An 8-year-old female domestic shorthair, presenting for a 3-day history of lethargy and hyporexia, was obtunded, dehydrated, tachypneic, and had abdominal distension on physical exam with no vaginal discharge or pyrexia. Abdominal radiographs revealed a large, ovoid soft tissue mass and a tortuous, tubular soft tissue structure in the abdomen. Abdominal ultrasound revealed a severely fluid-distended uterus with a left uterine torsion, which was demonstrated by a "whirl sign." Emergency ovariohysterectomy surgically confirmed a 360 degrees torsion of the left uterine horn with a fluid-distended right uterine horn. Histopathology confirmed a diagnosis of pyometra, and the cat recovered uneventfully.

Ultrasound phantoms are training tools that can help students learn basic ultrasound principles. The purpose of this prospective cohort design study was to determine whether preclinical veterinary students in a curriculum with more phantom training sessions acquire better-quality ultrasound images of kidneys in live canines compared with students in a curriculum without sequential phantom training sessions. In clinical skills labs, 132 second-year (2VM) and 130 third-year (3VM) veterinary students obtained sagittal and transverse images of the left kidney of healthy, student-owned dogs. Images were graded on proper identification/orientation, technique, and image anatomy using a modified Brightness Mode Quality Ultrasound Imaging Examination Technique, a modified standardized ultrasound interpretation scale. A two-sample t-test was used to compare 2VM and 3VM performance. 2VM students were inaugural members of a redesigned curriculum and had previously participated in eight clinical skills labs involving hands-on ultrasound practice using phantoms and live animals prior to this study. The 3VM students were the final members of the prior curriculum and had previously participated in a single ultrasound lab using phantoms and a single ultrasound lab using live animals. For Identification/Orientation categories, 2VM students acquired slightly but statistically significantly better transverse images (P = 0.04). There were no significant differences between identification/orientation tasks for sagittal images or for technique and image anatomy categories. The findings indicate that future studies assessing more sensitive evaluation tools and serial evaluation of students may be beneficial in monitoring student competency and assist in evaluating the role of phantoms in ultrasound training in the veterinary curriculum.

Previous studies have demonstrated evidence that three-dimensional (3D) visualization techniques can be helpful as learning tools. This prospective randomized control study was designed to test the hypothesis that 3D learning tools would have improved translation into interpreting normal and abnormal canine abdominal radiographic images over traditional learning tools. Sagittal and dorsal plane 3D image scenes were created from CT scans, with canine abdominal organs labeled using virtual reality and 3D visualization software tools. Eighty students from the first- and second-year veterinary classes at a single institution participated in the study. The control group studied canine abdominal anatomy from a textbook and the experimental group studied canine abdominal anatomy using the 3D learning tools for a set time. Each participant then took a three-part written examination to assess their learning for the following categories: 3D anatomy organ identification, radiographic anatomy organ identification of normal structures and radiographic anatomy organ identification of abnormal structures. All participants were also asked to identify the sex of the test patient from the 3D study. Participants from the experimental group performed statistically better than participants in the control group for all parts of the examination, with the exception of normal radiographic anatomy.

Case summary A 3-month-old intact male domestic shorthair kitten’s cervical region was inadvertently punctured during routine subcutaneous fluid administration. A swelling rapidly developed on the left lateral neck and continued to grow, despite compression. An emergency facility evaluated the kitten 48 h later and the swelling was determined to be blood. Fine-needle aspiration of the swelling resulted in further swelling of the mass on the neck. The kitten began showing signs of systemic shock, necessitating a blood transfusion. The kitten was referred to a tertiary facility 24 h later for further diagnostics and treatment. CT of the head and neck revealed a large fluid-filled mass with progressive contrast enhancement noted during the filling phase, consistent with active hemorrhage. A carotid pseudoaneurysm was suspected and surgery was recommended. The left carotid artery was ligated proximal to the pseudoaneurysm; hemorrhage continued and the swelling was further explored. A small connection to the carotid artery within the medial aspect of the swelling was identified and ligated. The kitten required autotransfusion and massive allotransfusion during surgery due to blood loss. Recovery was uneventful. A head tilt and Horner’s syndrome were noted postoperatively and improved over the following months. Histopathology was consistent with pseudoaneurysm. Relevance and novel information This is the first reported case of pseudoaneurysm in a kitten that was treated surgically, with massive blood transfusion and minimal complications. Early surgical intervention can result in excellent prognosis. The need for blood product administration should be anticipated.

