Computed Tomographic Angiography under Sedation in the Diagnosis of Suspected Canine Pancreatitis: A Pilot Study

Adrian, A. M.; Twedt, D C; Kraft, Susan L.; Marolf, Angela J.

doi:10.1111/jvim.12467

Cited by 31 publications

(39 citation statements)

References 33 publications

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“…Although not routinely utilized in the clinical setting, computed tomographic angiography appears superior to AUS in its ability to visualize overt and subtle pancreatic abnormalities, identify potential complications such as portal vein thrombi, and provide prognostic information. 20 There was no difference in hospitalization period between the PLI pos and the PLI neg group (4 days), which might be explained by the lack of power due to the relatively small numbers of dogs in each group. Studies with larger numbers of dogs would be needed to determine if the duration of hospitalization for dogs with DKA is affected by the PLI result.…”

Section: Discussionmentioning

confidence: 86%

“…Currently, there is no consensus regarding optimal noninvasive testing for pancreatitis in dogs and many clinicians rely on both AUS and PLI results. Although not routinely utilized in the clinical setting, computed tomographic angiography appears superior to AUS in its ability to visualize overt and subtle pancreatic abnormalities, identify potential complications such as portal vein thrombi, and provide prognostic information …”

Section: Discussionmentioning

confidence: 99%

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Pancreatic Lipase Immunoreactivity in Serum of Dogs with Diabetic Ketoacidosis

Bolton

Cook

Steiner

et al. 2016

Veterinary Internal Medicne

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BackgroundDiabetic ketoacidosis (DKA) is a relatively common endocrine disorder in dogs and is routinely associated with concurrent pancreatic injury.ObjectivesThe aims of this study were to determine the prevalence of pancreatic injury in dogs with DKA based on measurement of pancreatic lipase immunoreactivity in serum (PLI); compare demographic, clinicopathologic, and ultrasonographic findings in dogs with and without evidence of concurrent pancreatic injury; determine the impact of pancreatic injury on duration of hospitalization and short‐term outcome.AnimalsOne hundred and nineteen dogs with DKA with or without concurrent pancreatic injury.MethodsRetrospective study. Dogs with DKA were divided into three groups on the basis of PLI results: positive for pancreatic injury (PLI pos), negative for pancreatic injury (PLI neg), and not tested (PLI na). Demographics, clinicopathologic test results, findings on abdominal ultrasonography (AUS), duration of hospitalization, and short‐term outcome were compared between the three groups.ResultsBased on serum PLI activity, 45 dogs (73%) with DKA had evidence of concurrent pancreatic injury. Median total carbon dioxide was significantly lower in the PLI pos dogs compared to the PLI neg dogs. There was fair agreement (κ = 0.26) between serum PLI activity and AUS. Evidence of pancreatic injury was not associated with significantly longer periods of hospitalization (PLI pos median 6 days, range 4–7 days, PLI neg median 4 days, range 3–6 days) and did not influence short‐term outcome (PLI pos failure to survive to discharge 11/45, 24%, PLI neg failure to survive to discharge 2/17, 12%).Clinical ImportanceConcurrent pancreatic injury is common in dogs with DKA, but did not affect prognosis in this population of dogs.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Pancreatic Lipase Immunoreactivity in Serum of Dogs with Diabetic Ketoacidosis

Bolton

Cook

Steiner

et al. 2016

Veterinary Internal Medicne

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“…Thus, CT could allow faster and more complete abdominal evaluation for these patients, but scientific investigation of canine biliary contents in veterinary medicine using CT is minimal . Computed tomography is becoming a more accessible tool and, in some instances, a first choice diagnostic modality for larger dogs . The ability of CT to distinguish between canine gallbladder sludge and mucoceles is unknown.…”

Section: Introductionmentioning

confidence: 99%

“…21 Computed tomography is becoming a more accessible tool and, in some instances, a first choice diagnostic modality for larger dogs. 20,22 The ability of CT to distinguish between canine gallbladder sludge and mucoceles is unknown.…”

Section: Introductionmentioning

confidence: 99%

CT attenuation values and mineral distribution can be used to differentiate dogs with and without gallbladder mucoceles

