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Vidal PA, Boysen SR, Fordellone J, Nectoux A, Allaouchiche B, Pouzot-Nevoret C. Retrospective evaluation of the agreement between thoracic point-of-care ultrasound and thoracic radiographs in cats with recent trauma: 111 cats. Front Vet Sci 2024; 11:1376004. [PMID: 38988977 PMCID: PMC11234836 DOI: 10.3389/fvets.2024.1376004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/12/2024] [Indexed: 07/12/2024] Open
Abstract
Introduction Motor vehicular trauma, bite wounds, high-rise syndrome, and trauma of unknown origin are common reasons cats present to the emergency service. In small animals, thoracic injuries are often associated with trauma. The objective of this retrospective study was to evaluate limits of agreement (LOA) between thoracic point-of-care ultrasound (thoracic POCUS) and thoracic radiography (TXR), and to correlate thoracic POCUS findings to animal trauma triage (ATT) scores and subscores in a population of cats suffering from recent trauma. Methods Cats that had thoracic POCUS and TXR performed within 24 h of admission for suspected/witnessed trauma were retrospectively included. Thoracic POCUS and TXR findings were assessed as "positive" or "negative" based on the presence or absence of injuries. Cats positive on thoracic POCUS and TXR were assigned 1 to 5 tentative diagnoses: pulmonary contusions/hemorrhage, pneumothorax, pleural effusion, pericardial effusion, and diaphragmatic hernia. When available ATT scores were calculated. To express LOA between the two imaging modalities a kappa coefficient and 95% CI were calculated. Interpretation of kappa was based on Cohen values. Results One hundred and eleven cats were included. 83/111 (74.4%) cats were assessed as positive based on thoracic POCUS and/or TXR. Pulmonary contusion was the most frequent diagnosis. The LOA between thoracic POCUS and TXR were moderate for all combined injuries, moderate for pulmonary contusions/hemorrhage, pneumothorax, diaphragmatic hernia, and fair for pleural effusion. Cats with positive thoracic POCUS had significantly higher median ATT scores and respiratory subscores compared to negative thoracic POCUS cats. Discussion The frequency of detecting intrathoracic lesions in cats was similar between thoracic POCUS and TXR with fair to moderate LOA, suggesting thoracic POCUS is useful in cats suffering from trauma. Thoracic POCUS may be more beneficial in cats with higher ATT scores, particularly the respiratory score.
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Affiliation(s)
- Pierre-André Vidal
- Intensive Care Unit (SIAMU), Université de Lyon, VetAgro Sup, Marcy l’Etoile, France
- APCSe, Université de Lyon, VetAgro Sup, Marcy l'Étoile, France
| | - Søren R. Boysen
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Julie Fordellone
- Intensive Care Unit (SIAMU), Université de Lyon, VetAgro Sup, Marcy l’Etoile, France
| | - Alexandra Nectoux
- Intensive Care Unit (SIAMU), Université de Lyon, VetAgro Sup, Marcy l’Etoile, France
- APCSe, Université de Lyon, VetAgro Sup, Marcy l'Étoile, France
| | - Bernard Allaouchiche
- APCSe, Université de Lyon, VetAgro Sup, Marcy l'Étoile, France
- Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Service de Réanimation, Pierre-Bénite, France
| | - Céline Pouzot-Nevoret
- Intensive Care Unit (SIAMU), Université de Lyon, VetAgro Sup, Marcy l’Etoile, France
- APCSe, Université de Lyon, VetAgro Sup, Marcy l'Étoile, France
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Hardwick JJ, Ioannides-Hoey CSFK, Finch N, Black V. Bicavitary effusion in cats: retrospective analysis of signalment, clinical investigations, diagnosis and outcome. J Feline Med Surg 2024; 26:1098612X241227122. [PMID: 38506622 PMCID: PMC10983610 DOI: 10.1177/1098612x241227122] [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] [Indexed: 03/21/2024]
Abstract