Abstract There are few differential diagnoses for non‐orthopedic thoracic limb lameness in adult dogs aside from nerve tumors and disk‐associated nerve compression; this report introduces another etiology. A 9‐year‐old male castrated mixed dog presented with an episodic history of nonweight‐bearing thoracic limb lameness. Additional clinical signs included an atrophied thoracic limb with cool paw pads and painful axillary region. Magnetic resonance imaging, computed tomography, ultrasound, and exploratory surgery confirmed a chronic thrombus of the right brachial artery. No underlying cause for the thrombus was identified. The dog has been successfully managed on long‐term rivaroxaban and clopidogrel. Follow‐up ultrasound of the thrombus suggested early remodeling.

As new technologies are incorporated into the practice of veterinary medicine, it is imperative we utilize the most effective and impactful content delivery methods. Ultrasound technology has become more affordable and compact for veterinary hospitals, leading to easier incorporation into practice. This study compares three methods of delivering ultrasound knobology content to first-year veterinary students at Texas A&M University College of Veterinary Medicine and Biomedical Sciences. In a prospective study, first-year veterinary students were randomly selected to receive one of three content delivery methods: self-directed active learning (SDL), in-person instructor demonstration, or online module instruction. Knowledge acquisition was assessed using a 10-question quiz for short-term understanding followed by a 10-question quiz after a 6-week period to assess long-term knowledge retention. Student demographics were analyzed using the Chi-square test. Quiz scores were analyzed between groups using Kruskal–Wallis tests followed by Dunn’s post-tests for multiple comparisons. Values of p ≤ .05 were considered significant. On the short-term and retention quiz questions, students participating in SDL scored significantly higher (10 [5–10]) than those receiving in-person instructor demonstration (9 [3–10] p = .01 and 8 [2–10] p = .0004, respectively) or the online module instruction training (Group C) (6 [1–10] p < 0.0001 and 8 [4–10] p < .001, respectively). Based on quiz scores, veterinary students exhibited better ultrasound knobology and image quality recognition proficiency immediately and at 6-weeks following SDL when compared with other content delivery methods. Self-directed learning methods are recommended when teaching ultrasonography to veterinary students.

Non-human primate models will expedite therapeutics and vaccines for coronavirus disease 2019 (COVID-19) to clinical trials. Here, we compare acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in young and old rhesus macaques, baboons and old marmosets. Macaques had clinical signs of viral infection, mild to moderate pneumonitis and extra-pulmonary pathologies, and both age groups recovered in two weeks. Baboons had prolonged viral RNA shedding and substantially more lung inflammation compared with macaques. Inflammation in bronchoalveolar lavage was increased in old versus young baboons. Using techniques including computed tomography imaging, immunophenotyping, and alveolar/peripheral cytokine response and immunohistochemical analyses, we delineated cellular immune responses to SARS-CoV-2 infection in macaque and baboon lungs, including innate and adaptive immune cells and a prominent type-I interferon response. Macaques developed T-cell memory phenotypes/responses and bystander cytokine production. Old macaques had lower titres of SARS-CoV-2-specific IgG antibody levels compared with young macaques. Acute respiratory distress in macaques and baboons recapitulates the progression of COVID-19 in humans, making them suitable as models to test vaccines and therapies. Acute respiratory distress in macaques and baboons recapitulates COVID-19 disease progression in humans, making them suitable as models to test vaccines and therapies.

SummaryThere are no known cures or vaccines for COVID-19, the defining pandemic of this era. Animal models are essential to fast track new interventions and nonhuman primate (NHP) models of other infectious diseases have proven extremely valuable. Here we compare SARS-CoV-2 infection in three species of experimentally infected NHPs (rhesus macaques, baboons, and marmosets). During the first 3 days, macaques developed clinical signatures of viral infection and systemic inflammation, coupled with early evidence of viral replication and mild-to-moderate interstitial and alveolar pneumonitis, as well as extra-pulmonary pathologies. Cone-beam CT scans showed evidence of moderate pneumonia, which progressed over 3 days. Longitudinal studies showed that while both young and old macaques developed early signs of COVID-19, both groups recovered within a two-week period. Recovery was characterized by low-levels of viral persistence in the lung, suggesting mechanisms by which individuals with compromised immune systems may be susceptible to prolonged and progressive COVID-19. The lung compartment contained a complex early inflammatory milieu with an influx of innate and adaptive immune cells, particularly interstitial macrophages, neutrophils and plasmacytoid dendritic cells, and a prominent Type I-interferon response. While macaques developed moderate disease, baboons exhibited prolonged shedding of virus and extensive pathology following infection; and marmosets demonstrated a milder form of infection. These results showcase in critical detail, the robust early cellular immune responses to SARS-CoV-2 infection, which are not sterilizing and likely impact development of antibody responses. Thus, various NHP genera recapitulate heterogeneous progression of COVID-19. Rhesus macaques and baboons develop different, quantifiable disease attributes making them immediately available essential models to test new vaccines and therapies.

Introduction: Ultrasound-guided nerve blocks offer superior and safe analgesia compared to traditional methods. The quadratus lumborum block described in other species, may provide flank anesthesia in ruminants, if the last thoracic and first three lumbar nerves are effectively blocked.

