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deLaforcade A, Bacek L, Blais M, Boyd C, Brainard BM, Chan DL, Cortellini S, Goggs R, Hoareau GL, Koenigshof A, Li R, Lynch A, Ralph A, Rozanski E, Sharp CR. 2022 Update of the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) Domain 1- Defining populations at risk. J Vet Emerg Crit Care (San Antonio) 2022; 32:289-314. [PMID: 35499966 PMCID: PMC9322658 DOI: 10.1111/vec.13204] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 03/31/2022] [Accepted: 03/31/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To expand the number of conditions and interventions explored for their associations with thrombosis in the veterinary literature and to provide the basis for prescribing recommendations. DESIGN A population exposure comparison outcome format was used to represent patient, exposure, comparison, and outcome. Population Exposure Comparison Outcome questions were distributed to worksheet authors who performed comprehensive searches, summarized the evidence, and created guideline recommendations that were reviewed by domain chairs. The revised guidelines then underwent the Delphi survey process to reach consensus on the final guidelines. Diseases evaluated in this iteration included heartworm disease (dogs and cats), immune-mediated hemolytic anemia (cats), protein-losing nephropathy (cats), protein-losing enteropathy (dogs and cats), sepsis (cats), hyperadrenocorticism (cats), liver disease (dogs), congenital portosystemic shunts (dogs and cats) and the following interventions: IV catheters (dogs and cats), arterial catheters (dogs and cats), vascular access ports (dogs and cats), extracorporeal circuits (dogs and cats) and transvenous pacemakers (dogs and cats). RESULTS Of the diseases evaluated in this iteration, a high risk for thrombosis was defined as heartworm disease or protein-losing enteropathy. Low risk for thrombosis was defined as dogs with liver disease, cats with immune-mediated hemolytic anemia, protein-losing nephropathy, sepsis, or hyperadrenocorticism. CONCLUSIONS Associations with thrombosis are outlined for various conditions and interventions and provide the basis for management recommendations. Numerous knowledge gaps were identified that represent opportunities for future studies.
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Affiliation(s)
- Armelle deLaforcade
- Department of Clinical Sciences, Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachusettsUSA
| | - Lenore Bacek
- Bluepearl Specialty and Emergency Pet HospitalTampaFloridaUSA
| | - Marie‐Claude Blais
- Department of Clinical SciencesUniversity of MontrealSaint‐HyacintheQCCanada
| | - Corrin Boyd
- School of Veterinary MedicineMurdoch UniversityMurdochAustralia
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, Clinical SciencesUniversity of GeorgiaAthensGeorgiaUSA
| | - Daniel L. Chan
- Department of Clinical Science and ServicesThe Royal Veterinary CollegeLondonUK
| | - Stefano Cortellini
- Department of Clinical Science and ServicesThe Royal Veterinary CollegeLondonUK
| | - Robert Goggs
- Department of Clinical SciencesCornell University College of Veterinary MedicineIthacaNew YorkUSA
| | | | - Amy Koenigshof
- Department of Emergency CareTwo by Two Animal HospitalBerrien SpringsMichiganUSA
| | - Ron Li
- Department of Veterinary Surgical and Radiological SciencesSchool of Veterinary MedicineUniversity of California DavisDavisCaliforniaUSA
| | - Alex Lynch
- Department of Clinical SciencesNC State College of Veterinary MedicineRaleighNorth CarolinaUSA
| | | | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachusettsUSA
| | - Claire R Sharp
- School of Veterinary MedicineMurdoch UniversityMurdochAustralia
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2
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Hardwick JJ, Reeve EJ, Hezzell MJ, Reeve JA. Prevalence of ultrasonographic gastrointestinal wall changes in dogs with acute pancreatitis: A retrospective study (2012-2020). J Vet Intern Med 2022; 36:947-956. [PMID: 35318742 PMCID: PMC9151481 DOI: 10.1111/jvim.16414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 11/26/2022] Open
Abstract
