Reply to play again…

Thank you for your comments!

See below a still image with labels.  The bladder wall is normal, even ventrally (green arrows).  An unusual echogenic line complies to the cranio-ventral aspect of the bladder, and considering the large amount of lipid droplets in the lumen of the bladder (some of them in yellow circles), fat suspension is suspected.  The cat had no urinary signs and the presence of lipid was confirmed on urinalysis.

lipid droplets.001

On the CT performed for cancer staging, a discrete hypodense line supports fat level on the non-dependent side of the bladder.  See the image below (red arrows).

ct.001

Lipid droplets are quite common in cats and with high resolution equipment, we see them quite well!

lipid

 

Ready to play again?

View the short video of the bladder (sagittal plane) of this cat…what is your main finding?  Have you seen that before?  What is the clinical relevance of this finding?

Looking forward to your comments… I’ll get back to you in a couple of days!

 

Errata in the Atlas: Chapter 5 HEART

While we did our best for producing an accurate textbook, a few errors slipped under our radar…

Erratum #1: page 137, Figure 5.27.

Caption refers to E:A peak velocity ratio as normally to be less than 1, but should be more than 1.

 

 

 

 

 

 

 

 

 

 

 

Erratum #2: page 176 

The published IVSd value for greyhounds is 0.5 instead of 0.05.

Thanks Mariam Mattar for highlighting those :-).

Please, if anyone else finds errors in the book, let us know!

Pure heaven…sleepy puppy on the table…

IMG_2573

Courtesy of Julien Fages

Join us at the next Imaging Summer Camp !

Dominique and I have been invited to speak at the next Imaging Summer Camp taking place in Lanzarote on May 20-24, 2019. We’re super excited and hope to meet some of you there! For more information on that meeting, visit VetMeet.

Here is the answer…

Here is the annotated video clip of the 13 year old miniature poodle.

Thank you for your comments !

The pedunculated lesions (at least 2) were located in the antrum of the stomach.  The dog was rotated to the right, in order to move the existing fluid in the stomach toward the pyloro-duodenal junction.  As you can see during peristaltic activity, the nodules “float” and move back and forth…possibly mimicking an intussusception.  The lesions are moderately echogenic and partially layered, and seem bordered by a hyperechoic wavy mucosal line.  When asked after the ultrasound findings, the owner mentioned a recent episode of vomiting of undigested food.

Endoscopic biopsies were taken and the diagnosis was gastric inflammatory polyps with concurrent marked diffuse mucosal hyperplasia and moderate chronic neutrophilic and lymphohistiocytic gastritis (myriad of bacteria).

These lesions can be quite spectacular but not uncommon in miniature breeds.  In absence of clinical signs, follow-up ultrasound may be recommended.

Time to play!

13-year-old toy Poodle is presented for a routine blood glucose curve and a neurological evaluation for ataxia.

What do you think about the video clip of his stomach?

Notice the patient’s position…how is it impacting your findings?

I cannot wait to read your replies and I will give you my thoughts in a couple of days.

What about Coco?

To see the original post, click here.

The duodenostomy site shows expected focal thickening, with numerous hyperechoic foci representing suture material.  The local fat is hyperechoic which is expected for a one week post-operative recheck.  There was no abnormal fluid collection near the anastomosis site.

See below a longitudinal image of the duodenostomy, between the shadows of 2 ribs, and a transverse image with numerous sutures seen best in the near wall:

But the incision of the abdominal wall appears like this:

inc 2

An elongated fluid pocket dissecting the subcutaneous tissues, and likely representing an infected seroma.

The dog was sent back to surgery for debridement of the infected incision.  The abdominal cavity was lavaged as it was suspected to be contaminated, but the duodenostomy site was confirmed to be intact.

The dog recovered uneventfully.

Time to play…

One week ago, Coco, a 3 year old mixed dog breed, had surgery for a foreign body at a referral clinic.  He was doing well but now his appetite has decreased and he is a bit lethargic.   An ultrasound was performed to rule out dehiscence…what do you think?

To read the answer, click here.

And the answer for Blackie is…

Thank you all for your comments on this case!

Blackie was sent to surgery as the ultrasound showed a stick perforating the fundus of the stomach, and most of the stick was embedded in the adjacent omentum.  The inhomogeneous appearance of the omentum supports regional inflammation/infection. The omentum successfully sealed off the foreign body, which explains why the dog did not display any gastrointestinal signs.  The process was likely chronic.

Right after surgery, the heart rate returned to normal!

Please review the annotated video below: