IMAGING DIAGNOSIS-CELIAC ARTERY PSEUDOANEURYSM ASSOCIATED WITH A MIGRATING GRASS AWN

Application of Ultrasound in Detecting and Removing Migrating Grass Awns in Dogs and Cats: A Systematic Review

Migrating grass awns are an important cause of disease in dogs and cats. Plant awns can migrate into several body tissues and cavities because of their fusiform shape and backward-pointing barbs. Their migration causes inflammatory tissue reaction and clinical signs depend upon their localization. Ultrasound has been described as a useful, noninvasive, and readily available tool to identify and guide vegetal foreign bodies removal in animals. The aim of this systematic review was to summarize current knowledge on the application of ultrasonography in the identification and removal of grass awns from various anatomic locations in dogs and cats. We selected and analyzed 46 papers on the application of ultrasonography in dogs and cats affected by migrating grass awns. The ultrasonographic appearance of grass awns is characteristic, although their size and location can influence the visualization and the attempt of removal. In some cases, migrating grass awns are not directly visualized by ultrasonography, but the lesions caused by their migration can be easily seen. Ultrasonography can be considered a useful diagnostic tool to localize and remove migrating grass awns; however, when the migration occurs in less accessible locations or discrete foreign bodies are present, this diagnostic tool should be considered as a part of a multidisciplinary approach with advanced diagnostic imaging modalities.

Carotid pseudoaneurysm in a kitten after accidental puncture with a needle

Case summary

A 3-month-old intact male domestic shorthair kitten’s cervical region was inadvertently punctured during routine subcutaneous fluid administration. A swelling rapidly developed on the left lateral neck and continued to grow, despite compression. An emergency facility evaluated the kitten 48 h later and the swelling was determined to be blood. Fine-needle aspiration of the swelling resulted in further swelling of the mass on the neck. The kitten began showing signs of systemic shock, necessitating a blood transfusion. The kitten was referred to a tertiary facility 24 h later for further diagnostics and treatment. CT of the head and neck revealed a large fluid-filled mass with progressive contrast enhancement noted during the filling phase, consistent with active hemorrhage. A carotid pseudoaneurysm was suspected and surgery was recommended. The left carotid artery was ligated proximal to the pseudoaneurysm; hemorrhage continued and the swelling was further explored. A small connection to the carotid artery within the medial aspect of the swelling was identified and ligated. The kitten required autotransfusion and massive allotransfusion during surgery due to blood loss. Recovery was uneventful. A head tilt and Horner’s syndrome were noted postoperatively and improved over the following months. Histopathology was consistent with pseudoaneurysm.

Relevance and novel information

This is the first reported case of pseudoaneurysm in a kitten that was treated surgically, with massive blood transfusion and minimal complications. Early surgical intervention can result in excellent prognosis. The need for blood product administration should be anticipated.

Clinical and clinicopathological characteristics, treatment, and outcome for dogs and cats with confirmed foxtail foreign body lesions: 791 cases (2009-2018)

OBJECTIVE

To describe the clinical and clinicopathological characteristics, treatment, and outcome for dogs and cats with a confirmed foxtail.

DESIGN

Retrospective study utilizing a medical records database over a 10-year period from January 1, 2009 to December 31, 2018.

SETTING

University teaching hospital.

ANIMALS

Seven hundred and fifty-four dogs and 37 cats with a diagnosis of foxtail foreign body. Cases with direct visualization by a clinician or on histopathology were included. Information extracted for each case included signalment; anatomical foxtail location; clinicopathological and imaging findings; treatments and interventions provided; and outcome.

MEASUREMENTS AND MAIN RESULTS

The prevalence of foxtail associated disease was 0.25% in dogs and 0.07% in cats over this time period. Most animals were young to middle-aged and presented in the summer months. The most common location in dogs was the aural canal, cutaneous/subcutaneous space, and nasal canal. In cats, ocular foxtails were most common (30/37). Blood work changes were nonspecific. Ultrasound supervised by a boarded radiologist was utilized in 114 cases, mainly for subcutaneous, sublumbar, and intracavitary foxtail locations, with successful location of a foxtail in 72.8% of cases scanned. Computed tomography was performed in 78 dogs with suspected intracavitary foxtail migration, and in all cases, structural changes related to the presence of the foxtail were found. Anerobic bacteria were most commonly isolated when a culture was submitted, with Actinomyces spp. rarely isolated. The most common of the 120 anaerobic isolates were Bacteroides/Prevotella spp. (n = 38), Fusobacterium spp. (n = 32), and Peptostreptococcus anaerobius (n = 30).

CONCLUSIONS

The short-term outcome for foxtail-associated lesions is good, and most cases can be managed on an outpatient basis. A minority of cases develop life-threatening disease and may require a multidisciplinary approach of multimodal imaging, endoscopy, or surgery.

Computed tomographic and ultrasonographic findings of abdominal arterial pseudoaneurysms caused by systemic mycosis in dogs

OBJECTIVES

To describe multidetector CT and ultrasonographic characteristics of abdominal arterial pseudoaneurysms (segmental dilatations of an artery with a ruptured tunica intima) arising secondary to systemic mycosis in dogs.

MATERIALS AND METHODS

Retrospective study on dogs with confirmed histological diagnosis of a fungal pseudoaneurysm and the availability of multidetector CT or ultrasound images.

RESULTS

At the time of admission, the three dogs included in this study demonstrated segmental arterial dilation, irregular arterial wall thickening, and increased echogenicity or attenuation within the local perivascular fat on ultrasound and multidetector CT images. Follow-up examinations revealed progressive increase in arterial wall thickening and saccular dilation with formation of a pseudoaneurysm in affected vessels of two dogs.

CLINICAL SIGNIFICANCE

Multidetector CT and ultrasonography can be useful imaging modalities in the diagnosis and monitoring of abdominal arterial pseudoaneurysms caused by systemic mycosis.

Diagnostic imaging for the assessment of acquired abdominal vascular diseases in small animals: A pictorial review

Advances in interventional radiology and surgical techniques now allow complex abdominal diseases to be more successfully treated in small animals. Abdominal vascular alterations, acquired as individual process or as complication of other lesions such as neoplasia, can be life-threatening or at least greatly limit curative interventions of underlying diseases. Computed tomography (CT) and high-definition ultrasonography are now readily available in veterinary referral centers. Yet, there is little information currently available on the use of these modalities for the diagnosis and characterization of these vascular alterations. The purpose of this article is to review the CT and ultrasonographic findings of acquired vascular diseases in the abdomen of dogs and cats, using both the veterinary and human medicine literature as references, and highlighting essential concepts through figures.

Carotid artery pseudoaneurysm in a cat

CLINICAL SUMMARY: A 4-month-old female intact domestic shorthair cat presented to Kansas State University Veterinary Medical Teaching Hospital for investigation of a large, firmly adhered mass in the left mid-cervical region that developed after phlebotomy performed at the referring veterinarian's clinic. Ultrasound examination of the mass revealed a cystic structure in communication with the left carotid artery, with bidirectional blood flow through the area. A diagnosis of pseudoaneurysm secondary to accidental needle penetration of the carotid artery during jugular venepuncture was made.

OUTCOME

Strict cage rest and pain management resulted in complete resolution of clinical and ultrasonographic signs in this cat.