[Computed tomography with computer-assisted detection of pulmonary nodules in dogs and cats]

OBJECTIVE

The aim of this study was to assess the potential benefit of computer-assisted detection (CAD) of pulmonary nodules in veterinary medicine. Therefore, the CAD rate was compared to the detection rates of two individual examiners in terms of its sensitivity and false-positive findings.

MATERIALS AND METHODS

We included 51 dogs and 16 cats with pulmonary nodules previously diagnosed by computed tomography. First, the number of nodules ≥ 3 mm was recorded for each patient by two independent examiners. Subsequently, each examiner used the CAD software for automated nodule detection. With the knowledge of the CAD results, a final consensus decision on the number of nodules was achieved. The software used was a commercially available CAD program.

RESULTS

The sensitivity of examiner 1 was 89.2%, while that of examiner 2 reached 87.4%. CAD had a sensitivity of 69.4%. With CAD, the sensitivity of examiner 1 increased to 94.7% and that of examiner 2 to 90.8%.

CONCLUSION AND CLINICAL RELEVANCE

The CAD-system, which we used in our study, had a moderate sensitivity of 69.4%. Despite its severe limitations, with a high level of false-positive and false-negative results, CAD increased the examiners' sensitivity. Therefore, its supportive role in diagnostics appears to be evident.

[Sonographically detectable changes in abdominal lymph nodes in dogs with malignant lymphoma. Evaluation with special consideration of the Solbiati-Index]

OBJECTIVE

Characterization of the disorders of abdominal lymph nodes in dogs with malignant lymphoma and evaluation of the Solbiati-Index (SI) and the relationship between the short axis and the length of the lymph node (S  :  L ratio) as malignancy criteria.

MATERIAL AND METHODS

Retrospective analysis of data from dogs with malignant lymphoma. Inclusion criteria were cytological or histological diagnosis of the malignant lymphoma and an ultrasound examination of the abdomen prior to initiation of therapy. Criterion for exclusion was the application of a cytostatic agent prior to diagnosis. Furthermore, abdominal lymph nodes with non-neoplastic disorders were examined, when sonography as well as cytological/histological examinations were available.

RESULTS

A total of 261 lymph nodes (127 dogs) with malignant lymphoma and 17 lymph nodes (nine dogs) with benign disorders were evaluated. Sonography revealed massively rounded, clearly enlarged lymph nodes in 115/127 dogs (91%) with malignant lymphoma, while the lymph nodes of the other 12 dogs (9%) displayed an enlargement in the long axis. All 17 lymph nodes with benign disorders were enlarged in the long axis. The nodal parenchyma of 91% of the 127 dogs (malignant lymphoma) presented as hypoechoic to anechoic, and the cortex and medulla could not be differentiated. In the remaining 9% of dogs, a physiological isoechoic nodal parenchyma was observed. The parenchyma of lymph nodes with benign disorders was sonographically inconspicuous. In 71% of the 127 dogs with malignant lymphoma, the SI was < 2 and the S  :  L ratio > 0.5 (indicative for malignancy). Of the nine dogs with benign lymph node disorders, 71% had an SI of > 2 and 76% of them had an S  :  L ratio < 0.5 (indicative of a benign process).

CONCLUSION AND CLINICAL RELEVANCE

The significant increase in the size, rounding and hypoechoic changes in the lymph nodes in dogs with malignant lymphoma are indicative parameters of malignancy. In addition, the SI and the S:L ratio serve as a differentiation between benign and malign processes. Because of blurred boundaries between the malignant and benign changes, the various parameters should always be considered in conjunction.

[Sonographically detectable splenic disorders in dogs with malignant lymphoma]

OBJECTIVE

To evaluate the frequency of different sonographic splenic disorders in dogs with different anatomic forms of malignant lymphoma. Additionally, the occurrence of the moth-eaten pattern in the parenchyma of the spleen in patients with diseases other than lymphoma should be investigated.

MATERIAL AND METHODS

Retrospective analysis of patient data collected from dogs histologically or cytologically diagnosed with malignant lymphoma and for which ultrasonographic images were available before the initiation of therapy. Patient data from dogs with a moth-eaten pattern within the splenic parenchyma were evaluated separately. Exclusion criterion was the administration of cytostatic agents prior to diagnosis.

