Abstract A 9-year-old female, neutered European shorthair cat was presented with acute vomiting, obvious jaundice and painful enlargement of the abdomen. Icteric skin and mucous membranes in addition to severe bilirubinaemia (mainly direct bilirubin) and a large increase in liver enzyme activities were the main findings at the initial examination. Radio- and ultrasonographic evaluation revealed a massive fluid-filled structure caudal to the liver displacing abdominal organs, in particular the stomach. As this structure with a diameter of 8–10 cm occupied considerable space in the cranioventral abdomen, a detailed ultrasonographic examination of the liver and the gallbladder, and determination of the structure’s association with a particular abdominal organ was initially impossible. Via ultrasound-assisted puncture under general anaesthesia 300 ml of an almost clear fluid could be aspirated. Cytological examination revealed a cyst content-like fluid with cell detritus. Further ultrasonographic and computed tomographic diagnostics followed by abdominal laparotomy finally enabled diagnosis of a cystic dilatation of the entire common bile duct and accumulation of white bile. Histopathological examination after euthanasia (requested by the owner) identified lymphoplasmacytic cholangitis and necrosis of the duodenal papilla. The massive dilatation of the common bile duct complicated its definite diagnosis by diagnostic imaging methods. It was most likely caused by a longer-standing obstruction of the bile flow by lymphoplasmacytic cholangitis with necrosis and granulation tissue formation in the area of the duodenal papilla. An interesting but initially misleading feature was the presence of white bile. The etiology of this extremely rare condition remains obscure but in the described case a manifestation of impaired hepatocyte function secondary to biliary stasis is suspected to be the cause.

Background The left atrium (LA) is an important prognostic parameter in cardiac pathologies of cats. Its size is currently measured in one-dimensional methods, while human medicine considers two- and three-dimensional echocardiography as standard. The objectives of this study were to compare monoplane, biplane, triplane and real-time three dimensional echocardiography for volumetric measurement of the left atrium in healthy cats and establish a reference interval for further studies on cats with heart disease. Additionally, the influence of age, sex and weight on left atrial volume (LAV) was tested. Results One dimensional monoplane Simpson method of discs (SMOD) in the right parasternal four chamber view (r4) and the left apical 2 chamber view (l2) as well as biplane SMOD had no significant difference for left atrial maximum volume (LAMax). They can be used as equivalent in future studies and one common reference range was set up (1.96 ± 0.54 ml). Those three methods produced significantly higher volumes than triplane echocardiography (RTTPE) and real time three dimensional echocardiography (RT3DE) using TomTec® software. LA volumetry with RTTPE and RT3DE-TomTec™ was more feasible than expected, but low RT3DE image quality was the main reason for excluding patients. Neither age nor weight had an influence on LA volume in healthy cats. Male LAV results were only slightly, but in 2D and RTTPE significantly higher than those of female cats with a range of + 10.46% to + 19.58%. Conclusions Monoplane, biplane, triplane and real-time three dimensional echocardiography were feasible for LA volumetry in healthy cats and showed acceptable intra- and interobserver variability. One common LAMax reference range for monoplane r4, l2 and biplane SMOD was set up. Raw data can be used for LA volumes and does not need to be correlated with the cat’s weight or age. Male cats have only slightly but significantly larger atria than females in 2D and RTTPE. Therefore, under reservation, also sex related limit values were defined.

An Entlebucher Mountain Dog (57 months old, case 1), a Labrador Retriever (24 months, case 2) and an Irish Soft-Coated Wheaten Terrier (31 months old, case 3) were presented for breeding soundness evaluation to the clinic. During semen collection in all 3 dogs, the pre-secretion and the sperm-rich fraction showed normal consistency and colour, whereas the prostatic secretion (3 rd ejaculate fraction) appeared strikingly yellow. In cases 1 and 2, a severely decreased sperm motility (asthenozoospermia) and an increased amount of abnormal spermatozoa (teratozoospermia), and in case 3, a moderately decreased total sperm count (oligozoospermia) were detected. Sonographical examination revealed abnormal findings regarding the uretero-vesical junction and ectopic ureters. Therefore it is concluded that urine admixture to the 3 rd ejaculate fraction may indicate the presence of ectopic ureters and may cause impairment of semen quality and fertility. The present cases raise questions regarding urospermia concerning: 1. its incidence in dogs in general and in connection with ectopic ureters and 2. its relevance as a cause of deficient ejaculate quality and subfertility or infertility.

A 4-year-old male Eurasian Dog presented at our veterinary clinic with a history of perpetual forelimb lameness in both thoracic limbs. In the clinical exploration, direct pressure over the infraspinatus tendon of insertion caused pain in both thoracic forelimbs and a firm band-like structure was palpable. No improvement was observed after treatment with rest, non-steroidal anti-inflammatory drugs and an intralesional injection of a long-acting glucocorticoid. Radiographic examination, ultrasonographic exploration and computed tomography were performed, identifying ossified structures lateral to the proximal humerus and an irregular roughened periosteum at the insertion and tendon of the infraspinatus muscle on both sides. There were more distinct alterations on the right thoracic limb. The imaging results led to a diagnosis of an infraspinatus tendon-bursa ossification accompanied by a chronic tendinopathy/tendovaginitis, accentuated on the right side. The dog was subjected to physiotherapy and autologous conditioned plasma (ACP) was injected into the insertion of the infraspinatus muscle of both thoracic limbs. After 5 months of physiotherapy and two injections of ACP with an interval of one week in both forelimbs, the dog showed no signs of lameness. This case report describes the diagnosis and management of infraspinatus tendon-bursa ossification in a Eurasian Dog. To the authors' knowledge, this condition has previously not been described in this breed of dog.