Background Ultrasonographic gastrointestinal wall changes in dogs with acute pancreatitis (AP) are not well characterized in the literature. No detailed studies have described their prevalence, characteristics, distribution, or clinical relevance. Hypothesis/Objectives Describe the prevalence of ultrasonographic gastrointestinal wall changes in a population of dogs with AP and evaluate for associations between the presence of gastrointestinal wall changes and clinical or clinicopathological variables. Animals Referral population of 66 client‐owned dogs with AP. Methods Retrospective search of clinical records to identify dogs with AP. Clinical variables, clinicopathological variables and ultrasonographic findings were reported using descriptive statistics. A binary logistic regression model was used to evaluate for associations between the presence of gastrointestinal wall changes and clinical or clinicopathological variables. Results Sixty‐six dogs were included. Forty‐seven percent of dogs (95% confidence interval [CI], 35.0%‐59.0%; n = 31) with AP had ultrasonographic gastrointestinal wall changes. Gastrointestinal wall changes were most common in the duodenum and identified in 71% (n = 22) of affected dogs. Of dogs with gastrointestinal wall changes, 74.2% (n = 23) had wall thickening, 61.3% (n = 19) had abnormal wall layering, and 35.5% (n = 11) had wall corrugation. In the multivariable model, only heart rate remained an independent predictor of ultrasonographic gastrointestinal wall changes (P = .02). Conclusions and Clinical Importance Ultrasonographic gastrointestinal wall changes in this population of dogs with AP were common. Increased heart rate was the only independent predictor of gastrointestinal wall changes, which might imply more severe disease. Additional studies are required to elucidate whether ultrasonographic gastrointestinal wall changes reflect disease severity in AP.
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Affiliation(s)
- Joshua J Hardwick
- Bristol Veterinary School, University of Bristol, North Somerset, United Kingdom.,Langford Vets, Small Animal Referral Hospital, Langford, United Kingdom
| | | | - Melanie J Hezzell
- Bristol Veterinary School, University of Bristol, North Somerset, United Kingdom
| | - Jenny A Reeve
- Bristol Veterinary School, University of Bristol, North Somerset, United Kingdom
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3
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Griffin S. Feline abdominal ultrasonography: What's normal? What's abnormal? Abdominal lymph nodes, peritoneal cavity and aorta. J Feline Med Surg 2021; 23:835-849. [PMID: 34428939 PMCID: PMC10812149 DOI: 10.1177/1098612x211037874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the lymph nodes, peritoneal cavity and abdominal vasculature provides important information useful in the investigation of a number of conditions, including aortic thromboembolism. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even for the experienced ultrasonographer, differentiating between incidental findings such as Bates bodies and pathological changes can be challenging. AIM This review, the last in an occasional series on feline abdominal ultrasonography, discusses ultrasound examination of the abdominal lymph nodes and peritoneal cavity, and also the role of the technique in identifying thromboembolism of the aorta. Aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although the use of ultrasonography as a diagnostic tool is highly dependent on operator experience. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
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Affiliation(s)
- Sally Griffin
- Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
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4
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Ohta H, Nagata N, Yokoyama N, Osuga T, Sasaki N, Morishita K, Takiguchi M. Prognostic value of small intestinal dilatation in dogs with protein-losing enteropathy. J Vet Med Sci 2021; 83:378-384. [PMID: 33431757 PMCID: PMC8025421 DOI: 10.1292/jvms.20-0489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To date, little is known about the prognostic significance of ultrasonographic findings in dogs with protein-losing enteropathy (PLE). The aim of this
retrospective study was to examine the prognostic value of ultrasonographic findings in dogs with PLE. A total of 26 dogs with PLE were included: 20 dogs with
chronic enteropathy and 6 dogs with gastrointestinal lymphoma. The presence of small intestinal dilatation was associated with shorter survival time in dogs
with PLE (P=0.003). The presence of hyperechoic intestinal mucosal striations was associated with longer survival time in dogs with PLE
(P=0.0085). The results of the current study indicate that the presence of small intestinal dilatation might be associated with poor
prognosis in dogs with PLE.
