Case report: Application of color Doppler sonography for the assessment of pulmonary consolidations in a dog

Retrospective Evaluation of Subpleural Consolidations Using Lung Ultrasound in 634 Dogs and 347 Cats

BACKGROUND

Human literature describes vascular patterns in various types of lung consolidations; however, these changes have not been analyzed in dogs and cats. This retrospective analysis of medical records aimed to describe vascular patterns observed in the airless subpleural lung tissue of dogs and cats and to compare these patterns to various lung consolidations and clinical diagnoses according to parenchymal and vascular criteria described in human literature.

ANIMALS

This study included 347 cats and 634 dogs.

METHODS

This was a retrospective study encompassing medical records obtained between 2018 and 2023. Lung ultrasound was performed in dogs and cats and cases with different sonographically identified airless subpleural lung tissue were selected. Airless subpleural lung tissue was categorized into five types of consolidations: shred, nodule, wedge sign, mass, and tissue sign. Further classification was based on the parenchymal criteria, the presence or absence of bronchograms and the vascular patterns identified within these regions. Bronchograms were classified as air bronchograms (dynamic and/or static), fluid bronchograms, mixed fluid and air bronchograms, and/or absence of bronchograms. Vascular patterns were classified as tree-like, residual, chaotic, "vascular sign", and whether they were continuous with and extended from the chest wall or not.

CONCLUSIONS AND CLINICAL IMPORTANCE

It is possible to identify and characterize airless subpleural lung tissue in cats and dogs based on the parenchymal and vascular characteristics.

Point-of-Care Lung Ultrasound in Small Animal Emergency and Critical Care Medicine: A Clinical Review

Thoracic point-of-care ultrasound (T-POCUS) has grown in popularity and usage in small animal emergencies and critical care settings due to its non-invasive nature, mobility, and ability to acquire images in real time. This review summarizes current understanding about T-POCUS in dogs and cats with respiratory illnesses, including normal thoracic ultrasonography appearance and numerous pathological situations. The basics of T-POCUS are covered, including equipment, scanning procedures, and picture settings. Practical applications in patients with respiratory distress are discussed, with an emphasis on pleural space abnormalities and lung diseases. Ultrasound results define pulmonary disorders such as pneumonia, atelectasis, cardiogenic and non-cardiogenic pulmonary edema, lung lobe torsion, pulmonary fibrosis, pulmonary thromboembolism, pulmonary neoplasms, and pulmonary bleeding. The evaluation focuses on T-POCUS diagnostic skills in a variety of clinical settings. Limitations and the need for more study to standardize techniques, establish agreed terminology, and create specialized educational routes are highlighted.

Lung ultrasound for the diagnosis of subpleural consolidations - a review of the veterinary and human literature

Lung ultrasound (LUS) is an imaging modality of growing importance in human medicine. LUS has been extensively applied to human patients. Guidelines have been created for internal medicine, describing ultrasonographic features of various lung pathologic processes. Such guidelines do not exist for veterinary medicine, and studies on the utility of LUS in companion animals are limited. Therefore, this review compares conclusions from veterinary studies to recommendations in human medicine for the detection of subpleural consolidations beyond the application of LUS as a point-of-care modality in emergency and critical care.

RATTUS (Rat Thoracic Ultrasound): diagnosis of pneumothorax in pet rats

Introduction

Rat thoracic ultrasound (RATTUS) is a non-invasive, easy-to-perform method for the evaluation of the pleural space and lungs in pet rats. The aim of the article is to present species-specific differences in the sonographic diagnosis of pneumothorax (PTX) in pet rats.

Methods

In total, 158 client-owned pet rats were examined during the period from July 2023 to January 2024. PTX was diagnosed in 20 of the examined rats (13.25%, the age of the animals ranged from 2 months to 32 months (19.08 ± 6.93 months; mean ± SD) and their body weight ranged from 97 g to 885 g (461.27 ± 138.97 g; mean ± SD). Radiographic confirmation of PTX was performed in all these 20 rats, in the control group radiography was used to confirm that PTX was not present.

Results

The lung point and the barcode sign was found in 7/20 animals with sensitivity of 33.3% (95% CI, 0.16-0.59) and specificity of 100% (95% CI, 0.97-1.0). The abnormal curtain sign was found in 19/20 of animals with the sensitivity of 95% (95% CI, 0.73-0.99.7) and the specificity of 89% (95% CI, 0.82-0.93). The abnormalities in the substernal access were in 17/20 of animals with the sensitivity of 85% (95% CI, 0.61-0.96) and the specificity of 71% (95% CI, 0.62-0.78).

Discussion

In conclusion, RATTUS is a non-invasive method for the diagnosis of PTX in rats. Lung point and barcode sign are specific but not easily diagnosed signs. The curtain sign in RATTUS is not specific for PTX, as there are e.g. geriatric rats (rats older than 1,5 years) in which the abnormal curtain sign is visible without the presence of PTX. The presence of moderate to severe PTX can be assessed by the substernal approach based on the presence of cardiac displacement toward the collapsed lung lobe, and on evaluation of the lung inflation symmetry. This sign is not specific for PTX but in conjunction with other ultrasonic signs described makes the RATTUS a feasible tool for PTX diagnosis in rats.

The Rat Thoracic Ultrasound protocol: scanning technique and normal findings

Respiratory diseases (especially pneumonia) are very common disorders in pet rats. The suspected diagnosis is mostly based on the clinical signs, thoracic auscultation, and thoracic radiography. However, auscultation is insensitive in determining the severity of the disease, and radiographs are often unremarkable. Non-cardiac thoracic ultrasonography is increasingly used in veterinary medicine; however, it has not been described in detail in rats. Thoracic ultrasonic examination was conducted on 400 client-owned conscious pet rats. The rats were examined in the period from June 2023 to August 2023 in two veterinary clinics. Due to the small size of the animal, different anatomical considerations, and different evaluation protocols, as well as to meet the optimal outcome of detailed thoracic ultrasound, a standard methodological protocol was developed, and the name RATTUS (Rat Thoracic Ultrasound) was proposed. Typical signs of normal RATTUS were described (bat sign, lung sliding, A-lines, abdominal curtain sign, ski jump sign, lung pulse, seashore sign in M-mode, and bamboo sign). The new evaluation of lung inflation symmetry by substernal access was also described. The methodical approach presented and the normal findings description are proposed to be used for a standard/routine thoracic ultrasound examination in pet rats.