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Blank C, Granger LA, Gaschen L, Liu CC, Gaschen F. Fluoroscopically measured bronchial collapse in healthy dogs during cough exceeds 25%, and a cutoff of 60% bronchial collapse can be used to distinguish healthy from chronically coughing dogs. Vet Radiol Ultrasound 2024; 65:219-226. [PMID: 38363122 DOI: 10.1111/vru.13344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/07/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024] Open
Abstract
Bronchomalacia, the weakening of bronchial cartilage, is a common cause of cough in dogs. The gold standard for diagnosis of bronchomalacia is bronchoscopy; however, fluoroscopy is often used as a preliminary diagnostic test due to its noninvasiveness. The normal amount of bronchial collapse in healthy dogs using fluoroscopy has not been previously established, with some authors citing <25%. The aims of this prospective and retrospective analytical observational study were to determine the normal amount of airway collapse in healthy animals, the amount of airway collapse in dogs with chronic cough and presumed bronchomalacia, and cut-off values of airway collapse during expiration and cough to distinguish between the two groups. Thoracic fluoroscopy was performed in right and left lateral recumbency during inspiration, expiration, and cough to evaluate the percentage collapse of the trachea and lobar bronchi in 45 healthy and 76 chronically coughing dogs. The bronchi of chronically coughing dogs exhibited a significantly greater amount of collapse during both expiration and cough compared with healthy dogs. Chronically coughing dogs exhibited up to 31.7 ± 26.6% collapse in expiration and 87.5 ± 23.7% collapse during cough, whereas healthy dogs exhibited 14.9 ± 6.1% collapse in expiration and 35.0 ± 13.7% collapse during cough. Based on ROC curves, the authors suggest using cut-off values of 30% during expiration and 60% during cough to distinguish between healthy dogs and those with presumed bronchomalacia. Findings suggest that though healthy dogs can exhibit a greater degree of airway collapse than previously thought, fluoroscopy can be used to distinguish between healthy and presumed bronchomalacic dogs.
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Affiliation(s)
- Carolyn Blank
- Department of Radiology, Louisiana State School of Veterinary Medicine, Baton Rouge, Louisiana, USA
| | - L Abbigail Granger
- Department of Radiology, Louisiana State School of Veterinary Medicine, Baton Rouge, Louisiana, USA
| | - Lorrie Gaschen
- Department of Radiology, Louisiana State School of Veterinary Medicine, Baton Rouge, Louisiana, USA
- VetCT, Orlando, Florida, USA
| | - Chin-Chi Liu
- Department of Veterinary Clinical Sciences, Louisiana State School of Veterinary Medicine, Baton Rouge, Louisiana, USA
| | - Frederic Gaschen
- Department of Internal Medicine, Louisiana State School of Veterinary Medicine, Baton Rouge, Louisiana, USA
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Noh D, Shin HG, Choi H, Lee Y, Lee K. Non-brachycephalic dogs with stertor have higher nasopharyngeal collapsibility compared with dogs without stertor and foramen lacerum level is ideal for evaluating nasopharyngeal collapse on dynamic CT. Vet Radiol Ultrasound 2024. [PMID: 38608172 DOI: 10.1111/vru.13371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/17/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024] Open
Abstract
Stertor, a clinical sign associated with obstructive airway syndrome, is often observed in non-brachycephalic dogs. This prospective, case-control study aimed to compare soft palate dimensions, nasopharyngeal cross-sectional area (CSA), and nasopharyngeal collapsibility at various locations in non-brachycephalic dogs with and without stertor. A total of 50 dogs were recruited and stratified into control (n = 34) and stertor (n = 13) groups. Static and dynamic computed tomography was conducted without tracheal intubation, and the following variables were calculated: normalized soft palate length and thickness, normalized maximum and minimum nasopharyngeal CSAs (rCSAmax and rCSAmin), and nasopharyngeal collapsibility at the level of the cranial end of the soft palate, pterygoid hamulus, foramen lacerum, bony labyrinth, and caudal end of the soft palate. The stertor group demonstrated significantly lower rCSAmax and rCSAmin, as well as higher nasopharyngeal collapsibility compared with the control group, while no significant differences were noted in the soft palate dimension. Evaluating nasopharyngeal collapse at the foramen lacerum level was recommended due to the clear presence of identifiable bony landmarks and lower overlap in the nasopharyngeal collapsibility between dogs with and without stertor. Physical dimensions of the soft palate may not be the primary contributing factor to nasopharyngeal collapse and clinical signs in non-brachycephalic dogs.
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Affiliation(s)
- Daji Noh
- College of Veterinary Medicine, Kyungpook National University, Daegu, South Korea
- 24 Africa Animal Medical Center, Daejeon, South Korea
| | - Hyun-Guk Shin
- 24 Africa Animal Medical Center, Daejeon, South Korea
| | - Hojung Choi
- College of Veterinary Medicine, Chungnam National University, Daejeon, South Korea
| | - Youngwon Lee
- College of Veterinary Medicine, Chungnam National University, Daejeon, South Korea
| | - Kija Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu, South Korea
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Lin CH, Johnson LR, Chang WT, Lo PY, Chen HW, Wu HD. Quantifiable features of a tidal breathing phenotype in dogs with severe bronchomalacia diagnosed by bronchoscopy. Vet Q 2023; 43:1-10. [PMID: 37616027 PMCID: PMC10478619 DOI: 10.1080/01652176.2023.2252518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 08/25/2023] Open
Abstract
Dynamic lower airway obstruction is the primary component of canine bronchomalacia, but the ventilatory function remains underinvestigated. This prospective study analyzed tidal breathing characteristics in 28 dogs, comprising 14 with severe bronchomalacia diagnosed by bronchoscopy versus 14 without respiratory disease. Spirometry was conducted in all dogs. Bronchoscopy with bronchoalveolar lavage or brush under anesthesia was performed in 14 dogs with cough and expiratory effort. Severe bronchomalacia was defined by the severity of collapse and total number of bronchi affected. Ventilatory characteristics were compared between groups. Results revealed that dogs with severe bronchomalacia had lower minute volume (218 vs 338 mL/kg, p = .039) and greater expiratory-to-inspiratory time ratio (1.55 vs 1.35, p = .01) compared to control dogs. The tidal breathing pattern of dogs with bronchomalacia was different from that of normal dogs, and the pattern differed from the concave or flat expiratory curves typical of lower airway obstruction. Compared to control dogs, dogs with severe bronchomalacia had a significantly prolonged low-flow expiratory phase (p < .001) on the flow-time plot and a more exponential shape of the expiratory curve (p < .001) on the volume-time plot. Flow-time index ExpLF/Te (>0.14) and volume-time index Vt-AUCexp (≤31%) had a high ROC-AUC (1.00, 95% confidence interval 0.88 to 1.00) in predicting severe bronchomalacia. In conclusion, the tidal breathing pattern identified here indicates abnormal and complicated ventilatory mechanics in dogs with severe bronchomalacia. The role of this pulmonary functional phenotype should be investigated for disease progression and therapeutic monitoring in canine bronchomalacia.
