Hedlund, C. and Taboada, J.: Clinical Atlas of Ear, Nose and Throat Diseases in Small Animals (Farbatlas der Hals-Nasen-Ohren-Erkrankungen bei Kleintieren). Schlütersche Verlag und Druckerei. Hannover, 2002. 208 pages, 353 colour pictures, radiographs and 64 drawings in hard leather cover.
Since percussion started to be a method forgotten and not trusted by many practitioners, the aim of the study was to demonstrate whether this procedure could deliver exact data if done accurately and by a practised examiner. The trial presented here included 31 healthy warm-blooded horses. Percussion of the area of cardiac dullness and then echocardiographic imaging of the same region were performed. To obtain the relevant measurement points, the 4th and 5th intercostal spaces (ICS) were used on the left and the 4th ICS on the right side. On the left side, the dorsal border of cardiac dullness was determined in the 4th ICS (1st point). Then the ventral border of the cardiac dullness was determined at the same place (2nd point). This was followed by the examination of the same points in the 5th ICS (3rd and 4th points). The following step was to measure the distance of these points from the ventral border of the thorax, and also that between the 2nd and the 4th points. On the right side the same procedure was used in the 4th ICS only. Mean values/standard errors (in cm) of absolute values of differences between percussional and echocardiographic measurements were as follow. Left side, 4th ICS, dorsal border: 0.8/0.1; ventral border: 0.7/0.1; 5th ICS, dorsal border: 0.8/0.1, ventral border: 0.9/0.2; right side, 4th ICS, dorsal border: 0.8/0.2; ventral border: 0.7/0.1. Due to the close correlation between the results of the two techniques, it is reasonable to consider cardiac percussion as an integrated part of the physical examination.
The aim of the study was to establish normal echocardiographic values of the left atrium just above the mitral annulus (LAama) in healthy dogs. In the first part of the study 20 dogs of various breeds were examined. The diameter of the left atrium just above the mitral annulus (LAama) was compared to the linear (left to right) dimension of the left atrium (LAr-l) as published earlier. There was a linear relationship between LAr-l and the body weight (LAr-l = 0.5061 BW (kg) + 22.206; R2 = 0.81), but the proportion of LAr-l/LAama was independent of the body weight (LAr-l/LAama = 0.0004 BW (kg) + 1.0833; R2 = 0.01). In the second part of the study the left atrial diameter just above the mitral annulus (LAama) was measured in 121 dogs of various breeds. There was a positive linear relationship (R2 = 0.697; p < 0.001) between body weight and LAama (LAama = 0.54 BW (kg) + 18.502 ± 4.76), but there were no significant correlations between the age of animals and LAama (p = 0.45) as well as between the gender of animals and LAama (p = 0.78). Two-dimensional echocardiographic (2DE) determination of LAama as described in the present study can be recommended for use in those dogs where measurement of LAr-l encounters technical difficulties. In these cases LAr-l can be calculated from LAama using the formula LAr-l/LAama = 0.0004 BW (kg) + 1.0833, worked out in the first experiment.
Histological and electron microscopic examinations of the kidneys of 8 dogs suffering from fatal, naturally acquired
infection and nephropathy are presented. Seven animals were treated with imidocarb dipropionate on average 4.5 days prior to death. Severe anaemia was present only in 2 cases. Degenerative histological changes observed mostly in the proximal convoluted tubules included vacuolar-hydropic degeneration, necrosis and detachment of renal tubular epithelial (RTE) cells from the basement membrane. Necrotic debris occasionally formed acidophilic casts within the tubules. In some cases, necrosis of the whole tubule was observed. Haemoglobin casts in the tubules and haemoglobin droplets in RTE cells seldom appeared. No significant histological changes were seen in the glomeruli. Ultrastructural lesions in RTE cells included nuclear membrane hyperchromatosis, karyopyknosis, karyolysis, swelling or collapse of mitochondria with fragmentation of cristae and vacuolar-hydropic degeneration in the endoplasmic reticulum and microvilli. Nuclear oedema was also observed. Many RTE cells exhibiting necrosis collapsed. Vacuolar-hydropic degeneration and necrosis were also observed in the glomerular and interstitial capillary endothelium. The severe acute tubular necrosis described in this study is probably the result of hypoxic renal injury. Systemic hypotension leading to vasoconstriction in the kidneys might be the most important cause of renal hypoxia in
infections, but anaemia may also contribute to inadequate oxygenation. Imidocarb should be applied with caution in patients with possible renal involvement until further data become available on its potential nephrotoxicity in dogs.
Authors:K. Vörös, Ágnes Sterczer, F. Manczur and et al.