OBJECTIVES To estimate the sensitivity and specificity of ultrasound and CT for localising solitary hepatic masses to particular liver divisions. MATERIALS AND METHODS Dogs diagnosed with a solitary liver mass by ultrasound and/or CT, with surgical or necropsy confirmation within 1 month of imaging. Ultrasound reports were reviewed for mass location. CT scans were reviewed by two radiologists and mass location was determined by consensus agreement. Sensitivity and specificity were calculated for ultrasound and CT for each liver division. RESULTS Fourteen of 71 dogs had CT only, 27 of 71 had ultrasound only and 30 of 71 had both. Location was correctly predicted in 42 of 57 dogs (74%) by ultrasound and in 37 of 44 dogs (84%) by CT. Both CT and ultrasound had high specificity for localising masses in all divisions. Sensitivity varied among divisions and was highest for left division masses. CLINICAL SIGNIFICANCE The results suggest that either imaging modality is appropriate for presurgical planning. Prospective studies are recommended to help identify additional factors that may aid in determination of hepatic mass location.

OBJECTIVE To estimate reliability of interpretation of neurologic examination findings for localization of vestibular dysfunction in dogs. DESIGN Cross-sectional study. ANIMALS 496 dogs that underwent MRI of the head for diagnosis of a neurologic problem between September 2011 and September 2015. PROCEDURES Medical records were reviewed and data collected regarding signalment and neurologic examination, MRI, and CSF findings. Independent observers interpreted the findings, and agreement was assessed for a subset of dogs. Distributions of variables were compared between dogs with and without a neurologic findings-based interpretation of vestibular disease. RESULTS 37% (185/496) of dogs had signs of vestibular dysfunction, of which 82% (151/185) had MRI abnormalities. In 73% (110/151) of dogs with MRI abnormalities, lesions involved central vestibular structures, and in 19% (29/151), lesions involved peripheral vestibular structures. On the basis of neurologic findings interpretation, 86% (160/185) of dogs were classified as having central vestibular dysfunction, and 61% (98/160) of these had an MRI-identified central vestibular lesion. Agreement among 3 independent observers was good (κ = 0.72) regarding use of neurologic examination findings to diagnose central versus peripheral vestibular dysfunction and very good (κ = 0.85) regarding use of MRI to diagnose peripheral vestibular lesions. Despite this agreement, only 29% (7/24) of dogs with a consensus clinical interpretation of peripheral vestibular dysfunction had MRI-identified peripheral lesions. CONCLUSIONS AND CLINICAL RELEVANCE Although interobserver agreement was good for distinguishing central from peripheral vestibular dysfunction in dogs through interpretation of neurologic examination findings, this interpretation did not agree with the MRI-based diagnosis.

Journal of Small Animal PracticeVolume 58, Issue 1 p. 57-57 IMAGES IN SMALL ANIMAL PRACTICE Caudal mediastinal cystic lesion in a dog C. Gremillion, Corresponding Author C. Gremillion christine.lynn.gremillion@gmail.com North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607, USACorresponding author email: christine.lynn.gremillion@gmail.comSearch for more papers by this authorA. Voges, A. Voges Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, TX 77843, USASearch for more papers by this authorJ. Griffin, J. Griffin Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, TX 77843, USASearch for more papers by this author C. Gremillion, Corresponding Author C. Gremillion christine.lynn.gremillion@gmail.com North Carolina State University College of Veterinary Medicine, Raleigh, NC 27607, USACorresponding author email: christine.lynn.gremillion@gmail.comSearch for more papers by this authorA. Voges, A. Voges Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, TX 77843, USASearch for more papers by this authorJ. Griffin, J. Griffin Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, TX 77843, USASearch for more papers by this author First published: 17 January 2017 https://doi.org/10.1111/jsap.12612Citations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume58, Issue1January 2017Pages 57-57 This article also appears in:2017 Virtual Issue RelatedInformation

A 4-year-old, spayed-female great Dane was referred for surgical treatment of a suspected meningioma, diagnosed on magnetic resonance imaging 10 days prior to presentation. The suspected meningioma was removed via image-guided stereotactic craniotomy. Histopathological diagnosis was severe, locally extensive, chronic meningoencephalitis with an intralesional nematode egg. The egg was morphologically consistent with Eucoleus boehmi, and aberrant migration into the cranial cavity was the presumed cause of this lesion. Three faecal samples were collected and revealed 4+ E. boehmi eggs. Treatment involved 110 mg/kg fenbendazole (Panacur, Intervet) orally twice daily for 14 days. Nematodes including E. boehmi are a previously un-recognised source of intracranial disease in dogs, and should be considered as a differential for mass-like lesions visualised by magnetic resonance imaging.

