Esame TC in corso di Displasia del gomito del cane

Introduction: Canine Elbow dysplasia (CED) is one of the most common cause of artropathy in large and giant size dogs. At least 4 forms of CED are described: Ununited Anconeal Process (UAP); Osteocondritis dissecans (OCD) of the humeral condyle; fragmented medial coronoid process (FMCP); elbow incongruity (EI) for short radius, short ulna or underdeveloped ulnar troclear notch. CED is often assessed using computed tomography (CT), particularly in case of inconsistent or not definitive radiographical diagnosis. However, until now there is not any standardized protocol for the elbow CT. A number of procedures have been proposed, but they all require a great stressful positioning of the cervical spine since the head is pulled laterally or caudally, in order to avoid beam-hardening and streak artifacts. The aim of this study was to describe CT findings in dogs with CED and to propose a new, non-stressful procedure for CT of the canine elbow using a lateral recumbent position and a specifically designed positioning device. Material and Methods: The study was performed at the Interdepartmental Radiology Veterinary Centre of the University Federico II of Naples and it was developed in two steps: first, a retrospective analysis of CT exams of the elbow performed on dogs affected by suspect CED, from January 2005 to December 2011; and second, a prospective analysis of CT exams performed with the new proposed procedure, from January 2012 to December 2016. All of the CT exams were performed on dogs under general anesthesia. In all subjects, both elbows were studied at the same time. In the new procedure, the dogs were placed on the CT bed ever in the lateral recumbent position with the forelimbs cranially pulled and, in order to obtain the best elbow alignment and to remove the air gap between the neck and the forelimbs, a purpose-handmade positioning device, shaped from polyurethane foam, was used. For comparative purposes, in two dogs, the elbow CT was also performed using a previously described procedure, i.e. in sternal recumbent position with the forelimbs parallel one to each other and cranially extended and the head and neck laterally and caudally pulled. All of the CT exams were obtained using 1 mm thick contiguous axial slices at 120 kV and 200–260 mAs, together with a bone convolution filter, and evaluated on a workstation equipped with a DICOM software, using a bone window [window level (WL) 500, window width (WW) 3000]. In order to improve the evaluation, multiplanar reconstruction (MPR) and three dimensional volume rendering (3D-VR) images were obtained too. For each joint, the presence or absence of a primary lesion (FCP, OCD, UAP, EI), possibly associated to a “Kissing Lesions” (KL), was assessed. Furthermore, each joint was analytically assessed for the visualization of relevant anatomical landmarks such as the medial coronoid process, humero-radio-ulnar joint space, anconeal process, humeral condyle, subchondral bone, proximal radial and ulnar relationship. In addition, the presence of sclerosis, periarticular osteophites, subchondral cyst-like lesions, deformed, fissured or fragmented medial coronoid process, incongruence from short radius, short ulna or underdeveloped ulnar troclear notch were evaluated too. CT quality was assessed measuring the image noise represented by the standard deviation of Hounsfiel unit (HU) in a region of interes (ROI) manually traced around the bones of the elbows at three omologous level. Data obtained were compared using the Wilcoxon rank test for paired data, with a significance level of p<0.05. Results: 61 dogs, 45 males and 16 females, mean age of 11.7 months, for a total of 122 elbows were collected. Breed distribution was: Labrador retriever (24), German shepherd (11), rottweiler (5), golden retriever (4), dogue de Bordeaux (3), Bernese mountain dog (2), chow chow (2), mix breed (2), Alaskan Malamute (1), American Staffordshire (1), Belgian Shepherd (1), border collie (1), Bloodhound (1), cane corso (1), pitbull Terrier (1), and terranova (1). In three dogs, elbows were bilaterally normal. Fifty-eight dogs were affected by dysplasia (43 dogs bilaterally and 15 monolaterally affected). There were 88 EI, 70 FMCP, 10 OCD and 3 UAP. All of the images obtained using the new procedure were of diagnostic use. There were not any significant differences in CT quality between the new procedure and the previously described one. The purpose-handmade device demonstrated to help the positioning and to avoid the appearance of streaks or beam hardening artifacts. Discussion and Conclusion: Labrador retriever and German shepherd dogs confirmed to be particularly prone to CED. There was a high prevalence of male dogs, as reported in other studies. Our results confirmed the high sensitivity and accuracy of CT in diagnosing CED, particularly in case of EI and FMCP. The EI represents the most prevalent lesion found in our sample. Actually, this finding has to be related to the higher sensitivity of the CT examination in diagnosing EI even when small gaps of incongruence (<2mm) are present. The FMCP represents the second most frequent lesion in our sample This particular distribution can be referred both to the higher prevalence of this lesion among those responsible of CED or to the fact that, usually, CT is performed when radiographs were questionable for the presence of FMCP. This explanation can justify also the small number of OCD and UAP in our sample as well as in others, since those two lesions are easily diagnosed with radiography. In spite of the high sensitivity and specificity of elbow CT, to date there is not any standardized protocol, universally accepted. A number of procedures have been described, all of which designed to avoid streak and beam-hardening artifacts by entering only the elbows in the gantry but, in order to obtain this, the neck is subject to a stressful positioning. Considering that most of the canine breeds predisposed to develop CED are, at the same time, at high risk for caudal cervical spondylopathy (Wobbler syndrome), in our opinion, all the positionings used in the previously described methods are potentially dangerous. Our experience shows that the lateral recumbency with both forelimbs pulled cranially, obtained with the help of the positioning device, represents a simple and safe positioning and that the quality of the images is comparable and without streak or beam hardening artifats. The positioning device, developed during the study, demonstrated its usefulness so that, recently, we started to create a prototype computer made. In conclusion, the CT procedure described here offers several advantages over existing procedures: non-stressful positioning; simple and quick, even in giant dogs, owing to the special positioning device; high quality images with low noise; easy image assessing thanks to simultaneous visualization of both elbows