RESULTS

In 84% of 164 dogs with malignant lymphoma, an altered pattern of the spleen was diagnosed ultrasonographically. Ninety-four of these 137 patients had a moth-eaten pattern of the splenic parenchyma and 43 dogs displayed abnormalities in the form of splenomegaly, coarse echotexture or other changes of the parenchyma. When a moth-eaten pattern was diagnosed, the affected dogs suffered significantly more often from a multicentric lymphoma (95%) than from any other anatomical lymphoma form. Only one dog displayed a moth-eaten pattern of the splenic parenchyma without diagnosis of a malignant lymphoma. The positive predictive value of the moth-eaten pattern for malignant lymphoma was 99% and, in particular, for the multicentric lymphoma this was 95%. In total, 84% of the 164 dogs displayed a multicentric lymphoma, 5% a mediastinal or a cutaneous lymphoma, respectively, 4% a gastrointestinal lymphoma, and one animal had an ocular or renal lymphoma, respectively.

CONCLUSION AND CLINICAL RELEVANCE

Sonographic changes of the spleen are often diagnosed in dogs with malignant lymphoma, independent of the anatomical lymphoma form. When the moth-eaten pattern is observed, it is very likely that the affected dog suffers from a malignant lymphoma, most probably a multicentric lymphoma.

[Sonographic measurement of soft-palate thickness and comparison with the measurement by computed tomography]

OBJECTIVE

The aim of this study was to measure the thickness of the soft palate at specific locations in normocephalic dogs using sonography and computed tomography (CT), and to subsequently compare the two different methods.

MATERIAL AND METHODS

A total of 15 normocephalic dogs were examined under general anesthesia. The CT was performed while patients were in a sternal recumbent position, their mouth held open by placing their upper jaw on a positioning device. Dorsal recumbency together with submental and midsagittal positioning of the transducer were chosen for sonography. Measurements were made in both sonographic and reconstructed sagittal CT images. Two measuring points (MP) were defined for measuring the cranial and the middle part of the soft palate (MP1: 1 cm caudal to the transition from the hard to the soft palate; MP2: at the origin of the dorsal pharyngeal muscles). It was investigated whether repeated procedures with one measuring method provided consistent values and, furthermore, whether the two different measuring methods (sonography and CT) provided comparable data.

RESULTS

The data acquired by repeat measurements within one method corresponded very well. However, the data provided by the two different measurement methods showed varying results for the first measuring point and was even greater for the second measuring point. Sonography overestimated the measurements obtained by CT by up to 0.26 cm for MP1 and up to 0.79 cm for MP2.

CONCLUSION

Due to the significant discrepancies in their results, the two measurement methods are not interchangeable. Sonography showed good reliability for repeat measurements. Consequently, the variable values between CT and sonography appeared to result from differing examination conditions. Sonography may be a rapid and non-invasive diagnostic tool to measure soft palate thickness if the applied method proves to be applicable in clinical practice.

[Ultrasonographic findings for selected gastrointestinal tract diseases]

OBJECTIVE

In addition to general and specific examinations, ultrasonographic and endoscopic examinations of the gastrointestinal tract may be necessary. This study aimed to determine possible relationships between the ultrasonographic and histopathological findings in the following diseases of the gastrointestinal tract: IBD (inflammatory bowel disease), FRD (food-responsive diarrhoea), ulcer and infection with GHLO (gastric Helicobacter-like organisms).

MATERIAL AND METHODS

The data of 41 dogs and 19 cats were analysed. The inclusion criterion was the presence of acute or chronic gastrointestinal symptoms in patients that had also undergone the standard diagnostic tests to rule out extragastrointestinal diseases. The patients underwent ultrasonographic and endoscopic examinations of the gastrointestinal tract, and a histopathological examination of the tissue samples from the endoscopy was performed. Patients with intestinal foreign bodies, neoplasms of the gastrointestinal tract or inconclu- sive histopathological results were excluded.

