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Slead TS, Callahan BJ, Schreeg ME, Seiler GS, Stowe DM, Azcarate‐Peril MA, Jacob ME, Gookin JL. Microbiome analysis of bile from apparently healthy cats and cats with suspected hepatobiliary disease. J Vet Intern Med 2023; 37:2178-2187. [PMID: 37702381 PMCID: PMC10658561 DOI: 10.1111/jvim.16852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/23/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Bacterial infection of bile is a common cause of hepatobiliary disease in cats. Whether bile harbors a core microbiota in health or in cases of suspected hepatobiliary disease in cats is unknown. OBJECTIVES Establish if gallbladder bile in apparently healthy cats harbors a core microbiota composed of bacterial taxa common to many individuals. Compare results of bile cytology, bile culture, and 16S rRNA gene amplicon sequencing in apparently healthy cats and cats with suspected hepatobiliary disease. ANIMALS Forty-three client-owned cats with suspected hepatobiliary disease and 17 control cats. METHODS Bile was collected by ultrasound guided cholecystocentesis (cats with suspected hepatobiliary disease) or laparotomy after euthanasia (controls). Bile samples underwent cytologic examination, aerobic and anaerobic culture, and DNA was extracted for 16S rRNA gene amplification and sequencing. RESULTS Microbiome sequencing did not identify a core microbiota in control cats or cats having bile sampled because of clinical suspicion for hepatobiliary disease. Microbiome profiles from control cats were indistinguishable from profiles obtained from sampling instruments and reagents that were not exposed to bile (technical controls). Bacterial taxa that could not be explained by contamination or off-target amplification were identified only in samples from cats with bactibilia and positive bile culture results for Escherichia coli. In several E. coli positive samples, microbiome sequencing also identified a small number of potentially co-infecting bacterial genera not identified by culture. CONCLUSIONS AND CLINICAL IMPORTANCE Cat bile does not harbor a core microbiota. Uncultured bacteria may contribute to pathogenesis of hepatobiliary disease in cats with bile E. coli infection.
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Affiliation(s)
- Tanner S. Slead
- Department of Clinical SciencesNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Benjamin J. Callahan
- Department of Population Health and PathobiologyNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Megan E. Schreeg
- Department of Population Health and PathobiologyNorth Carolina State UniversityRaleighNorth CarolinaUSA
- The Ohio State University, 1925 Coffey RoadColumbusOhioUSA
| | - Gabriela S. Seiler
- Department of Molecular Biomedical SciencesNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Devorah M. Stowe
- Department of Population Health and PathobiologyNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Maria Andrea Azcarate‐Peril
- Department of Plant and Microbial BiologyUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Megan E. Jacob
- Department of Population Health and PathobiologyNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Jody L. Gookin
- Department of Clinical SciencesNorth Carolina State UniversityRaleighNorth CarolinaUSA
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Cordle KJ, Seiler GS, Barnes D, Olby NJ. MRI features can help to confirm a diagnosis of progressive myelomalacia, but may not be accurate in dogs lacking characteristic clinical signs at the time of imaging. Vet Radiol Ultrasound 2023; 64:283-293. [PMID: 36660871 DOI: 10.1111/vru.13178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 08/16/2022] [Accepted: 08/20/2022] [Indexed: 01/21/2023] Open
Abstract
Progressive myelomalacia (PMM) is a fatal sequela of acute thoracolumbar intervertebral disc extrusion in dogs, with unpredictable onset in the days after the inciting injury. No single reliable diagnostic test is currently available. Magnetic resonance imaging (MRI) features such as T2-weighted spinal cord hyperintensity and loss of subarachnoid signal in a half-Fourier single-shot turbo spin echo (HASTE) sequence have been associated with PMM, but are sometimes present in other dogs with severe deficits. Magnetic resonance imaging findings in 22 dogs with a clinical or histopathologic diagnosis of PMM and 38 deep pain-negative paraplegic dogs were compared in a retrospective case-control study. Length of T2-weighted hyperintense spinal cord change and HASTE signal loss were significantly associated with clinically evident PMM (P = .0019 and P = .0085), however, there were no significant differences between groups when analysis was restricted to dogs not yet showing clinical signs of PMM. The PMM group also had significantly shorter compressive lesions than the control group (P = 0.026), suggesting a possible role of more severe focal pressure at the extrusion site. A segment of total loss of contrast enhancement in the venous sinuses and meninges, a feature not previously described, was more common in the PMM group and the difference approached significance (P = 0.054). Findings show that MRI features can support the diagnosis in dogs with clinical evidence of PMM, and absence of these features supports absence of PMM at time of imaging. However, their absence does not reliably differentiate dogs with imminent progressive myelomalacia from other dogs with severe deficits following intervertebral disc extrusion.
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Affiliation(s)
- Katelyn J Cordle
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Gabriela S Seiler
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Danielle Barnes
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Natasha J Olby
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
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Appleby RB, Vaden SL, Monteith G, Seiler GS. Shear wave elastography evaluation of cats with chronic kidney disease. Vet Radiol Ultrasound 2023; 64:330-336. [PMID: 36324225 DOI: 10.1111/vru.13184] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 11/06/2022] Open
Abstract
Chronic kidney disease (CKD) is a major health condition in cats that can lead to poor quality of life and financial implications for therapy. Currently staging and identification of CKD is limited by diagnostic testing such as creatinine and urine-specific gravity, which do not change until late in the disease course. Other methods to evaluate CKD would be valuable in the clinical setting. Shear wave elastography is one novel ultrasound method, which has shown promise in identifying increases in tissue stiffness and identifying CKD in people. As CKD is often histologically characterized by tubulointerstitial fibrosis, shear wave elastography has the potential to identify CKD and differentiate between stages of CKD in cats. This prospective observational case-control study with 78 cats found no difference in shear wave velocities between groups (P = 0.33), a contradictory finding to one prior publication. There was no effect of weight (P = 0.65), nor the presence of mineralization (P = 0.31) or infarction (P = 0.52) on cortical shear wave velocities. There was a significant effect of age on shear wave velocity (P = 0.018) where velocities increased with age. The intraclass correlation coefficient was only moderate (0.62). Possible reasons for the difference in results between our work and that published prior, include differences in methodology and differences in instrumentation. Variability in measurements in our population may be due to the effects of respiratory motion or limitations in shear wave elastography software. As such, shear wave elastography is not currently recommended as a tool to evaluate CKD in cats and further work is necessary.
