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Ji Y, Kang J, Heo S, Lee K, Yoon H. Case report: Echocardiographic and computed tomographic features of congenital bronchoesophageal artery hypertrophy and fistula in a dog. Front Vet Sci 2024; 11:1400076. [PMID: 38840636 PMCID: PMC11150795 DOI: 10.3389/fvets.2024.1400076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/30/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Studies on aberrant bronchoesophageal arteries are limited. Herein, we report a case of a multi-origin systemic-to-pulmonary shunt with suspected bronchoesophageal artery hypertrophy and fistula in a dog. Case report A 4-year-old castrated male beagle weighing 11 kg underwent routine medical screening. Physical examination revealed a right-sided continuous murmur of grades 1-2. Thoracic radiography revealed a mild cardiomegaly. Echocardiography revealed a continuous turbulent shunt flow distal to the right pulmonary artery (RPA) branch from the right parasternal short axis pulmonary artery view. Computed tomography demonstrated systemic-to-pulmonary shunts originating from the descending aorta at the level of T7-8, the right 5th and 6th dorsal intercostal arteries, and the right brachiocephalic trunk, which formed anomalous networks around the trachea and esophagus that anastomosed into a large tortuous vessel at the level of T6-7 and entered the RPA. Surgical ligation of multiple shunting vessels was performed. Postoperative echocardiography and computed tomography showed decreased left ventricular volume overload and markedly decreased size of the varices. Additionally, most of the shunting vessels were without residual shunt flow. Conclusion The present study provides information regarding imaging features and the successful surgical management of multiple systemic-to-pulmonary shunts originating from the descending aorta, right brachiocephalic trunk, and intercostal arteries and terminating at the RPA. Multimodal imaging features after surgical ligation have also been described.
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Affiliation(s)
- Yewon Ji
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
| | - Jinsu Kang
- Department of Veterinary Surgery, College of Veterinary Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Suyoung Heo
- Department of Surgery, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
| | - Kichang Lee
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
- Biosafety Research Institute and College of Veterinary Medicine, Jeonbuk National University, Iksan, Republic of Korea
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Slead TS, Gremillion CL, Cohen EB, Tolbert MK. Esophageal varices in dogs: A retrospective case series. J Vet Intern Med 2022; 36:493-499. [PMID: 35001429 PMCID: PMC8965243 DOI: 10.1111/jvim.16355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Esophageal varices (EV) are abnormally dilated veins in the esophagus caused by alterations of blood flow or pressure. Esophageal variceal hemorrhage is a major complication of hepatic disease in humans, but a lack of information exists regarding associated adverse events in dogs. OBJECTIVE To describe the clinical manifestations and associated etiologies and outcomes of dogs with EV. ANIMALS Twenty-five client-owned dogs with EV diagnosed via computed tomography (CT), endoscopy, or fluoroscopy. METHODS Retrospective case series. Cases were identified by review of the hospital imaging records database between 2010 and 2020. Signalment, clinical signs, and outcomes were documented. When present, additional collateral vasculature was also recorded. Cases were subcategorized into suspected etiology based upon the anatomic location or absence of an attributable underlying disease process, as well as the direction of blood flow. RESULTS Twenty-four of 25 cases were identified via CT, with a prevalence of 0.012% (24/1950 total studies). Presenting clinical signs were nonspecific, and more likely because of the underlying cause as opposed to complications secondary to EV themselves. Etiologic anatomic locations were similar in occurrence between the abdomen (N = 14) and thorax (N = 11). All cases with an abdominal etiologic location had presumed or confirmed portal hypertension and 9/11 cases with a thoracic etiologic location had pulmonary, caval, or systemic hypertension. No cases died or were euthanized as a direct result of EV or associated hemorrhage. CONCLUSIONS AND CLINICAL IMPORTANCE Esophageal varices are rarely reported in dogs and commonly identified concurrently with portal, pulmonary, and caval hypertension. Hemorrhage is not a common clinical manifestation of EV.