RESULTS

In a total of 41 dogs, 16 were diagnosed with IBD, 14 with FRD, 5 with ulceration and six with an infection with GHLO. Of the 19 cats, 12 had a diagnosis of IBD, 2 of FRD, 2 with ulceration and 3 with an infection with GHLO. In 26 dogs and 4 cats of the evaluated patients, the ultrasonographic examination did not show pathological changes, even though the patients had clinical symptoms and significant histopathological findings. However, in 14 dogs and 4 cats of the included patients, one or more pathological changes of the extragastrointestinal organs were found. In particular, cats with a diagnosis of IBD often presented lymphadenopathies (4 cats) or thickening of the zona muscularis (six cats). There were no specific ultrasonographic findings confirming an FRD or an infection with GHLO. Only 5 dogs and 1 cat without a primary diagnosis of infection with GHLO were positive for colonization with GHLO. The presence of ulcers was ultrasonographically indicated as areas showing a loss of wall layering with accumulation of gas.

CONCLUSION AND CLINICAL RELEVANCE

Changes can be found during ultrasonographic examinations of patients with IBD and ulcer. However, the absence of findings in ultrasonographic examinations does not necessarily rule out serious gastrointestinal diseases. The histopathological examination still plays an important part in diagnosing the evaluated diseases.

[Multiphasic contrast-enhanced CT: correlation of the peak attenuation in the aorta abdominalis and portal vein with easily detectable clinical parameters]

OBJECTIVE

The diagnostic value of a multiphase CT strongly depends on the correct timepoints of analysis. Therefore, we investigated whether the peak attenuation time in the aorta and portal vein are predictable using easily detectable clinical parameters. Regression equations were developed that enable an approximate prediction of these scan times.

MATERIAL AND METHODS

Contrast dynamic CT was performed in 39 anaesthetised dogs of different breeds. The heart rate at the onset of the examination, the age and the body weight were documented. The contrast agent Imeron 300® was injected into a cephalic vein at 3 ml/s with 600 mg iodine/kg body weight using an automatic injector and a dynamic axial CT was started at the same time. The peak enhancement time in the aorta (pETA) and portal vein (pETP) were measured.

RESULTS

The mean pETA was 24.5 ± 8.6 seconds and the mean pETP was 43.6 ± 13.4 seconds. There was a strong correlation (r = 0.92) between pETA and body weight in combination with the heart rate, and a moderate correlation (r = 0.66) between pETP and body weight in combination with the age. The regression equation was: pETA = 12.23 + 0.61 body weight - 0.07 heart rate. The time between pETA and pETP was 8-24 seconds in 34 animals.

CONCLUSION

To plan the arterial peak the authors recommend the use of the established regression equations based on the statistical results or alternatively bolus tracking to plan the arterial peak. When it is planned to examine the portal venous peak, an interscan duration of 8-14 seconds is recommended.

[Comparison of projection radiography and computed tomography for the detection of pulmonary nodules in the dog and cat]

OBJECTIVE

The aim of our study was to evaluate the value of projection radiography as a standard screening method for the detection of lung nodules compared to computed tomography (CT). Furthermore, we attempted to describe the reasons that might lead to a failed detection of pulmonary nodules in radiography.

MATERIALS AND METHODS

From dogs and cats which were diagnosed in CT (multislice CT) with nodular changes in the lung pattern we selected radiographs (projection radiography with soft copy reading) in at least two projection planes produced in the same timeframe as the CT images. Exclusion criteria were nodules > 3 cm and homogenously calcified nodules (osteomata). A total of 70 animals (50 dogs and 20 cats) met the inclusion criteria.

RESULTS

In 43 animals (61%), nodular changes had already been detected using radiography and were then confirmed by the results of the computed tomography. In detail, 32 of 50 dogs (64%) and 11 of 20 cats (55%) showed nodular lesions in the radiographs. In cats, undetected nodules were often accompanied by highly changed lung opacities, resulting in a poor contrast of the lung. In dogs the reasons for a failed detection of lung nodules were relatively equally distributed to several causes. Interestingly, small nodule size itself was not the predominant reason for missing the nodules in radiographs.

CONCLUSION AND CLINICAL RELEVANCE

In general, radiography still plays an important role as a screening method for the detection of nodular lung lesions. However, one needs to be aware, that a quite high percentage of nodular lung changes can be missed in radiographs. The overall detection rate in this study was 61%. Furthermore, we showed that plane radiographs are of poor diagnostic value when concurrent problems exist which lead to increased lung opacity.

