Deep Vegetal Foreign Bodies in Cats: A Retrospective Study of 10 Cases

Ultrasonographic findings may be useful for differentiating interdigital abscesses secondary to migrating grass awns and interdigital furunculosis in dogs

Grass awn migration and furunculosis are common diseases in dogs that can lead to interdigital subcutaneous lesions with a similar clinical presentation, and occasionally similar ultrasonographic images, but different treatments are required. This retrospective, multicentric, analytical study aimed to determine whether epidemiological, clinical, and ultrasonographic features could be used to differentiate interdigital furunculosis and abscesses secondary to migrating grass awns. Fifty-nine dogs that underwent interdigital ultrasonography were included (interdigital furunculosis [IDF], n = 27; interdigital abscess secondary to a migrating grass awn [IAGA], n = 32). Ultrasonographic images were reviewed by two observers blinded to the diagnosis, who graded nine qualitative and four quantitative parameters for each patient. In both groups, pruritus/licking (IDF 74%, IAGA 70%), a discharging interdigital wound (63% for each group), and thoracic limb involvement (IDF 88%, IAGA 75%) were common features. On ultrasound, a subcutaneous multilinear hyperechoic main element was identified in most dogs (IDF 85%, IAGA 100%). The ability to display this element in a single plane (P < 0.01), the absence of additional hyperechoic linear elements in different planes (P < 0.01), and a surrounding hypoechoic halo (P < 0.05) were significantly more common in dogs with interdigital abscesses secondary to migrating grass awns. A cut-off value of 0.83 cm for the length of the main multilinear element provided a sensitivity of 91% and a specificity of 87% in the diagnosis of a migrating grass awn. Findings supported prioritizing a differential diagnosis of interdigital abscesses secondary to grass awns in dogs with these ultrasonographic characteristics.

Application of Ultrasound in Detecting and Removing Migrating Grass Awns in Dogs and Cats: A Systematic Review

Migrating grass awns are an important cause of disease in dogs and cats. Plant awns can migrate into several body tissues and cavities because of their fusiform shape and backward-pointing barbs. Their migration causes inflammatory tissue reaction and clinical signs depend upon their localization. Ultrasound has been described as a useful, noninvasive, and readily available tool to identify and guide vegetal foreign bodies removal in animals. The aim of this systematic review was to summarize current knowledge on the application of ultrasonography in the identification and removal of grass awns from various anatomic locations in dogs and cats. We selected and analyzed 46 papers on the application of ultrasonography in dogs and cats affected by migrating grass awns. The ultrasonographic appearance of grass awns is characteristic, although their size and location can influence the visualization and the attempt of removal. In some cases, migrating grass awns are not directly visualized by ultrasonography, but the lesions caused by their migration can be easily seen. Ultrasonography can be considered a useful diagnostic tool to localize and remove migrating grass awns; however, when the migration occurs in less accessible locations or discrete foreign bodies are present, this diagnostic tool should be considered as a part of a multidisciplinary approach with advanced diagnostic imaging modalities.

Comparison of computed tomography and surgical findings and investigation of their associations with outcomes for dogs with sublumbar abscesses

OBJECTIVE

To describe and compare the results of preoperative CT and surgical findings in dogs with sublumbar abscesses and investigate potential associations between these variables and the outcome of abscess recurrence.

ANIMALS

51 client-owned dogs.

PROCEDURES

A retrospective, records-based study was performed of dogs undergoing surgery for treatment of sublumbar abscesses diagnosed by use of CT between January 2010 and December 2018. Signalment, clinical signs, clinicopathologic data, CT findings, surgical techniques and findings, duration of hospitalization, postoperative treatment, and complications were recorded. Long-term follow-up was performed through telephone interviews. Logistic regression analysis was used to investigate associations between the variables of interest and abscess recurrence.

RESULTS

51 dogs met the study inclusion criteria; 48 were included in outcome analysis. The CT findings agreed with surgical findings for identification of a migrating vegetal foreign body for 39 of 51 (77%) dogs. All dogs survived to hospital discharge; 1 dog died of hemoabdomen 3 days after surgery, and 6 had minor (surgical wound) complications reported. Abscess recurrence developed in 12 of 48 (25%) dogs with a median time to recurrence of 6 months. Identification of diskospondylitis on CT examination was the only investigated factor significantly associated with recurrence; odds of recurrence in dogs with this finding were 8.4 times those for dogs without this finding.