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Affiliation(s)
- Chung-Hui Lin
- National Taiwan University Veterinary Hospital, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
- TACS-Alliance Research Center, Taipei, Taiwan
| | - Lynelle R. Johnson
- Department of Medicine and Epidemiology, The University of California School of Veterinary Medicine, Davis, CA, USA
| | - Wei-Tao Chang
- National Taiwan University Veterinary Hospital, National Taiwan University, Taipei, Taiwan
- TACS-Alliance Research Center, Taipei, Taiwan
| | - Pei-Ying Lo
- TACS-Alliance Research Center, Taipei, Taiwan
| | - Hui-Wen Chen
- Department of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
| | - Huey-Dong Wu
- Section of Respiratory Therapy, Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
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Yangwanitset W, Huaijantug S, Tansakul M, Sakcamduang W. The Agreement between Radiography and Fluoroscopy as Diagnostic Tools for Tracheal Collapse in Dogs. Animals (Basel) 2023; 13:ani13091434. [PMID: 37174471 PMCID: PMC10177530 DOI: 10.3390/ani13091434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/15/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Tracheal collapse is a common disease in small, middle-aged dogs, and imaging tools are essential for its diagnosis. Radiography and fluoroscopy are the main diagnostic modalities used, but their agreement in different regions is not well documented. In this study, the agreement between thoracic radiography and fluoroscopy in tracheal collapse was investigated in 29 dogs. The results showed that radiography detected a lower degree of collapsing trachea compared to fluoroscopy at the carina region (p < 0.001). However, there was no significant difference observed between the degree of collapsing trachea detected by radiography and fluoroscopy at the cervical, thoracic inlet, and intra-thoracic regions (p = 0.780, 0.537, and 0.213, respectively). The kappa statistic indicated a slight agreement at the cervical region at a 16.4% cut-off (κ = 0.20), while the other regions showed a non-agreement. In conclusion, although radiography is useful for screening, fluoroscopy was able to detect the degree of the collapsing trachea greater than radiography in the carina region. Additionally, if a collapse in the cervical region is detected by radiography, it is prone to have a positive relationship with fluoroscopy as well.
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Affiliation(s)
| | - Somkiat Huaijantug
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Mookmanee Tansakul
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Walasinee Sakcamduang
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom 73170, Thailand
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Chan JC, Johnson LR. Prospective evaluation of the efficacy of inhaled steroids administered via the AeroDawg spacing chamber in management of dogs with chronic cough. J Vet Intern Med 2023; 37:660-669. [PMID: 36892108 DOI: 10.1111/jvim.16673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/13/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Glucocorticoids are frequently required for management of cough because of inflammatory airway disease (IAD) and airway collapse (AWC). OBJECTIVES/HYPOTHESIS To determine the efficacy and feasibility of inhaled administration of corticosteroids in controlling cough in dogs with noninfectious airway disease. ANIMALS Thirty-six client-owned dogs. METHODS Dogs were prospectively recruited for this placebo-controlled cross-over study. Inflammatory airway disease was diagnosed through bronchoalveolar lavage cytology. Airway collapse was diagnosed through bronchoscopy, or if dogs were unsuitable anesthetic candidates, by crackles on auscultation, radiographic changes in airway diameter, or fluoroscopy. Dogs were randomly assigned to receive placebo or fluticasone propionate for the first 2 weeks of the trial then crossed over to fluticasone. A quality of life (QOL) survey (best score 0, worst score 85) was completed at 0 and 6 weeks. A visual-analog cough survey was submitted at 0, 2, 4, and 6 weeks to assess cough, feasibility, and adverse effects of treatment. RESULTS For 32 dogs, QOL score at study end (mean 28.1 ± 14.1) was significantly lower (P < .0001) compared to entry (mean 11.3 ± 9.7), with a median change of 69% in QOL score, indicating improved quality of life. Cough frequency, duration, and severity were significantly (P < .0001) decreased at study end. Feasibility of aerosolized delivery improved with continued use (P = .05) with only 1 dog unable to accept inhaled medication. CONCLUSION AND CLINICAL IMPORTANCE This study supports the utility of fluticasone propionate by inhalation in management of cough in dogs with IAD and AWC.
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Affiliation(s)
- Jennifer C Chan
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, Davis, California 95616, USA
| | - Lynelle R Johnson
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California 95616, USA
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Ventilator-Assisted Inspiratory and Expiratory Breath-Hold Thoracic Computed Tomographic Scans Can Detect Dynamic and Static Airway Collapse in Dogs with Limited Agreement with Tracheobronchoscopy. Animals (Basel) 2022; 12:ani12223091. [PMID: 36428319 PMCID: PMC9686793 DOI: 10.3390/ani12223091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/04/2022] [Accepted: 11/09/2022] [Indexed: 11/11/2022] Open
Abstract
Airway collapse (AC) in dogs includes a tracheal collapse, mainstem and lobar bronchial collapse, and bronchomalacia (i.e., segmental/subsegmental bronchial collapse). The clinical presentation of AC may overlap with non-collapsible airway disease (NCAD) or another non-lower airway respiratory disease (NLARD). This study determined whether paired inspiratory (I)/expiratory (E)-breath-hold computed tomography (I/E-BH CT) can detect a static and dynamic AC in dogs with spontaneous respiratory disease and it compared the CT-derived metrics of the AC to the tracheobronchoscopy metrics. The CT-acquired I and E diameter and cross-sectional area (CSA) for the trachea, mainstem and lobar bronchi in dogs with an AC (n = 16), NCAD (16), and NLARD (19) served for a dynamic percent of the airway narrowing (%AN) calculation. A scoring system assessed the bronchomalacia. The circularity was calculated for each airway. The results were compared to the tracheobronchoscopy collapse grading. In the dogs with an AC, the %AN was larger for the trachea, right mainstem bronchus and right middle lobar bronchus when they were compared to the dogs with NCAD and NLARD. Flattening was only identified for the trachea of the AC dogs. The agreement between the CT and tracheobronchoscopy scores was 20% from trachea to the lobar bronchi and 47% for the segmental/subsegmental bronchi. Paired I/E-BH CT can detect static and dynamic AC with limited agreement with the tracheobronchoscopy metrics. Independent scoring systems that are tailored to the clinical manifestations of functional impairments are needed.