[Liver abscess in a dog. A case report]

The presented case report describes diagnostic and therapy of a liver abscess in a male Golden Retriever dog. The dog was adversely affected by fever, apathy, and vomitus. Diagnostic imaging including radiography, sonography and computed tomography, revealed an abscess-forming lesion of 10 × 5 cm in the left middle liver lobe with detectable multiple gas accumulation within the lesion. The surgical therapy included lobectomy with adjacent omentopexy. Four days after the operation the dog was discharged in a good general condition and with physiological body temperature. Detecting multiple gas accumulation in circular, inhomogeneous lesions by sonography allowed confirmation of the diagnosis. Surgical removal of the affected liver lobe led to recovery of the patient. In human medicine, less invasive methods are preferred, e.g. percutaneous drainage and alcoholization of the lesion. Exclusive medicamentous therapy yields the worst outcome in humans.

[Sonographic examination of the soft palate in dogs]

PURPOSE

The aim of this study was to characterize the normal sonographic anatomy of the soft palate in dogs.

MATERIALS AND METHODS

The study was performed on seven canine heads via a submental and intraoral approach. The detected anatomical structures were then reexamined via a submental approach in a water bath. Each anatomic layer was subsequently dissected starting with the submental layers and working towards the soft palate. After every preparation a sonographic examination was carried out.

RESULTS

Differentiation between the soft palate and the surrounding oropharyngeal tissue can be effectively achieved. Using the submental approach, the transition between hard palate and soft palate as well as the middle section of the soft palate were distinguished from other oropharyngeal structures in all cases. Visualization of the caudal part of the velum and evaluation of the echogenicity of the soft palate were difficult and not always possible. In the two brachycephalic dogs of the study, it was challenging to distinguish the soft palate from the surrounding tissue.

CONCLUSION

The sonographic appearance of the canine soft palate in cadavers was described in this study. The submental approach allows differentiation between intraoral structures. Evaluation of the echogenicity and length of the soft palate is limited.

Classification of climate-change-induced stresses on biological diversity

Conservation actions need to account for and be adapted to address changes that will occur under global climate change. The identification of stresses on biological diversity (as defined in the Convention on Biological Diversity) is key in the process of adaptive conservation management. We considered any impact of climate change on biological diversity a stress because such an effect represents a change (negative or positive) in key ecological attributes of an ecosystem or parts of it. We applied a systemic approach and a hierarchical framework in a comprehensive classification of stresses to biological diversity that are caused directly by global climate change. Through analyses of 20 conservation sites in 7 countries and a review of the literature, we identified climate-change-induced stresses. We grouped the identified stresses according to 3 levels of biological diversity: stresses that affect individuals and populations, stresses that affect biological communities, and stresses that affect ecosystem structure and function. For each stress category, we differentiated 3 hierarchical levels of stress: stress class (thematic grouping with the coarsest resolution, 8); general stresses (thematic groups of specific stresses, 21); and specific stresses (most detailed definition of stresses, 90). We also compiled an overview of effects of climate change on ecosystem services using the categories of the Millennium Ecosystem Assessment and 2 additional categories. Our classification may be used to identify key climate-change-related stresses to biological diversity and may assist in the development of appropriate conservation strategies. The classification is in list format, but it accounts for relations among climate-change-induced stresses.

[Computed tomography imaging of the temporomandibular joint in dogs and cats. Effects of different scan parameters on image quality]

OBJECTIVE

Temporomandibular joints (TMJs) of dogs and cats were examined with multislice computed tomography (MSCT) using different technical scan parameters in order to investigate their impact on image quality. Another aspect was to analyze whether size differences of the TMJ affect the display of small joint structures.

MATERIAL AND METHODS

The TMJs of two dogs and two cats were examined using MSCT. Scan parameters were varied including tube current, scan matrix, resolution mode, slice thickness, and reconstruction increment. Three observers being blinded with respect to the used scan parameters independently assessed the image quality in terms of "contrast resolution", "bone structure", "spatial resolution", "evaluation of the joint space", and "artefacts" according to a 4-point scale.

RESULTS

The criteria "spatial resolution" and "evaluation of the joint space" emphasize the influence of the size of the TMJ. The image quality of the TMJ of the dogs was evaluated superior (by 0.5 to 1.5 points higher graded) compared to the smaller ones of the cats. In terms of "spatial resolution" and "bone structure" the images of an ultra high resolution technique achieved a higher evaluation level (scoring one point superior) compared to the images created by a high resolution protocol. The tube current did not significantly influence the image quality in any of the pictures.