Fuerst

Hostnik

2019

Vet Radiology Ultrasound

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Gallbladder mucoceles are potentially fatal in dogs. Multiphase CT angiography was performed to evaluate the canine gallbladder in three conditions: no sludge, sludge occupying ≥25% of the lumen, and mucoceles. Twenty dogs with normal hepatobiliary bloodwork and no‐to‐minimal gallbladder sludge, 13 dogs with normal bloodwork and ≥25% sludge in the gallbladder lumen, and 18 dogs with histologically confirmed gallbladder mucoceles were enrolled in a prospective, observational diagnostic accuracy study. Three regions of interest (ROI) were stratified in the dorsal‐ventral orientation and a single ROI was measured within the hepatic parenchyma. Mean attenuation and presence of mineral were recorded. Average Hounsfield units (HU) were recorded for precontrast, arterial, portovenous, and late venous phases. The overall median HU value for mucoceles was significantly higher than gallbladders without sludge and with sludge; precontrast median overall attenuation was 49.3, 35.8, and 39.7 HU, respectively (P < .000004). Mineral was seen in four (20%) dogs with no sludge, seven (56%) dogs with sludge, and nine (50%) dogs with mucoceles. Mineral in the dogs with mucoceles was located within the central aspect of the gallbladder lumen in 67% of mucoceles; this mineral distribution was not seen in any dog without a mucocele. Computed tomography can differentiate a subset of gallbladder mucoceles from dogs with and without gallbladder sludge, especially in the precontrast series. An HU value of 48.6 is 52% sensitive and 96% specific for a gallbladder mucocele. A hyperattenuating gallbladder on precontrast CT images and centrally distributed mineral can be a gallbladder mucocele.

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“…This information is important to not only allow more accurate identification of abnormal morphologic changes of the feline pancreas and differentiation of disease, but it may also be useful in developing methodology to assess pancreatic function in cats. Previous canine studies have found multiphase CT valuable in diagnosing pancreatitis and pancreatic neoplasms . In people, CT has been used to evaluate pancreatic endocrine function and predict which patients will become diabetic following pancreatectomy …”

Section: Introductionmentioning

confidence: 99%

Triple phase computed tomography of the pancreas in healthy cats

Secrest

Sharma

Bugbee

2017

Vet Radiology Ultrasound

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While the availability and use of computed tomography (CT) continues to grow, no study has described the size and multiphase CT appearance of the normal feline pancreas. This information is important to not only allow more accurate identification and differentiation of disease, but it may also be useful in assessing pancreatic function. In this prospective analytical study, we described a triple phase CT protocol of the pancreas for use in sedated cats and the attenuation, enhancement pattern, size, and volume of the pancreas for a group of healthy cats. Fifteen healthy cats were enrolled in the study and a standardized protocol for acquiring arterial, portal, and delayed phase CT images of the pancreas was developed and described. The pancreas was hypo to isoattenuating to both the liver and spleen in all phases in the majority of cats with a homogenous enhancement pattern noted in all 15. Mean pancreatic attenuation was 48, 79, 166, and 126 Hounsfield units (HU) respectively on precontrast, arterial, portal, and delayed phase images. In addition, mean height, length, and width of the left lobe of the pancreas were larger than the right lobe in all 15 cats. There were no associations between volume and volume: body weight ratio with age (P = 0.6518, P = 0.6968) or sex (P = 0.7013, P = 0.2043). This baseline information may be beneficial for use in future studies characterizing pancreatic disease in cats as well as future research studies evaluating pancreatic endocrine function.

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Computed Tomographic Angiography under Sedation in the Diagnosis of Suspected Canine Pancreatitis: A Pilot Study

Cited by 31 publications

References 33 publications

Pancreatic Lipase Immunoreactivity in Serum of Dogs with Diabetic Ketoacidosis

Pancreatic Lipase Immunoreactivity in Serum of Dogs with Diabetic Ketoacidosis

CT attenuation values and mineral distribution can be used to differentiate dogs with and without gallbladder mucoceles

Triple phase computed tomography of the pancreas in healthy cats

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