Contrast‐enhanced multidetector computed tomography to diagnose pulmonary thromboembolism in an awake dog with pyothorax

Ngwenyama, Thandeka R.; Herring, Jennifer; O'Brien, Mauria; Hartman, Susan K.; Galloway, Kimberly A; O’Brien, Robert T.

doi:10.1111/vec.12235

Cited by 12 publications

(10 citation statements)

References 28 publications

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“…In human pediatric radiology, high resolution CT scanning is often performed without general anesthesia . In previous studies where VetMousetrap™ device has been used to scan awake or mildly sedated animals, image quality has been adequate for diagnosis of airway diseases including dogs with primary laryngeal and tracheal airway obstruction, pulmonary thromboembolism, cats with upper airway obstruction and allergic asthma, and dogs with abdominal diseases and traumatic pelvic fractures . Motion artifact has been considered absent or mild in majority of examinations, as was the case also in our study.…”

Section: Discussionsupporting

confidence: 66%

“…It was first used in CT imaging of thorax of awake healthy cats and cats with different thoracic diseases . Computed tomographic imaging with minimal or no sedation has been described also in dogs with respiratory and abdominal diseases . The positioning device could provide a rapid and safe alternative to obtain thoracic CT without need for sedation or general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

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Thoracic high resolution CT using the modified VetMousetrap™ device is a feasible method for diagnosing canine idiopathic pulmonary fibrosis in awake West Highland White Terriers

Holopainen

Rautala

Lilja‐Maula

et al. 2019

Vet Radiology Ultrasound

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Canine idiopathic pulmonary fibrosis is a chronic, progressive interstitial lung disease particularly prevalent in West Highland White Terriers. In the present prospective pilot study, we evaluated the feasibility of modified VetMousetrap TM device in high resolution CT to detect idiopathic pulmonary fibrosis in West Highland White Terriers. Twelve awake West Highland White Terriers with canine idiopathic pulmonary fibrosis and 24 clinically healthy West Highland White Terriers were scanned using a helical dual slice scanner utilizing VetMousetrap TM device without or with minimal chemical restraint with butorphanol. Three evaluators blindly assessed the images for image quality and the presence of canine idiopathic pulmonary fibrosis related imaging findings such as ground glass opacity and reticular opacities. Additionally, the attenuation of the lung was quantified with ImageJ software using histogram analysis of density over the lung fields. Computed tomography was successfully completed and motion artifact ranked in statistical analysis barely noticeable to mild in all dogs. The agreement between imaging findings and clinical status was very good with overall value 0.91 and percentage of agreement of 94%. There was also very good intraobserver ( range = 0.79-0.91) and interobserver agreement ( = 0.94). Moderate to severe ground glass opacity was present in all affected dogs. In the ImageJ analysis, a significant difference in lung attenuation between the study groups was observed. We conclude that modified VetMousetrap TM device is applicable in diagnosing canine idiopathic pulmonary fibrosis in awake West Highland White Terriers avoiding anesthetic risk in these often severely hypoxic patients.

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Thoracic high resolution CT using the modified VetMousetrap™ device is a feasible method for diagnosing canine idiopathic pulmonary fibrosis in awake West Highland White Terriers

Holopainen

Rautala

Lilja‐Maula

et al. 2019

Vet Radiology Ultrasound

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“…In humans, studies (LOE 6, Good–Fair) support discontinuation of anticoagulation in patients with risk factors for thrombosis that can be resolved or removed . Multiple veterinary case reports (LOE 5, Poor) support indefinite use of antithrombotics in patients with chronic (noncurable) underlying causes particularly for the treatment of venous thrombi …”

Section: Guidelinesmentioning

confidence: 99%

American College of Veterinary Emergency and Critical Care (ACVECC) Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines: Small animal

Goggs

Blais

Brainard

et al. 2019

J Vet Emergen Crit Care

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Objectives: To systematically review available evidence and establish guidelines related to the risk of developing thrombosis and the management of small animals with antithrombotics. Design: Standardized, systematic evaluation of the literature (identified by searching Medline via PubMed and CAB abstracts) was carried out in 5 domains (Defining populations at risk; Defining rational therapeutic use; Defining evidence-based protocols; Refining and monitoring antithrombotic therapies; and Discontinuing antithrombotic therapies). Evidence evaluation was carried out using Population, Intervention, Comparison, Outcome generated within each domain questions to address specific aims. This was followed by categorization of relevant articles according to level of evidence and quality (Good, Fair, or Poor). Synthesis of these data led to the development of a series of statements. Consensus on the final guidelines was achieved via Delphi-style surveys.Draft recommendations were presented at 2 international veterinary conferences and made available for community assessment, review, and comment prior to final revisions and publication. Settings: Academic and referral veterinary medical centers.Results: Over 500 studies were reviewed in detail. Worksheets from all 5 domains generated 59 statements with 83 guideline recommendations that were refined during 3 rounds of Delphi surveys. A high degree of consensus was reached across all guideline recommendations. Conclusions:Overall, systematic evidence evaluations yielded more than 80 recommendations for the treatment of small animals with or at risk of developing thrombosis. Numerous significant knowledge gaps were highlighted by the evidence reviews undertaken, indicating the need for substantial additional research in this field. K E Y W O R D S ) for their dedicated contributions to this effort. We would also like to thank the members of the veterinary community who attended and contributed to the discussion of the guidelines during the 2018 EVECC Congress and IVECCS sessions and subsequently during the online open-comment stages. CONFLICT OF INTERESTThe authors declare that they have no conflicts of interest.

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“…In human, thoracic multidetector CT angiography is the gold standard for the clinical diagnosis of pulmonary thromboembolism . The use of multidetector CT angiography for the visualization of pulmonary arterial system in healthy dogs and for diagnosing thromboembolism in a dog with pyothorax has been recently reported . However, because multidetector CT angiography is not readily available in small animal practice, selective pulmonary angiography is at present the most commonly employed diagnostic method for identifying thromboembolism in the clinical setting .…”

Section: Discussionmentioning

confidence: 99%

Multidetector computed tomographic pulmonary angiography in a cat with fatal heartworm disease

Panopoulos

Specchi

Soubasis

et al. 2017

Vet Radiology Ultrasound

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A 17-month-old neutered male domestic shorthair cat was referred for a computed tomographic (CT) study of the thorax due to respiratory distress. Multidetector CT angiography showed a multifocal interstitial ground glass opacity, tortuous and blunted pulmonary arteries consistent with thromboembolism with perivascular lung infiltration and hypoventilation in multiple lung lobes. A blood antigen test was positive for Dirofilaria immitis. The cat's clinical condition rapidly declined and the owners elected euthanasia. The histopathologic examination confirmed heartworm disease with parasitic pulmonary thromboembolism.

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Contrast‐enhanced multidetector computed tomography to diagnose pulmonary thromboembolism in an awake dog with pyothorax

Abstract: To the authors' knowledge, this is the first reported case of PTE diagnosed in a dog with pyothorax using CE-MDCT.

Cited by 12 publications

References 28 publications

Thoracic high resolution CT using the modified VetMousetrap™ device is a feasible method for diagnosing canine idiopathic pulmonary fibrosis in awake West Highland White Terriers

Thoracic high resolution CT using the modified VetMousetrap™ device is a feasible method for diagnosing canine idiopathic pulmonary fibrosis in awake West Highland White Terriers

American College of Veterinary Emergency and Critical Care (ACVECC) Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines: Small animal

Multidetector computed tomographic pulmonary angiography in a cat with fatal heartworm disease

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