CONCLUSIONS AND CLINICAL RELEVANCE

The display quality of small structures of the TMJ is dependent on the spatial resolution of the CT images. Therefore, a thin slice collimation, a small field of view, and a high resolution reconstruction matrix should be used. Under those aspects subtle alterations of bone structure of the TMJ can be reliably detected. The soft tissue structures of the TMJ can not be visualized with MSCT in small animals. In principle, the results can be applied to any other MSCT-scanner. However, adjustments of the technical parameters may be still necessary.

[Effects of a neuroleptic analgesia with acepromazine on the blood perfusion of the canine kidney. Examination using the sonographic recordable blood circulation parameters of resistance index and pulsatility index]

OBJECTIVE

Kidney failure after anaesthesia constitutes a serious clinical complication. A number of patients suffer from compensated kidney insufficiency, which may be transformed into an acute kidney insufficiency through additional stress, such as an operation and anaesthesia. The aim of the present study was to investigate the effects of a neurolept analgesia with acepromazine on sonographically accessible blood perfusion parameters.

MATERIAL AND METHODS

Following anaesthesia with acepromazine/l-methadone (0.1 mg/kg BW acepromazine, 0.5 mg/kg BW l-methadone) a sonographic examination of the left kidney was performed in 19 clinically healthy foxhound and beagle dogs. Every 5 minutes resistance index and pulsatility index as well as invasive blood pressure were measured and digitally recorded.

RESULTS

Within 5 minutes after induction of anaesthesia a transient increase of the mean arterial blood pressure occurred. After 10 minutes the blood pressure decreased to the initial value and remained essentially constant to the end of the investigation. Resistance index and pulsatility index showed a similar behaviour: After a small initial decrease during the first 5 minutes both parameters displayed a significant increase. This rise was very pronounced up to approximately 15 minutes and then flattened significantly until the end of the test period after 30 minutes. The values corresponded to those found in vessel stenosis.

CONCLUSION AND CLINICAL RELEVANCE

Due to the described changes this type of anaesthesia should not be used in dogs with nephropathy, even though the results of this experimental study might not be necessarily transferable to the clinical patient.

Body weight: the male and female perception

The aim of the present study was to examine the relationship between actual body weight, characterization of one's weight, and satisfaction with it. 246 students of medicine in the third (clinical) stage of their studies at the University of Vienna responded to a questionnaire asking about their weight and attitudes regarding their personal body weight. The results indicate that many young women and men are either unable to characterize their weight (as normal, underweight, overweight, or obese) or guess incorrectly. The results point to the fact that a lot of women and men do not estimate their body weight in correspondence to the valid definition of the BMI. Women in particular seem to model themselves more on the current beauty ideal than men. Women seem to be more influenced by the current ideal of slenderness than their male counterparts. Women are more frequently dissatisfied with their weight, and see themselves as considerably heavier than they actually are. Because of this perception, women attempt to reduce weight more often than men. This type of dissatisfaction with one's body weight and excessive attention paid to body image, particularly weight, are considered as risk factors for the development of eating disorders. Not surprisingly, women are significantly more prone to these conditions than are men.

Nocturnal sleep-disturbing nicotine craving: a newly described symptom of extreme nicotine dependence

In our research on smoking and nicotine dependence we have noticed a sleep disturbance, which is a further symptom of extreme nicotine dependence. We call this symptom "nocturnal sleep-disturbing nicotine craving" (NSDNC). NSDNC is characterised by craving for cigarettes during the individual sleep times. The smoker awakes (one or several times per week) during his regular sleep time, and has to smoke a cigarette before he/she continues sleeping. This symptom can be explained by the decreasing nicotine levels during the sleep time, which results in nicotine craving. However, NSDNC should be carefully separated from other sleep disturbances, or sleep disturbing events (nycturia, medication side effects), when nicotine craving is not the main reason for awakening.