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Carr SV, Reinero C, Rishniw M, Pritchard JC. Specialists' approach to tracheal collapse: survey-based opinions on diagnostics, medical management, and comorbid diseases. J Am Vet Med Assoc 2022; 261:80-86. [PMID: 36166502 DOI: 10.2460/javma.22.03.0108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the current standard of care among specialists for the routine diagnostic evaluation and medical management of stable tracheal collapse in dogs, identifying gaps between practice and scientific evidence to facilitate the development of future prospective studies. A secondary objective was to describe the perceived incidence of selected comorbid disorders in dogs with tracheal collapse and the diagnostic tests performed to evaluate for those disorders. SAMPLE 180 veterinary specialists in 22 countries. PROCEDURES An electronic survey was sent to 4 specialty listservs to target diplomates. Respondents completed multiple-choice and free-response questions related to the diagnostic evaluation and treatment of a theoretical stable dog with suspected tracheal collapse. RESULTS Most respondents routinely utilized radiography, tracheobronchoscopy, and fluoroscopy to diagnose tracheal collapse and performed airway sampling, sedated airway examination, and echocardiograms to rule out comorbidities. The most frequently perceived comorbid disorders included chronic bronchitis, bronchomalacia, and myxomatous mitral valve disease. Respondents most often prescribed opioid antitussives, glucocorticoids, anxiolytics, and antibiotics as treatments. Less frequently, they utilized bronchodilators and nonopioid medications for cough. CLINICAL RELEVANCE Despite a lack of published guidelines, specialists have similar approaches in their diagnostic and therapeutic approach to a stable dog with suspected tracheal collapse and believe evaluating for comorbid disorders is important. A description of a typical diagnostic approach and knowledge of realistic treatment goals will assist the general practitioner managing dogs with stable tracheal collapse. Additionally, gaps between current practices established via this survey and data supporting those practices exist, specifically concerning the use of antibiotics and nonopioid medications for cough, representing areas for further study.
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Affiliation(s)
- Susan V Carr
- 1College of Veterinary Medicine & Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Carol Reinero
- 2College of Veterinary Medicine, University of Missouri, Columbia, MO
| | - Mark Rishniw
- 3College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - Jessica C Pritchard
- 4School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI
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Falerno I, Paolini A, Tamburro R, Aste G, De Bonis A, Terragni R, Vignoli M. Imaging and endoscopic diagnosis of lung diseases in small animals. A review. Top Companion Anim Med 2022; 51:100701. [PMID: 36041659 DOI: 10.1016/j.tcam.2022.100701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 08/10/2022] [Accepted: 08/23/2022] [Indexed: 11/25/2022]
Abstract
Diagnostic imaging plays a fundamental role in the diagnosis of pulmonary diseases. Radiography, ultrasound, computed tomography, and endoscopy are important tools for achieving a diagnosis. The choice of diagnostic procedure varies according to the patient, the suspected diagnosis and the risk/benefit ratio. Culture, cytology and histology are nearly always necessary to obtain a definitive diagnosis. Several biopsy sampling techniques are described. Surgical biopsies are the gold standard for the diagnosis of bronchiolitis or interstitial lung diseases but often not performed due to the high risk. In humans, the introduction of transbronchial cryobiopsies has led to excellent results in the study of interstitial lung diseases.
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Affiliation(s)
- Ilaria Falerno
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
| | - Andrea Paolini
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
| | - Roberto Tamburro
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
| | - Giovanni Aste
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
| | - Andrea De Bonis
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
| | | | - Massimo Vignoli
- Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy.
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Peyrecave‐Capo X, Munoz‐Diaz J, Rocafort Ferrer G, Watrelot D, Desjardins I. Acute tracheal trauma and chronic tracheal collapse in an asthmatic mature pony. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Xavier Peyrecave‐Capo
- VetAgro Sup, Veterinary Campus – Equine Department University of Lyon Marcy l'Etoile France
| | - Javier Munoz‐Diaz
- VetAgro Sup, Veterinary Campus – Clinical Imaging Department University of Lyon Marcy l'Etoile France
| | - Gloria Rocafort Ferrer
- VetAgro Sup, Veterinary Campus – Equine Department University of Lyon Marcy l'Etoile France
| | - Dorothée Watrelot
- VetAgro Sup, Veterinary Campus – Pathology Department University of Lyon Marcy l'Etoile France
| | - Isabelle Desjardins
- VetAgro Sup, Veterinary Campus – Equine Department University of Lyon Marcy l'Etoile France
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Na H, Lee SK, Choi H, Lee Y, Lee K. Nasopharyngeal collapse can be identified on radiography in healthy male Beagle dogs without cardiopulmonary diseases. Vet Radiol Ultrasound 2022; 63:546-551. [PMID: 35569116 DOI: 10.1111/vru.13094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 02/22/2022] [Accepted: 02/27/2022] [Indexed: 11/27/2022] Open
Abstract
Pharyngeal collapse has been described as a decrease of more than 50% in the diameter of the lumen. However, there has been no study on changes in the pharyngeal lumen in clinically normal dogs. The hypothesis of this prospective, observational, and pilot study was that change in nasopharyngeal lumen would be over 50% in Beagle dogs without cardiopulmonary diseases. Thus, we assessed the nasopharyngeal luminal change using cervical radiography in Beagle dogs without respiratory signs or cardiac abnormalities. The study sample included 42 Beagle dogs without cardiopulmonary diseases. Cervical radiographies were acquired during inspiration and expiration, and nasopharyngeal luminal change (%) was calculated. The median nasopharyngeal luminal change was 16.6%, and nasopharyngeal luminal change over 50% was identified in two dogs. The nasopharyngeal luminal change was significantly associated with body condition score and body weight. There was no correlation between nasopharyngeal luminal change and age. This study revealed that change in nasopharyngeal lumen over 50% can be identified in Beagle dogs without cardiopulmonary diseases and may be over-diagnosed as partial pharyngeal collapse. Further studies for comparing change in nasopharyngeal lumen between clinically normal dogs and dogs with respiratory signs are warranted.