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Affiliation(s)
- Ryan B Appleby
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Shelly L Vaden
- Department of Clinical Sciences, NC State College of Veterinary Medicine, Raleigh, North Carolina, USA
| | - Gabrielle Monteith
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | - Gabriela S Seiler
- Department of Molecular and Biological Sciences, NC State College of Veterinary Medicine, Raleigh, North Carolina, USA
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Gookin JL, Hartley AN, Aicher KM, Mathews KG, Cullen R, Cullen JM, Callahan BJ, Stowe DM, Seiler GS, Jacob ME, Arnold JW, Azcarate-Peril MA, Stauffer SH. Gallbladder microbiota in healthy dogs and dogs with mucocele formation. PLoS One 2023; 18:e0281432. [PMID: 36763596 PMCID: PMC9916591 DOI: 10.1371/journal.pone.0281432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
To date studies have not investigated the culture-independent microbiome of bile from dogs, a species where aseptic collection of bile under ultrasound guidance is somewhat routine. Despite frequent collection of bile for culture-based diagnosis of bacterial cholecystitis, it is unknown whether bile from healthy dogs harbors uncultivable bacteria or a core microbiota. The answer to this question is critical to understanding the pathogenesis of biliary infection and as a baseline to exploration of other biliary diseases in dogs where uncultivable bacteria could play a pathogenic role. A pressing example of such a disease would be gallbladder mucocele formation in dogs. This prevalent and deadly condition is characterized by excessive secretion of abnormal mucus by the gallbladder epithelium that can eventually lead to rupture of the gallbladder or obstruction of bile flow. The cause of mucocele formation is unknown as is whether uncultivable, and therefore unrecognized, bacteria play any systematic role in pathogenesis. In this study we applied next-generation 16S rRNA gene sequencing to identify the culture-negative bacterial community of gallbladder bile from healthy dogs and gallbladder mucus from dogs with mucocele formation. Integral to our study was the use of 2 separate DNA isolations on each sample using different extraction methods and sequencing of negative control samples enabling recognition and curation of contaminating sequences. Microbiota findings were validated by simultaneous culture-based identification, cytological examination of bile, and fluorescence in-situ hybridization (FISH) performed on gallbladder mucosa. Using culture-dependent, cytological, FISH, and 16S rRNA sequencing approaches, results of our study do not support existence of a core microbiome in the bile of healthy dogs or gallbladder mucus from dogs with mucocele formation. Our findings further document how contaminating sequences can significantly contribute to the results of sequencing analysis when performed on samples with low bacterial biomass.
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Affiliation(s)
- Jody L. Gookin
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
- * E-mail:
| | - Ashley N. Hartley
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Kathleen M. Aicher
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Kyle G. Mathews
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Rachel Cullen
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
| | - John M. Cullen
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Benjamin J. Callahan
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Devorah M. Stowe
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Gabriela S. Seiler
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Megan E. Jacob
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Jason W. Arnold
- Department of Medicine, Division of Gastroenterology and Hepatology, and UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - M. Andrea Azcarate-Peril
- Department of Medicine, Division of Gastroenterology and Hepatology, and UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Stephen H. Stauffer
- Department of Clinical Sciences, College of Veterinary Medicine and Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina, United States of America
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Seiler GS, Cohen EB, d'Anjou MA, French J, Gaschen L, Knapp S, Salwei RM, Saunders HM. ACVR and ECVDI Consensus Statement for the Standardization of the Abdominal Ultrasound Examination. Vet Radiol Ultrasound 2022; 63:661-674. [PMID: 36189784 DOI: 10.1111/vru.13151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/29/2022] [Accepted: 07/31/2022] [Indexed: 11/27/2022] Open
Abstract
This consensus statement is designed to provide a standard of care document and describes the ACVR and ECVDI definition for performing a standard abdominal ultrasound examination in dogs and cats. The ACVR and ECVDI define a standard abdominal ultrasonographic examination as a complete exam of the abdominal organs which is appropriately documented. The consensus statement intends to provide guidance to veterinary sonographers and veterinarians for the performance and documentation of high-quality diagnostic ultrasound examination. The document may also serve as a teaching aid for veterinary students, veterinarians, and residents in diagnostic imaging who seek proficiency in diagnostic ultrasound. Finally, it may serve an additional role in educating the public as to what a high-quality abdominal ultrasound examination should entail.
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Affiliation(s)
- Gabriela S Seiler
- Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Eli B Cohen
- Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | | | - John French
- Antech Imaging Services, Fountain Valley, California, USA
| | - Lorrie Gaschen
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Stephanie Knapp
- BluePearl Veterinary Partners of North Carolina, Cary, North Carolina, USA
| | | | - H Mark Saunders
- Lynks Group, PLC Veterinary Imaging, Shelburne, Vermont, USA
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Gilbertie JM, Schaer TP, Engiles JB, Seiler GS, Deddens BL, Schubert AG, Jacob ME, Stefanovski D, Ruthel G, Hickok NJ, Stowe DM, Frink A, Schnabel LV. A Platelet-Rich Plasma-Derived Biologic Clears Staphylococcus aureus Biofilms While Mitigating Cartilage Degeneration and Joint Inflammation in a Clinically Relevant Large Animal Infectious Arthritis Model. Front Cell Infect Microbiol 2022; 12:895022. [PMID: 35711655 PMCID: PMC9195519 DOI: 10.3389/fcimb.2022.895022] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/02/2022] [Indexed: 12/03/2022] Open
Abstract
The leading cause of treatment failure in Staphylococcus aureus infections is the development of biofilms. Biofilms are highly tolerant to conventional antibiotics which were developed against planktonic cells. Consequently, there is a lack of antibiofilm agents in the antibiotic development pipeline. To address this problem, we developed a platelet-rich plasma (PRP)-derived biologic, termed BIO-PLY (for the BIOactive fraction of Platelet-rich plasma LYsate) which has potent in vitro bactericidal activity against S. aureus synovial fluid free-floating biofilm aggregates. Additional in vitro studies using equine synoviocytes and chondrocytes showed that BIO-PLY protected these cells of the joint from inflammation. The goal of this study was to test BIO-PLY for in vivo efficacy using an equine model of infectious arthritis. We found that horses experimentally infected with S. aureus and subsequently treated with BIO-PLY combined with the antibiotic amikacin (AMK) had decreased bacterial concentrations within both synovial fluid and synovial tissue and exhibited lower systemic and local inflammatory scores compared to horses treated with AMK alone. Most importantly, AMK+BIO-PLY treatment reduced the loss of infection-associated cartilage proteoglycan content in articular cartilage and decreased synovial tissue fibrosis and inflammation. Our results demonstrate the in vivo efficacy of AMK+BIO-PLY and represents a new approach to restore and potentiate antimicrobial activity against synovial fluid biofilms.
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Affiliation(s)
- Jessica M. Gilbertie
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States
| | - Thomas P. Schaer
- Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States
| | - Julie B. Engiles
- Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States
- Department of Pathobiology New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States
| | - Gabriela S. Seiler
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Bennett L. Deddens
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Alicia G. Schubert
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Megan E. Jacob
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Darko Stefanovski
- Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States
| | - Gordon Ruthel
- Department of Pathobiology New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States
| | - Noreen J. Hickok
- Department of Orthopedic Surgery, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, United States
| | - Devorah M. Stowe
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Alexa Frink
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Lauren V. Schnabel
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States
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Traverson M, Lin S, Kendall A, Vaden S, Schafer KA, Seiler GS. Investigation of the use of microwave ablation with and without cooling urethral perfusion for thermal ablation of the prostate gland in canine cadavers. Am J Vet Res 2021; 82:395-404. [PMID: 33904800 DOI: 10.2460/ajvr.82.5.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the use of microwave ablation (MWA) with cooling urethral perfusion and with no perfusion (MWA-UP and MWA-NP, respectively) for prostate gland ablation in canine cadavers. ANIMALS Cadavers of 18 sexually intact male dogs. PROCEDURES After technique refinement in 2 cadavers, laparotomy with ultrasound-guided MWA-UP (n = 8) or MWA-NP (8) of the prostate gland was performed in 16 cadavers. Normograde cystourethroscopy was performed before and after treatment; recorded images were reviewed in a blinded manner for scoring of urethral mucosal discoloration and loss of integrity. Difficulty with cystoscope insertion was recorded if present. Excised prostate glands were fixed for serial sectioning, gross measurements, and calculation of percentage ablation. Percentages of prostate tissue necrosis from MWA, denuded urethral mucosa, and depth of epithelial surface loss in an adjacent section of the colon were estimated histologically. Variables of interest were statistically analyzed. RESULTS Difficulty with cystoscope insertion after treatment was significantly more common and scores for urethral mucosal discoloration and loss of integrity were significantly higher (indicating more severe lesions) for the MWA-NP group than for the MWA-UP group. The histologically assessed percentage of denuded urethral mucosa was also greater for the MWA-NP group. Overall median percentage prostate gland ablation was 73%; this result was not associated with prostate gland volume or chronological order of treatment. CONCLUSIONS AND CLINICAL RELEVANCE MWA-UP induced subtotal thermal necrosis of prostate glands in canine cadavers while limiting urethral mucosal injury. Further study is required to optimize the technique and evaluate its safety and efficacy in vivo as a future curative-intent treatment for prostatic tumors in dogs.