[Primary prevention from the viewpoint of social medicine--examples of prevention projects]

Life style factors play an essential role in etiology and prognosis of cardiovascular diseases; therefore, from a public health point of view, primary preventive measures are of especial importance. Health reports in the form of specific health reports (such as the Viennese Men's Health Report, the Lower Austrian Public Health Report) represent an important foundation for the matter of health promoting projects. In Austria, various preventive projects were suggested and successfully carried out because of these reports. Furthermore, the introduction of the WEBS organisation (scientific dietary counselling service) has shown that professional dietary counselling can indeed induce a change for the better in dietary behaviour and selection of foodstuffs. By the establishment of the first Austrian Institute for the Treatment of Tobacco and Nicotine Addiction (Nicotine Institute Vienna) not only is the diagnosis and treatment of tobacco addiction ensured, but it also provides information for the populace and those active in the health sector. These social public projects provide a valuable contribution to the prevention of cardiovascular diseases.

[Obesity in Austria: epidemiologic and social medicine aspects]

The importance of overweight not only for individual health and life expectancy but also for resulting health economics is stressed considering data from Austria. Epidemiology of overweight in Austria shows 8.5% of the population to be morbidly obese (Body Mass Index [BMI] higher than 30) and 14.5% overweight (BMI between 27 and 29.9). Prevalence of overweight in Austria shows a very masked decrease from eastern to the western districts of the country. As in other countries correlation of overweight with cardiovascular risk factors (cholesterol, triglycerides, glucose and systolic blood pressure) was found to be highly significant also in Austrian health screening programs. As far as treatment of overweight and its prevention is concerned not only short term weight loss, but it maintenance is important. Not only a realistic change in feeding behaviour and dieting but also a change in life style including regular physical activity is recommended requiring repeated and long-term controlling by qualified persons of the health profession.

[Cancer preventive value of natural, non-nutritive food constituents]

Numerous epidemiologic studies have shown that a diet rich in vegetables, fruits and fiber is associated with a decreased risk of cancer, particularly of epithelial tumors. Especially this association is evident for various citrus fruits, carrots, leafy green vegetables, as well as cruciferous-(sorts of cabbage, broccoli) and leak vegetables (garlic, onions, etc.). In the course of investigation of the protective mechanisms exerted by vegetable foodstuffs, a great number of secondary plant products such as carotenoids, sulfides, glucosinolates, plant sterols saponins, terpens, phytoestrogens, flavones, protease inhibitors, or phenolic acids, which are substantial constituents of our daily food, have changed their meaning from a non-nutritive constituent to a probably cancer preventive biological-active substance. But also fermentable, soluble fibers and substances in fermented foods can exert protective effects on development of cancer. Mostly the anticarcinogenic action of biological-active substances is limited to an early stage of carcinogenesis. Therefore it seems to be important to start prevention of cancer by nutrition as early as possible and adhere to it over a long period.

[Evaluation of a weight reduction program: slender without diets]

"Schlank ohne Diät" ("Weight-Reduction Without Diet") is a strategy to normalize body weight, by influencing multiple factors that appear to influence and promote obesity. The base line of therapy is the modification of nutritional habits. Self-control, especially monitoring and recording of calorie intake and the loss of energy by physical activities is the key that trains every client to change his nutritional habits and helps to reduce body weight and keep normal body weight stable. In a retrospective study, including 134 persons, 84 clients (62,69%) were able to reduce body weight, 9 clients (6,72%) reached starting point of weight and in 30,60% (41 clients) during the participation in this methods an increase of body weight was seen. On an average 120 clients achieved a weight reduction of 5.98 kg during the participation in this method. The loss of weight ranged from 1 to 31 kg per person.

[Evaluation of the weight reduction program "Reducing without Diet"]

"Schlank ohne Diät" ("Weight-Reduction Without Diet") is a strategy to normalize body weight, by influencing multiple factors that appear to influence and promote obesity. The base line of therapy is the modification of nutritional habits. Self-control, especially monitoring and recording of caloric intake and the loss of energy by physical activities is the key that trains every client to change his nutritional habits and helps to reduce body weight and keep normal body weight stable. In a retrospective study, including 134 persons, 84 clients (62.69%) were able to reduce body weight, 9 clients (6.72%) reached starting point of weight and in 30, 60% (41 clients) during the participation in this methods an increase of body weight was seen. On an average 120 clients achieved a weight reduction of 5.98 kg during the participation in this methode. The loss of weight ranged from 1 to 31 kg per person.