Percutaneous ultrasound-guided cholecystocentesis was performed on 13 healthy beagle dogs to determine whether percutaneous ultrasound-guided cholecystocentesis in the dog was a feasible and safe procedure. Clinical, laboratory and ultrasonographic examinations were done at 0 and 10 minutes, in the 2nd and 16th hour, and on the 7th day. They included a detailed physical examination of the mucous membranes, cardiorespiratory system and abdominal organs. Laboratory examinations of the blood consisted of a complete blood count, determination of packed cell volume (PCV), haemoglobin (Hb), total plasma protein (TPP), parameters of haemostasis including prothrombin time (PT), activated partial thromboplastin time (APTT), and enzyme activities reflecting hepatobiliary function, i.e. aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltransferase (GGT). Ultrasonographic findings of the gallbladder (size, shape, wall, content) and appearance of the biliary tract and the surrounding cranial intraabdominal organs were also evaluated. Percutaneous ultrasound-guided cholecystocentesis was performed easily during the study, and dogs tolerated well the procedure performed without anaesthesia. All laboratory parameters of the blood remained within normal limits throughout the study. However, some follow-up values, i.e. PCV, TPP, APTT and ALT, demonstrated statistically significant differences when compared to baseline measurements, which might reflect the effect of 24-hour fasting before the experiment, as well as day-to-day metabolic fluctuations due to feeding and water supply during the study. There were no visible signs of bleeding from the liver, bile leakage from the gallbladder or accumulation of free peritoneal fluid during repeated ultrasonographic examinations. Percutaneous ultrasound-guided cholecystocentesis seems to be an important diagnostic procedure in canine gallbladder diseases and can be used safely and easily to gain gallbladder bile for diagnosis of bacterial cholecystitis or for investigating hepatobiliary function in the dog.
Authors:Z. Bakos, K. Vörös, Heidi Kellokoski and J. Reiczigel
The aim of the study was to evaluate the diagnostic value of thoracic percussion and ultrasonography with the help of distance measurements and statistical methods in the determination of the caudal lung border in horses with recurrent airway obstruction (RAO). Examinations were performed on 11 healthy, warm-blooded horses of different breeds, age and grade of disease. First, the caudal lung border was determined by the traditional indirect percussion method in the 10th, 12th, 14th and 16th intercostal spaces at the end of inspiration and expiration on both sides of the thorax. To apply standardised measurements, a fix point was chosen as described earlier by the same authors for healthy horses. The distance between this point and the caudal lung border was measured with a tape-measure. Percussion was followed by ultrasonographic determination of the caudal lung border. Measurements were performed in the same way as described for the percussion technique. Mean values and standard errors of absolute values of differences between percussion and ultrasonographic measurements were the following, in centimetres (10th, 12th, 14th and 16th intercostal spaces). Left side expiration: 1.4, 0.4; 0.8, 0.2; 0.9, 0.2; 0.8, 0.4; left side inspiration: 0.8, 0.3; 1.5, 0.3; 1.4, 0.3; 1.1, 0.3; right side expiration: 2.1, 1.0; 2.1, 0.5; 1.6, 0.5; 0.8, 0.1; right side inspiration: 1.5, 0.7; 1.2, 0.6; 0.8, 0.2; 0.8, 0.3, respectively. Ultrasonography proved to be reliable in determining the caudal lung borders in horses with RAO. Results of the percussion examination did not differ significantly from those of the ultrasound method which was used as a reference technique. The differences between inspiration and expiration were greater in horses with RAO than in healthy horses in a previous study. Based on these results, percussion can be used as an integrated part of the physical examination in diagnosing caudal shift of the caudal lung border of horses suffering from RAO.
Authors:Z. Bakos, K. Vörös, Taina Järvinen and et al.
The aim of the study was to establish normal echocardiographic values of healthy Standardbred trotters not published previously. Twenty-three clinically normal horses weighing between 350 and 490 kg were examined in the same manner: first a thorough physical and then detailed echocardiographic examination were performed. Standardised two-dimensional (2D) and guided M-mode echocardiographic imaging techniques were used to measure interventricular septal thickness (IVS), left ventricular internal diameter (LVID), left ventricular wall thickness (LVW), left atrial internal diameter (LAID) in end-systole (s) and end-diastole (d) and aortic diameter (AOD) in end-diastole. Mean, range and standard deviation of the different parameters were calculated. The mean values (in centimetres) were as follow (2D/M-mode): IVSs: 4.6/4.7; IVSd: 3.1/3.0; LVIDs: 7.0/7.0; LVIDd: 10.7/10.7; LVWs: 3.9/3.9; LVWd: 2.7/2.7; LAIDs: 10.4/-; LAIDd: 11.3/-; AODd: 7.2/-. Results of two-dimensional and M-mode measurements were compared to each other and to normal values obtained from other breeds.