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Affiliation(s)
- Hyemin Na
- College of Veterinary Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Sang-Kwon Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Hojung Choi
- College of Veterinary Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, 34134, Republic of Korea
| | - Youngwon Lee
- College of Veterinary Medicine, College of Veterinary Medicine, Chungnam National University, Daejeon, 34134, Republic of Korea
| | - Kija Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu, Republic of Korea
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Côté E, Weisse C, Lamb K, Tozier E. Computed tomographic assessment of principal bronchial anatomy in dogs of various thoracic conformations: 93 cases (2012-2017). J Am Vet Med Assoc 2022; 260:1-10. [PMID: 35417410 DOI: 10.2460/javma.20.12.0716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To better understand spatial relationships between principal bronchi and other intrathoracic structures by use of CT images of dogs of various somatotypes. ANIMALS 93 dogs that underwent thoracic CT. PROCEDURES Information was collected from medical records regarding signalment and physical examination and echocardiographic findings. Two investigators recorded multiple measurements on a thoracic axial CT image from each dog. RESULTS Thoracic height-to-width ratio (H:W) was associated with left principal bronchus (LPB) and right principal bronchus (RPB) H:W, aortic-LPB separation, focal LPB narrowing, and aortic-vertebral overlap. Thoracic H:W was not associated with dog age, weight, sex, or brachycephalic breed. Twenty-five (27%) dogs had focal LPB narrowing, compared with 5 (5%) dogs with focal RPB narrowing (P < 0.001). Ten of 25 dogs had overlap or contact between vertebrae, aorta, LPB, and heart, suggesting a cumulative compressive effect on the LPB, while 15 had LPB-aorta contact and lack of contact between the aorta and thoracic vertebrae, suggesting an aortic constrictive effect on the LPB. None had LPB narrowing without contact from surrounding structures. Inter-rater agreement was high. CLINICAL RELEVANCE In dogs that underwent CT and were not selected for clinical suspicion of bronchial disease, principal bronchial morphology was associated with thoracic conformation. Focal LPB narrowing occurred more often than RPB narrowing. Focal LPB narrowing occurred with evidence of extraluminal compression, with or without contact between aorta and vertebrae. Brachycephalic breed could not be used for predicting thoracic H:W.
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Affiliation(s)
- Etienne Côté
- 1Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Chick Weisse
- 2Department of Interventional Radiology & Endoscopy, The Animal Medical Center, New York, NY
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12
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Osathanon R, Lamb CR, Church DB. Associations between respiratory signs, thoracic CT findings and results of tracheobronchoscopy and bronchoalveolar lavage in dogs. Vet Rec 2022; 191:e1385. [PMID: 35092696 DOI: 10.1002/vetr.1385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/20/2021] [Accepted: 01/06/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Several diagnostic techniques are used in dogs with signs of respiratory disease. The aims of the present study are to estimate the relative sensitivities and associations between the results of diagnostic tests in dogs with respiratory conditions. METHOD A retrospective cross-sectional study of dogs referred for investigation of respiratory signs. Associations between clinical signs, thoracic CT findings, tracheobronchoscopic findings, cytology results and bacterial culture results were tested using binary logistic regression. RESULTS One hundred and thirty-three dogs were included. Abnormalities were detected by cytology, tracheobronchoscopy, CT and bacterial culture in 91%, 88%, 80% and 25% cases, respectively. There were associations between cough and bronchial lesions on thoracic CT (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.1-6.4, p = 0.037), and between cough and neutrophilic inflammation on cytology (OR 4.5, 95% CI 1.3-15.8, p = 0.020). Bronchial foreign body at bronchoscopy was associated with pulmonary consolidation on CT (OR 8.0, 95% CI 1.6-41.7, p = 0.013) and with positive bacterial culture (OR 10.9, 95% CI 2.1-57.0, p = 0.005). In dogs with normal thoracic CT, abnormalities were detected by cytology, tracheobronchoscopy and bacterial culture in 89%, 77% and 23% cases, respectively. CONCLUSION Airway cytology and tracheobronchoscopy provided useful information for diagnosis in many dogs with respiratory signs that had a normal thoracic CT.
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Affiliation(s)
- Rungrote Osathanon
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK.,Department of Clinical Science and Public Health, Faculty of Veterinary Science, Mahidol University, Salaya, Phutthamonthon, Nakorn Pathom, Thailand
| | - Christopher R Lamb
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - David B Church
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
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Ward JL, Lisciandro GR, Ware WA, Miles KG, Viall AK, DeFrancesco TC. Lung ultrasonography findings in dogs with various underlying causes of cough. J Am Vet Med Assoc 2020; 255:574-583. [PMID: 31429645 DOI: 10.2460/javma.255.5.574] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize lung ultrasonography (LUS) findings in dogs with a primary clinical complaint of cough. ANIMALS 100 client-owned coughing dogs. PROCEDURES A standardized LUS examination was performed for all dogs to quantify the number of B lines and identify subpleural abnormalities at 4 sites on each hemithorax. The final clinical diagnosis (reference standard) was determined by medical record review, and sensitivity and specificity of LUS for the diagnosis of selected causes of cough was determined. RESULTS Common underlying causes of cough included dynamic airway collapse (n = 37), cardiogenic pulmonary edema (CPE; 12), and bronchitis (10). Compared with dogs with other causes of cough, dogs with bacterial pneumonia (n = 7) were more likely to have subpleural shred signs, whereas dogs with pulmonary neoplasia (4) were more likely to have subpleural nodule signs. Dogs with CPE had higher total B-line scores and higher numbers of LUS sites strongly positive for B lines (> 3 B lines/site) than other dogs. The LUS criteria of total B-line score ≥ 10 and presence of ≥ 2 sites strongly positive for B lines were each 92% sensitive and 94% specific for CPE diagnosis. Notably, 18% (16/88) of dogs with noncardiac causes of cough had been treated previously with diuretics because of prior CPE misdiagnosis. CONCLUSIONS AND CLINICAL RELEVANCE LUS profiles in dogs with cough differed by the underlying cause. In dogs with a clinical history of cough, this imaging modality could be diagnostically useful, particularly to help exclude the possibility of underlying CPE.
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14
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Beltrán K, Pascon J, Mistieri M. Radiographic evaluation of tracheal collapse in dogs by compressive technique. ARQ BRAS MED VET ZOO 2020. [DOI: 10.1590/1678-4162-11324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT The purpose of this study was to verify the applicability of the compressive radiographic technique (pressures of 5, 10, 15 and 20mmHg) in the diagnosis of tracheal collapse in small breed dogs, in lateral cervicothoracic radiography. Out of the 50 dogs evaluated, 25 presented tracheal collapse (TG group), 23 did not present tracheal collapse (CG) and two were excluded because they did not tolerate a pressure of 20 mmHg. The TG group presented a smaller internal diameter of the trachea in the region of the fourth cervical vertebra (D4) and at the entrance of the thorax (TDE) compared to the CG group, in all the radiographic projections performed, as well as within the TG group where the compressive technique differed from conventional. Furthermore, there was a correlation between the clinical sign of coughing during cervical collar use and the presence of radiographic tracheal collapse at a pressure of 20 mmHg. It was concluded that the compressive radiographic technique was feasible and efficient in confirming the diagnosis of tracheal collapse in dogs, especially in the pressure of 20 mmHg, where it was associated with clinical signs, and can be used in isolation or complementary to the conventional technique.
