Are postnatal traumatic events an underestimated cause of porencephalic lesions in dogs and cats?

IntroductionPorencephaly is defined as a fluid-filled cavity of variable size in the brain cortex. It is regarded as a congenital condition and is typically considered a developmental or an encephaloclastic defect. Our hypothesis is that postnatal traumatic events in the first few months of life may represent a cause of canine and feline porencephaly that is more common than generally suspected. The aims of this study were to retrospectively investigate porencephaly in a large population of dogs and cats, detect MRI features that might be useful to differentiate postnatal acquired traumatic forms from congenital/perinatal porencephaly, and define the prevalence of seizure activity in porencephalic patients.Materials and methodsThis is a double-center, descriptive, retrospective case series. Databases were searched for cases within a 17-year time span that involve dogs and cats with an MRI-based diagnosis of cerebral cavitary lesions. Animals were included if a complete signalment and an exhaustive MRI of the brain were available. Besides the porencephalic lesions, MRIs of the head were reviewed to detect concomitant musculoskeletal abnormalities.ResultsThirty-two cases involving nine cats and twenty-three dogs were selected. Of all the cases, 21.9% were aged six years or older at the time of diagnosis. All patients in which the neuroanatomical localization was available showed clinical signs of a prosencephalic disorder. Epileptic seizures were observed in 71.8% of cases. A single porencephalic cavity was found in 78.1% of cases. The most affected cerebral lobe was the parietal lobe (n = 20). The defects involved both the grey and white matter in 78.1% of cases. Twenty cases showed concomitant musculoskeletal abnormalities overlying the porencephalic cavities. Fourteen of twenty cases showed evidence of fractures, of which thirteen showed depression of the calvarium and twelve masticatory muscle abnormalities. Of these, seven of fourteen had a history consistent with a head trauma in the first period of life.ConclusionThe recognition of skull fractures and muscular abnormalities closely associated with the porencephalic cavity may support a diagnosis of a postnatal traumatic origin of porencephaly. Therefore, this study highlights the importance of evaluating musculoskeletal structures in the MRIs of the heads of porencephalic cases

Prevalence, MRI findings, and clinical features of lumbosacral intervertebral disc protrusion in French Bulldogs diagnosed with acute thoracic or lumbar intervertebral disc extrusion

IntroductionIntervertebral disc protrusion (IVDP) is a neurological disorder commonly observed at the lumbosacral junction of old, medium-to-large breeds, non-chondrodystrophic dogs. Although uncommon, lumbosacral IVDP can also be seen in chondrodystrophic dogs, among them French Bulldogs (FBs) and could be associated with congenital vertebral malformations in this breed. This study aims to evaluate the prevalence, clinical features, and MRI characteristics of lumbosacral IVDP and congenital vertebral malformations in FBs diagnosed with thoracic or lumbar intervertebral disc extrusion (IVDE) and to evaluate the possible interference of the neurologic deficits related to chronic IVDP on neurological examination.Materials and methodsThis is a single-center, retrospective case series. A search for FBs diagnosed with IVDE affecting the thoracic or lumbar regions is done on the database of the AniCura I Portoni Rossi Veterinary Hospital (Zola Predosa, Bologna, Italy). Eligible dogs have a complete medical report and a high-field MRI of the lumbosacral junction. MRIs of the lumbosacral junction are evaluated to determine the position of IVDP, cranial intervertebral foraminal stenosis, and signs of nerve root involvement. Radiographs, when available, are reviewed to identify the presence of lumbosacral congenital vertebral malformations.ResultsEighty FBs are included in the study. The prevalence of lumbosacral IVDP among FBs is 91.3%. Among FBs with lumbosacral IVDP, 45.0% show concurrent cranial intervertebral foraminal stenosis, 28.8% exhibit concurrent nerve root involvement, 56.2% appear to be asymptomatic for lumbosacral changes, while 15.1% manifest a decreased or absent withdrawal reflex as a supposed consequence of chronic lumbosacral IVDP. Congenital vertebral malformations are detected in 10 dogs.ConclusionThe results of this study support the hypothesis that lumbosacral IVDP is frequent in FBs presenting with thoracic or lumbar IVDE. In over half the dogs lumbosacral IVDP appears to be asymptomatic; however, in other cases, chronic lumbosacral IVDP seems to cause neurological deficits that may lead to erroneous localization of acute IVDE, representing a confounding factor for clinicians

Prediction of vascular invasion using a 7-point scale computed tomography grading system in adrenal tumors in dogs