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Gieger TL, Seiler GS, Nolan MW. Treatment of feline gastrointestinal intermediate- or large-cell lymphoma with lomustine chemotherapy and 8 Gy abdominal cavity radiation therapy. J Feline Med Surg 2020; 23:469-476. [PMID: 32996835 DOI: 10.1177/1098612x20959602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The goal of this study was to document the outcomes and toxicity of a novel multimodality treatment protocol for feline gastrointestinal intermediate- or large-cell lymphoma (FGL) in which cats were treated at 21-day intervals. METHODS This was a prospective, single-arm study. Twelve client-owned cats with cytologically diagnosed FGL were treated with a combination of abdominal cavity radiation therapy (RT; 8 Gy total dose administered in two 4 Gy fractions, 21 days apart), lomustine chemotherapy (approximately 40 mg/m2, administered orally at 21-day intervals for four treatments), prednisolone (5 mg PO q24h) and cobalamin (250 µg/week SC). RESULTS Three cats were euthanized prior to the second treatment and it was difficult to discern treatment-associated toxicity from progressive disease. Four of the remaining cats developed cytopenias, resulting in 7-14-day lomustine treatment delays and/or dose reductions. Six cats had a partial response to treatment and three had stable disease based on ultrasound at day 21 (50% overall response rate). Three of these six cats completed the study and lived >240 days; one died of refractory diabetes mellitus with no clinical evidence of FGL, and the other two died as a result of FGL. The median overall survival time was 101 days (95% confidence interval [CI] 9-240). The median progression-free survival time was 77 days (95% CI 8-212). Necropsies were performed in eight cats, which revealed multifocal lymphoma throughout the gastrointestinal tract and other organs. CONCLUSIONS AND RELEVANCE Oncological outcomes reported herein are comparable to those achieved with multiagent injectable chemotherapy (eg, CHOP). Treatment was seemingly well tolerated in most cats and was relatively cost-effective. It is therefore plausible that improved disease control may be achievable through continued optimization and intensification of the combinatorial chemoradiotherapy protocol.
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Affiliation(s)
- Tracy L Gieger
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA
| | - Gabriela S Seiler
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA.,Department of Molecular and Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Michael W Nolan
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.,Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA.,Duke Cancer Institute, Duke University, Durham, NC, USA
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Rivas LR, Seiler GS, Robertson ID, Ryu H, Mathews KG. Ability of positive and negative contrast computed tomographic peritoneography to delineate canine liver lobe fissures. Vet Surg 2019; 48:1444-1449. [PMID: 31461163 DOI: 10.1111/vsu.13318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 07/23/2019] [Accepted: 08/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the efficacy of contrast peritoneography in delineating liver lobe fissures by using computed tomography (CT). STUDY DESIGN Prospective cross-sectional study. ANIMALS Canine cadavers (n = 10). METHODS An abdominal CT image of each cadaver was obtained under three conditions: without peritoneal contrast (precontrast), after insufflation of the peritoneal cavity with CO2 (negative contrast), and after intraperitoneal administration of iohexol (positive contrast). Images were reconstructed in three planes. Three reviewers independently scored each plane/contrast combination. Observers measured the length of each fissure in each plane. The measurable length of fissures was compared between techniques but was not compared with the actual length on cadavers. RESULTS When assessment of all fissures was combined, measurements were obtained in 96 to 108 of 120 (80%-90%) positive contrast studies, 56 to 96 of 120 (47%-80%) negative contrast studies, and 12 to 32 of 120 (10%-27%) precontrast CT images. All observers measured fissures in all planes that were approximately two times longer on positive compared with negative contrast studies and two times longer on negative contrast studies compared with CT images without contrast. Measurable fissure lengths were greater on positive contrast CT images (P < .0001) than on other CT images. CONCLUSION Positive contrast CT peritoneography improved the delineation of hepatic interlobar fissures in normal canine cadavers. CLINICAL SIGNIFICANCE These results justify further studies to determine the ability to locate large hepatic masses in dogs with positive CT. Positive contrast CT peritoneography may assist treatment planning in dogs with large hepatic tumors.
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Affiliation(s)
- Luis R Rivas
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Gabriela S Seiler
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Ian D Robertson
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Hongyu Ryu
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Kyle G Mathews
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
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Seiler GS, Griffith E. Comparisons between elastographic stiffness scores for benign versus malignant lymph nodes in dogs and cats. Vet Radiol Ultrasound 2017; 59:79-88. [DOI: 10.1111/vru.12557] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 05/23/2017] [Accepted: 06/12/2017] [Indexed: 12/26/2022] Open
Affiliation(s)
- Gabriela S. Seiler
- Department of Molecular Biomedical Sciences; North Carolina State University; Raleigh NC 27607
| | - Emily Griffith
- Department of Clinical Sciences; North Carolina State University; Raleigh NC 27607
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Policelli Smith R, Gookin JL, Smolski W, Di Cicco MF, Correa M, Seiler GS. Association between Gallbladder Ultrasound Findings and Bacterial Culture of Bile in 70 Cats and 202 Dogs. J Vet Intern Med 2017; 31:1451-1458. [PMID: 28755468 PMCID: PMC5598895 DOI: 10.1111/jvim.14792] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/05/2017] [Accepted: 06/22/2017] [Indexed: 12/03/2022] Open
Abstract
Background Bacterial cholecystitis often is diagnosed by combination of gallbladder ultrasound (US) findings and positive results of bile culture. The value of gallbladder US in determining the likelihood of bile bacterial infection in cats and dogs with suspected biliary disease is unknown. Hypothesis/Objectives To determine the value of gallbladder US in predicting bile bacterial culture results, identify most common bacterial isolates from bile, and describe complications after cholecystocentesis in cats and dogs with suspected hepatobiliary disease. Animals Cats (70) and dogs (202) that underwent an abdominal US and submission of bile for culture were included in the study. Methods A cross‐sectional study design was used to determine the association of gallbladder US abnormalities and the results of bile cultures, and complications of cholecystocentesis. Results Abnormal gallbladder US had high sensitivity (96%) but low specificity (49%) in cats with positive and negative results of bile bacterial culture, respectively. Cats with normal gallbladder US findings were unlikely to have positive bile bacterial culture (negative predictive value of 96%). Gallbladder US had lower sensitivity (81%), specificity (31%), positive predictive value (20%), and negative predictive value (88%) in dogs. The most common bacterial isolates were of enteric origin, the prevalence being higher in cats. Incidence of complications after cholecystocentesis was 3.4%. Conclusions and clinical importance Gallbladder US has a high negative predictive value for bile culture results in cats. This modality is less predictive of infection in dogs. Percutaneous US‐guided cholecystocentesis has a low complication rate.