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Jeung SY, Sohn SJ, An JH, Chae HK, Li Q, Choi M, Yoon J, Song WJ, Youn HY. A retrospective study of theophylline-based therapy with tracheal collapse in small-breed dogs: 47 cases (2013-2017). J Vet Sci 2020; 20:e57. [PMID: 31565900 PMCID: PMC6769334 DOI: 10.4142/jvs.2019.20.e57] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 07/17/2019] [Accepted: 08/28/2019] [Indexed: 12/23/2022] Open
Abstract
Theophylline acts as a bronchodilator and has an anti-inflammatory effect. In addition, theophylline can be applied in patients where there are concerns regarding the side-effects of corticosteroids. This retrospective case series evaluated theophylline-based therapy in tracheal collapse (TC) canine patients. Forty-seven dogs with TC that received theophylline-based therapy during 2013–2017 were investigated. A fluoroscopic examination was performed to diagnose and grade TC. Theophylline was prescribed (7.5–30 mg/kg PO q12h) and the theophylline serum concentrations were measured. Coughing was assessed using a coughing scoring scale. The mean coughing score decreased after the theophylline-based therapy compared with that observed before treatment. Clinical improvements were observed in 46/47 patients (97.9%). As the intrathoracic TC grading increased, the final theophylline dosage also increased (p value 0.019). The symptom-free period (SFP) with therapy was 189.7 ± 194.45 days (range, 0–720 days) and there was no statistically significant correlation between the SFP and age, sex, or TC grade on fluoroscopy. Although theophylline has generally been used as a third-line treatment, it was used as the main treatment in this study and most patients showed improvements. Dogs have a wider therapeutic index of serum concentrations than humans, and any undesirable effects were easily overcome. With further research, this therapy may prove to be a useful approach, but its safety for long-term use in the treatment of canine TC patients needs to be established.
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Affiliation(s)
- So Young Jeung
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Sang June Sohn
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Ju Hyun An
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Hyung Kyu Chae
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Qiang Li
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Mincheol Choi
- Laboratory of Veterinary Radiology, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Junghee Yoon
- Laboratory of Veterinary Radiology, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea
| | - Woo Jin Song
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea.
| | - Hwa Young Youn
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Science, College of Veterinary Medicine, Seoul National University, Seoul 08826, Korea.
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16
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Yoon H, Yu J, An G, Bang S, Kwon D, Kim H, Lee H, Chang J, Chang D. CT and radiographic evaluation of bronchial collapsibility at forced expiration in asymptomatic brachycephalic dogs. Vet Radiol Ultrasound 2020; 61:167-180. [PMID: 31896169 DOI: 10.1111/vru.12829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 08/20/2019] [Accepted: 09/02/2019] [Indexed: 11/27/2022] Open
Abstract
Bronchial collapse due to bronchomalacia is an important cause of chronic coughing in dogs. Radiographic and CT evidence of bronchial collapse has previously been reported in healthy Beagle dogs under forced expiration. However, published studies in brachycephalic dog breeds that are prone to bronchial collapse are currently lacking. In the present prospective analytical experimental study, CT and radiography were used to measure the bronchial diameter and collapsibility of each pulmonary bronchus during end-expiratory, 5 mL/kg forced-expiratory, and 10 mL/kg forced-expiratory phases in 17 asymptomatic brachycephalic dogs and six healthy Beagle dogs. Bronchial collapsibility was significantly greater during forced expiration, than that at the end of expiration in both groups (P < .001). Bronchial collapsibility measurements of the left lung lobes and the right cranial, middle, and accessory lobes were significantly higher in asymptomatic brachycephalic dogs than those in healthy Beagle dogs, during all expiratory phases (P < .05). The higher bronchial collapsibility of brachycephalic dogs was also supported using CT multiplanar reconstruction images and radiography. In conclusion, radiographic and CT measures of bronchial collapsibility in asymptomatic brachycephalic dogs are higher than measures in healthy Beagle dogs. Therefore, measures of bronchial collapse in brachycephalic dogs should not be evaluated using the same baseline measures as those used for healthy Beagle dogs.
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Affiliation(s)
- Hyounglok Yoon
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Jin Yu
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Gayeon An
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Sohyun Bang
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Dohoon Kwon
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Hyunryung Kim
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Hanbin Lee
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Jinhwa Chang
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
| | - Dongwoo Chang
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, Korea
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Scherf G, Masseau I, Bua AS, Beauchamp G, Dunn ME. Fluoroscopic and radiographic assessment of variations in tracheal height during inspiration and expiration in healthy adult small-breed dogs. CANADIAN JOURNAL OF VETERINARY RESEARCH = REVUE CANADIENNE DE RECHERCHE VETERINAIRE 2020; 84:24-32. [PMID: 31949326 PMCID: PMC6921987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 01/16/2019] [Indexed: 06/10/2023]
Abstract
The objective of this study was to document tidal variations in tracheal height during normal respiration in 19 healthy adult (> 1 y old) small-breed dogs (< 10 kg) using fluoroscopy and radiography. Each dog underwent tracheal fluoroscopic examination on inspiration and expiration while in a standing position (F-S) and in right lateral recumbency (F-RL), followed by radiographic projections obtained in right lateral recumbency. The percent variation in tracheal height during maximal inspiration and expiration was determined at 3 different locations [cervical region (CR), thoracic inlet (TI), and intrathoracic (IT) region]. When all imaging procedures and sites of measurement were considered, tracheal height varied during physiologic inspiration and expiration from 0% to 21.1%, with a mean of 4.5%. The mean percent variation in tracheal height was not significantly different among imaging modalities (F-S versus F-RL versus radiography) (P = 0.16) or measurement sites (CR versus TI versus IT) (P = 0.89). The body condition score (BCS) (P = 0.96), age (P = 0.95), and breed (P = 0.19) did not significantly influence the mean percent variation in tracheal height. The average variation in tracheal height during maximal physiological inspiration and expiration is small (< 6%) in most healthy adult small-breed dogs as assessed by fluoroscopy and radiography, although tracheal height may vary by as much as 21.1% in some healthy individuals. Inspiratory and expiratory radiographs acquired in right lateral recumbency provide an accurate assessment of tracheal height as an alternative to fluoroscopy.