CONCLUSIONS AND CLINICAL RELEVANCE

Our results suggested dogs with sublumbar abscesses have a good prognosis after surgery, although recurrence can develop. Preoperative identification of diskospondylitis was significantly associated with abscess recurrence in this study sample.

Comparison of imaging techniques to detect migrating foreign bodies. Relevance of preoperative and intraoperative ultrasonography for diagnosis and surgical removal

OBJECTIVE

To report the relative sensitivity of different diagnostic imaging (DI) techniques to detect migrating foreign bodies (FB) in subcutaneous and underlying soft tissue structures of dogs and evaluate the value of intraoperative ultrasonography (intraop-US).

STUDY DESIGN

Retrospective study.

SAMPLE POPULATION

Forty-one dogs.

METHODS

Medical records (2007-2019) of dogs that underwent surgery for a chronic abscess or draining tract were included when preoperative US (preop-US), computed tomography (preop-CT), or preop-MRI, and at least 6 months of follow-up information were available. Collected data included the DI techniques used, DI findings, and surgical findings. The relative sensitivity of each preoperative DI (preop-DI) technique was calculated. Dogs were divided into two groups, dogs that underwent only a preop-DI examination (group A) and dogs that underwent an additional intraop-US (group B). The success rates for FB surgical removal were compared between groups.

RESULTS

The relative sensitivity of preop-US and preop-CT/MRI was 88% (95% CI, 70%-95.8%) and 57.1% (95% CI, 32.6%-78.6%), respectively. The success rate for FB removal was higher in group B (89.5%) than in group A (59.1%; P = .038). Clinical resolution occurred in 90.2% of dogs for a median duration of follow-up of 4.2 years (6 months to 9.3 years).

CONCLUSION

Preoperative US seems more suitable than preop-CT/MRI for detection of migrating FB in subcutaneous and underlying soft tissue structures. The use of intraop-US increases the success rate for FB surgical removal.

CLINICAL SIGNIFICANCE

Intraoperative US should be used in combination with preop-US to increase the likelihood of migrating FB surgical removal in dogs.

The use of small-bore wire-guided chest drains for the management of feline pyothorax: A retrospective case series

Background:

Pyothorax in cats is routinely managed, at least initially, with thoracic tube placement associated with systemic antimicrobial administration. Traditionally, large-bore trocar-type thoracostomy tubes have preferentially been used for the drainage of thick material from the pleural space. In recent years, the use of small-bore wire-guided thoracic drains has increased in both small animals and in humans. Few studies have highlighted the efficacy of small-bore wire-guided thoracostomy tubes.

Aim:

The purpose of this study was to describe the use of small-bore wire-guided thoracostomy tubes in feline pyothorax in terms of efficacy, safety, and outcome.

Methods:

Cats with pyothorax managed with small-bore thoracostomy tubes (SBTTs) (2015–2018) were retrospectively studied. The number of drains inserted, the need for anesthesia and analgesia for chest tube placement and maintenance, and related major and minor complications were reviewed. Clinical data, diagnostic results, treatment, and outcome were recorded.

Results:

Ten cats were enrolled. Thoracostomy tube placement was unilateral in 7/10 cats, despite the presence of bilateral effusion in 9/10 cats, and required sedation (8/10) or anesthesia (2/10). Three cats experienced minor complications during the chest tube insertion, including self-limiting pneumothorax (1/3) and malpositioning (2/3). One cat had a major complication (non-functional malposition) requiring reposition of the drain. Pain management was adequately achieved using opioids (8/10) or opioids plus nonsteroidal anti-inflammatory drugs (2/10). Partial chest tube occlusion occurred in three cases and it was resolved with lavage. In one case, the occlusion was complete, requiring drain removal. Three out of 10 cats were treated medically, combining thoracostomy tubes and antibiotics, while 7/10 cats underwent surgery. All the cats survived.

Conclusion:

SBTTs represent a safe and effective option for the initial management of feline pyothorax. In fact, mainly minor complications were reported during insertion and usage. The SBTTs were well tolerated by the cats with a satisfactory performance in terms of exudate drainage in most cases. The combined use of a small-bore thoracostomy drain together with the common practice of surgical treatment might have resulted in the successful management of the cases presented.