Ultrasonographic Detection of Interstitial Nephritis in a Canine Fetus

Background: A detailed ultrasound examination of the fetal urinary tract as part of prenatal care is important to detect possible abnormalities. Early diagnosis can prevent more serious damage such as loss of kidney function. Interstitial nephritis can compromise renal functionality. Also, acute interstitial nephritis is a frequent cause of acute kidney injury and can become chronic if not treated. Besides, a renal biopsy can help in the diagnosis and at the staging of the disease. Therefore, this report aims to describe the ultrasonographic findings of the renal tissues in a canine fetus affected by interstitial nephritis.Case: Gestational ultrasound evaluations were performed in a female Pug, at the 25th, 45th, and 58th gestational days. Ultrasound examination was performed with a 9.0 MHz linear transducer and a high-resolution digital transducer with a frequency standardized at 17.0 MHz. During the first evaluation, embryonic vesicles were detected and were compatible with the gestational period. At 45 days of gestation, some abnormalities were observed in the kidneys of one of the fetuses, such as increased cortical echogenicity, cortical thickening, loss of corticomedullary ratio (1:1), renal pelvis and ureter dilatation by echogenic content. Biparietal and abdominal diameters were also lower than that from the other fetuses, which did not show abnormalities, being compatible with the estimated gestational age. However, the heart rate was similar among all fetuses. On the 58th day, we observed in the underdeveloped fetus that both kidneys still presented the abnormalities seen previously, in addition to the presence of a cystic structure in the right kidney, in the cranial topography of the cortex. The other fetuses kept showing normal ultrasonographic findings, normal heartbeat, all of these compatible with the ultrasound gestational age. The delivery occurred without complications and only the underdeveloped fetus stillborn. Then, it was submitted to a necropsy where chronic interstitial nephritis was found in the histopathological analysis.Discussion: Adequate prenatal care is important to detect abnormalities in fetuses, in which ultrasound examination allows to access fetal development. The gestation in the bitch seemed to be occurring without complications, but the B mode and High Definition ultrasound techniques were able to identify abnormal development of the fetus' kidneys. Both techniques showed to be secure to the fetuses and the mother, as they are non-invasive and free of radiation. These findings, different from those described as normal for a fetus, reinforce the warning signal for a possible establishment of anomalies consistent with nephropathy. Still, histopathology is important to exclude other diseases and help to define prognosis. Interstitial nephritis can significantly affect perinatal survey, considering that the fetus was stillborn, confirming that the description of such anomalies can help to prevent disease. Since nephritis can be associate with the use of some medicines, the orientation of the owner regarding drug use during bitch pregnancy is essential.  Therefore, this is the first report describing renal abnormalities in a canine fetus, which highlights the importance of ultrasound examination for disease identification in prenatal care. Lastly, high-resolution ultrasound (HD) could provide detailed information on abnormalities in the fetal kidney

Contrast-enhanced Ocular Ultrasonography in Brachycephalic Dogs

Background: Contrast Enchantment Ultrasonography (CEUS) allows for detection of vascular flows that are difficult to detect with traditional methods. There were no reports found in the literature of the use of CEUS to evaluate the vascular pattern of the eye of brachycephalic dogs. The objective of this paper is to describe ultrasound findings observed in the eyes of healthy brachycephalic dogs subjected to CEUS.Materials, Methods & Results: Thirty adult brachycephalic dogs were subjected to physical, laboratorial, and ophthalmic examination. The eye structures were evaluated using CEUS after intravenous administration of Sonovue®. Contrast enhancement was seen in 52 eyes with a homogeneous and centrifugal filling pattern. Structures adequately enhanced consisted of the optic nerve, the retina-choroid-sclera complex (RCSC), and the ciliary body. The optic nerve was hyperenhanced and the other structures were isoenhanced.  The wash-in time, peak enhancement time, and wash-out time were similar for both right and left eyes. Mean values and standard deviation were calculated for contrast wash-in time, peak enhancement time, and wash-out time in the optic nerve, RCSC, and ciliary body.Discussion: Ultrasound is an important diagnostic resource for veterinary ophthalmology and provides relevant information for the detection of pathological conditions of the eyes of animals. The contrast-enhanced ultrasound allows evaluation of tissues at the capillary level (macro and microcirculation), complementing the vascular ultrasound scan. This study brings original information on contrast-enhanced ultrasound findings for evaluation of eyes in dogs, creating novel diagnostic possibilities for the use of this imaging technique in veterinary ophthalmology. The vascular pattern identified in this study, with enhancement starting at the region of the optic nerve and retina, and then ciliary body (with the optic nerve as the most hyperenhanced structure) is consistent with the expected pattern for dogs without ophthalmic disorders. The posterior ciliary artery is primarily responsible for supplying the optic nerve, later irrigating the retina, lateral and medial segments of the ciliary body. Some works on the evaluation of orbital vascular pattern in humans report a significant variability on anatomical course of the ophthalmic artery and its branches. However, in our study, no significant variation was observed on vascular flow of dogs of different brachycephalic breeds. Retinal blood vessels consist of arteries and veins that emerge from the optic nerve region and from the choroid. Contrast enhancement at the region of the RCSC is justified by the presence of vessels from the choroid that are irrigated by posterior ciliary arteries and drained by vorticose veins, since this structure is responsible for the nutrition of the external portion of the retina. Wash-in, peak enhancement, and wash-out times were similar for right and left eyes owing to anatomical and physiological similarities in vascularization. The homogeneous contrast-filling pattern is of paramount importance, since it will allow differentiation of abnormalities in sick animals, such as partial or total loss of capillarization, which will cause heterogeneity or absence of capillary fill. It will also be important for early diagnosis and evaluation of vascular alterations, especially ischemic changes, especially glaucoma, intraocular neoplasm, progressive retina atrophy, and uveitis. CEUS gives relevant information about the vascular pattern of the eyes of brachycephalic dogs, and is a quick, non-invasive, and safe exam