OBJECTIVES The aim of this study was to describe the clinical and diagnostic findings and outcome of cats with bicavitary effusion presenting to a referral centre. METHODS Medical records of cats presenting with bicavitary effusion were identified and their history, physical examination findings, clinicopathological data, diagnostic imaging findings, aetiology of bicavitary effusions (cardiac disease, neoplasia, infectious disease, sterile inflammatory disease, severe hypoalbuminaemia, trauma, coagulopathy or 'open' if no definitive diagnosis was reached) and outcome were recorded. Cox regression analysis was performed to identify independent predictors of death in cats with bicavitary effusion. Kaplan-Meier curves were generated for survival analysis. RESULTS In total, 103 cats with bicavitary effusion were included. Neoplasia and cardiac disease were the most common aetiologies of bicavitary effusion, in 21 (20.4%) and 20 (19.4%) cats, respectively, followed by infectious disease (n = 11, 10.7%), trauma (n = 13, 12.6%), hypoalbuminaemia (n = 6, 5.8%), sterile inflammatory disease (n = 4, 3.9%) and coagulopathy (n = 1, 1.0%). The median survival time for all cats with bicavitary effusion was 3 days. Cats with a neoplastic aetiology had a 2.03 times greater risk of death compared with cats in which no diagnosis was achieved. Neoplasia (P = 0.030) and pedigree breed status (P = 0.016) were independent predictors of death in the multivariable Cox regression model. CONCLUSIONS AND RELEVANCE This study highlights that bicavitary effusions in cats generally carry a guarded to poor prognosis, particularly if neoplasia is the underlying aetiology or if the cat is a pedigree breed. Cardiac disease appeared to be associated with a better prognosis, suggesting that assessment for congestive heart failure should be considered early when evaluating cats with bicavitary effusion. The prognosis for cats with feline infectious peritonitis is likely to be markedly improved by the advent of novel antiviral drugs, compared with the historical cohort of cats presented here.
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Affiliation(s)
- Joshua J Hardwick
- Cave Veterinary Specialists (part of Linnaeus Veterinary), Wellington, UK
| | | | - Natalie Finch
- Langford Vets Small Animal Referral Hospital, Langford, UK
| | - Victoria Black
- Langford Vets Small Animal Referral Hospital, Langford, UK
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Burnotte P, Graziano N, Gommeren K. A retrospective study on parapneumonic effusion in 130 dogs with a clinical diagnosis of pneumonia. Front Vet Sci 2023; 10:1144148. [PMID: 37008361 PMCID: PMC10060870 DOI: 10.3389/fvets.2023.1144148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
ObjectiveTo screen the occurrence of parapneumonic effusion in dogs.MethodsMedical records were searched for dogs with a presumptive diagnosis of bacterial pneumonia from 2017 to 2021 at the Liege university teaching hospital. Bacterial pneumonia was presumptively diagnosed based on compatible clinical signs and findings; thoracic radiographs compatible with bacterial bronchopneumonia; and either increased serum C-reactive protein (CRP) levels, a positive bronchoalveolar lavage culture or a positive clinical evolution in response to antibiotic therapy. Patients diagnosed with parasitic or other non-bacterial inflammatory pneumonia or with pulmonary neoplasia were excluded. Signalment, clinical findings, and outcome were recorded.ResultsOne hundred and thirty dogs were included in the study, of which 44 dogs (33.8%) developed a parapneumonic effusion. Four of these dogs (4/44; 9%) had thoracocentesis performed, displaying a modified transudate (2) or septic exudate (2).ConclusionsAlthough parapneumonic effusion in dogs with a presumptive diagnosis of bacterial pneumonia appears to be rather common (33.8%), thoracocentesis or chest tube placement was rarely performed. Furthermore, the outcome of dogs with and without parapneumonic effusion appears to be similar.
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LaVine D, Conner B, Daniel GB, Freeman M. Non‐coagulopathic hemothorax in a dog: A case report. Clin Case Rep 2022; 10:e6370. [PMID: 36188037 PMCID: PMC9487448 DOI: 10.1002/ccr3.6370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 08/20/2022] [Accepted: 09/08/2022] [Indexed: 11/09/2022] Open
Abstract
An 8‐year‐old, female‐spayed, Blue Heeler presented with suspected non‐coagulopathic spontaneous, hemothorax with neoplasia as the most likely differential as coagulation parameters were normal and no obvious history of trauma was reported. Computed tomography scan was crucial for diagnosis of a traumatic partial vascular avulsion injury that was successfully managed supportively.