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Affiliation(s)
- Hiroshi Ohta
- Laboratory of Veterinary Internal Medicine, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido 060-0818, Japan.,Present address: Laboratory of Veterinary Internal Medicine, Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, 582 Bunkyodai-Midorimachi, Ebetsu, Hokkaido 069-8501, Japan
| | - Noriyuki Nagata
- Laboratory of Veterinary Internal Medicine, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido 060-0818, Japan
| | - Nozomu Yokoyama
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido 060-0818, Japan
| | - Tatsuyuki Osuga
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido 060-0818, Japan
| | - Noboru Sasaki
- Laboratory of Veterinary Internal Medicine, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido 060-0818, Japan
| | - Keitaro Morishita
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido 060-0818, Japan
| | - Mitsuyoshi Takiguchi
- Laboratory of Veterinary Internal Medicine, Graduate School of Veterinary Medicine, Hokkaido University, N18 W9, Sapporo, Hokkaido 060-0818, Japan
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5
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Isaya R, Ciccarelli S, Enache D, Specchi S, Pesaresi M, Ferri F, Porporato F, Auriemma E, Contiero B, Coppola LM, Zini E. Gastrointestinal ultrasonographic findings in cats with Feline panleukopenia: a case series. BMC Vet Res 2021; 17:20. [PMID: 33413382 PMCID: PMC7791690 DOI: 10.1186/s12917-020-02720-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 12/09/2020] [Indexed: 11/30/2022] Open
Abstract
Background Feline panleukopenia virus (FPV) is very resistant and highly contagious and infects domestic cats and other felids. FPV is particularly widespread among sheltered cats, and is associated with high morbidity and mortality, causing severe gastroenteritis characterized by anorexia, lethargy, fever, dehydration, hemorrhagic diarrhea, and vomiting. There is currently no data on the ultrasonographic features of cats affected with FPV. This case series describes abdominal ultrasonographic findings in shelter cats with naturally-occurring FPV, and assesses whether are associated with clinical and laboratory findings. Cats affected by FPV were enrolled in the study if an abdominal ultrasound was performed within 12 hours of diagnosis. Clinical, laboratory and survival data were collected from medical records. Ultrasonographic examinations were reviewed for gastrointestinal abnormalities and their associations with the above data were explored. Results Twenty-one cats were included. Nine cats (42.9%) died and 12 (57.1%) recovered. Based on ultrasonography, the duodenum and jejunum showed thinning of the mucosal layer in 70.6% and 66.6% of cats, thickening of the muscular layer in 52.9% and 57.1% of cats, and hyperechogenicity of the mucosa in 41.2% and 33.3%. Jejunal hyperechoic mucosal band paralleling the submucosa and irregular luminal surface were both observed in 33.3% of the cats. Survival was positively associated with increased jejunal mucosal echogenicity (P = 0.003) and hyperechoic mucosal band (P = 0.003). Peritoneal free fluid was positively associated with vomiting (P = 0.002). Conclusions This study provides ultrasonographic features of naturally-occurring FPV in cats, which, as expected, are compatible with gastroenteropathy. The most frequent findings were diffuse small intestine mucosal layer thinning, muscular layer thickening and mucosal hyperechogenicity, jejunal hyperechoic mucosal band and irregular luminal surface. Ultrasonographic features may be useful to complete the clinical picture and assess the severity of the gastroenteropathy in FPV cats. Prospective studies are needed to confirm ultrasonographic prognostic factors.
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Affiliation(s)
- Rosaria Isaya
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy.