Biometrics measurements in Red foxes (Vulpes vulpes) in the Picentini area. Discussion and conclusions

Techniques for assigning individual to age-classes and/or distinguish between sexes are necessary to understand population dynamics and behavioral interactions of Red foxes (Vulpes vulpes). Many studies have focused on separating juveniles from adults; age of captured live pups can be estimated from morphological changes, hind foot (HF) length, zygomatic (Z) width and body weight1. Methods that avoid capturing the animals would be particularly useful, but none is available. In this paper biometric differences between young adults and adults subjects and between sexes are investigated. Lower canine length (LCL), lower canine width (LCW), condilo-basal (CB) and scapular length resulted smaller than female adults, whereas male young adults had withers height, occipito-coccygeal (OC), ear length, and upper canine width (UCW) smaller than male adults. Almost all the parameters included in this study confirmed sexual dimorphism and some of the differences already present in young adults gained significance (from P<0.05 to P<0.01) in the adult foxes. In particular bodyweight, OC length, withers height, ear length, upper canine length and LCL, scapular and mandibular length, and inter-carnassial (IC) and Z width were significantly greater in male than in female adult foxes (P<0.01). Nasal-occipitalis (NO) length, total length, UCW and LCW, and upper dentition (UD) were significantly greater in male than in female adult foxes, as well (P<0.05). The low number of subjects included in each category, strictly due to hunting season, did not allow estimating an accurate range for the biometrics measurements performed and probably biased recordings, producing some contradictory results. Fox size varies geographically, thus mean adults measurements should be determined for each area in which they have to be applied1. HF method has been demonstrated to be an accurate method for assessing age of pups1; our data suggest that it might be as efficient in young adults, at least in female subjects. On the other hand, our results confirm the sexual dimorphism in the canine region to be higher than in the carnassial region (data not shown in our results)

Using geographical information system for spatial evaluation of canine extruded disc herniation

Disc herniation is one of the most common pathologies of the vertebral column in dogs. The aim of this study was to develop a geographical information system (GIS)-based vertebral canal (VC) map useful for spatial evaluation of extruded disc herniation (EDH) in dogs. ArcGIS® was used to create two-dimensional and three-dimensional maps, in which the VC surface is divided into polygons by lines representing latitude and longitude. Actual locations and directions of the herniated disc material were assessed by a series of 142 computer tomographies of dogs collected between 2005 and 2013. Most EDHs were located on the cervical and transitional regions (thoraco-lumbar and lumbo-sacral) and shown at the level of the ven- tro-cranial and ventro-central polygons created. Choropleth maps, highlighting the distribution and the location/direction patterns of the EDHs throughout the VC, were produced based on the frequency of the ailment. GIS proved to be a valuable tool in analysing EDH in dogs. Further studies are required for biomechanical analysis of EDH patterns

Geographical information system analysis on road accidents involving wandering dogs in the urban area of Naples