Background: Previous studies evaluating the accuracy of computed tomography (CT) in detecting caudal vena cava (CVC) invasion by adrenal tumors (AT) used a binary system and did not evaluate for other vessels. Objective: Test a 7-point scale CT grading system for accuracy in predicting vascular invasion and for repeatability among radiologists. Build a decision tree based on CT criteria to predict tumor type. Methods: Retrospective observational cross-sectional case study. Abdominal CT studies were analyzed by 3 radiologists using a 7-point CT grading scale for vascular invasion and by 1 radiologist for CT features of AT. Animals: Dogs with AT that underwent adrenalectomy and had pre- and postcontrast CT. Results: Ninety-one dogs; 45 adrenocortical carcinomas (50%), 36 pheochromocytomas (40%), 9 adrenocortical adenomas (10%) and 1 unknown tumor. Carcinoma and pheochromocytoma differed in pre- and postcontrast attenuation, contralateral adrenal size, tumor thrombus short- and long-axis, and tumor and thrombus mineralization. A decision tree was built based on these differences. Adenoma and malignant tumors differed in contour irregularity. Probability of vascular invasion was dependent on CT grading scale, and a large equivocal zone existed between 3 and 6 scores, lowering CT accuracy to detect vascular invasion. Radiologists' agreement for detecting abnormalities (evaluated by chance-corrected weighted kappa statistics) was excellent for CVC and good to moderate for other vessels. The quality of postcontrast CT study had a negative impact on radiologists' performance and agreement. Conclusions and Clinical Importance: Features of CT may help radiologists predict AT type and provide probabilistic information on vascular invasion

Relationship between magnetic resonance imaging findings and histological grade in spinal peripheral nerve sheath tumors in dogs

BackgroundPeripheral nerve sheath tumors (PNSTs) are a group of neoplasms originating from Schwann cells or pluripotent cell of the neural crest. Therapeutic options and prognosis are influenced by their degree of malignancy and location.Hypothesis/ObjectivesIdentify magnetic resonance imaging (MRI) features predictive of PNST histologic grade.AnimalsForty‐four dogs with histopathological diagnosis of spinal PNSTs and previous MRI investigation.MethodsA multicenter retrospective study including cases with (a) histopathologic diagnosis of PNST and (b) MRI studies available for review. Histologic slides were reviewed and graded by a board‐certified pathologist according to a modified French system (FNCLCC) for grading soft tissue sarcomas. The MRI studies were reviewed by 2 board‐certified radiologists blinded to the grade of the tumor and the final decision on the imaging characteristics was reached by consensus. Relationships between tumor grade and histological and MRI findings were assessed using statistical analysis.ResultsForty‐four cases met inclusion criteria; 16 patients were PNSTs Grade 1 (low‐grade), 19 were PNSTs Grade 2 (medium‐grade), and 9 were PNSTs Grade 3 (high‐grade). Large volume (P = .03) and severe peripheral contrast enhancement (P = .04) were significantly associated with high tumor grade. Degree of muscle atrophy, heterogeneous signal and tumor growth into the vertebral canal were not associated with grade.Conclusions and Clinical ImportanceGrade of malignancy was difficult to identify based on diagnostic imaging alone. However, some MRI features were predictive of high‐grade PNSTs including tumor size and peripheral contrast enhancement

Ultrasound evaluation of the renal pelvis in cats with ureteral obstruction treated with a subcutaneous ureteral bypass: a retrospective study of 27 cases (2010-2015).

Objectives The objective of the study was to measure the preoperative and postoperative renal pelvic size and describe the ultrasound findings following successful decompression of a ureteral obstruction using the subcutaneous ureteral bypass (SUB) device in cats. Methods This retrospective study assessed the measurement of the renal pelvis of 27 cats with unilateral (n = 21) or bilateral (n = 6) ureteral obstruction before (pre-t0) and after placement of a SUB during short- (before t0 + 3 months) and long-term (after t0 + 3 months) follow-up. Several qualitative ultrasound parameters were recorded for each cat. At both intervals, the last ultrasound examination was used for qualitative criteria and the mean pelvic size was recorded. The complications observed during follow-up were divided into obstructive and non-obstructive. Results No qualitative ultrasound parameter was statistically significant. The presence of retroperitoneal or peritoneal effusion was rarely seen (n = 4/25 during the short term and n = 1/14 during the long term). Hyperechogenicity of the peri-renal adipose tissue decreased in the long term. A statistically significant decrease in the width of the renal pelvis was noted in the short- (2.4 mm, range 0-7.0 mm) and long-term (1.7 mm, range 0-3.5 mm) follow-ups compared with the preoperative value (11.7 mm, range 0.9-41 mm). Three months following SUB placement, each cat without an obstructive complication had a pelvic width \u2a7d3.5 mm. Conclusions and relevance Renal pelvic distension is at least partially reversible when ureteral obstruction is treated by placement of a SUB. Ultrasound monitoring is a useful tool to detect obstructive complications

Assessment of interobserver agreement and use of selected magnetic resonance imaging variables for differentiation of acute noncompressive nucleus pulposus extrusion and ischemic myelopathy in dogs