| | - Stefano Ciccarelli
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy.,Department of Veterinary Medicine, University of Bari "Aldo Moro", BA, 70010, Valenzano, Italy
| | - Daniela Enache
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy
| | - Swan Specchi
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy
| | - Marco Pesaresi
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy
| | - Filippo Ferri
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy
| | - Federico Porporato
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy
| | - Edoardo Auriemma
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, PD, Italy
| | - Luigi M Coppola
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, PD, Italy
| | - Eric Zini
- Istituto Veterinario di Novara, 28060, Granozzo con Monticello (NO), Italy.,Department of Animal Medicine, Production and Health, University of Padova, Legnaro, PD, Italy.,Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057, Zurich, Switzerland
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6
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Berman CF, Lobetti RG, Lindquist E. Comparison of clinical findings in 293 dogs with suspect acute pancreatitis: Different clinical presentation with left lobe, right lobe or diffuse involvement of the pancreas. J S Afr Vet Assoc 2020; 91:e1-e10. [PMID: 32370532 PMCID: PMC7203193 DOI: 10.4102/jsava.v91i0.2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/29/2019] [Accepted: 02/12/2020] [Indexed: 12/13/2022] Open
Abstract
Pancreatitis is a common clinical condition seen in companion animals. The correlation of the region of the pancreas affected to the presentation of clinical signs has not been previously described. A retrospective study on the clinical findings in 293 client-owned dogs diagnosed with suspect pancreatitis based on history, clinical signs, laboratory testing and abdominal ultrasonography was performed. Based on ultrasonography, dogs were divided into three groups: group 1: 41 dogs with ultrasonographic changes consistent with pancreatitis within the left lobe of the pancreas; group 2: 105 dogs with ultrasonographic changes compatible with pancreatitis within the right lobe of the pancreas; and group 3: 147 dogs with ultrasonographic evidence of diffuse pancreatitis. No significant differences regarding age, breed and sex were evident. Furthermore, statistical significance was demonstrated with the presence of pain in group 3; poor appetite in groups 2 and 3; and vomiting and diarrhoea in group 3. Pain is expected to occur with a higher frequency in diffuse pancreatitis, but it is not a common clinical sign. This may represent a more severe form of the disease when the pancreas is diffusely affected. Vomiting was more common than diarrhoea with both clinical signs more prevalent in dogs with diffuse pancreatitis, and this could be ascribed to gastric and intestinal tract involvement. Poor appetite occurred more frequently in dogs with diffuse and right lobe pancreatitis. A possible explanation can be attributed to the fact that the duodenum has many receptors and is referred to as the 'organ of nausea'.
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Affiliation(s)
- Chad F Berman
- Bryanston Veterinary Hospital, Johannesburg, South Africa; and, Department of Companion Animal and Clinical Studies, Onderstepoort.
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7
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Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the pancreas is a vital part of the investigation into feline pancreatic disease. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even for the experienced ultrasonographer, differentiating between incidental findings such as nodular hyperplasia and pathological changes such as neoplasia can be challenging. AIM This review, part of an occasional series on feline abdominal ultrasonography, discusses the ultrasonographic examination and appearance of the normal and diseased pancreas. Aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
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Affiliation(s)
- Sally Griffin
- Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
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8
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Griffin S. Feline abdominal ultrasonography: What's normal? What's abnormal? The diseased gastrointestinal tract. J Feline Med Surg 2019; 21:1047-1060. [PMID: 31648606 PMCID: PMC10814209 DOI: 10.1177/1098612x19880434] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. B-mode ultrasonography is likely the most widely used modality for imaging the gastrointestinal (GI) tract in cats and it can help in the diagnosis of GI masses, foreign bodies and disorders of the ileocaecocolic junction. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variations and pathological changes can be challenging for all but the most experienced. For example, while for inflammatory conditions of the feline GI tract changes are frequently identified on ultrasound, there may occasionally be no changes to the appearance of the intestine; hence a 'normal' ultrasound does not exclude the possibility of inflammatory disease. AIM This review, part of an occasional series on feline abdominal ultrasonography, describes the appearance of a range of conditions that affect the feline GI tract; the normal GI tract is addressed in an accompanying article in this issue of JFMS. Aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
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Affiliation(s)
- Sally Griffin
- Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
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9
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Nisa K, Lim SY, Shinohara M, Osuga T, Yokoyama N, Tamura M, Nagata N, Sasaoka K, Dermlim A, Leela-Arporn R, Morita T, Sasaki N, Morishita K, Nakamura K, Ohta H, Takiguchi M. Evaluation of duodenal perfusion by contrast-enhanced ultrasonography in dogs with chronic inflammatory enteropathy and intestinal lymphoma. J Vet Intern Med 2019; 33:559-568. [PMID: 30784123 PMCID: PMC6430930 DOI: 10.1111/jvim.15432] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 01/17/2019] [Indexed: 02/06/2023] Open
Abstract
Background Contrast‐enhanced ultrasonography (CEUS) can be used to evaluate intestinal perfusion in healthy dogs. It is helpful for diagnosing and monitoring inflammatory bowel disease in humans and could be useful for dogs with chronic intestinal diseases. Objectives To examine duodenal perfusion in dogs with chronic inflammatory enteropathy (CIE) and intestinal lymphoma. Animals Client‐owned dogs with CIE (n = 26) or intestinal lymphoma (n = 7) and dogs with gastrointestinal signs but histopathologically normal duodenum (controls, n = 14). Methods In this cross‐sectional study, dogs with CIE were classified into remission (n = 16) and symptomatic (n = 10) groups based on clinical scores determined at the time of CEUS. The duodenum was scanned after IV injection of Sonazoid® (0.01 mL/kg). CEUS‐derived perfusion parameters, including time‐to‐peak, peak intensity (PI), area under the curve (AUC), and wash‐in and wash‐out rates were evaluated. Results The PI was significantly higher in the symptomatic CIE group (median (range); 105.4 (89.3‐128.8) MPV) than in the control group (89.9 (68.5‐112.2) MPV). The AUC was significantly higher in the symptomatic CIE group (4847.9 (3824.3‐8462.8) MPV.sec) than in the control (3448.9 (1559.5‐4736.9) MPV.sec) and remission CIE (3862.3 (2094.5‐6899.0) MPV.sec) groups. The PI and clinical score were positively correlated in the CIE group. No significant differences in perfusion parameters were detected between the lymphoma and CIE groups or the lymphoma and control groups. Conclusions and Clinical Importance The PI and AUC can detect duodenal inflammation and hence are potentially useful for excluding a diagnosis of CIE.