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Affiliation(s)
- R Policelli Smith
- Departments of Molecular Biomedical Sciences, Clinical Sciences, and Population Health and Pathobiology, North Carolina State University, Raleigh, NC
| | - J L Gookin
- Departments of Molecular Biomedical Sciences, Clinical Sciences, and Population Health and Pathobiology, North Carolina State University, Raleigh, NC
| | - W Smolski
- Departments of Molecular Biomedical Sciences, Clinical Sciences, and Population Health and Pathobiology, North Carolina State University, Raleigh, NC
| | - M F Di Cicco
- Departments of Molecular Biomedical Sciences, Clinical Sciences, and Population Health and Pathobiology, North Carolina State University, Raleigh, NC
| | - M Correa
- Departments of Molecular Biomedical Sciences, Clinical Sciences, and Population Health and Pathobiology, North Carolina State University, Raleigh, NC
| | - G S Seiler
- Departments of Molecular Biomedical Sciences, Clinical Sciences, and Population Health and Pathobiology, North Carolina State University, Raleigh, NC
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12
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Bullen LE, Evola MG, Griffith EH, Seiler GS, Saker KE. Validation of ultrasonographic muscle thickness measurements as compared to the gold standard of computed tomography in dogs. PeerJ 2017; 5:e2926. [PMID: 28149695 PMCID: PMC5270592 DOI: 10.7717/peerj.2926] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 12/19/2016] [Indexed: 01/05/2023] Open
Abstract
Objective The objective was to quantitatively evaluate the validity of ultrasonographic (US) muscle measurements as compared to the gold standard of computed tomography (CT) in the canine. Design This was a prospective study. Population Twenty-five, client-owned dogs scheduled for CT as part of a diagnostic work-up for the management of their primary disease process were included. Materials and Methods Specific appendicular (cubital flexors and extensors, coxofemoral flexors and extensors) and axial (temporalis, supraspinatus, infraspinatus, lumbar epaxials) muscle groups were selected for quantitative measure based on CT planning and patient position. Prior to CT scan, the skin over the muscle sites was shaved and marked with a permanent marker. Patient body position was determined based on the patient’s CT plan; positioning was consistent between CT and US imaging. To ensure identical imaging position for both CT and US measurements, radio-opaque fiducial markers were placed directly over the skin marks once the dog was positioned. Quantitative measurements (cm) for both lean muscle mass (LMM) and subcutaneous adipose (SQA) were recorded. Statistical comparisons between CT and US values were done separately for each site and type. Results Muscle groups and associated SQA measured by US and CT were not statistically different based on an adjusted p-value using Bonferroni’s correction (p < 0.0031). In addition, all LMM and SQA sites had good reliability and agreement (Cronbach’s α = 0.8 − 1.0) between the two metrics, excluding the coxofemoral extensor muscle group (Cronbach’s α = 0.73232). Linear regression analysis of muscle measures indicated close agreement (slope range 0.93–1.09) and minimal bias of variation (intercept range 0.05–0.11) between CT versus US modalities, with the exception of the coxofemoral extensor muscle. Similarly, SQA CT and US measures indicated close agreement with the slope range of 0.88–1.02 and minimal bias of variation with an intercept range of 0.021–0.098, excluding the cubital flexor and extensor groups. Additionally, the R2 values for these remaining LMM and SQA sites are reported as >0.897 for LLM and >0.8289 for SQA. Conclusions Ultrasound imaging of selected appendicular and axial muscle groups in dogs can provide comparable assessment of muscle thickness to the current gold standard, CT. In consideration of both statistical reliability to CT and cage-side accessibility, the temporalis, supraspinatus, infraspinatus, and lumbar epaxial LMM sites are considered the most useful targets for US LMM assessment in the canine. Our findings support the potential utility of US as a clinical tool in veterinary medicine to assess LMM status in patients. Additional studies are indicated to develop standardized protocols of its use in a cage-side setting and to elucidate the benefit of this modality, in conjunction with nutritional interventions, to manage body LLM stores in compromised patients.
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Affiliation(s)
- Lindsey E Bullen
- College of Veterinary Medicine: Department of Molecular Biomedical Sciences, North Carolina State University , Raleigh , NC , United States
| | - Maria G Evola
- College of Veterinary Medicine: Department of Molecular Biomedical Sciences, North Carolina State University , Raleigh , NC , United States
| | - Emily H Griffith
- College of Sciences: Department of Statistics, North Carolina State University , Raleigh , NC , United States
| | - Gabriela S Seiler
- College of Veterinary Medicine: Department of Molecular Biomedical Sciences, North Carolina State University , Raleigh , NC , United States
| | - Korinn E Saker
- College of Veterinary Medicine: Department of Molecular Biomedical Sciences, North Carolina State University , Raleigh , NC , United States
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13
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Lewis MJ, Olby NJ, Early PJ, Mariani CL, Muñana KR, Seiler GS, Griffith EH. Clinical and Diagnostic Imaging Features of Brain Herniation in Dogs and Cats. J Vet Intern Med 2016; 30:1672-1680. [PMID: 27616749 PMCID: PMC5032863 DOI: 10.1111/jvim.14526] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 05/19/2016] [Accepted: 06/27/2016] [Indexed: 11/28/2022] Open
Abstract
Background Quantification of brain herniation on MRI and its immediate clinical implications are poorly described. Objectives Define the normal position of caudal fossa structures on brain MRIs in dogs and cats utilizing morphometry, compare this to dogs and cats with caudal transtentorial herniation (CTH), foramen magnum herniation (FMH) or both identified on MRI, and investigate associations between herniation severity, clinical signs, and 24‐hour outcome. Animals Ninety‐two controls (66 dogs, 26 cats), 119 cases with herniation (88 dogs, 31 cats). Methods Retrospective case series. The MRI database was searched for controls with normal brain anatomy and cases with brain herniation. Morphometry in controls established TTX (transtentorial to rostroventral cerebellum) to quantify CTH and FMX (caudoventral cerebellum to foramen magnum) to quantify FMH. Measurements were compared between cases and controls. Correlations with specific clinical variables and outcome were investigated. Results Measurements in medium/large control dogs versus small dog and cat controls were significantly different (P < .001, TTX: −0.46, −0.305, −0.3, FMX: 0.695, 0.27, 0.25, respectively). 119/1564 (7.6%) cases that underwent brain imaging had brain herniation. TTX and FMX were significantly different between controls and cases with CTH or FMH (P < .001). 67/89 (75%) cases with supratentorial lesions had no signs directly attributable to herniation. 71/119 (60%) had a normal anesthetic recovery. TTX was significantly associated with 24‐hour survival (P < .001). Conclusions and clinical importance Brain herniation can be quantified on MRI. Clinical signs directly attributable to brain herniation commonly are absent, and more severe CTH based on TTX is associated with a worse short‐term outcome.