Metodos ultrassonográficos para la evaluación de testículos en gatos

Los testículos son los principales órganos sexuales de los machos y su función es producir espermatozoides y hormonas sexuales. Los trastornos de estos órganos son comunes en gatos domésticos. La ultrasonografía convencional, combinada con el análisis hemodinámico en tiempo real por Doppler y ultrasonido contrastado son herramientas diagnósticas importantes para la evaluación de enfermedades testiculares en gatos. Además, La elastografía-ARFI es un método ecográfico actual que evalúa la elasticidad tisular por medio del elastograma y de la velocidad de propagación de las ondas de cizallamiento. El estudio ecográfico de los testículos es un procedimiento de diagnóstico por imágenes común

ULTRASSONOGRAFIA DOPPLER EM OBSTETRÍCIA DE PEQUENOS ANIMAIS: REVISÃO DE LITERATURA

Considerando os recentes avanços em diagnóstico por imagem para animais de companhia, a ultrassonografia Doppler está se destacando como uma importante e adequada ferramenta não invasiva para a avaliação do fluxo sanguíneo, utilizada para o estudo do ciclo estral em cadelas e gatas, assim como no diagnóstico e acompanhamento da gestação, no estudo da viabilidade fetal e na detecção da malignidade em tecidos mamários nestas espécies. Em machos, os estudos com a técnica Doppler em tecidos prostáticos e testiculares são recentes, com grandes perspectivas para sua aplicabilidade. Dessa forma, esta revisão tem como objetivo descrever o uso da técnica de ultrassonografia Doppler em reprodução e obstetrícia veterinária de pequenos animais, além de trazer um breve histórico a respeito dos diferentes modos de apresentação da tecnologia, que podem ser utilizadas em medicina veterinária de animais de companhia