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Affiliation(s)
- Khoirun Nisa
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Sue Yee Lim
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan.,Gastrointestinal Laboratory, Department of Small Animal Clinical Science, Texas A&M University, Texas
| | - Masayoshi Shinohara
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Tatsuyuki Osuga
- Veterinary Teaching Hospital, Graduate school of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Nozomu Yokoyama
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan.,Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Masahiro Tamura
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Noriyuki Nagata
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Kazuyoshi Sasaoka
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Angkhana Dermlim
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Rommaneeya Leela-Arporn
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Tomoya Morita
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Noboru Sasaki
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Keitaro Morishita
- Veterinary Teaching Hospital, Graduate school of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Kensuke Nakamura
- Veterinary Teaching Hospital, Graduate school of Veterinary Medicine, Hokkaido University, Sapporo, Japan.,Organization for Promotion of Tenure Track, University of Miyazaki, Miyazaki, Japan
| | - Hiroshi Ohta
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Mitsuyoshi Takiguchi
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Japan
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10
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Abstract
This article is an overview of the field of small animal veterinary sonography, including its history, examples of utilization, and a brief review of the small animal abdominal sonographic examination that includes images of normal examples and typical pathology.
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11
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Lim S, Nakamura K, Morishita K, Sasaki N, Murakami M, Osuga T, Ohta H, Yamasaki M, Takiguchi M. Qualitative and quantitative contrast-enhanced ultrasonographic assessment of cerulein-induced acute pancreatitis in dogs. J Vet Intern Med 2014; 28:496-503. [PMID: 24612403 PMCID: PMC4858020 DOI: 10.1111/jvim.12319] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 12/11/2013] [Accepted: 01/07/2014] [Indexed: 12/14/2022] Open
Abstract
Background Acute pancreatitis (AP) is the most common disease of the canine exocrine pancreas, and accurate noninvasive diagnosis is challenging. Hypothesis/Objectives To determine the feasibility of using quantitative contrast‐enhanced ultrasonography (CEUS) to detect pancreatic perfusional changes in cerulein‐induced AP in dogs. Animals Six adult female Beagles. Methods Each dog received 2 hours of IV infusion with 7.5 μg/kg/h of cerulein diluted in saline. As control, all dogs received 2 hours of IV infusion of saline 2 weeks before cerulein infusion. CEUS of the pancreas and duodenum were performed before (0 hour), and at 2, 4, 6, and 12 hours after saline and cerulein infusion. Time‐intensity curves were created from regions of interest in the pancreas and duodenum. Five perfusional parameters were measured for statistical analysis: time to initial up‐slope, peak time, time to wash‐out, peak intensity (PI), and area under the curve (AUC). Results In cerulein‐induced AP, pancreatic PI increased at 2 and 4 hours when compared to 0 hour, and at 2, 4, and 6 hours when compared to control. AUC increased at 4 hours when compared to 0 hour, and at 2 and 4 hours when compared to control. Time to wash‐out was prolonged at 4 hours when compared to control. For saline control, peak time was faster at 2 hours when compared to 0 hour. Conclusions and Clinical Importance CEUS parameters PI and AUC can provide useful information in differentiating acute pancreatitis from normal pancreas. Cerulein‐induced AP was characterized by prolonged hyperechoic enhancement on CEUS.