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Affiliation(s)
- Tanner S. Slead
- Department of Clinical SciencesNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Christine L. Gremillion
- Department of Molecular Biomedical SciencesNorth Carolina State UniversityRaleighNorth CarolinaUSA
- Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTexasUSA
| | - Eli B. Cohen
- Department of Molecular Biomedical SciencesNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - M. Katherine Tolbert
- Department of Clinical SciencesNorth Carolina State UniversityRaleighNorth CarolinaUSA
- Veterinary Medicine and Biomedical SciencesTexas A&M UniversityCollege StationTexasUSA
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Schorn C, Hildebrandt N, Schneider M, Schaub S. Anomalies of the aortic arch in dogs: evaluation with the use of multidetector computed tomography angiography and proposal of an extended classification scheme. BMC Vet Res 2021; 17:387. [PMID: 34915887 PMCID: PMC8675507 DOI: 10.1186/s12917-021-03101-7] [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: 04/29/2021] [Accepted: 12/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Congenital anomalies of the aortic arch are important as they may be associated with vascular ring anomalies. The most common vascular ring anomaly in dogs is a persistent right aortic arch. However, published data of the distribution of the different types of vascular ring anomalies and other aortic arch anomalies are lacking. The objective of this retrospective descriptive study was to evaluate both the prevalence and the different types of aortic arch anomalies that can be detected using thoracic computed tomography (CT) examination. Archived thoracic CT examinations acquired between 2008 and 2020 at a single institution were retrospectively evaluated by 2 evaluators for the prevalence and type of aortic arch anomaly. Breed, age, and presenting complaint were obtained from the medical record system. RESULTS A total of 213 CT studies were evaluated; 21 dogs (21/213, 9.9%) showed a right aortic arch and a left ligamentum arteriosum with compression of the esophagus. The following incidental additional findings were detected: aberrant left subclavian artery (17/21, 76.2%), branching from the persistent ductus arteriosus (PDA) (1/21, 4.8%), left-sided brachiocephalic trunk (3/21, 14.3%), bicarotid trunk (17/21, 81.0%), double aortic arch (1/21, 4.8%). One hundred ninety two dogs (192/213, 90.1%) showed a left aortic arch without esophageal compression. The following additional abnormalities were obtained in those dogs with left aortic arch: aberrant right subclavian artery (3/192, 1.6%) without clinical signs of esophageal compression, aberrant vessel branching from the aorta into the left caudal lung lobe (2/192, 1.0%), focal dilatation of the left or right subclavian artery (2/192, 1.0%), bicarotid trunk (1/192, 0.5%). CONCLUSION Similar to previous studies an aberrant left subclavian artery is the most common additional finding in dogs with persistent right aortic arch. Newly, a left-sided brachiocephalic trunk was identified in 14.3% of the dogs with a persistent right aortic arch; no additional compression was caused by the left sided brachiocephalic trunk. Similarly, aberrant right subclavian artery can be an incidental CT finding without causing compression of the esophagus.
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Affiliation(s)
- Christiane Schorn
- Justus-Liebig University Clinic for Small Animals, Frankfurter Strasse 114, 35390, Giessen, Germany.
| | - Nicolai Hildebrandt
- Justus-Liebig University Clinic for Small Animals, Frankfurter Strasse 114, 35390, Giessen, Germany
| | - Matthias Schneider
- Justus-Liebig University Clinic for Small Animals, Frankfurter Strasse 114, 35390, Giessen, Germany
| | - Sebastian Schaub
- Justus-Liebig University Clinic for Small Animals, Frankfurter Strasse 114, 35390, Giessen, Germany
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Scansen BA, Drees R. Joint virtual issue on recent advances in veterinary cardiac imaging. J Vet Intern Med 2020; 34:546-548. [PMID: 31943370 PMCID: PMC7096632 DOI: 10.1111/jvim.15669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Brian A Scansen
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Randi Drees
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hatfield, United Kingdom
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Scansen BA, Drees R. Joint virtual issue on recent advances in veterinary cardiac imaging. Vet Radiol Ultrasound 2020; 61:127-129. [PMID: 31943510 DOI: 10.1111/vru.12841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Brian A Scansen
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Randi Drees
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hatfield, UK
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Greenway C, Rozanski E, Johnson K, Cornejo L, Abelson A, Robinson N. Fatal hemoptysis after bronchoscopic biopsy in a dog. J Vet Intern Med 2019; 33:2718-2724. [PMID: 31663636 PMCID: PMC6872624 DOI: 10.1111/jvim.15640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 10/01/2019] [Indexed: 01/18/2023] Open
Abstract
An 8‐year‐old 24.6 kg mixed breed dog underwent bronchoscopy for evaluation of a persistent progressive cough. Bronchoscopy documented a markedly thick and irregular, cobblestone appearance of the mucosa. A bronchoscopic biopsy was obtained; immediately after the biopsy, a large amount of hemorrhage poured from the endotracheal tube. Multiple efforts to control the hemorrhage were unsuccessful and the dog suffered a cardiopulmonary arrest and could not be revived. A necropsy was performed, which was significant for pallor, evidence of prior heartworm disease, prominent bronchial arteries, and erosion of the submucosal vessels at the site of the biopsy. The cause of death was hemorrhage associated with transbronchial biopsy of an enlarged bronchial artery associated with heartworm disease. This report describes a rare complication of a routine diagnostic procedure.