Micropapillary carcinoma in a dog: case report

Mammary neoplasms in female dogs present a high incidence. Several histological types are observed, among them, micropapillary carcinoma is considered one of the most aggressive because it is related to vascular invasion, metastases and low survival time. Aimed to describe a case of micropapillary breast carcinoma, with cutaneous metastasis, in a dog. A canine, female, 14 years old, 8kg, not defined breed, uncastrated, nulliparous, with pseudocyesis and no contraceptives administration history was attended at the Veterinary Reproduction and Obstetrics Service from "Governador Laudo Natel” Hospital, FCAV, UNESP, Jaboticabal, presenting a breast ulcerated nodule, with one month estimated evolution. After stabilization and preoperative exams, radical unilateral mastectomy and ipsilateral axillary and inguinal lymphadenectomy were performed. Histopathologic diagnosis revealed micropapillary carcinoma and free surgical margins from neoplasm, however, there were metastasis in both lymph nodes. The tutors did not adhere to antineoplastic chemotherapy. In 60th post-surgical day, there was inflammatory reaction in the surgical scar region, with small cutaneous ulceration, where the elastogram  revealed  rigidity and shear velocity of 7.84m/s. Skin biopsy revealed metastasis of micropapillary breast carcinoma. There was progression of ulcerations, compromising animal’s welfare and its physiological activities, when on the 110th post-surgical day, it was decided to euthanize the patient.  The correct diagnosis and knowledge of tumor biological behavior are importants points to choose the correct treatment. The adjuvant chemotherapy treatment can impact on average survival time and ARFI elastography is an accurate predictor of rapid and non-invasive diagnosis of micropapillary carcinoma recurrence.Mammary neoplasms in female dogs have a high incidence. Among the several histological types observed, micropapillary carcinoma is considered one of the most aggressive due to vascular invasion, metastases, and short survival time. The present objective was to describe a case of mammary gland micropapillary carcinoma, with cutaneous metastasis, in a dog. A 14-year-old intact nulliparous mixed-breed bitch, weighing 8kg, with a history of pseudocyesis and no history of contraceptive administration, presented to the Veterinary Reproduction and Obstetrics Service from "Governador Laudo Natel” Hospital, FCAV, UNESP, Jaboticabal, with an ulcerated nodule in the mammary gland for approximately one month. After stabilization of clinical parameters and preoperative exams, a radical unilateral mastectomy and ipsilateral axillary and inguinal lymphadenectomy were performed. Histopathology revealed micropapillary carcinoma with clear surgical margins, however, there were metastases in both lymph nodes. Antineoplastic chemotherapy was refused by the owners. On the 60th day after surgery, there was an inflammatory reaction in the surgical scar region, with a small cutaneous ulceration, where elastography showed rigidity and shear velocity of 7.84m/s. Skin biopsy revealed metastasis of the micropapillary carcinoma. Even with continued treatment since the patient was first examined, the ulcerations progressed, compromising the animal’s welfare and physiological activities, and on the 110th day after surgery, euthanasia was decided on. A correct diagnosis and knowledge of tumor biological behavior are important points for choosing the correct treatment. Acoustic Radiation Force Image (ARFI) elastography has been shown to be a fast and non-invasive diagnostic method for detection of recurrent micropapillary carcinoma

Elastografia acoustic radiation force impulse (ARFI), doppler e ultrassonografia contrastada do baço canino

O baço é um órgão que desenvolve inúmeras funções importantes no organismo e é um dos principais locais para o desenvolvimento de tumores primários, metastáticos e afecções do sistema hematopoiético, por isso realizar uma avaliação apurada neste órgão é de suma importância, em Medicina veterinária, particularmente em cães devido à importância econômica, afetiva e de similaridade cientifica para o homem. Todavia, a maioria dos métodos utilizados para o diagnóstico conclusivo de enfermidades esplênicas são métodos invasivos, sendo que os nãos invasivos perdem em sensibilidade e especificidade, dificultando que se proceda a um correto diagnóstico. Sendo assim, este estudo prospectivo visou avaliar a aplicabilidade das novas técnicas ultrassonográficas para avaliação esplênica de caninos, utilizando a elastografia ARFI (qualitativa e quantitativa), Doppler e ultrassonografia por contraste com microbolhas, com o intuito de determinar valores ainda não descritos na veterinária, as quais forneçam subsídios suficientes para se obter um diagnóstico conclusivo sobre a condição esplênica, nesta espécie. Os resultados obtidos nos cães saudáveis, por meio da ultrassonografia modo B apresentaram-se normais, sendo que na elastografia qualitativa, as porções esplênicas avaliadas apresentaram-se não deformáveis, com parênquima homogêneo de cor cinza escuro (hard). Na elastografia quantitativa os valores médios da velocidade de cisalhamento foram de 2,32 m/s para a cabeça, 2,16 m/s para o corpo e 2,25 m/s para a cauda do baço, não apresentando diferença estatística (P > 0,05). Ao exame contrastado, foram avaliados animais com erliquiose na fase subclínica, e estes apresentaram ao exame modo-B, esplenomegalia com presença de bordas arredondadas, ecotextura heterogênea e ecogenicidade mista do baço. Ao Doppler, verificou-se valores para os índices vasculares da artéria esplênica: velocidade sistólica: 22,59 ± 8,07 cm/s; velocidade diastólica: 5,25 ± 4,66 cm/s; e índice de resistência: 0,71 ± 0,14. Pela ultrassonografia com contraste observaram-se valores para wash-in de 5,31 ± 0,7s, pico de realce de 18,56 ± 2,90s e wash-out: 94,56 ± 35,21s. A elastografia ARFI é um método recente que pode fornecer dados de base para o baço e permitir a utilização futura desta técnica, na avaliação de cães com doença esplênica. A ultrassonografia convencional do baço de cães com erliquiose associado com a utilização do método Doppler e ultrassonografia contrastada são importantes ferramentas na triagem diagnóstica e podem auxiliar a monitoração e evolução de animais na fase subclínica.The spleen is an organ develops much important functions in the body and the spleen is one of the main organs prone to the development of primary tumors, metastasis and a broad range of diseases of the hematopoietic system perform assessment of spleen is important. In veterinary medicine, principally in dogs because of economic importance, affective and scientific similarity to humans. However, the most of the methods used for conclusive diagnosis of splenic diseases are invasive methods, noninvasive lose in sensitivity and specificity difficulting proceed to a correct diagnosis. Thus, this study aimed to perform the ultrasound scan of dogs spleen using the elastographic (qualitative and quantitative) Doppler and contrast enhanced ultrasonography. Determining values not described in veterinary, which provide sufficient subsidies to get a conclusive diagnosis of the splenic condition in this species. The results in healthy dogs showed, all splenic segments visualized with the B-mode ultrasonography appeared normal. Different splenic segments examined with qualitative elastography were free of any detectable malformations and the images appeared as homogeneous dark areas. The mean shear velocity values were 2.32 m/s for head, 2.16 m/s for body and 2.25 m/s for tail of the spleen, and they did not vary between the different age groups (P>0.05). In dogs with ehrlichiosis in subclinical phase showed, by B-mode examination, observed splenomegaly with presence of rounded borders and heterogeneous echotexture and mixed echogenicity in spleen. For Doppler found values for vascular indices of the splenic artery: systolic velocity: 22.59 ± 8.07 cm/s; diastolic velocity: 5.25 ± 4.66 cm/s; and resistance index: 0.71 ± 0.14. For contrast enhanced ultrasonography observed values for wash-in: 5.31 ± 0.7s, peak enhancement: 18.56 ± 2.90s and wash-out: 94.56 ± 35.21s. The ARFI elastography is a new method and it may aid in the diagnosis and evaluation of splenic abnormalities routinely assessed in veterinary practice. The conventional ultrasonography of the spleen in dogs with ehrlichiosis associated with hemodynamic evaluation by Doppler and contrast enhanced ultrasonography are important tools for diagnosis trial and could help the monitoring clinical evolution in subclinical phase.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Ultrasonographic tools used in the evaluation of the canine spleen: A review