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Affiliation(s)
- S.Y. Lim
- Laboratory of Veterinary Internal MedicineGraduate School of Veterinary MedicineHokkaido UniversityHokkaidoJapan
| | - K. Nakamura
- Hokkaido University Veterinary Teaching HospitalGraduate School of Veterinary MedicineHokkaido UniversityHokkaidoJapan
| | - K. Morishita
- Hokkaido University Veterinary Teaching HospitalGraduate School of Veterinary MedicineHokkaido UniversityHokkaidoJapan
| | - N. Sasaki
- Laboratory of Veterinary Internal MedicineGraduate School of Veterinary MedicineHokkaido UniversityHokkaidoJapan
| | - M. Murakami
- Laboratory of Veterinary Internal MedicineGraduate School of Veterinary MedicineHokkaido UniversityHokkaidoJapan
| | - T. Osuga
- Laboratory of Veterinary Internal MedicineGraduate School of Veterinary MedicineHokkaido UniversityHokkaidoJapan
| | - H. Ohta
- Laboratory of Veterinary Internal MedicineGraduate School of Veterinary MedicineHokkaido UniversityHokkaidoJapan
| | - M. Yamasaki
- Laboratory of Veterinary Internal MedicineGraduate School of Veterinary MedicineHokkaido UniversityHokkaidoJapan
| | - M. Takiguchi
- Laboratory of Veterinary Internal MedicineGraduate School of Veterinary MedicineHokkaido UniversityHokkaidoJapan
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12
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Lim SY, Nakamura K, Morishita K, Sasaki N, Murakami M, Osuga T, Ohta H, Yamasaki M, Takiguchi M. Qualitative and quantitative contrast enhanced ultrasonography of the pancreas using bolus injection and continuous infusion methods in normal dogs. J Vet Med Sci 2013; 75:1601-7. [PMID: 23955397 PMCID: PMC3942965 DOI: 10.1292/jvms.13-0199] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Quantitative contrast enhanced
ultrasound is a major breakthrough for ultrasound imaging in recent years. However,
contrast enhancement of the pancreas is brief with bolus injection. To assess if
continuous infusion of Sonazoid® can prolong the duration of pancreatic
enhancement over bolus injections, eight adult dogs received bolus injection and
continuous infusion of Sonazoid® on separate days. Contrast enhanced ultrasound
of the pancreatic parenchyma and proximal descending duodenum was performed, and time
intensity curves reflecting tissue perfusions were generated. Perfusion parameters- time
to initial upslope, peak time, time to wash-out and peak intensity were calculated and
evaluated. Fast wash-in to intense peak, followed by rapid wash-out was observed for time
intensity curves of bolus injection. With continuous infusion, contrast wash-in to peak
intensity was gradual, followed by long plateau and slow wash-out. Median contrast
enhancement durations of the pancreas and duodenum were significantly prolonged by
continuous infusion from 11 sec (range, 10 to 23 sec) and 16 sec (range, 3 to 43 sec) at
bolus injection to 205 sec (range, 170 to 264 sec, P<0.01) and 193 sec
(range, 169 to 216 sec, P<0.05), respectively. Median peak intensity
of the pancreas was 100.9 MPV (range, 80.2 to 124.3 MPV) at bolus injection and 77.6 MPV
(range, 58.2 to 99.5 MPV, P<0.05) at continuous infusion. Prolonged
continuous imaging is afforded by continuous infusion of contrast agent. Peak intensity of
the pancreas was slightly diminished in continuous infusion, but offered adequate imaging
subjectively.
