Computed tomographic angiography and ultrasonography in the diagnosis and evaluation of acute pancreatitis in dogs

Abstract

BackgroundAcute pancreatitis in dogs is an under‐diagnosed disease. Current diagnostic methods are insufficient at identifying sequelae and lack prognostic capability. Computed tomographic angiography (CTA) is accurate for diagnosis and prognostication of pancreatitis in humans.ObjectivesIn comparison to ultrasound (US), CTA will (1) better diagnose more severe pancreatitis and sequelae and (2) provide assessment of patient outcome by identification of pancreatic contrast enhancement patterns.AnimalsTwenty‐six client‐owned dogs suspected to have acute pancreatitis.MethodsUS and CTA examinations performed at time of admission were compared to determine the detection of pancreatic changes and sequelae. CTA findings also were compared to outcome indicators for prognosis of dogs with acute pancreatitis. Specific canine pancreatic lipase (cPL) samples were obtained and compared with CTA findings.ResultsTen of 26 dogs had heterogeneous contrast enhancement of the pancreas. Compared to US, CTA better identified portal vein thrombosis (P = .003). Patients with heterogeneous contrast enhancement had longer hospitalization (P = .01), including hospital stays for >5 days (P = .02), had more relapses, and were more likely to have portal vein thrombosis (P = .002). Patients with heterogeneous contrast enhancement had increased spec cPL (P = .006).Conclusions and Clinical ImportanceIn comparison to US, CTA better identified dogs with more severe acute pancreatitis and those with portal vein thrombosis, factors that may predict longer hospitalization and increased risk of relapse. The presence of heterogeneous contrast enhancement and portal vein thrombosis may change therapy for patients with acute pancreatitis.

Association between abdominal ultrasound findings, the specific canine pancreatic lipase assay, clinical severity indices, and clinical diagnosis in dogs with pancreatitis

“…The still images and video clips were assessed for evidence of pancreatic enlargement, echogenicity, and echotexture. Pancreatic enlargement was determined via comparison with previously published reference intervals, whereas pancreatic echotexture was a subjective measure as utilized in previous literature . The echogenicity of the pancreas was assessed via comparison with internal landmarks such as the surrounding mesentery, kidneys, spleen, and liver.…”

“…Pancreatic enlargement was determined via comparison with previously published reference intervals, whereas pancreatic echotexture was a subjective measure as utilized in previous literature. [22][23][24][25] The echogenicity of the pancreas was assessed via comparison with internal landmarks such as the surrounding mesentery, kidneys, spleen, and liver. The echogenicity of the surrounding mesentery and the presence of peripancreatic free fluid were also assessed.…”

Імпульсно-Хвильове Допплерівське Дослідження Підшлункової Залози Собак, Хворих На Гострий Панкреатит

“…Захворювання підшлункової залози часто виникають у дрібних тварин, зокрема і собак, однак їх важко діагностувати через анатомічну недоступність підшлункової залози, неспецифічні клінічні ознаки та результати лабораторних досліджень [1][2][3][4][5]. Тому ультразвукове дослідження використовують усе частіше і нині воно є методом діагностики патології підшлункової залози в собак [4].…”

Effects of Sedation by Intramuscular Administration of Medetomidine on Canine Abdominal Vascular System and Hepatic Parenchyma Imaging Using Enhancement Dynamic Computed Tomography

“…In veterinary medicine, multiphasic multi-detector computed tomography (CT) angiography, including triple-phase helical CT, is currently used as a diagnostic tool for vascular disorders, such as portosystemic shunts [ 1 ], arteriovenous fistulae [ 2 ], and various tumors [ 3 , 4 , 5 , 6 , 7 , 8 ]. This method is also commonly used for characterizing parenchymal disease, such as pancreatic disease [ 9 , 10 , 11 , 12 ]. For triple-phase helical CT, a single bolus injection of contrast medium enhances imaging during the phase of preferential arterial enhancement, followed by the portal venous phase, and the delayed phase [ 5 , 6 ].…”

“…CT imaging further requires that the animal be immobilized, with anesthesia or sedation used to achieve this [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. However, agents used for anesthesia and sedation can influence the cardiovascular circulation.…”