The spleen is one of the most susceptible organs to primary tumours, metastasis, and a wide range of diseases of the hematopoietic system. Therefore, detailed assessment of the spleen is of great importance in veterinary medicine, especially in dogs, due to their economic and sentimental value, and as an experimental model in human medicine. Considering the recent advances in diagnostic imaging in companion animals, this review aims to describe the applicability of acoustic radiation force impulse (ARFI) elastography (qualitative and quantitative), Doppler, and contrast-enhanced ultrasonography for evaluating the spleen in dogs. The ARFI elastography is a recent ultrasound method that can provide reference values and aid in the diagnosis and evaluation of splenic abnormalities routinely encountered in veterinary practice. Conventional ultrasonography of the spleen combined with haemodynamic analysis by Doppler and contrast enhanced ultrasonography is an important tool in diagnosis and triage.O baço é um dos órgãos mais propensos a desenvolver tumores primários, metastáticos e afecções do sistema hematopoiético. Por isso, realizar uma avalição apurada neste órgão é de suma importância em medicina veterinária, particularmente em cães, devido à importância econômica, afetiva e de similaridade científica com o homem. Considerando os recentes avanços em diagnóstico por imagem, esta revisão visou descrever a aplicabilidade das novas técnicas ultrassonográficas para avaliação esplênica de caninos, utilizando a elastografia por impulso de força de radiação acústica (ARFI) qualitativa e quantitativa, Doppler e ultrassonografia por contraste com microbolhas. A elastografia ARFI é um método recente que pode fornecer dados de base para o baço e permitir a utilização futura desta técnica na avaliação de cães com doença esplênica. Similarmente, a ultrassonografia convencional, o método Doppler e a ultrassonografia contrastada são importantes ferramentas no diagnóstico e triagem.El bazo es uno de los órganos más propensos a desarrollar tumores, tanto primarios como metastásicos, y varias enfermedades que afectan el sistema hematopoyético. Es por eso que la evaluación clínica del mismo es de gran importancia en medicina veterinaria, principalmente en perros, debido a su valor económico, afectivo, y como modelo experimental en medicina humana. Considerando los recientes avances en imagenología diagnóstica, esta revisión tiene como objetivo describir el examen ecográfico del bazo en perros, utilizando la técnica de elastografía por impulso de fuerza de radiación acústica (ARFI) cuantitativa y cualitativa, Doppler y ultrasonido contrastado. La elastografía ARFI es un método reciente que puede proveer información básica sobre la conformación normal del órgano y, en un futuro próximo, ayudar en el diagnóstico de las enfermedades esplénicas. De modo similar, la ecografía convencional, Doppler y el ultrasonido contrastado son importantes herramientas en el diagnóstico y en el triaje