OBJECTIVE To evaluate interobserver agreement for features used in presumptive diagnosis of acute noncompressive nucleus pulposus extrusion (ANNPE) or ischemic myelopathy by MRI, compare findings on postcontrast T1-weighted (T1W) MRI sequences with fat saturation (FS) for the 2 conditions, and determine whether length and directional patterns of hyperintensity of the intramedullary spinal cord on T2-weighted (T2W) fast spin echo (FSE) MRI sequences differ between dogs with these diseases. DESIGN Retrospective, observational study. ANIMALS 20 dogs with clinical signs compatible with ANNPE (n = 14) or ischemic myelopathy (6). PROCEDURES 3 observers evaluated MRI data (including T2W FSE, T2W single-shot FSE, and T1W FS sequences) for dogs with a presumptive diagnosis of ischemic myelopathy or ANNPE. Interobserver agreement for variables of interest including presumptive diagnosis was assessed by \uce\uba statistic calculations. Associations between diagnosis and variables of interest were assessed with Fisher exact or Cochran-Mantel-Haenszel tests. RESULTS Perfect interobserver agreement (\uce\uba = 1 for all comparisons) was found for the presumptive diagnosis of ischemic myelopathy versus ANNPE. Meningeal enhancement on postcontrast T1W FS MRI images and nonlongitudinal directional pattern of intramedullary hyperintensity on T2W FSE images were significantly associated with a diagnosis of ANNPE. Greater length of intramedullary hyperintensity was significantly associated with a diagnosis of ischemic myelopathy. CONCLUSIONS AND CLINICAL RELEVANCE Directional pattern and length of intramedullary hyperintensity on T2W FSE MRI images and enhancement patterns in postcontrast T1W FS sequences may provide important contributions to the criteria currently used in the presumptive diagnosis of ischemic myelopathy versus ANNPE

Multidetector-row computed tomographic characteristics of presumed preureteral vena cava in cats

n humans. The aim of this retrospective cross-sectional study was to describe the contrast-enhanced multidetector row computed tomographic (MDCT) characteristics of presumed preureteral vena cava in a group of cats. Medical records from two institutions located in different continents were searched from 2010-2013 for cases with complete contrast-enhanced MDCT examinations of the abdomen (i.e. included the entire course of the ureters and prerenal and renal segments of the caudal vena cava) and a diagnosis of preureteral caudal vena cava. For cases meeting inclusion criteria, CT scan data were retrieved and characteristics of the preureteral caudal vena cava were recorded. Presence of concomitant renal or ureteral diseases was also recorded. A total of 272 cats had contrast-enhanced abdominal CT scans during the study period and of these, 68 cats (22.43 \ub1 4.96%) had a diagnosis of presumed preureteral vena cava. In all affected cats, a "reverse-J ureter" was observed, i.e. a ureter running medially at the level of L4-5, passing dorsally to the caudal vena cava and then exiting ventrally between the caudal vena cava and aorta returning to its normal position. Having a preureteral vena cava resulted in an increased risk for concurrent urinary signs (OR = 3.00; CI: 95%; 1.28-6.99; P = 0.01). Findings supported the use of contrast-enhanced MDCT for characterizing morphology of preureteral vena cava and its relation with ureters in cats

Mesenteric-reno-caval shunt in an aged dog

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RADIOGRAPHIC APPEARANCE OF PRESUMED NONCARDIOGENIC PULMONARY EDEMA AND CORRELATION WITH THE UNDERLYING CAUSE IN DOGS AND CATS

Noncardiogenic pulmonary edema is an important cause of respiratory disease in dogs and cats but few reports describe its radiographic appearance. The purpose of this retrospective case series study was to describe radiographic findings in a large cohort of dogs and cats with presumed noncardiogenic pulmonary edema and to test associations among radiographic findings versus cause of edema. Medical records were retrieved for dogs and cats with presumed noncardiogenic edema based on history, radiographic findings, and outcome. Radiographs were reviewed to assess lung pattern and distribution of the edema. Correlation with the cause of noncardiogenic pulmonary edema was evaluated with a Fisher's exact test. A total of 49 dogs and 11 cats were included. Causes for the noncardiogenic edema were airway obstruction (n = 23), direct pulmonary injury (n = 13), severe neurologic stimulation (n = 12), systemic disease (n = 6), near-drowning (n = 3), anaphylaxis (n = 2) and blood transfusion (n = 1). Mixed, symmetric, peripheral, multifocal, bilateral, and dorsal lung patterns were observed in 44 (73.3%), 46 (76.7%), 55 (91.7%), 46 (76.7%), 46 (76.7%), and 34 (57.6%) of 60 animals, respectively. When the distribution was unilateral, pulmonary infiltration involved mainly the right lung lobes (12 of 14, 85.7%). Increased pulmonary opacity was more often asymmetric, unilateral, and dorsal for postobstructive pulmonary edema compared to other types of noncardiogenic pulmonary edema, but no other significant correlations could be identified. In conclusion, noncardiogenic pulmonary edema may present with a quite variable radiographic appearance in dogs and cats