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Affiliation(s)
- M J Lewis
- College of Veterinary Medicine, NCSU, Raleigh, NC.,Comparative Medicine Institute, NCSU, Raleigh, NC
| | - N J Olby
- College of Veterinary Medicine, NCSU, Raleigh, NC. .,Comparative Medicine Institute, NCSU, Raleigh, NC.
| | - P J Early
- College of Veterinary Medicine, NCSU, Raleigh, NC
| | - C L Mariani
- College of Veterinary Medicine, NCSU, Raleigh, NC.,Comparative Medicine Institute, NCSU, Raleigh, NC
| | - K R Muñana
- College of Veterinary Medicine, NCSU, Raleigh, NC
| | - G S Seiler
- College of Veterinary Medicine, NCSU, Raleigh, NC
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14
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Seiler GS, Campbell N, Nixon B, Tsuruta JK, Dayton PA, Jennings S, Redding WR, Lustgarten M. FEASIBILITY AND SAFETY OF CONTRAST-ENHANCED ULTRASOUND IN THE DISTAL LIMB OF SIX HORSES. Vet Radiol Ultrasound 2016; 57:282-9. [DOI: 10.1111/vru.12333] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Revised: 10/03/2015] [Accepted: 11/06/2015] [Indexed: 12/22/2022] Open
Affiliation(s)
- Gabriela S. Seiler
- Department of Molecular Biomedical Sciences; North Carolina State University; Raleigh NC 27607
| | - Nigel Campbell
- Department of Molecular Biomedical Sciences; North Carolina State University; Raleigh NC 27607
| | - Britton Nixon
- Department of Clinical Sciences; North Carolina State University; Raleigh NC 27607
| | - James K. Tsuruta
- Joint Department of Biomedical Engineering; University of North Carolina Chapel Hill and North Carolina State University; Chapel Hill NC 27514
| | - Paul A. Dayton
- Joint Department of Biomedical Engineering; University of North Carolina Chapel Hill and North Carolina State University; Chapel Hill NC 27514
| | - Samuel Jennings
- Tufts Cummings School of Veterinary Medicine; North Grafton MA 01536
| | - W. Rich Redding
- Department of Clinical Sciences; North Carolina State University; Raleigh NC 27607
| | - Meghann Lustgarten
- Department of Molecular Biomedical Sciences; North Carolina State University; Raleigh NC 27607
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15
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Lustgarten M, Redding WR, Labens R, Davis W, Daniel TM, Griffith E, Seiler GS. ELASTOGRAPHIC EVALUATION OF NATURALLY OCCURING TENDON AND LIGAMENT INJURIES OF THE EQUINE DISTAL LIMB. Vet Radiol Ultrasound 2015; 56:670-9. [PMID: 26304065 DOI: 10.1111/vru.12284] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/01/2015] [Accepted: 06/03/2015] [Indexed: 12/17/2022] Open
Abstract
Compression elastography is an ultrasonographic technique that estimates tissue strain and may have utility in diagnosing and monitoring soft tissue injuries in the equine athlete. Recently, elastography has been proven to be a feasible and repeatable imaging modality for evaluating normal tendons and ligaments of the equine distal forelimb. The purposes of this prospective study were to investigate the ability of elastography to detect spontaneously occurring lesions of equine tendons and ligaments diagnosed with magnetic resonance imaging (MRI) and gray-scale ultrasound (US) and to characterize the differences in the elastographic appearance of acute vs. chronic injuries. Fifty seven horses with a total of 65 lesions were evaluated. Images were assessed quantitatively and qualitatively. Acute lesions were found to be significantly softer (P < 0.0001) than chronic lesions (P < 0.0001) and the stiffness of lesions increased with progression of healing (P = 0.0138). A negative correlation between lesion hypoechogenicity and softness was appreciated with more hypoechoic lesions appearing softer (P = 0.0087) and more hyperechoic regions harder (P = 0.0002). A similar finding occurred with increased signal intensity on short tau inversion recovery (STIR) and proton density (PD) MRI sequences correlating with increased softness on elastography (P = 0.0164). Using US and MRI as references, commonly encountered soft tissue injuries of the equine distal limb could be detected with elastography. However, elastography was limited for detecting small, proximal injuries of the hindlimb proximal suspensory ligament. Elastographic evaluation of equine tendons and ligaments may allow better characterization of lesion chronicity and severity, and sequential examinations may optimize lesion management, rehabilitation, and return to training.
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Affiliation(s)
- Meghann Lustgarten
- Department of Molecular Biomedical Science, North Carolina State University, 1052 William Moore Drive, Raleight, NC, 27607
| | - W Rich Redding
- Department of Clinical Science, North Carolina State University, 1052 William Moore Drive, Raleight, NC, 27607
| | - Raphael Labens
- The Royal (Dick) School of Veterinary Studies, Edinburgh, Scotland
| | - Weston Davis
- Palm Beach Equine Medical Centers, Wellington, FL, 33414
| | | | - Emily Griffith
- Department of Clinical Science, North Carolina State University, 1052 William Moore Drive, Raleight, NC, 27607
| | - Gabriela S Seiler
- Department of Molecular Biomedical Science, North Carolina State University, 1052 William Moore Drive, Raleight, NC, 27607
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16
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Mai W, Seiler GS, Lindl-bylicki BJ, Zwingenberger AL. CT AND MRI FEATURES OF CAROTID BODY PARAGANGLIOMAS IN 16 DOGS. Vet Radiol Ultrasound 2015; 56:374-83. [DOI: 10.1111/vru.12254] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/14/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Wilfried Mai
- Department of Clinical Studies, Section of Radiology, University of Pennsylvania School of Veterinary Medicine; Philadelphia PA 19104
| | - Gabriela S. Seiler
- Department of Molecular Biomedical Sciences, North Carolina State University College of Veterinary Medicine; Raleigh NC 27607
| | - Britany J. Lindl-bylicki
- William H. Pritchard Veterinary Medical Teaching Hospital; University of California-Davis; Davis CA 95616
| | - Allison L. Zwingenberger
- Department of Surgical and Radiological Sciences; University of California-Davis; Davis CA 95616
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17
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Mariani CL, Jennings MK, Olby NJ, Borst LB, Brown JC, Robertson ID, Seiler GS, MacKillop E. Histiocytic sarcoma with central nervous system involvement in dogs: 19 cases (2006-2012). J Vet Intern Med 2015; 29:607-13. [PMID: 25711602 PMCID: PMC4895499 DOI: 10.1111/jvim.12554] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 11/18/2014] [Accepted: 01/19/2015] [Indexed: 01/10/2023] Open
Abstract
Background Reports of histiocytic sarcoma (HS) involving the central nervous system (CNS) are sparse and consist mainly of case reports describing 1–3 animals. Objective The objective of this study was to report the signalments, clinical signs, clinicopathologic and diagnostic imaging findings, treatment, and outcome of a series of dogs with HS and CNS involvement. Animals Nineteen dogs with HS examined at veterinary referral hospitals. Methods Retrospective case series. Medical records were reviewed and cases with a histopathological diagnosis of CNS HS were included in the study. Diagnostic imaging studies of the CNS were evaluated and histopathologic samples were reviewed to confirm the diagnosis. Results Retrievers and Pembroke Welsh Corgis were overrepresented in this cohort of dogs. Tumors involved the brain in 14 dogs and the spinal cord in 5. In 4 dogs, HS was part of a disseminated, multiorgan process whereas it appeared confined to the CNS in 15 dogs. Diagnostic imaging had variable appearances although extraaxial masses predominated in the brain. There was meningeal enhancement in all dogs that was often profound and remote from the primary mass lesion. Pleocytosis was present in all dogs with CSF evaluation. Median survival was 3 days. Conclusions and Clinical Importance Breed predispositions appear to vary from reports of HS in other organ systems. Some unique imaging and clinicopathologic characteristics, particularly brain herniation, profound meningeal enhancement, and pleocytosis in combination with 1 or more mass lesions, might help to differentiate this neoplasm from others involving the CNS, although this requires further study.