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Affiliation(s)
- Sue Yee Lim
- Graduate School of Veterinary Medicine, Hokkaido University, Hokkaido 060-0818, Japan
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13
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Gaschen L. Ultrasonography of Small Intestinal Inflammatory and Neoplastic Diseases in Dogs and Cats. Vet Clin North Am Small Anim Pract 2011; 41:329-44. [DOI: 10.1016/j.cvsm.2011.01.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Stander N, Wagner WM, Goddard A, Kirberger RM. Normal canine pediatric gastrointestinal ultrasonography. Vet Radiol Ultrasound 2010; 51:75-8. [PMID: 20166399 DOI: 10.1111/j.1740-8261.2009.01626.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The normal sonographic appearance of the adult canine gastrointestinal tract has been described. Interpretation of abdominal ultrasonographic findings in puppies is difficult due to the lack of information on normal ultrasonographic findings. The gastrointestinal tract, jejunal lymph node size and the presence and appearance of abdominal fluid were investigated in 23 normal, 7-12-week-old Beagle puppies. The duodenal wall thickness was greater than in other parts of the gastrointestinal tract (mean 3.8 +/- standard deviation [SD] 5 mm, range 3.2-4.8 mm). The mean stomach wall thickness was 2.7 +/- SD 0.4 mm (range 2.2-3.7 mm), the mean jejunal wall thickness was 2.5 +/- SD 0.5 mm (range 1.2-3.4 mm), and the mean colonic wall thickness was 1.3 +/- SD 0.3 mm (range 0.7-2.0 mm). In addition, mean duodenal and jejunal mucosal layer thicknesses measured 2.7 +/- SD 0.5 mm (range 2.0-3.8 mm) and 1.5 +/- SD 0.4 mm (range 0.6-2.5 mm), respectively. Homogenous, hypoechoic jejunal lymph nodes were easily found and the mean thickness was 7.1 +/- SD 2.2 mm (range 1.5-12.5 mm). A mild amount of anechoic free peritoneal fluid was present in all puppies.
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Affiliation(s)
- Nerissa Stander
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort 0110, Republic of South Africa.
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15
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Nelson NC, Drost WT, Lerche P, Bonagura JD. Noninvasive estimation of central venous pressure in anesthetized dogs by measurement of hepatic venous blood flow velocity and abdominal venous diameter. Vet Radiol Ultrasound 2010; 51:313-23. [PMID: 20469555 DOI: 10.1111/j.1740-8261.2010.01668.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Determination of central venous pressure (CVP) is relevant to patients with right heart disease, hypovolemia, and following intravenous fluid therapy. We hypothesized that changes in CVP in dogs could be predicted by measurements of hepatic vein diameter, caudal vena cava (CVC) diameter, and hepatic venous flow velocities. Nine healthy American Foxhounds were anesthetized. Following baseline recordings, intravenous fluids were administered to increase CVP. Volume administration created treatment periods with CVP ranges of 5, 10, 15, 20, and 25 mm Hg. Flow velocities in the right medial hepatic vein were recorded using pulsed wave Doppler ultrasound. Hepatic vein, CVC, and aorta diameters were determined with B-mode ultrasound. Variables were compared across the treatment periods by ANOVA for repeated measures. Relationships between CVP, Doppler, and B-mode variables were evaluated using Spearman's rank correlations, multiple linear regression, and repeated measures linear regression. The a-, S- and v-wave velocities were augmented significantly with volume loading. The best part (semipartial) correlation coefficients predicting increasing CVP were identified with v-wave velocity (0.823), S-wave velocity (-0.800), CVC diameter (0.855), and hepatic vein diameter (0.815). Multiple linear regression indicated that CVP in this study could be predicted best by a combination of CVC and hepatic vein diameter and the v-wave velocity (r = 0.928). Ultrasound imaging identified gallbladder and pancreatic edema consistently, likely related to acute volume loading. These findings may be applicable in the assessment of volume status, dogs with right heart disease, and during serial monitoring of dogs receiving fluid or diuretic therapy.
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Affiliation(s)
- Nathan C Nelson
- Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI, USA.