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Affiliation(s)
- Clayton Greenway
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Kelsey Johnson
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Lilian Cornejo
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Amanda Abelson
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Nicholas Robinson
- Department of Biomedical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
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Winter RL, Horton JA, Newhard DK, Holland M. Transcatheter embolization of systemic-to-pulmonary artery fistulas in a dog using embolization coils and silk suture. J Vet Cardiol 2019; 23:104-111. [PMID: 31174720 DOI: 10.1016/j.jvc.2019.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 01/28/2019] [Accepted: 02/21/2019] [Indexed: 11/17/2022]
Abstract
A 4-month-old intact female Cavalier King Charles spaniel presented for evaluation of a left, basilar continuous murmur. Transthoracic echocardiography suggested anomalous vessels around the main pulmonary artery, and computed tomography angiography revealed two systemic-to-pulmonary artery fistulas. Transcatheter embolization of these fistulas was achieved with a combination of embolization coils and silk suture threads delivered through a microcatheter.
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Affiliation(s)
- R L Winter
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, 601 Vernon L. Tharp St, Columbus, OH, 43210, USA.
| | - J A Horton
- Department of Medicine, Tulane University School of Medicine, 131 South Robertson Avenue, New Orleans, LA, 70112, USA
| | - D K Newhard
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Auburn University, 1220 Wire Road, Auburn, AL, 36849, USA
| | - M Holland
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Auburn University, 1220 Wire Road, Auburn, AL, 36849, USA
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Myers M, Scrivani PV, Simpson KW. Presumptive non-cirrhotic bleeding esophageal varices in a dog. J Vet Intern Med 2018; 32:1703-1707. [PMID: 30216560 PMCID: PMC6189349 DOI: 10.1111/jvim.15303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 06/26/2018] [Accepted: 07/24/2018] [Indexed: 12/20/2022] Open
Abstract
An 8‐year‐old male American Staffordshire terrier was admitted for evaluation of chronic episodes of ptyalism and hematemesis after exercise. Abnormalities were not detected on routine clinicopathological tests, thoracic radiography, and abdominal ultrasonography. Endoscopic examination revealed a labyrinthine network of severely distended, hemorrhagic esophageal blood vessels. Computed tomography angiography demonstrated a network of para‐esophageal vessels that communicated with the celiac artery caudally and the brachiocephalic trunk cranially, consistent with a diagnosis of non‐cirrhotic esophageal varices. This is a report of exercise, ptyalism, and hematemesis secondary to presumptive, non‐cirrhotic, bleeding esophageal varices in a dog.
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Affiliation(s)
- Marc Myers
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Peter V Scrivani
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Kenneth W Simpson
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
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Newhard DK, Winter RL, Cline KA, Hathcock JT. Anomalous broncho‐oesophageal arteries and peripheral systemic‐to‐pulmonary connections in an asymptomatic puppy. VETERINARY RECORD CASE REPORTS 2017. [DOI: 10.1136/vetreccr-2016-000392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Daniel K Newhard
- Clinical SciencesAuburn University College of Veterinary MedicineAuburnALUSA
| | - Randolph L Winter
- Clinical SciencesAuburn University College of Veterinary MedicineAuburnALUSA
| | - Kelsey A Cline
- Clinical SciencesAuburn University College of Veterinary MedicineAuburnALUSA
| | - John T Hathcock
- Clinical SciencesAuburn University College of Veterinary MedicineAuburnALUSA
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