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Affiliation(s)
- C L Mariani
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC; Comparative Neuroimmunology and Neurooncology Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
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18
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Lustgarten M, Redding WR, Schnabel LV, Prange T, Seiler GS. Navigational ultrasound imaging: A novel imaging tool for aiding interventional therapies of equine musculoskeletal injuries. Equine Vet J 2015; 48:195-200. [PMID: 25640262 DOI: 10.1111/evj.12410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 12/17/2014] [Indexed: 12/01/2022]
Abstract
REASONS FOR PERFORMING STUDY Navigational ultrasound imaging, also known as fusion imaging, is a novel technology that allows real-time ultrasound imaging to be correlated with a previously acquired computed tomography (CT) or magnetic resonance imaging (MRI) study. It has been used in man to aid interventional therapies and has been shown to be valuable for sampling and assessing lesions diagnosed with MRI or CT that are equivocal on ultrasonography. To date, there are no reports of the use of this modality in veterinary medicine. OBJECTIVES To assess whether navigational ultrasound imaging can be used to assist commonly performed interventional therapies for the treatment of equine musculoskeletal injuries diagnosed with MRI and determine the appropriateness of regional anatomical landmarks as registration sites. STUDY DESIGN Retrospective, descriptive clinical study. METHODS Horses with musculoskeletal injuries of the distal limb diagnosed with MRI scheduled for ultrasound-guided interventional therapies were evaluated (n = 17 horses with a total of 29 lesions). Anatomical landmarks used for image registration for the navigational procedure were documented. Accuracy of lesion location and success of the procedure were assessed subjectively and described using a grading scale. RESULTS All procedures were accurately registered using regional anatomical landmarks and considered successful based on our criteria. Anatomical landmarks were described for each lesion type. The addition of navigational imaging was considered to greatly aid the procedures in 59% of cases and added information to the remainder of the procedures. The technique was considered to improve the precision of these interventional procedures. CONCLUSIONS Navigational ultrasound imaging is a complementary imaging modality that can be used for the treatment of equine soft tissue musculoskeletal injuries diagnosed with MRI.
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Affiliation(s)
- M Lustgarten
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, USA
| | - W R Redding
- Department of Clinical Sciences, North Carolina State University, Raleigh, USA
| | - L V Schnabel
- Department of Clinical Sciences, North Carolina State University, Raleigh, USA
| | - T Prange
- Department of Clinical Sciences, North Carolina State University, Raleigh, USA
| | - G S Seiler
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, USA
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19
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Seiler GS, Brown JC, Reetz JA, Taeymans O, Bucknoff M, Rossi F, Ohlerth S, Alder D, Rademacher N, Drost WT, Pollard RE, Travetti O, Pey P, Saunders JH, Shanaman MM, Oliveira CR, O'Brien RT, Gaschen L. Safety of contrast-enhanced ultrasonography in dogs and cats: 488 cases (2002-2011). J Am Vet Med Assoc 2013; 242:1255-9. [PMID: 23600783 DOI: 10.2460/javma.242.9.1255] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the incidence of adverse events within 24 hours after contrast-enhanced ultrasonography (CEUS) in dogs and cats and compare the risk of death within 24 hours after imaging for animals that underwent ultrasonography with and without injection of a contrast agent. DESIGN Retrospective case-control study. ANIMALS 750 animals (411 case dogs, 238 control dogs, 77 case cats, and 24 control cats). PROCEDURES At 11 institutions, medical records were reviewed of dogs and cats that had CEUS performed (cases) as were medical records of dogs and cats with clinical signs similar to those of case animals that had ultrasonography performed without injection of a contrast agent (controls). Information regarding signalment; preexisting disease; type, dose, and administration route of contrast agent used; immediate (within 1 hour after CEUS) and delayed (> 1 and ≤ 24 hours after CEUS) adverse events; and occurrence and cause of death (when available) was extracted from each medical record. Risk of death within 24 hours after ultrasonography was compared between case and control animals. RESULTS Of the 411 case dogs, 3 had immediate adverse events (vomiting or syncope) and 1 had a delayed adverse event (vomiting). No adverse events were recorded for case cats. Twenty-three of 357 (6.4%) clinically ill case animals and 14 of 262 (5.3%) clinically ill control animals died within 24 hours after ultrasonography; risk of death did not differ between cases and controls. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that CEUS was safe in dogs and cats.
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Affiliation(s)
- Gabriela S Seiler
- Department of Molecular Biomedical Science, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27695, USA.
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20
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Lustgarten M, Redding WR, Labens R, Morgan M, Davis W, Seiler GS. ELASTOGRAPHIC CHARACTERISTICS OF THE METACARPAL TENDONS IN HORSES WITHOUT CLINICAL EVIDENCE OF TENDON INJURY. Vet Radiol Ultrasound 2013; 55:92-101. [DOI: 10.1111/vru.12104] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 06/25/2013] [Indexed: 01/17/2023] Open
Affiliation(s)
- Meghann Lustgarten
- Department of Molecular Biomedical Sciences; North Carolina State University; Raleigh NC 27607
| | - W. Rich Redding
- the Department of Clinical Sciences; North Carolina State University; Raleigh NC 27607
| | - Raphael Labens
- the Department of Clinical Sciences; North Carolina State University; Raleigh NC 27607
| | - Michel Morgan
- the Department of Clinical Sciences; North Carolina State University; Raleigh NC 27607
| | - Weston Davis
- the Department of Clinical Sciences; North Carolina State University; Raleigh NC 27607
| | - Gabriela S. Seiler
- Department of Molecular Biomedical Sciences; North Carolina State University; Raleigh NC 27607
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Seiler GS, Robertson ID, Mai W, Widmer WR, Suran J, Nemanic S, Lamb CR, Lang J, Johnson JL, Thrall DE. Usefulness of a half-fourier acquisition single-shot turbo spin-echo pulse sequence in identifying arachnoid diverticula in dogs. Vet Radiol Ultrasound 2012; 53:157-61. [PMID: 22734150 DOI: 10.1111/j.1740-8261.2011.01893.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Single-shot turbo spin-echo sequences are heavily T2-weighted sequences that are exceptionally well suited to evaluate the subarachnoid space. In the T2-weighted fast spin-echo sequences that are used routinely in spinal magnetic resonance (MR) imaging, the subarachnoid space is not well differentiated from the surrounding epidural fat, which could lead to decreased detection of lesions of the subarachnoid space such as arachnoid diverticula. Our purpose was to determine the added value of a single-shot turbo spin-echo sequence in identifying cystic lesions of the subarachnoid space in dogs. MR images of six dogs with a confirmed arachnoid diverticulum and 24 dogs with other spinal disease were included. Six observers were asked to interpret only T2-weighted images initially, and in a second session, T2-weighted and half-Fourier acquisition single-shot turbo spin-echo (HASTE) sequences. The MR images were anonymized, and no signalment, history, or clinical information was provided. Without the HASTE sequences, 25% of arachnoid diverticula were identified. Adding the HASTE sequence increased the diagnosis of arachnoid diverticulum to 52.8%. The resulting difference, after adding the HASTE sequence, of 27.8% was statistically significant (P = 0.002). No false-positive diagnoses of arachnoid diverticulum were made with either sequence. Although sensitivity in this study was likely artificially low, the significantly increased detection rate of arachnoid diverticula when using HASTE imaging indicates that this sequence is a valuable addition to MR imaging protocols for the canine spine.