A 21-yr-old female red ruffed lemur (Varecia rubra) was presented with swelling and disuse of the right manus. Severely displaced fractures of metacarpals II-V were diagnosed radiographically. The fractures were surgically stabilized with intramedullary Kirschner wires attached externally with an acrylic external fixator and a bone plate on the dorsal aspect of metacarpal III. The fractures of metacarpals II-V were predominantly healed on radiographs obtained 12 wk after surgery. However, diffuse disuse osteopenia and phalangeal contracture were present, with possible osteomyelitis. An exercise regimen of the affected hand was initiated due to the incomplete extension of the phalanges. After 4 wk of therapy, the extension of the phalanges had improved and the fractures appeared radiographically to be nearly completely healed. Although metacarpal fractures are common in nonhuman primates, they are reported infrequently in the literature.

A 2.3-y-old female cynomolgus macaque (Macaca fascicularis) presented with a broken right tibia and fibula. Radiographs showed multiple cyst-like defects in all long bones. We suspected that both fractures were pathologic because they occurred through these defects. Ultrasonography, MRI, and dual X-ray absorptiometry revealed that the defects were filled with soft tissue. Grossly, the bones were abnormal in shape, and a gelatinous material filled the defects and the surrounding marrow cavity. Histologically, the gelatinous material was composed of fibrin and cartilage; few normal bone cells were seen. Genetic testing revealed extra material on the short arm of chromosome 8 in all tissues examined, but no copy number alterations of likely clinical significance were observed, and no abnormalities were found that were unique to the lesions. In light of the clinical signs and radiographic and pathologic findings, polyostotic fibrous dysplasia was diagnosed. This report represents the first documented case of fibrous dysplasia in a cynomolgus macaque.

Objective: To estimate the relative accuracy of a thoracic focused assessment with sonography for trauma (TFAST) protocol for rapid diagnosis of pneumothorax (PTX) and other thoracic injury in traumatized dogs.Design: Prospective case series.Setting: Private veterinary emergency center.Animals: One hundred and forty-five client-owned dogs evaluated within 24-hours of injury.Interventions: Thoracic focused assessment with sonography for trauma protocol.Measurements and Main Results: Traumatized dogs were evaluated with a conventional ultrasound (US) machine using a standardized 4-point thoracic FAST protocol before thoracic radiography (CXR) and thoracocentesis. PTX was diagnosed by the absence of the 'glide sign,' defined as the lack of the normal dynamic interface between lung margins gliding along the thoracic wall during respiration. Concurrent thoracic trauma was diagnosed by the presence of pleural or pericardial fluid or the presence of a 'step sign,' defined as an abnormal glide sign. Accuracy of TFAST was calculated relative to CXR findings.Results: Overall sensitivity (Se), specificity (Sp), and accuracy of TFAST relative to CXR were 78.1% (95% CI; 61.5, 89.9), 93.4% (95% CI; 87.4, 97.1), and 90.0%, respectively. Se and Sp were higher in dogs with penetrating trauma (93.3%, 96.0%) and for the evaluator with the most clinical experience (95.2%, 96.0%); only Se between the most experienced compared with others was statistically significant (P < 0.05). TFAST documented other concurrent thoracic injury. Median time for TFAST was 3 minutes.Conclusions and Clinical Relevance: TFAST has the potential to rapidly diagnose PTX and other thoracic injury and guide therapy, including potentially life-saving interventions, in traumatized dogs.

In humans the dural tail is a sign seen on contrast enhanced T1 weighted magnetic resonance images. This finding is considered specific for meningioma. The purpose of this study was to determine how often the dural tail occurs in cats and dogs and whether it is a specific sign for meningiomas in these species. MR examinations for eighteen dogs and four cats with proven diagnoses were reviewed. Diagnoses included ten meningiomas (seven dogs and three cats), three gliomas, two pituitary tumors, single examples of two other tumor types and five patients with mass lesions due to inflammatory disease. Contrast enhanced T1 weighted images were evaluated independently by three of the authors for the presence of a dural tail, without knowledge of the diagnoses. The results were compared to the diagnosis for each patient and the performance of individual reviewers compared. When their results were averaged, the reviewers reported the presence of a dural tail in 6 of 10 (60%) meningiomas, although detection varied between observers from 40% to 80%. Each reviewer had one false positive result, two reported a dural tail with a chromophobe adenocarcinoma and one with a toxoplasma meningoencephalitis. When a dural tail is seen an associated mass is most likely a meningioma. It is uncertain whether the dural tail represents neoplastic infiltration beyond the margins of the meningioma. This should be considered when planning treatment.

A report of a cat with a true diaphragmatic hernia in which only falciform fat had herniated is presented. The lesion was misinterpreted as a pulmonary mass. Additional radiographic studies which may have been of diagnostic benefit are briefly discussed.