In this study, the spatial distribution of road accidents involving wandering dogs on urban roads of Naples was assessed using kernel density estimation (KDE). The study included 423 dogs victim of road collisions in the period 2012-2015 collected from the medical records of Interdepartmental Centre of Veterinary Radiology, of Pathological Anatomy Service, of Veterinary Teaching Hospital, "Federico II" University of Naples, and of Veterinary Hospital Attendance of the Local Public Health Unit Napoli1. There were a significant prevalence of young male dogs and the KDE demonstrated the presence of five hotspots in five city neighbourhoods. All areas with the highest KDE were found to be peripheral zones in which wide green areas, uncultivated or cultivated, merged with built areas and crossed by large straight roads with a lot of intersections. Wandering dogs as other animals represent a mounting problem on urban roads in Italy, despite of the effort to reduce these populations. Better knowledge of this phenomenon is important with reference to taking countermeasures and improve road safety. It is also important with reference to One Health and the Decade of Action for Road Safety 2011- 2020 of the United Nations

Communication and visiting policies in Italian intensive care units during the first COVID-19 pandemic wave and lockdown: a nationwide survey

Background: During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions. Methods: A national web-based survey was conducted among 290 Italian hospitals. Each ICU (active between February 24 and May 31, 2020) was encouraged to complete an individual questionnaire inquiring the hospital/ICU structure/organization, communication/visiting habits and the role of clinical psychology prior to, and during the first COVID-19 pandemic wave. Results: Two hundred and nine ICUs from 154 hospitals (53% of the contacted hospitals) completed the survey (202 adult and 7 pediatric ICUs). Among adult ICUs, 60% were dedicated to COVID-19 patients, 21% were dedicated to patients without COVID-19 and 19% were dedicated to both categories (Mixed). A total of 11,102 adult patients were admitted to the participating ICUs during the study period and only approximately 6% of patients received at least one visit. Communication with family members was guaranteed daily through an increased use of electronic devices and was preferentially addressed to the same family member. Compared to the prepandemic period, clinical psychologists supported physicians more often regarding communication with family members. Fewer patients received at least one visit from family members in COVID and mixed-ICUs than in non-COVID ICUs, l (0 [0–6]%, 0 [0–4]% and 11 [2–25]%, respectively, p &lt; 0.001). Habits of pediatric ICUs were less affected by the pandemic. Conclusions: Visiting policies of Italian ICUs dedicated to adult patients were markedly altered during the first COVID-19 wave. Remote communication was widely adopted as a surrogate for family meetings. New strategies to favor a family-centered approach during the current and future pandemics are warranted

A new CT procedure for the study of the elbow in the dog

ntroduction: Previous described canine elbow-CT procedures need the head pulled laterally and caudally. This positioning is stressful for the neck and potentially dangerous in breeds prone to the Wobbler syndrome. Aim: To develop a new non-stressful procedure for canine elbow-CT. Materials and methods: Prospectively, from January 2013, two elbow-CT procedures were used. The described procedure (DP): sternal recumbency with laterally and caudally pulled head and cranially extended forelimbs. The new procedure (NP): lateral recumbency, with forelimbs cranially pulled, very close one to each other and to the neck, in order to obtain the smallest field of view (FOV) and mean pixel dimension (MPD). CT procedures were compared for spatial resolution and presence of artefacts. Results: 18 elbows, from 9 dogs, were included. Mean FOV was: NP 126.6 mm (±14.1); DP 103.3 (±5.16); mean MPD was: NP 0.25 mm (±0.03); DP 0.21 mm (±0.01). FOV and MPD were significantly larger in NP. Streak artefacts were absent in both procedures. Discussion and conclusion: compared to the DP, the NP has a significantly larger FOV and MPD, but a simpler and safer positioning, without streak artefacts. Furthermore, NP permits a more symmetrical positioning of the elbows and therefore to visualize them simultaneously

Resistive index for kidney evaluation in normal and diseased cats

OBJECTIVES: To determine the resistive index (RI) in normal cats and in cats with various renal diseases, and to evaluate the effect of age on RI. METHODS: The subjects were cats that had ultrasonography (US) of the urinary tract and RI measurement at our centre between January 2003 and April 2014. Based on clinical evaluation, biochemical and haematological tests, urinalysis and US, the cats were classified as healthy or diseased. RI measurements were made from the interlobar or arcuate arteries. Data were analysed for differences between the right and the left kidney, the two sexes, different age groups in healthy cats, and between healthy and diseased cats. RESULTS: A total of 116 cats (68 males, 48 females) were included: 24 healthy and 92 diseased. In the healthy cats, RI (mean ± SD) differed significantly (P = 0.02) between the right kidney (0.54 ± 0.07) and the left kidney (0.59 ± 0.08). For the left kidney, RI was significantly higher in cats with chronic kidney disease (0.73 ± 0.12) and acute kidney injury (0.72 ± 0.08) (P = 0.0008). For the right kidney, RI was significantly higher in cats with chronic kidney disease (0.72 ± 0.11), acute kidney injury (0.74 ± 0.08), polycystic kidney disease (0.77 ± 0.11) and renal tumour (0.74 ± 0.001) (P <0.0001). There was no significant effect on RI value in either kidney in terms of age or sex. CONCLUSIONS AND RELEVANCE: RI could be considered a valuable diagnostic tool in cats, useful in the differential diagnosis of diffuse renal diseases. While it does not change with the age of the cat, ultrasonographers should be aware that RI may differ between the two kidneys