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Affiliation(s)
- Gabriela S Seiler
- Department of Molecular Biomedical Sciences, North Carolina State University, 1052 William Moore Drive, Raleigh, NC 27607, USA.
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Seiler GS, Salmon JH, Mantuo R, Feingold S, Dayton PA, Gilger BC. Effect and distribution of contrast medium after injection into the anterior suprachoroidal space in ex vivo eyes. Invest Ophthalmol Vis Sci 2011; 52:5730-6. [PMID: 21685338 DOI: 10.1167/iovs.11-7525] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine the effects and posterior distribution of injections made into the anterior suprachoroidal space (SCS). METHODS The anterior SCS of adult porcine and canine ex vivo eyes was cannulated. Latex injections and high frequency ultrasound (50 MHz) was used to image the effect and distension of the SCS. Flow characteristics and percentage maximal distribution of microbubble contrast injection into the SCS were assessed by 2D and 3D ultrasound. RESULTS Mean (SD) distension of the SCS with PBS increased from 1.57 (0.48) mm after injection of 250 μL to 3.28 (0.57) mm with 1000 μL PBS. Eyes injected at physiologic IOP had no significant difference in SCS distension. In real-time 2D ultrasound, the contrast agent flowed from the injection site to the opposite ventral anterior SCS and the posterior SCS. Contrast arrived at the opposite and posterior SCS 7.8 (4.6) and 7.7 (4.6) seconds after injection, respectively. In sagittal images, contrast was visible in 24.0%to 27.2% of the SCS; in 10 of 12 eyes, contrast reached the posterior pole of the eye. In 3D images, contrast medium occupied 39.0% to 52.1% of the entire SCS. CONCLUSIONS These results suggest that the SCS can expand, in a dose-dependent manner, to accommodate various volumes of fluid and that it is possible to image the SCS with ultrasound contrast. The authors' hypothesis that a single anterior SCS injection can reach the ocular posterior segment was supported. Further development of SCS injections for treatment of the ocular posterior segment is warranted.
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Affiliation(s)
- Gabriela S Seiler
- Department of Molecular Biomedical Sciences, North Carolina State University, Raleigh, North Carolina 27607, USA.
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Seiler GS, Robertson ID, Mukundan S, Thrall DE. Imaging diagnosis-magnetic resonance imaging pulsatility artifact in the canine cervical spine. Vet Radiol Ultrasound 2011; 52:313-6. [PMID: 21554480 DOI: 10.1111/j.1740-8261.2010.01769.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Pulsatile venous flow in the internal vertebral venous plexus of the cervical spine can lead to vertical, linear T2-hyperintensities in the spinal cord at the cranial aspect of C3 and C4 in transverse T2-weighted images in large breed dogs that are not accompanied by ghosting. The artifact is more conspicuous in pre- and postcontrast transverse T1-weighted images and is accompanied by ghosting in that sequence, typical of a pulsatility artifact. A flow-related artifact was confirmed as the cause for this appearance by noting its absence after either exchange of phase and frequency encoding direction or by flow compensation. Care should be exercised to avoid misdiagnosing this pulsatility artifact seen in transverse T2-weighted images of the midcervical spine in large dogs as an intramedullary lesion when T1-images or phase-swap images are not available to confirm its artifactual origin.
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Affiliation(s)
- Gabriela S Seiler
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough Street, Raleigh, NC 27606, USA.
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Cervera V, Mai W, Vite CH, Johnson V, Dayrell-Hart B, Seiler GS. Comparative magnetic resonance imaging findings between gliomas and presumed cerebrovascular accidents in dogs. Vet Radiol Ultrasound 2011; 52:33-40. [PMID: 21322385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Cerebrovascular accidents, or strokes, and gliomas are common intraaxial brain lesions in dogs. An accurate differentiation of these two lesions is necessary for prognosis and treatment decisions. The magnetic resonance (MR) imaging characteristics of 21 dogs with a presumed cerebrovascular accident and 17 with a glioma were compared. MR imaging findings were reviewed retrospectively by three observers unaware of the final diagnosis. Statistically significant differences between the appearance of gliomas and cerebrovascular accidents were identified based on lesion location, size, mass effect, perilesional edema, and appearance of the apparent diffusion coefficient map. Gliomas were predominantly located in the cerebrum (76%) compared with presumed cerebrovascular accidents that were located mainly in the cerebellum, thalamus, caudate nucleus, midbrain, and brainstem (76%). Gliomas were significantly larger compared with presumed cerebrovascular accidents and more commonly associated with mass effect and perilesional edema. Wedge-shaped lesions were seen only in 19% of presumed cerebrovascular accidents. Between the three observers, 10-47% of the presumed cerebrovascular accidents were misdiagnosed as gliomas, and 0-12% of the gliomas were misdiagnosed as cerebrovascular accidents. Diffusion weighted imaging increased the accuracy of the diagnosis for both lesions. Agreement between observers was moderate (kappa = 0.48, P < 0.01).
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Affiliation(s)
- Vicente Cervera
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104-6010, USA
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Suran JN, Durham A, Mai W, Seiler GS. Contrast enhancement of extradural compressive material on magnetic resonance imaging. Vet Radiol Ultrasound 2011; 52:10-16. [PMID: 21322382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Gadolinium-enhancement of compressive extradural material is detected occasionally with magnetic resonance (MR) imaging in dogs. Our goal was to characterize contrast enhancement of extradural compressive material associated with intervertebral disc herniation, and to evaluate the association between enhancement and histopathologic findings and the onset of clinical signs. Ninety-three dogs with a total of 99 lesions diagnosed as intervertebral disc herniation on MR imaging were assessed. Images were evaluated for lesion location, type of herniation, degree of compression, intramedullary T2-weighted (T2W) intensities, and contrast enhancement. In 23 dogs, surgically removed compressive material was evaluated histopathologically for hemorrhage, inflammation, neovascularization, fibroplasia, fibrosis, mineralization, necrosis, and chronicity. Contrast enhancement of extradural compressive material, meninges, and both the compressive materials and meninges was present in 51.5%, 39.4%, and 17.2% of lesions, respectively. Extradural enhancement occurred more frequently in extrusions than protrusions (P = 0.001). Meningeal enhancement and more severe neurologic deficits were significantly associated with a shorter duration of clinical signs (P = 0.04 and 0.01, respectively). Intramedullary T2W hyperintensities, present with 44.4% of lesions, were associated with more severe neurologic deficits (P = 0.001). Lesions with extradural enhancement were more often considered subacute to chronic in duration and more frequently associated with hemorrhage compared with nonenhancing material; however, no statistically significant association was established between contrast enhancement and histopathologic findings. Contrast enhancement of extradural compressive material and the meninges was found to be common with intervertebral disc herniation, and should not be interpreted as a specific sign of a mass lesion such as neoplasia.