Perspectiva veterinaria del sistema renal en la sepsis

This paper aims to review, discuss and define the factors associated with development of kidney injury in patients with sepsis, diagnosis alternatives, therapy and prevention, offering to the veterinarians an updated guide to improve the prognosis of sepsis patients. Sepsis is a clinical condition that leads to systemic complications and to multiple organ dysfunction syndrome (MODS), mainly due to poor tissue perfusion in humans and animals. Acute kidney injury (AKI) is considered the most frequent and lethal among organ complications secondary to sepsis, however the etiology of AKI in patients with sepsis is complex and multifactorial and not completely elucidated. Early diagnosis of AKI is difficult and consequently the treatment is not very successful, due to hemodynamic aspects. The ultrasonography seems to be a promising exam for early diagnosis of this lesion, especially with the advent of contrast-enhanced ultrasonography (CEUS) technique, which makes possible to detect microcirculation changes in the renal parenchyma, opening the door for a variety of physiological, clinical and therapeutic applications, however, studies proving CEUS accuracy for early detection of renal damage related to sepsis in humans and animals are still necessary.Esta revisión tiene como objetivo discutir y definir los factores asociados con el desarrollo de lesión renal en pacientes con sepsis, alternativas de diagnóstico, terapia y prevención, ofreciendo a los veterinarios una guía actualizada para mejorar el pronóstico de los pacientes con sepsis. La sepsis es una condición clínica que conduce a complicaciones sistémicas y al síndrome de disfunción multiorgánica (MODS), principalmente debido a una pobre perfusión tisular en humanos y animales. La lesión renal aguda (LRA) se considera la más frecuente y letal entre las complicaciones orgánicas secundarias a la sepsis, sin embargo, la etiología de la LRA en pacientes con sepsis es compleja, multifactorial y no está completamente elucidada. El diagnóstico temprano de LRA es difícil y, en consecuencia, el tratamiento no es muy exitoso debido a los aspectos hemodinámicos. La ecografía parece ser un examen prometedor para el diagnóstico precoz de esta lesión, especialmente con el advenimiento de la técnica de ecografía contrastada (CEUS), que permite detectar cambios en la microcirculación de el parénquima renal, abriendo la puerta a una variedad de componentes fisiopatológicos, aplicaciones clínicas y terapéuticas, sin embargo, los estudios que demuestran la precisión de CEUS para la detección temprana de daño renal relacionado con sepsis en humanos y animales aún son limitados

Ultrasonography of the canine pancreas

This study describes the ultrasonographic techniques currently used in the evaluation of the canine pancreas. Ultrasonography was the first method to enable direct visualization of the pancreas in humans and it has been subsequently applied to animals. Currently, it is the method of choice for pancreatic evaluation and is essential as a diagnostic tool in the detection of abnormalities, especially tumors. Innovative equipment technology has led to the emergence of techniques complementary to B-mode ultrasound; such as Doppler, elastography, and contrast-enhanced ultrasonography, which have enabled more accurate diagnosis. Doppler provides information on vascular architecture and the hemodynamic aspect of blood vessels in multiple organs. ARFI elastography provides detailed images of the alterations detected by conventional examination (qualitative method) and assists in differentiating between benign and malignant processes (quantitative method). Microbubble contrast agents determine parameters related to homogeneous and heterogeneous filling of organs with microbubbles, mainly nodular areas, thus defining high and low intensity patterns.Este estudio describe las técnicas ecográficas frecuentemente utilizadas para evaluar el pancreas del perro. La ecografía fue el primer método que permitió la visualización directa del páncreas en seres humanos y que luego se aplicó en animales. Es actualmente el método de elección para la evaluación del páncreas y es esencial como herramienta diagnóstica en la detección de anomalías, especialmente tumores. La tecnología innovadora de los equipos, llevó a la aparición de técnicas complementarias al modo B, tales como Doppler, elastografía, ecografía de contraste, que han permitido realizar diagnósticos más precisos. El Doppler proporciona información sobre la arquitectura vascular y aspectos hemodinámicos de los vasos sanguíneos en múltiples órganos. La elastografía ARFI ofrece imágenes detalladas de las alteraciones detectadas en exámenes convencionales (método cualitativo) y ayuda a diferenciar entre procesos benignos y malignos (método cuantitativo). Los agentes de contraste con microburbujas permiten determinar parámetros relacionados con el llenado homogéneo o heterogéneo de los órganos, principalmente áreas nodulares, definiendo, por tanto, patrones de alta o baja intensidad