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Affiliation(s)
- Grégoire Scherf
- Tufts University Cummings School of Veterinary Medicine, Clinical Sciences, 200 Westboro Road, North Grafton, Massachusetts 01536, USA (Scherf); Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, 3200 rue Sicotte, Saint-Hyacinthe, Quebec J2S 2M2 (Masseau, Bua, Beauchamp, Dunn)
| | - Isabelle Masseau
- Tufts University Cummings School of Veterinary Medicine, Clinical Sciences, 200 Westboro Road, North Grafton, Massachusetts 01536, USA (Scherf); Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, 3200 rue Sicotte, Saint-Hyacinthe, Quebec J2S 2M2 (Masseau, Bua, Beauchamp, Dunn)
| | - Anne-Sophie Bua
- Tufts University Cummings School of Veterinary Medicine, Clinical Sciences, 200 Westboro Road, North Grafton, Massachusetts 01536, USA (Scherf); Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, 3200 rue Sicotte, Saint-Hyacinthe, Quebec J2S 2M2 (Masseau, Bua, Beauchamp, Dunn)
| | - Guy Beauchamp
- Tufts University Cummings School of Veterinary Medicine, Clinical Sciences, 200 Westboro Road, North Grafton, Massachusetts 01536, USA (Scherf); Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, 3200 rue Sicotte, Saint-Hyacinthe, Quebec J2S 2M2 (Masseau, Bua, Beauchamp, Dunn)
| | - Marilyn E Dunn
- Tufts University Cummings School of Veterinary Medicine, Clinical Sciences, 200 Westboro Road, North Grafton, Massachusetts 01536, USA (Scherf); Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, 3200 rue Sicotte, Saint-Hyacinthe, Quebec J2S 2M2 (Masseau, Bua, Beauchamp, Dunn)
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Abstract
Tracheal and airway collapse (bronchomalacia) are common causes of chronic cough in middle-aged to older dogs in which weakening of cartilage within the respiratory system leads to narrowing of airways, irritation, inflammation, partial to complete airway obstruction, and other secondary effects. Tracheomalacia occurs in small-breed dogs, whereas bronchomalacia can occur in any size dog. Successful treatment involves correct identification of the problem, recognition of concurrent disease processes, and appropriate medical therapy. Surgical intervention and intraluminal stenting are readily available so it is important to understand indications for such procedures.
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Affiliation(s)
- Ann Della Maggiore
- MarQueen Pet Emergency and Specialty Group, 9205 Sierra College Boulevard #120, Roseville, CA 95661, USA.
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Johnson LR, Stern JA. Clinical features and outcome in 25 dogs with respiratory-associated pulmonary hypertension treated with sildenafil. J Vet Intern Med 2019; 34:65-73. [PMID: 31816127 PMCID: PMC6979098 DOI: 10.1111/jvim.15679] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 11/25/2019] [Indexed: 12/16/2022] Open
Abstract
Background Pulmonary hypertension (PH) can develop secondary to many common cardiopulmonary diseases, and the use of sildenafil has improved care of affected dogs. Objective To evaluate response to sildenafil in dogs with respiratory‐associated PH. Animals Twenty‐five dogs with PH. Methods Prospective clinical trial. Doppler echocardiography identified dogs with moderate to severe PH, and additional tests were performed to detect underlying diseases. A 17‐point quality of life (QOL) questionnaire was completed, and sildenafil was prescribed, along with other medications deemed necessary for the management of clinically diagnosed respiratory diseases. After 30 days, dogs returned to the hospital for repeat echocardiogram and QOL survey. Results The median age was 12.4 years, and most dogs were small breed dogs (median weight, 6.5 kg). Syncope (64%), cough (56%), and respiratory difficulty (32%) were the most common presenting complaints. Respiratory diseases associated with PH included tracheobronchomalacia, pulmonary fibrosis, inflammatory airway disease, and brachycephalic syndrome, with multiple diseases in some dogs. Eight of 25 dogs (32%) died or were euthanized within 1 month. In the remaining dogs, tricuspid regurgitation pressure gradient (83.0 ± 17.4 mm Hg before, 55.4 ± 17.4 mm Hg after) and QOL scores were significantly improved after 1 month of sildenafil. Fifty percent mortality was reached 6 months after study entry, with 4 dogs alive 5 years after diagnosis. Conclusions and Clinical Importance Sildenafil responsiveness is variable in dogs with respiratory‐associated PH, but improved QOL was demonstrated in dogs surviving >1 month, and long‐term survival was noted in some cases.
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Affiliation(s)
- Lynelle R Johnson
- Department of Medicine and Epidemiology, University of California, Davis, Davis, California
| | - Joshua A Stern
- Department of Medicine and Epidemiology, University of California, Davis, Davis, California
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Lopez-Minguez S, Serrano-Casorran C, Guirola JA, Rodriguez-Zapater S, Bonastre C, De Gregorio MA. New tracheal stainless steel stent pilot study: twelve month follow-up in a rabbit model. PeerJ 2019; 7:e7797. [PMID: 31608174 PMCID: PMC6788445 DOI: 10.7717/peerj.7797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/30/2019] [Indexed: 01/27/2023] Open
Abstract
Background Canine tracheal collapse is a complex airway pathology without promising treatment results. Currently nitinol stents are the best surgical option; however, some professionals are doubting if stent placement is the best option due to the associated complications. Objective Determine the technical feasibility, safety, and long-term follow-up after the implantation of a new tracheal stent designed for canine tracheal collapse. Methods Thirteen healthy, adult female New Zealander rabbits were involved in this pilot study.A new intra-tracheal device (Reference number 902711 patent registered as CasMin-Twine) was implanted in ten animals. Deployment was performed under general anesthesia, making a puncture incision via a 21 Gauge needle in the intra-tracheal space where the stent was introduced with a screwing process. The device was fixed to the tracheal wall with a non-absorbable suture. Computerized Tomography (CT) and an endoscopy to study structural abnormalities were performed after 30, 90 and 365 days after stent placement. Results Technical and clinical success was 100%. There was no significant change in behavior or respiratory disorders. CT studies showed no significant alterations. After the 30 days, 60% of the animals showed partial endothelization in the endoscopy study, and only one animal still presented partial endothelization after 12 months. Mucus accumulation was only present in 40% of cases and classified as low, without respiratory consequences. Only one animal presented a single granuloma at caudal stent tip. Conclusions This new tracheal stent (CasMin-Twine) is an effective and safe procedure with promising results, and also shows the possibility of removing the device after endothelization has been produced. New studies should be carried out to evaluate the effectiveness in patients with tracheomalacia. Clinical Significance/Impact This new product can give veterinarians a new option of treatment for this complicated pathology. Minimizing specific equipment for its deployment, CasMin-Twine will be more accessible for all professionals.