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16
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STANDER NERISSA, WAGNER WENCKEM, GODDARD AMELIA, KIRBERGER ROBERTM. ULTRASONOGRAPHIC APPEARANCE OF CANINE PARVOVIRAL ENTERITIS IN PUPPIES. Vet Radiol Ultrasound 2010; 51:69-74. [DOI: 10.1111/j.1740-8261.2009.01625.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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17
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Cepparulo A, Valentini S, Tamburro R, Bettini G, Scarpa F, Diana A, Pietra M. What is your diagnosis? Intestinal neoplasia, segmental enteritis, and linear foreign body associated with a partially obstructive pattern. J Am Vet Med Assoc 2009; 235:27-8. [PMID: 19566449 DOI: 10.2460/javma.235.1.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Alessandra Cepparulo
- Veterinary Clinical Department, School of Veterinary Medicine, University of Bologna, Ozzano dell'Emilia (Bologna), Italy
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18
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19
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Webb C, Trott C. Laparoscopic Diagnosis of Pancreatic Disease in Dogs and Cats. J Vet Intern Med 2008; 22:1263-6. [DOI: 10.1111/j.1939-1676.2008.0176.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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20
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Eker K, Salmanoğlu MR, Vural SA. Unilateral leiomyoma in the mesosalpinx of a dog. J Am Anim Hosp Assoc 2008; 42:392-4. [PMID: 16960044 DOI: 10.5326/0420392] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Routine ultrasonographic evaluation of the genital organs of a 3-year-old terrier bitch revealed a mass at the level of the left ovary. The mass was located next to the caudal pole of the left kidney and ventrocaudal to the left ovary. Ultrasonographically, the uterus was not enlarged and had no luminal contents. Exploratory laparotomy revealed a mass attached to the left ovarian bursa with a small and thin pedicle. The mass had smooth margins, was whitish in color, and was lobulated on cut surface. The histopathological diagnosis of the mass was leiomyoma associated with the mesosalpinx.
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Affiliation(s)
- Kemal Eker
- Department of Obstetrics and Gynecology, Faculty of Veterinary Medicine, Ankara University, 06110, Diskapi, Ankara, Turkey
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21
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Gaschen L, Kircher P. Two-dimensional grayscale ultrasound and spectral Doppler waveform evaluation of dogs with chronic enteropathies. ACTA ACUST UNITED AC 2007; 22:122-7. [PMID: 17844818 DOI: 10.1053/j.ctsap.2007.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Sonography is an important diagnostic tool to examine the gastrointestinal tract of dogs with chronic diarrhea. Two-dimensional grayscale ultrasound parameters to assess for various enteropathies primarily focus on wall thickness and layering. Mild, generalized thickening of the intestinal wall with maintenance of the wall layering is common in inflammatory bowel disease. Quantitative and semi-quantitative spectral Doppler arterial waveform analysis can be utilized for various enteropathies, including inflammatory bowel disease and food allergies. Dogs with inflammatory bowel disease have inadequate hemodynamic responses during digestion of food. Dogs with food allergies have prolonged vasodilation and lower resistive and pulsatility indices after eating allergen-inducing foods.
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Affiliation(s)
- Lorrie Gaschen
- School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA.
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22
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Sutherland-Smith J, Penninck DG, Keating JH, Webster CRL. ULTRASONOGRAPHIC INTESTINAL HYPERECHOIC MUCOSAL STRIATIONS IN DOGS ARE ASSOCIATED WITH LACTEAL DILATION. Vet Radiol Ultrasound 2007; 48:51-7. [PMID: 17236361 DOI: 10.1111/j.1740-8261.2007.00204.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In this retrospective study, the medical records of 23 dogs with the sonographic feature of small intestinal hyperechoic mucosal striations and an endoscopic or surgical intestinal biopsy were reviewed. Histopathologic lacteal dilation was present in 96% of dogs with mucosal striations. Sonographic findings associated with mucosal striations included: mild jejunal wall thickening (96%), mild duodenal wall thickening (78%), mucosal speckles (70%), and abdominal effusion (87%). The mucosal striations were diffuse (70%) or multifocal (30%) and did not cause loss of wall layering, except in one dog with a severe mural lipogranuloma. Mesenteric lymphadenopathy was identified in 9% of dogs. Thirteen dogs with endoscopic biopsies had mild to moderate villus lacteal dilation and the nine dogs with surgical biopsies had moderate to severe dilation. Inflammatory infiltrates were mild (61%) or moderate (30%) with variable numbers and combinations of cells, including eosinophils (65%), plasma cells (61%), lymphocytes (57%), and neutrophils (30%); one dog had disseminated villus histiocytic sarcoma. The biochemistry changes and clinical signs were consistent with protein-losing enteropathy in 78% of dogs. Hyperechoic mucosal striations in dogs are associated with lacteal dilation and are frequently associated with mucosal inflammation and protein losing enteropathy.
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Affiliation(s)
- James Sutherland-Smith
- Department of Clinical Sciences, Sections of Diagnostic Imaging, Hospital for Small Animals, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA 01536, USA
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