with an estimated body weight of 6-35 kg were retrieved. Five cervical spines were dissected to assess the length and thickness of the dorsal atlantoaxial ligament and correlate ultrasound-guided injection of ink with anatomical dissection. Ultrasonographic evaluation of the dorsal atlantoaxial ligament was performed on 30 cadavers. The visibility of the dorsal atlantoaxial ligament in both the transverse and the sagittal planes was subjectively scored (0-3). Results: The dorsal atlantoaxial ligament was detectable on ultrasonographic examination in all cadavers: 27/30 and 28/30 were graded as moderately visible (grade 2) or clearly visible (grade 3) in the sagittal and transverse view, respectively. Only 1/30 cadaver specimen of a large breed dog was graded as 1 (indistinct) in both the sagittal and transverse planes. None of the cadavers were graded as 0 (not visible) in any view. Conclusion: The dorsal atlantoaxial ligament can be identified in ultrasonographic examination of normal canine cadavers. Future studies on animals with clinical atlantoaxial instability/subluxation are needed to evaluate the role of this imaging technique in providing a safer diagnosis of this condition. Clinical relevance: Ultrasonographic examination of the dorsal atlantoaxial ligament could potentially provide a noninvasive and safe imaging technique that may contribute to the diagnosis of atlantoaxial instability/subluxation in dogs

Self assessment: acute-onset vomiting in a Tibetan Terrier

No abstract available

Intracerebral haemorrhage in a dog with steroid-responsive meningitis arteritis

A one-year and six-month-old female neutered Boxer dog was presented with a four-day history of pyrexia, lethargy and neck pain. An intracerebral haemorrhage and a mediastinal mass were identified. Cerebrospinal fluid analysis revealed severe neutrophilic pleocytosis, and steroid-responsive meningitis arteritis (SRMA) was suspected. A significant improvement was observed with immunosuppressive steroid therapy and subsequent imaging revealed a reduction in size of the intracerebral haemorrhage and disappearance of the mediastinal mass. SRMA is a systemic disease with potential involvement of multiple organs. Intracerebral haemorrhage can occur secondary to SRMA and can have a successful outcome

Use of bisecting angle techniques in veterinary orthopaedic radiography

Problems encountered in veterinary orthopaedic radiography include difficulties obtaining optimally positioned radiographs. In these situations, compromise radiographic projections are used to obtain the necessary clinical information. Results of investigations into the use of bisecting angle radiographic techniques for imaging canine long bones are presented. Comparisons are made between radiographs made using ideal positioning and using three different compromise techniques, including bisecting angle projections. The use of bisecting angle techniques in a series of ten clinical cases is also discussed. A study into the radiographic images obtained of canine femora and humeri using an ideal projection technique (with the long axis of the bone parallel to the cassette) and using three techniques when the bone was at an angle to the cassette (beam perpendicular to cassette, beam perpendicular to bone and bisecting projection) demonstrated that the ideal radiographic technique gave the most accurate image of the bone in terms of reproduction of size and proportions. However, of the three angled techniques, the bisecting angle projection gave the most accurate reproduction of proportions at all bone-cassette angles. All angled projections created a size distortion, and at lower bone-cassette angles, this was lowest when the primary X-ray beam was perpendicular to the cassette. At higher bone-cassette angles, this projection was no more accurate at reproducing bone size than the bisecting projection. A subjective assessment demonstrated that maintenance of the radiographic appearance of the trabecular bony detail was best with the ideal projection, followed by the angled projection with the tube perpendicular to the cassette. In 10 clinical cases, where the required information (e.g. implant placement or post-operative progression) could not be adequately obtained from standard radiographic projections, use of the bisecting angle technique allowed the area of interest to be examined more completely. Use of bisecting angle techniques for veterinary orthopaedic investigations could be considered where optimal positioning for radiography is not possible

Spongiform leucoencephalomyelopathy in border terriers: clinical, electrophysiological and imaging features

A novel spongiform leucoencephalomyelopathy was reported in border terrier puppies in 2012 causing a shaking puppy phenotype, but no information regarding clinical progression, imaging or electrophysiological findings were available. The aim of the present study was to describe the clinical, electrophysiological and MRI features of this disease in seven dogs and compare them with human white matter disorders. All cases presented with cerebellar ataxia and severe generalised coarse body tremors, which started at three weeks of age. The three cases that were not euthanased showed slow but progressive improvement over several months. Brainstem auditory evoked response demonstrated a normal wave I, reduced amplitude of wave II and an absence of waves III-VII. MRI revealed bilateral and symmetrical T2-weighted hyperintensities affecting the brainstem and cerebellar white matter. Histological examination of the brain and spinal cord showed spongiform change affecting the white matter of the cerebellum, brainstem and spinal cord with decreased myelin content. In summary, this leucoencephalomyelopathy has a pathognomonic clinical presentation with defining MRI and electrophysiological characteristics, and it is the first report to describe a long-term improvement of this condition