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Affiliation(s)
- Jantra Ngosuwan Suran
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA
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Seiler GS, Nolan TJ, Withnall E, Reynolds C, Lok JB, Sleeper MM. Computed tomographic changes associated with the prepatent and early patent phase of dirofilariasis in an experimentally infected dog. Vet Radiol Ultrasound 2010; 51:136-40. [PMID: 20402396 DOI: 10.1111/j.1740-8261.2009.01637.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Evolution of pulmonary arterial and parenchymal changes as assessed with computed tomography (CT) is described in a dog experimentally infected with Dirofilaria immitis. The dog was imaged 125, 168, 216, and 402 days after infection. Initial changes during the prepatent phase of infection included enlargement of the peripheral caudal lobar pulmonary arteries and intermittent periarterial interstitial infiltrates. The changes were progressive, involving additional arteries over time, but remained mild. With the presence of adult filariae a filling defect was observed in the caudal lobar pulmonary artery using CT angiography. Recognizing thoracic CT findings associated with the prepatent phase of canine heartworm infection may be important in endemic areas.
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Affiliation(s)
- Gabriela S Seiler
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Spruce Street, Philadelphia, PA 19104-6010, USA.
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Affiliation(s)
- Vicente Cervera Castellanos
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Ivančić M, Long F, Seiler GS. Contrast harmonic ultrasonography of splenic masses and associated liver nodules in dogs. J Am Vet Med Assoc 2009; 234:88-94. [DOI: 10.2460/javma.234.1.88] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Many factors affect the sensitivity and reliability of tumor vasculature assessment at the small doses of contrast agent necessary for imaging mice. In this study we investigate the dose-response relationship of ultrasound contrast agent for a minimal exposure power Doppler technique (minexPD) in a murine melanoma model. K1735 murine melanomas grown in 25 C3H/HeN mice were imaged by power Doppler ultrasound using different doses of contrast agents, Optison(R) and Definity(R). Six mice were treated with an antivascular agent, combretastatin A4-phosphate (CA4P), and imaged before and after treatment. The color-weighted fractional area (CWFA) of the peak-enhanced image was measured to assess tumor perfusion on a relative scale of 0 to 100. CWFA increased logarithmically with dose (R(2)=0.97). Treatment with CA4P resulted in pronounced reduction in tumor perfusion 2 h after contrast injection, but perfusion recovered in the tumor periphery after 2 days. CWFA was significantly different between pre- and post-treatment for all doses at 2 h and 2 days (p < 0.05, respectively). There was no significant difference detectable between the two contrast agents, Optison(R) and Definity(R) (p = 0.46). In vivo tumor enhancement in mice increases as logarithmic function with dose. Although the extent of enhancement is dose dependent, the difference between pre- and post-therapy enhancement is relatively unchanged and uniform at varying doses. The two contrast agents tested in this study performed equally well. These results suggest that quantitative contrast-enhanced power Doppler imaging is an effective method for monitoring therapy response of tumors in mice.
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Affiliation(s)
- Gabriela S Seiler
- Department of Clinical Studies, Philadelphia, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
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Benninger MI, Seiler GS, Robinson LE, Ferguson SJ, Bonél HM, Busato AR, Lang J. Effects of anatomic conformation on three-dimensional motion of the caudal lumbar and lumbosacral portions of the vertebral column of dogs. Am J Vet Res 2006; 67:43-50. [PMID: 16426210 DOI: 10.2460/ajvr.67.1.43] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the association between the 3-dimensional (3-D) motion pattern of the caudal lumbar and lumbosacral portions of the canine vertebral column and the morphology of vertebrae, facet joints, and intervertebral disks. SAMPLE POPULATION Vertebral columns of 9 German Shepherd Dogs and 16 dogs of other breeds with similar body weights and body conditions. PROCEDURE Different morphometric parameters of the vertebral column were assessed by computed tomography (CT) and magnetic resonance imaging. Anatomic conformation and the 3-D motion pattern were compared, and correlation coefficients were calculated. RESULTS Total range of motion for flexion and extension was mainly associated with the facet joint angle, the facet joint angle difference between levels of the vertebral column in the transverse plane on CT images, disk height, and lever arm length. CONCLUSIONS AND CLINICAL RELEVANCE Motion is a complex process that is influenced by the entire 3-D conformation of the lumbar portion of the vertebral column. In vivo dynamic measurements of the 3-D motion pattern of the lumbar and lumbosacral portions of the vertebral column will be necessary to further assess biomechanics that could lead to disk degeneration in dogs.
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Affiliation(s)
- Monika I Benninger
- Division of Radiology, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty of Bern, Länggassstrasse 128, 3001 Bern, Switzerland
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Benninger MI, Seiler GS, Robinson LE, Ferguson SJ, Bonél HM, Busato AR, Lang J. Three-dimensional motion pattern of the caudal lumbar and lumbosacral portions of the vertebral column of dogs. Am J Vet Res 2004; 65:544-51. [PMID: 15141871 DOI: 10.2460/ajvr.2004.65.544] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the 3-dimensional motion pattern including main and coupled motions of the caudal lumbar and lumbosacral portions of the vertebral column of dogs. ANIMALS Vertebral columns of 9 German Shepherd Dogs (GSDs) and 16 dogs of other breeds with similar body weights and body conditions. PROCEDURE Main and coupled motions of the caudal lumbar and lumbosacral portions of the vertebral column (L4 to S1) were determined by use of a testing apparatus that permitted precise application of known pure moments to the vertebral column. Motion was compared between GSDs and dogs of other breeds. RESULTS All specimens had a similar motion pattern consisting of main motion and a certain amount of coupled motion including translation. Vertebral columns of GSDs had significantly less main motion in all directions than that of dogs of other breeds. Translation was similar in GSDs and dogs of other breeds and was smallest at the lumbosacral motion segment. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that motion in the caudal lumbar and lumbosacral portions of the vertebral column of dogs is complex and provided a basis for further studies evaluating abnormal vertebral columns.
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Affiliation(s)
- Monika I Benninger
- Division of Radiology, Department of Clinical Veterinary Medicine, University of Bern, Länggassstrasse 128, 3001 Bern, Switzerland
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Seiler GS, Häni H, Busato AR, Lang J. Facet joint geometry and intervertebral disk degeneration in the L5-S1 region of the vertebral column in German Shepherd Dogs. Am J Vet Res 2002; 63:86-90. [PMID: 16206786 DOI: 10.2460/ajvr.2002.63.86] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the possible association between facet joint geometry and intervertebral disk degeneration in German Shepherd Dogs. ANIMALS 25 German Shepherd Dogs and 11 control dogs of similar body weight and condition. PROCEDURE Facet joint angles in the caudal portion of the lumbar region of the vertebral column (L5-S1) were measured by use of computed tomography, and the intervertebral discs were evaluated microscopically. The relationship between facet joint geometry and disk degeneration was evaluated by use of statistical methods. RESULTS German Shepherd Dogs had significantly more facet joint tropism than control dogs, but an association with disk degeneration was not found. However, German Shepherd Dogs had a different facet joint conformation, with more sagittally oriented facet joints at L5-L6 and L6-L7 and a larger angle difference between the lumbar and lumbosacral facet joints, compared with control dogs. CONCLUSIONS AND CLINICAL RELEVANCE A large difference between facet joint angles at L6-L7 and L7-S1 in German Shepherd Dogs may be associated with the frequent occurrence of lumbosacral disk degeneration in this breed.
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Affiliation(s)
- Gabriela S Seiler
- Section of Radiology, Department of Clinical Veterinary Medicine, University of Bern, Länggasse 122+128/Bremgartenstrasse 109a, 3012 Bern, Switzerland
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