A minimally invasive method for delivering injectable therapeutic agents would be desirable for the treatment of intervertebral disc disease in dogs. The purpose of this study was to compare computed tomography (CT), ultrasonography (US), and fluoroscopy modalities for guiding percutaneous injection into canine intervertebral discs. Intervertebral discs of 14 dog cadavers were injected with a gelified ethanol therapeutic agent. Successful injectate placement and injectate leakage were determined based on necropsy inspection of discs. Injection into the nucleus pulposus was successful in 55 of 78 (71%) of all injected discs. Injections guided using CT and fluoroscopy were significantly more successful than US-guided injections. Odds of successful injection without leakage were greater for CT vs. US (P = 0.0026) but there was no significant difference between CT and fluoroscopy (P = 0.0620). Injection success rates did not differ among vertebral sites or dog cadavers of varying weights. Forty-nine (63%) of injection sites had injectate leakage outside the disc and 10 of these involved structures within the vertebral canal. The highest rate of injection success with the least amount of leakage was achieved with CT guidance. Findings indicated that CT, fluoroscopy, and US are feasible modalities for guiding percutaneous injection of a gelified ethanol therapeutic agent into the canine intervertebral disc, with moderate to high success rates for different regions of the spine. However, a moderately high rate of injectate leakage occurred outside of the disc and this should be taken into consideration for future safety and efficacy studies.
CASE DESCRIPTION A 2-year-old female pigeon was evaluated because of a 5-day history of lower than typical activity level, weight loss, and polyuria.
CLINICAL FINDINGS Whole-body radiography revealed a linear metallic foreign body in the area of the ventriculus. Fluoroscopy followed by contrast-enhanced CT was performed to further characterize the lesion location, revealing that the foreign body had perforated the ventral aspect of the ventriculus wall and that the ventral extremity of the foreign body was surrounded by a mass, consistent with a granuloma.
TREATMENT AND OUTCOME A midline celiotomy was performed, and a large granuloma was identified ventral to the ventriculus, adherent to the dorsal aspect of the keel bone. The metallic foreign body (a nail) was removed, and the content of the granuloma was debrided. Amoxicillin–clavulanic acid (150 mg/kg [68.2 mg/lb], PO, q 12 h for 10 days), meloxicam (1 mg/kg [0.45 mg/lb], PO, q 12 h for 5 days), and sucralfate (100 mg/kg [45 mg/lb], PO, q 8 h for 10 days) were prescribed. The pigeon made a successful recovery and was still doing well at a 1-year recheck evaluation.
CLINICAL RELEVANCE Although traumatic gastritis in pigeons has been reported, use of advanced diagnostic imaging for the pigeon of this report facilitated identification of the precise nature of the lesion and, therefore, surgical planning. The outcome for this pigeon suggested that successful resolution of traumatic gastritis may be possible in other affected birds with surgery.
A 5-month-old intact male Basset Hound presented for evaluation of pain and crepitation during manipulation of the temporomandibular joint, worse on the right side. A computed tomography (CT) scan of the head was performed. The CT images demonstrated the osseous features of temporomandibular joint dysplasia and facilitated a 3D reconstruction, which allowed better visualization of the dysplastic features. The patient responded to conservative management with a tape muzzle with no recurrence reported by the owner 6 months after presentation.
Salbutamol toxicity has been documented previously in dogs but oral thermal injury associated with a salbutamol MDI has not been reported in dogs. Although a rare complication, dogs who have been exposed to MDIs should have a thorough oral exam and be monitored closely for signs of respiratory compromise.
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