Authors:Noémi Tarpataki, Kinga Pápa, J. Reiczigel, P. Vajdovich and K. Vörös
Medical records of 600 dogs diagnosed with atopic dermatitis were reviewed and evaluated with reference to history, geographical distribution, breed predilection, clinical signs and positive reactions to allergens as determined by intradermal skin testing (IDT) manufactured by Artuvetrin Laboratories**. In 66.6% of dogs, the age of onset of atopic dermatitis was between 4 months and 3 years. Dogs living in the garden suburb of Budapest were more sensitive to house dust mites, fleas and moulds, and dogs from the western part of Hungary were more sensitive to weeds than to other allergens (p < 0.01). Positive reactions were most common to Dermatophagoides farinae followed by human dander. The breed distribution found in the present study was consistent with that reported in the literature, except for the breeds Hungarian Vizsla, Pumi, French bulldog, Doberman Pinscher and Bobtail which were over-represented among atopic dogs compared to the breed distribution of the general dog population of a large city in Hungary. Breeds with verified adverse reaction to food were Cocker spaniels, French bulldogs, Bullmastiffs, Bull terriers, St. Bernards, Tervurens, West Highland White terriers and American Staffordshire terriers (p < 0.05). The clinical signs of atopic dermatitis and their occurrence are in accordance with the data described in the literature.
Authors:Á. Máthé, K. Vörös, L. Papp and J. Reiczigel
Clinical observations of Babesia canis infection in 63 dogs during a 1-year period are summarised, demonstrating the pathogenicity of the Babesia strain endemic in Hungary. Most patients had babesiosis in the spring and autumn, correlating with the seasonal activity of ticks. Male animals appeared in higher numbers, probably due to an overrepresentation of outdoor dogs. Uncomplicated babesiosis was diagnosed in 32 cases. The disease affected dogs of any age in this study. Symptoms were similar to those published from other parts of the world: lethargy, fever, splenomegaly, pallor, icterus, haemoglobinuria and presence of ticks were the most common observations. Thrombocytopenia, lymphopenia and neutropenia were frequent haemogram changes. Imidocarb appeared to be highly effective in eliminating the Babesia infection. Thirty-one animals demonstrated babesiosis with complications. Most Rottweilers (7/9) developed complicated disease. Old age was a risk factor for multiple complications. Multiple organ manifestations had poor prognosis. Hepatopathy (44%), pancreatitis (33%), acute renal failure (ARF; 31%) and disseminated intravascular coagulation (DIC; 24%) were frequent complications, while immune-mediated haemolytic anaemia (IMHA; 10%), acute respiratory distress syndrome (ARDS; 6%) and cerebral babesiosis (3%) were rarely observed. There was a significant difference between the mean age of dogs having uncomplicated disease, babesiosis with a single complication and babesiosis with multiple complications (3.4, 4.8 and 8.6 years, respectively, p < 0.001). The recovery rate (78, 68 and 25%, respectively, p = 0.005) and mortality rate (3, 21 and 67%, respectively, p < 0.001) also tended to differ significantly in these groups. Systemic inflammatory response syndrome (SIRS) and DIC are two possible pathways leading to multiple organ dysfunction syndrome (MODS) in babesiosis. DIC was found to predict MODS more sensitively in this study than SIRS: there were 6 animals developing MODS out of 11 identified with DIC, while only 5 dogs developed MODS out of 22 having SIRS.
Authors:Orsolya Kutasi, K. Vörös, I. Biksi, O. Szenci and P. Sótonyi
This paper presents the embryological and pathological features as well as the terminology and classification of common atrioventricular canal, a type of endocardial cushion defect. The authors give a complete description of an extremely rare congenital cardiac malformation in an equine neonate. The diagnosis of a complete, balanced common atrioventricular canal of type C in Rastelli’s classification scheme was based on two-dimensional, contrast and colour Doppler echocardiography and subsequent postmortem gross pathology. To support our diagnosis and study the pathophysiological effect of the alteration, physical examination, blood gas analysis and other laboratory tests, electrocardiography and thoracic radiography were also performed. Our search of the literature suggests that this type of developmental anomaly might account for a higher percentage of equine congenital cardiac defects than was thought earlier. We suppose that some previously described congenital heart abnormalities were misinterpreted: these anomalies could have actually represented some type of atrioventricular canal defect, resulting from the failure of the endocardial cushions to undergo complete and proper fusion.