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Affiliation(s)
- Danielle LaVine
- Virginia‐Maryland Regional College of Veterinary Medicine Blacksburg Virginia USA
| | - Bobbi Conner
- Virginia‐Maryland Regional College of Veterinary Medicine Blacksburg Virginia USA
| | - Gregory B. Daniel
- Virginia‐Maryland Regional College of Veterinary Medicine Blacksburg Virginia USA
| | - Mark Freeman
- Virginia‐Maryland Regional College of Veterinary Medicine Blacksburg Virginia USA
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Garrett KS, Embertson RM, Hopper SA, Woodie JB, McQuerry KJ. Preoperative computed tomographic evaluation of neonatal foals with rib fractures. Vet Surg 2022; 51:816-826. [DOI: 10.1111/vsu.13817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/12/2022] [Accepted: 04/11/2022] [Indexed: 11/26/2022]
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Yamada K, Yokoyama T, Aihara N, Une Y, Sato R. Role of autopsy imaging-computed tomography in the post-mortem study of farm animals. Vet Rec Open 2021; 8:e1. [PMID: 33981435 PMCID: PMC8109047 DOI: 10.1002/vro2.1] [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] [Received: 09/04/2020] [Revised: 10/23/2020] [Accepted: 12/28/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Autopsy imaging (Ai) is used to determine the cause of death, providing pre-dissection information. Ai is often used in the field of human forensic medicine but has never been applied on farm animals. METHODS Ai-computed tomography (CT) was performed before necropsy for farm animals (one goat, one ox, one cow and three calves) that died or were euthanised. RESULTS Ai-CT findings of rib fractures (case 1), urethral calculi (case 2), multiple osteolytic bone lesions (case 3 and 4) and hair balls (case 4) were confirmed by dissection. However, a tentative diagnosis of actinomycosis was made in an ox (case 5) using antemortem radiography and Ai-CT, and the mass was identified as ameloblastic fibro-odontoma on histological examination. A tentative diagnosis of maxillary abscess was made from antemortem radiography in a cow (case 6); however, the lesion was shown to be maxillary neoplasia on Ai-CT. The mass was identified as hemangiosarcoma on histopathological examination. CONCLUSION Ai is helpful in pathological examination because the specific findings are known before the dissection, the lesions can be pinpointed in the pathological dissection, facilitating workflow; furthermore, the oversight of lesions can be reduced. In addition, Ai-CT images, including three-dimensional images and a three-dimensional printed model, allowed an easy understanding of pathology among students and farmers. Ai-CT for farm animals represents a novel option for veterinary education.
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Affiliation(s)
- Kazutaka Yamada
- School of Veterinary MedicineAzabu UniversitySagamiharaJapan
| | - Taiki Yokoyama
- Veterinary Teaching HospitalAzabu UniversitySagamiharaJapan
| | - Naoyuki Aihara
- School of Veterinary MedicineAzabu UniversitySagamiharaJapan
| | - Yumi Une
- Faculty of Veterinary MedicineOkayama University of ScienceImabariJapan
| | - Reiichiro Sato
- Faculty of AgricultureUniversity of MiyazakiMiyazakiJapan
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Hunt TD, Wallack ST. Minimal atelectasis and poorly aerated lung on thoracic CT images of normal dogs acquired under sedation. Vet Radiol Ultrasound 2021; 62:647-656. [PMID: 34672040 DOI: 10.1111/vru.13016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 05/29/2021] [Accepted: 06/01/2021] [Indexed: 11/29/2022] Open
Abstract
General anesthesia optimizes image quality of thoracic CT in dogs by providing patient immobilization and respiratory control. However, it also comes with disadvantages that may serve as a detractor to the use of CT in veterinary practice. With the use of multidetector helical CT combined with injectable sedation for restraint, parameters such as atelectasis and poorly aerated lung should not be appreciably different from what has been observed in dogs under general anesthesia. This prospective pilot study aimed to evaluate the mean lung attenuation and the amount of atelectasis and poorly aerated lung on thoracic CT images acquired under injectable sedation in normal dogs. The entire thorax of 10 client-owned dogs was scanned. Attenuation measurements were generated by three-dimensional reconstruction software. Mean ± SD lung attenuation was -707.0 ± 60.0. Atelectasis was not identified on any of the scans. Hypoinflated lung, the percentage of lung parenchyma with attenuation greater than -500 and -250 Hounsfield units (HU), was 10.7 ± 4.7% and 2.4 ± 1.2% (mean ± SD), respectively. There was no significant change in these percentages over time. Compared to previously published data, thoracic CT images obtained under sedation had mean attenuation comparable to normal expiratory lung and a lower percentage of poorly aerated lung compared to that of anesthetized dogs. Using sedation to complete canine thoracic CT does not itself lead to alterations of lung attenuation and may confer less hypoinflation and atelectasis than general anesthesia.
