Colonic torsion is a life-threatening condition in dogs and radiographic findings for this condition have not been well described. The purpose of this retrospective case series was to describe radiographic findings and clinical signs in a group of dogs with colonic torsion. Inclusion criteria were dogs presenting during the period of 2006 and 2016, and that had abdominal radiography and a surgically confirmed or presumed diagnosis of colonic torsion. For each dog, clinical data were recorded from medical records and imaging findings were recorded from retrieved plain radiographs and positive contrast radiographs in which barium enema was performed. Fourteen dogs met inclusion criteria. Of these, nine dogs had colonic torsion confirmed at surgery, with five dogs having surgical confirmation of colonic congestion or mesenteric torsion. Radiographic findings included segmental distention of the colon (14/14), focal narrowing of the colon (11/14), displacement of cecum (11/14), displacement of descending colon (14/14), and mild to no small intestinal distention (14/14). In cases where barium enema was performed, focal narrowing of the colon and longitudinal striations that course in a helical pattern were identified, termed the "torsion sign." Vomiting was the most common clinical sign observed (12/14), followed by abdominal pain in a small majority of cases (8/14). Severe abdominal pain and hypovolemic shock were uncommon in the patients reported (3/14). Colonic torsion should be considered as a differential diagnosis for dogs with radiographic segmental colonic distention with displacement of the descending colon and cecum. Barium enema is recommended for more definitive diagnosis.
Healthcare is, and will continue to be, impacted by unrelenting forces transforming the healthcare system. The Internet (computers and telecommunication) makes it possible for patients to communicate globally on healthcare issues, and they are more educated about wellness, disease prevention, and medical treatments. This age of information also offers telehealth, which continues to alter the doctor-patient relationship, as well as disease management. The world as we know it changes daily. From the drastically changing demographic composition of the social order to rapidly emerging new technologies, the world of healthcare today is more expansive--an important dimension that nurse executives must recognize in order to lead their organizations in a new global marketplace. When historians chronicle the events that impacted the 21st century, they are certain to highlight the world's increasing consciousness of its interdependence. Abundant evidence will be found in literature that speaks to "globalization" when describing cultural, economic, environmental, and political issues. This unprecedented interconnectedness of healthcare across the globe will include nurse executive leadership talents.
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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