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Affiliation(s)
- Sandra Lopez-Minguez
- University of Zaragoza, GITMI Minimally Invasive Techniques Research Group, Zaragoza, Spain
| | - Carolina Serrano-Casorran
- University of Zaragoza, GITMI Minimally Invasive Techniques Research Group, Zaragoza, Spain.,Animal Pathology, University of Zaragoza, Zaragoza, Spain
| | - Jose A Guirola
- University of Zaragoza, GITMI Minimally Invasive Techniques Research Group, Zaragoza, Spain.,Pediatrics, Radiology and Phisical medicine, University of Zaragoza, Zaragoza, España.,Interventional Radiology Service, Lozano Blesa University Hospital Zaragoza, Spain
| | | | - Cristina Bonastre
- University of Zaragoza, GITMI Minimally Invasive Techniques Research Group, Zaragoza, Spain.,Animal Pathology, University of Zaragoza, Zaragoza, Spain
| | - Miguel Angel De Gregorio
- University of Zaragoza, GITMI Minimally Invasive Techniques Research Group, Zaragoza, Spain.,Pediatrics, Radiology and Phisical medicine, University of Zaragoza, Zaragoza, España.,Interventional Radiology Service, Lozano Blesa University Hospital Zaragoza, Spain
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Suematsu M, Suematsu H, Minamoto T, Machida N, Hirao D, Fujiki M. Long-term outcomes of 54 dogs with tracheal collapse treated with a continuous extraluminal tracheal prosthesis. Vet Surg 2019; 48:825-834. [PMID: 31115067 DOI: 10.1111/vsu.13229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 03/22/2019] [Accepted: 04/14/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To describe the surgical placement of a continuous extraluminal tracheal prosthesis (CETP) and report the subsequent postoperative clinical outcomes in dogs with tracheal collapse. STUDY DESIGN Retrospective case series. ANIMALS Fifty-four dogs. METHODS Medical records of dogs in which cervical and/or thoracic inlet tracheal collapse was diagnosed and treated by placement of a CETP between 2010 and 2017 were reviewed to evaluate postoperative complications, changes in respiratory function, and survival. Histological examinations of tracheal tissues performed in 2 dogs at 51 and 57 months after surgery were also reviewed. RESULTS Fifty-three (98%) dogs survived to discharge. Postoperative complications included laryngeal paralysis (1 dog), disseminated intravascular coagulation (1 dog), and recurrent tracheal collapse (2 dogs). None of the dogs exhibited clinical evidence of tracheal necrosis. Preoperative dry, harsh cough resolved in 87% of the dogs after surgery. Goose honking cough was resolved in 25 of 26 (96%) dogs. Median follow-up time was 30 months (range, 16 days to 76 months). The survival rate at 36 months was 86% (CI: 75%-96%). On histological examination in 2 dogs, the tracheal tissue surrounding the prosthesis was well preserved and without evidence of chronic inflammation. CONCLUSION Continuous extraluminal tracheal prosthesis placement in dogs with tracheal collapse resulted in low postoperative complication rates and good long-term outcomes. CLINICAL SIGNIFICANCE Continuous extraluminal tracheal prosthesis placement provides a viable alternative surgical option for managing dogs with tracheal collapse.
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Affiliation(s)
- Masahiro Suematsu
- AMC Suematsu Animal Hospital, Oita, Japan.,Laboratory of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima, Japan
| | | | | | - Noboru Machida
- Cooperative Department of Veterinary Medicine, Laboratory of Veterinary Clinical Oncology, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | | | - Makoto Fujiki
- Laboratory of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Kagoshima University, Kagoshima, Japan
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Weisse C, Berent A, Violette N, McDougall R, Lamb K. Short-, intermediate-, and long-term results for endoluminal stent placement in dogs with tracheal collapse. J Am Vet Med Assoc 2019; 254:380-392. [DOI: 10.2460/javma.254.3.380] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Oh D, Lee S, Kim S, Choen S, Choi M, Yoon J. Computed tomographic bronchial collapsibility values over 50% may be detected in healthy dogs. Vet Radiol Ultrasound 2018; 60:28-37. [DOI: 10.1111/vru.12692] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/15/2018] [Accepted: 07/17/2018] [Indexed: 11/27/2022] Open
Affiliation(s)
- Dayoung Oh
- College of Veterinary Medicine and the Research Institute for Veterinary Science; Seoul National University; Seoul 08826 Republic of Korea
| | - Siheon Lee
- College of Veterinary Medicine and the Research Institute for Veterinary Science; Seoul National University; Seoul 08826 Republic of Korea
| | - Seungji Kim
- College of Veterinary Medicine and the Research Institute for Veterinary Science; Seoul National University; Seoul 08826 Republic of Korea
| | - Sangkyung Choen
- College of Veterinary Medicine and the Research Institute for Veterinary Science; Seoul National University; Seoul 08826 Republic of Korea
| | - Mincheol Choi
- College of Veterinary Medicine and the Research Institute for Veterinary Science; Seoul National University; Seoul 08826 Republic of Korea
| | - Junghee Yoon
- College of Veterinary Medicine and the Research Institute for Veterinary Science; Seoul National University; Seoul 08826 Republic of Korea
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Ward JL, Lisciandro GR, DeFrancesco TC. Distribution of alveolar-interstitial syndrome in dogs and cats with respiratory distress as assessed by lung ultrasound versus thoracic radiographs. J Vet Emerg Crit Care (San Antonio) 2018; 28:415-428. [PMID: 30075063 DOI: 10.1111/vec.12750] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 11/01/2016] [Accepted: 12/05/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To assess distribution of alveolar-interstitial syndrome (AIS) detected by lung ultrasound (LUS) compared to thoracic radiographs (TXR). DESIGN Prospective study. SETTING University teaching hospital. ANIMALS Seventy-six dogs and 24 cats with acute respiratory distress or tachypnea. INTERVENTIONS Patients underwent LUS and TXR within 6 hours. Lung ultrasound images were scored for presence and quantity of B-lines in 4 lung quadrants (right cranial, right caudal, left cranial, left caudal). An individual LUS quadrant was scored positive if > 3 B-lines were observed within a single intercostal space. Dorsoventral TXR were scored for presence of AIS in the same 4 quadrants. An individual TXR quadrant was scored positive if infiltrate was present in ≥ 25% of the quadrant. Medical records were evaluated for final diagnosis. MEASUREMENTS AND MAIN RESULTS Quadrant-by-quadrant spatial agreement in assigning AIS using LUS versus TXR was fair (K = 0.24 - 0.56). Lung ultrasound scored a higher number of quadrants positive per patient (2.65 ± 1.59 vs. 2.13 ± 1.48; P = 0.012). Patterns of distribution of AIS differed significantly based on final diagnosis. Patients with left-sided congestive heart failure were more likely to have diffuse AIS on LUS (P < 0.001) or bilateral caudal AIS on TXR (P = 0.04) while patients with noncardiac disease were more likely to have absence of AIS in all quadrants using either modality (P < 0.001). Differences in spatial distribution of AIS were also noted among disease subcategories. CONCLUSIONS Lung ultrasound and TXR were both useful to detect and categorize distribution of alveolar or interstitial pulmonary pathology. Spatial agreement between modalities was only fair. Overall, LUS detected a higher incidence of AIS compared to TXR. Both modalities detected differences in distribution of AIS based on final diagnosis, suggesting that a regional pattern-based approach to thoracic imaging may prove diagnostically useful.