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Affiliation(s)
- Tania D Hunt
- Veterinary Imaging Center of San Diego, San Diego, California, USA
| | - Seth T Wallack
- Veterinary Imaging Center of San Diego, San Diego, California, USA
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Mann O, Peery D, Bader Segev R, Klainbart S, Kelmer E, Sobarzo A, Shub V, Rapoport K, Shamir MH, Chai O. CT findings and the prognostic value of the Koret CT score in cats with traumatic brain injury. J Feline Med Surg 2021; 24:91-97. [PMID: 33847537 PMCID: PMC8807991 DOI: 10.1177/1098612x211005306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aims of this study were to evaluate associations between abnormal head CT findings and outcome, and to examine the prognostic value of the Koret CT score (KCTS) in cats sustaining acute traumatic brain injury (TBI). METHODS The medical records of cats hospitalised with TBI that underwent head CT scans within 72 h of admission were retrospectively reviewed. CT scans were evaluated independently by a radiologist and a neurologist who were blinded to the outcome. A KCTS and modified Glasgow Coma Scale (MGCS) were assigned to each cat and the association between abnormal CT findings, KCTS, MGCS and outcome were analysed. RESULTS Fourteen cats were included in the study: nine (64.2%) survivors and five (35.7%) non-survivors. Of the nine cats that were discharged, one was a short-term survivor (10 days) and eight (57.1%) were long-term survivors (⩾6 months). Abnormal CT findings included lateral ventricle asymmetry/midline shift (42.8%), intracranial haemorrhage (35.7%), caudotentorial lesions (14.2%) and cranial vault fractures (14.2%), all of which were depressed. Intracranial haemorrhage was found to be significantly and negatively associated with short-term (P = 0.005) and long-term (P = 0.023) survival. KCTS was significantly associated with short-term survival (P = 0.002) and long-term survival (P = 0.004). A KCTS cut-off value of 2 yielded a 100% sensitivity and 100% specificity for short-term survival and 100% sensitivity and 80% specificity for long-term survival. A MGCS cut-off value of ⩾13 was associated with a 100% sensitivity and 100% specificity for short-term survival, and with a 100% sensitivity and 80% specificity for long-term survival. CONCLUSIONS AND RELEVANCE KCTS, performed up to 72 h from injury, can be used as an additional diagnostic tool for the prediction of survival in cats with TBI.