Presumptive coccygeal discospondylitis in a cat

No abstract available

Effect of osteoarthritis on the repeatability of patella tendon angle measurement in dogs

Objective: To evaluate the influence of osteoarthritis on the measurement of patella tendon angle (PTA) and determine intraobserver and interobserver variability. Study design: Retrospective clinical study. Sample population: Eighty‐seven mediolateral radiographs that were obtained prior to tibial tuberosity advancement. Methods: Radiographic osteoarthritis was scored by 2 observers using guidelines derived from the International Elbow Working Group Protocol. Patella tendon angle was measured by 3 observers on 3 occasions, with at least 7 days between measurements. The data were statistically analyzed via weighted κ and Kruskal‐Wallis testing. Results: A fair strength of agreement was found among observers scoring osteoarthritis, with the same grades in 48% of radiographs. The intraobserver average bias between PTA measurements 1 and 3 ranged from −0.38° to −0.94°. Interobserver bias in angle measurement ranged from −0.92° to −2.00°. Observer 1 had the narrowest range of PTA differences (12.1°), and observer 3 had the highest range of PTA differences (23.5°). Observer 2 had the lowest mean bias (−0.38°). The mean bias was lowest between observers 1 and 2 (−0.92°) and highest between observers 1 and 3 (−2.0°). The mean intraobserver standard deviation of the PTA measurement differences was 2.90°, and interobserver standard deviation of the PTA measurement differences was 2.26°. The degree of osteoarthritis did not influence PTA measurements or their variability. Conclusion: The current study did not find evidence of an influence of osteoarthritis on PTA or on the repeatability of measurements. Clinical significance: Our findings suggest that osteoarthritis should not affect the radiographic planning for tibial tuberosity advancement surgery. The high variances in PTA measurement in less experienced observers may influence the clinical outcome of surgery

Feline emphysematous gastritis in a cat with pancreatitis and secondary hepatic lipidosis

A 7 yr old female neutered domestic shorthair was presented with a 2 mo history of lethargy and hyporexia progressing to anorexia. Initial diagnostics indicated pancreatitis with secondary hepatic lipidosis. Supportive care, including the placement of an esophageal feeding tube, was initiated. The feeding tube was removed traumatically by the cat and thus replaced. The cat acutely deteriorated while hospitalized, developing marked hypersalivation and an obtunded mentation. Radiographs were taken to confirm placement of the feeding tube in case tube dislodgement was contributing to the hypersalivation; results confirmed appropriate positioning and gastric pneumatosis. Despite intensified medical management, the patient suffered cardiopulmonary arrest 7 days after hospital admission. Post-mortem examination confirmed necrotizing gastritis with emphysema alongside segmental mucosal necrosis in the jejunum, focal pancreatic necrosis, and diffuse hepatic lipidosis. Gas in the gastric wall is a rare finding in veterinary medicine and can arise due to gastric pneumatosis or emphysematous gastritis; there are scant reports of either in feline medicine. This report documents a case of emphysematous gastritis in a cat with concurrent pancreatitis and hepatic lipidosis. The cat developed emphysematous gastritis without undergoing gastrointestinal surgery which is currently the only reported feline predis-posing factor for development

Retrospective evaluation of thoracic computed tomography findings in dogs naturally infected by Angiostrongylus vasorum

Angiostrongylus vasorum (A. vasorum) is an important emerging disease of canidae. Cardiorespiratory signs are common in affected dogs, therefore thoracic imaging is critical for diagnosing andmonitoring disease. Descriptions of thoracic computed tomography (CT) findings in dogs naturallyinfected with A. vasorum are currently lacking. Aims of this multicenter, retrospective study were to describe thoracic CT findings in a group of dogs with confirmed disease, determine whether any changes were consistent among dogs, and propose standardized terms for describing thoracic CT findings. Nine UK-based referral centers’ clinical and imaging databases were searched for dogs that had a confirmed diagnosis of A. vasorum, and had undergone thoracic CT examination. Eighteen dogs, from seven of the centers, fulfilled the inclusion criteria. The lung lobes were divided into the following three zones and the CT changes described in each: pleural (zone 1), subpleural (zone 2), and peribronchovascular (zone 3). The predominent abnormality was increased lung attenuation due to poorly defined ground-glass opacity or consolidation. There were regions of mosaic attenuation due to peripheral bronchiectasis. Nine/18 (50%) dogs showed hyperattenuating nodules of varying sizes with ill-defined margins. The distribution always affected zones 1and 2 with varied involvement of zone 3; this resulted in clear delineation between zones 2 and 3.Tracheobronchial lymphadenomegaly was frequently noted. Findings were nonspecific and there was considerable overlap with other pulmonary conditions. However, authors recommend that A. vasorum be considered a likely differential diagnosis for dogs with a predominantly peripheral distribution of lung changes