Lumbosacral luxation in dogs: clinical outcome of two different surgical procedures

The aim of this study is to evaluate clinical outcome of 2 surgical procedures performed to stabilze the traumatic luxation of the lumbosacral joint (LSJ) in 3 dogs thre paraplegic dogs with LSJ traumatic dislocation were included in the study. After premedication with Acepromazine at the dose of 20 µg/kg and Morphine at the dose of 0.3 mg/kg IM, anesthesia was induced by Propofol (4 mg/kg IV) and maintained with Isoflurane in 10% O2. Case 1: a 30 kg female mixbred, was treated with external skeletal fixation (ESF) utilzing 2 transilal pins, externaly locked with 2 clamps. Case 2 and 3: males of 15 and 30 kg respectively, were treating performing lumbosacral fixation utilzing 6 pins. Two pins were inserted, acros articular proces L7/S1, into the body of the sacrum; two pins were inserted into the L6 and L7 pedicle and body respectively. Al pins were cut and bent to achieve maximum overlap. Cerclage wire and polymethylmethacrylate (PMMA) was aplied to bond fre ends of pins Case 1: the ESF was removed 50 days after surgery although it has become lose 30 days before. By 7 months there was a marked improvement and the dog was able to walk and run with a slight neurological deficit. Case 2: the dog was able to stand and walk within 48 h after surgery. 90 days after surgery the dog stil had mild urinary and faecal incontinence. Case 3: the dog was able to stand and walk 24 h after surgery without presenting neurological alterations To the authors??? knowledge, diferent techniques have ben described to stabilze fracture or fracture/luxation of L7: nevertheles single traumatic LSJ dislocation and its treatment are not widely described in dogs1. In our experience the ESF is able to stabilze L7 fractures because the bone healing via calus formation neded a shorter time, while the healing via fibrosis requested for L7 luxation lasted longer. On the other hand ESF shows several advantages, including limited disection of soft tisues, adjustabilty after aplication and removal after repair. The stabilzation technique with pins and PMMA provides a relatively rigid construct to reduction of L7 luxation and have several advantages such as excelent strength and stabilty, minimal ned of postoperative care and short recovery time. Disadvantages can include soft tisues disection, relatively long time of surgery with higher risk of infections that we controled by using strict aseptic technique and antibiotic administration. In our experience the stabilzation with pin and PMMA shows beter clinical outcome with a short recovery time and mild complications, while ESF sems to not stabilze completely a LSJ luxation because of the early implant losening and the high risk of infection

Percutaneous transilial pinning for treatment of seventh lumbar vertebral body fracture

Objective: To evaluate outcomes after percutaneous application of transilial pinning in dogs with seventh lumbar vertebral body fracture with concurrent lumbosacral luxation. Methods: We reviewed the medical records of dogs with seventh lumbar vertebral body fracture stabilized with percutaneous transilial pinning that were treated at our hospital between January 2000 and March 2014. Radiographic measurements were used for comparing craniocaudal and ventrodorsal displacement pre- and postoperatively. Results: Seventeen dogs met the inclusion criteria. The neurological status of the majority of treated dogs improved quickly, with immediate pain reduction after surgery. Implants were well tolerated throughout the application period and were removed at a mean time of 54.4 +/- 9.2 days. One dog experienced a major complication (implant failure) and required surgical revision a week after the initial procedure. Minor complications included pin-tract inflammation, signs of back pain lasting five weeks and acute lameness after implant removal. Postoperative radiographic measurements showed shortening of the vertebral body and residual dorsoventral dislocation. Otherwise, functional recovery was good (5 of 17 dogs) to excellent (10 of 17 dogs) in the majority of the patients. Clinical relevance: The use of two percutaneous transilial pins can be considered as treatment for the management of seventh lumbar fracture-luxation in dogs. Our modified stabilization technique is relatively easy to perform; less invasive on the soft tissues; and uses implants that are versatile, modifiable, and easily removable