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Affiliation(s)
- Ohad Mann
- Department of Emergency and Critical Care, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Dana Peery
- Department of Radiology, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Ronnie Bader Segev
- Department of Emergency and Critical Care, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Sigal Klainbart
- Department of Emergency and Critical Care, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Efrat Kelmer
- Department of Emergency and Critical Care, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Ariel Sobarzo
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Pre-Clinical Research Center, Health Faculty, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Vered Shub
- Emergency and Specialist Veterinary Center, Ben-Shemen Youth Village, Israel
| | - Kira Rapoport
- Department of Neurology and Neurosurgery, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Merav H Shamir
- Department of Neurology and Neurosurgery, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
| | - Orit Chai
- Department of Neurology and Neurosurgery, Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, Rehovot, Israel
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Cole L, Pivetta M, Humm K. Diagnostic accuracy of a lung ultrasound protocol (Vet BLUE) for detection of pleural fluid, pneumothorax and lung pathology in dogs and cats. J Small Anim Pract 2021; 62:178-186. [PMID: 33496045 DOI: 10.1111/jsap.13271] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To assess the accuracy of the lung ultrasound protocol Vet BLUE, using thoracic CT as the reference standard, for the detection of thoracic pathology in dogs and cats. MATERIALS AND METHODS Animals that had thoracic ultrasound and thoracic CT were prospectively recruited between May 2017 and September 2018. The Vet BLUE protocol was performed on animals at the time of admission by veterinarians with basic training in emergency ultrasound. A board-certified radiologist, blinded to the Vet BLUE findings, reviewed the CT images. RESULTS CT was abnormal in 64.5% (20/31) animals. The number of CT sites positive for alveolar-interstitial syndrome was 24.2% (60/248). When using CT as the reference standard, detection of ≥3 B lines with thoracic ultrasound had a sensitivity of 18.33% and specificity of 98.4% for detection of site specific alveolar-interstitial syndrome. The sensitivity of Vet BLUE to detect alveolar-interstitial syndrome increased to 56.9% when including the presence of any B line as abnormal. Overall accuracy for detection of alveolar-interstitial syndrome based on these two criteria was 79% and 73%, respectively. Vet BLUE correctly identified consolidation in 58.3% (14/24) sites, pleural effusion in 66.6% (2/3) cases, pneumothorax in 33.3% (1/3) cases and intrathoracic mass in 25% (1/4) cases. CLINICAL SIGNIFICANCE The Vet BLUE protocol is a useful technique to detect alveolar-interstitial syndrome and other thoracic pathology but should not be used as a sole imaging method. Detection of ≥3 B lines is highly suggestive of alveolar-interstitial syndrome and warrants further diagnostics.
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Affiliation(s)
- L Cole
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, UK
| | - M Pivetta
- Antech Imaging Services, Irvine, CA, 92614, USA
| | - K Humm
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, UK
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Trauma-Associated Pulmonary Laceration in Dogs-A Cross Sectional Study of 364 Dogs. Vet Sci 2020; 7:vetsci7020041. [PMID: 32290621 PMCID: PMC7356257 DOI: 10.3390/vetsci7020041] [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: 03/05/2020] [Revised: 03/31/2020] [Accepted: 04/08/2020] [Indexed: 12/03/2022] Open
Abstract
In this study, we describe the computed tomography (CT) features of pulmonary laceration in a study population, which included 364 client-owned dogs that underwent CT examination for thoracic trauma, and compared the characteristics and outcomes of dogs with and without CT evidence of pulmonary laceration. Lung laceration occurred in 46/364 dogs with thoracic trauma (prevalence 12.6%). Dogs with lung laceration were significantly younger than dogs in the control group (median 42 months (interquartile range (IQR) 52.3) and 62 months (IQR 86.1), respectively; p = 0.02). Dogs with lung laceration were significantly heavier than dogs without laceration (median 20.8 kg (IQR 23.3) and median 8.7 kg (IQR 12.4 kg), respectively p < 0.0001). When comparing groups of dogs with thoracic trauma with and without lung laceration, the frequency of high-energy motor vehicle accident trauma was more elevated in dogs with lung laceration than in the control group. No significant differences were observed between groups regarding tge frequency and length of hospitalization and 30-day mortality. Similar to the human classification scheme, four CT patterns are described in dogs in this study: Type 1, large pulmonary laceration located deeply in the pulmonary parenchyma or around an interlobar fissure; Type 2, laceration occurring in the paraspinal lung parenchyma, not associated with vertebral fracture; Type 3, subpleural lung laceration intimately associated with an adjacent rib or vertebral fracture; Type 4, subpleural lesions not associated with rib fractures. Complications were seen in 2/46 dogs and included lung abscess and collapse.
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