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Affiliation(s)
- Jessica L Ward
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA
| | | | - Teresa C DeFrancesco
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
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25
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Kim H, Kim YJ, Lee H, An T, Yu J, Yoon H, An G, Jung J, Chang J, Chang D. Computed tomographic and radiographic bronchial collapse may be a normal characteristic of forced expiration in dogs. Vet Radiol Ultrasound 2018; 59:551-563. [PMID: 29786925 DOI: 10.1111/vru.12625] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/15/2018] [Accepted: 02/04/2018] [Indexed: 11/30/2022] Open
Abstract
Tracheobronchomalacia has been diagnosed using radiography or bronchoscopy to confirm bronchial changes in luminal diameter during the respiratory cycle. However, studies in healthy humans suggest that some degree of bronchial collapse may be observed during the normal respiratory cycle. In this analytical study, the luminal diameter of the bronchus to each of the six pulmonary lobes and the mean percentage of expiratory collapse from end inspiratory, end expiratory, and two forced expiratory phases (10 and 15 ml/kg) were determined via computed tomography (CT) and radiography in 22 healthy Beagle dogs. The bronchial collapsibility was significantly greater during the forced expiration than the end expiration (P < 0.001); the same results were observed in dorsal and sagittal CT images and radiographs (P < 0.001). Median collapsibility values associated with 15 ml/kg forced expiratory collapse determined via cross-sectional CT images were measured as 16.6-45.5% and differed according to the pulmonary lobe. Median collapsibilities on radiography with 15 ml/kg forced expiration were 57.8% and 62.1% in the right cranial lobe and right caudal lobe, respectively. In conclusion, bronchial diameter may change during the respiratory cycle, and some degree of reduction in bronchial diameter may be an incidental finding in healthy dogs. More rigorous criteria are needed with regards to bronchial collapsibility during normal respiration for the diagnosis of bronchomalacia in order to avoid false-positive diagnoses.
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Affiliation(s)
- Hyunryung Kim
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Young Joo Kim
- Western University of Health Science, College of Veterinary Medicine, Pomona, CA
| | - Hanbin Lee
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Taegeon An
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jin Yu
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Hyounglok Yoon
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Gayeon An
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jaihyun Jung
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Jinhwa Chang
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
| | - Dongwoo Chang
- Section of Veterinary Medical Imaging, Veterinary Medical Center, College of Veterinary Medicine, Chungbuk National University, Cheongju, South Korea
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Chan JC, Johnson LR, Brown CS, Pollard RE. Fluoroscopic Estimation of Thoracic Dimensional Changes in Healthy Dogs. J Vet Intern Med 2017; 31:1841-1848. [PMID: 28961336 PMCID: PMC5697204 DOI: 10.1111/jvim.14825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 07/23/2017] [Accepted: 08/03/2017] [Indexed: 01/27/2023] Open
Abstract
Background Current methods available for assessing alterations in lung mechanics require sophisticated equipment and are of limited availability. A method that could assess lung area change with respiration might be a clinically useful surrogate for assessing lung compliance. Objective To use fluoroscopy to determine percent change in thoracic and lung areas in healthy dogs. Animals Forty‐four client‐owned dogs with no evidence of respiratory disease. Methods Prospective study. Resting respiration was recorded fluoroscopically, and peak inspiratory and expiratory frames were captured for 3 typical respiratory cycles. The number of intrathoracic pixels in the entire thoracic cavity was measured for both inspiration and expiration, and the average percent change in intrathoracic area was determined for each dog. This process was repeated by a hemithorax measurement of lung area that excluded the mediastinum and cardiac silhouette. Proposed reference ranges (and 95% confidence intervals [CI]) were computed by a nonparametric percentile distribution. Results Median percent change in thoracic dimension for the total thorax measurement was 12.5% (CI, 8.9–24.0%). Median percent change for the hemithorax measurement was significantly (P < 0.001) larger (20.8%, CI, 14.3–37.6%). Both measurement techniques were correlated with body weight but not with age, sex, thoracic conformation, body condition score (BCS), or breed. Conclusions and Clinical Importance Fluoroscopy allows a noninvasive and repeatable measure of lung area changes during respiration that must be corrected for body weight. Additional studies in dogs with respiratory diseases are needed to determine its utility in detecting clinically useful alterations in lung area changes.
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Affiliation(s)
- J C Chan
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, Davis, CA
| | - L R Johnson
- Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, CA
| | - C S Brown
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, Davis, CA
| | - R E Pollard
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, CA
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Heng HG, Lim CK, Gutierrez-Crespo B, Guptill LF. Radiographic and computed tomographic appearance of tracheal collapse with axial rotation in four dogs. J Small Anim Pract 2017; 59:53-58. [PMID: 28370000 DOI: 10.1111/jsap.12679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/17/2016] [Accepted: 01/08/2017] [Indexed: 11/28/2022]
Affiliation(s)
- H. G. Heng
- Department of Veterinary Clinical Sciences; Purdue University; West Lafayette IN 47907 USA
| | - C. K. Lim
- Department of Veterinary Clinical Sciences; Purdue University; West Lafayette IN 47907 USA
| | - B. Gutierrez-Crespo
- Department of Veterinary Clinical Sciences; Purdue University; West Lafayette IN 47907 USA
| | - L. F. Guptill
- Department of Veterinary Clinical Sciences; Purdue University; West Lafayette IN 47907 USA
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