Die Mukozele der Gallenblase ist eine immer häufiger diagnostizierte Erkrankung, die mit lebensbedrohlichen Komplikationen wie Gallenblasenruptur, Gallengangobstruktion oder nekrotisierender Hepatitis einhergehen kann. Die sonografische Untersuchung ist wichtigster Bestandteil der Diagnostik, um Frühstadien der Mukozele zu erkennen und mit medikamentöser Therapie eine Progression und somit eine Operation zu verhindern. Erkennen Sie im folgenden Beitrag die verschiedenen sonografischen Manifestationen der MZ und die daraus resultierende Therapie.

A one-year-old female dog was presented with severe dysphagia since being a puppy. After a detailed anamnesis, physical examination, observation of the process of swallowing and fluoroscopy, a suspected diagnosis of cricopharyngeal achalasia was made. A myectomy of the cricopharyngeus and parts of the thyreoph-aryngeus was performed. After surgery, the dog was able to eat and drink without difficulties. The success of treatment was controlled 6 months later by telephone interview. The dog was still mainly asymptomatic: on occasion, more than one attempt was necessary for the dog to swallow its food. This is the first case of this disease in a Lagotto Romagnolo.

ZusammenfassungAnhand von Anamnese, Signalement, Auskultations- und Röntgenbefund lässt sich bei Hunden die Verdachtsdiagnose der Mitralklappenendokardiose stellen. Die definitive Diagnosestellung und die genaue Bestimmung des Schweregrades erfordern jedoch eine radiologische Größenbeurteilung des Herzens und eine echokardiographische Evaluierung. Mithilfe der Anzeichen der Volumenbelastung kann so zwischen den Stadien B1 und B2 unterschieden werden. Im Stadium A und B1 bedarf es keiner Therapie, eine halbjährliche bis jährliche kardiologische Kontrolle sollte vorgenommen werden, um die Progression der Erkrankung zu beurteilen. Hinsichtlich der Behandlung im Stadium B2 bestand 2009 noch kein Konsens, doch ist heutzutage aufgrund der EPIC-Studie bei diesen Patienten die lebensverlängernde Wirkung von Pimobendan bewiesen. Nach den Resultaten überwiegend experimenteller Studien, in denen sich bei Gabe eines Hemmers des Angiotensin-konvertierenden Enzyms (ACE-H) ein Aldosteron-Escape-Mechanismus ergab, könnte die Hemmung des Renin-Angiotensin-Aldosteron-Systems durch Kombination von ACE-H und Spironolacton ebenfalls schon im Stadium B2 ein vielversprechender Therapieansatz sein. Für eine endgültige Entscheidung bleibt jedoch die DELAY-Stu die abzuwarten. Bei Hunden im akut lebensbedrohlichen dekompensierten Stadium C3 muss zunächst eine Stabilisierung mittels Steigerung der Diurese, positiv inotropen Medikamenten (Pimobendan) und Sauerstoffsubstitution erfolgen. Eine kontinuierliche Kontrolle der wichtigsten Vitalparameter ist durchzuführen. Anhand dieser Befunde wird die Therapie, insbesondere die Dosierung des Diuretikums, angepasst. Daher ist diese Behandlung nur unter intensivme dizinischer Betreuung möglich. Zur Therapie im chronischen Stadium C 1/2 wird das Vierfach-Therapieprotokoll bestehend aus Furosemid, Pimobendan, ACE-H und Spironolacton angeraten. Das Schleifendiuretikum Torasemid stellt dabei eine Alternative zu Furosemid dar. Hunde im Stadium D (trotz medikamentöser Therapie weiterhin refraktäres Herzversagen) sind schwierig zu stabilisieren und haben eine schlechte Prognose. Zur Stabilisierung finden üblicherweise Methoden Anwendung, die bislang nicht evidenzbasiert untersucht wurden.

Portal vein thrombosis has been rarely described in the dog. It had been associated with hepathopathy, nephropathy, steroid administration, immune mediated anaemia, pancreatitis, neoplasia and vasculitis due to chronic ehrlichiosis. This is the first description of treatment of portal vein thrombosis after abdominal surgery using dalteparin and phenprocoumon in a dog. Portal vein thrombosis developed after "repair of diaphragmatic hernia and small bowel resection in an eight month old Irish-Setter. Thrombosis resulted in ascites formation, portal hypertension, formation of pleural effusion and pancreatic oedema and was treated using dalteparin and phenprocoumon. A loading dose of 0.14 mg/kg BW phenprocoumon once daily on five consecutive days resulted in remarkable changes of the prothrombin time (PT) exceeding the target range. Fortunately, no obvious bleeding or other substantial side effects were observed. The dog showed complete recovery and full re-canalisation of the portal vein was achieved within 19 days. In conclusion, use of phenprocoumon in dogs must be closely monitored with PT and a reduced loading dose should be used in future cases.

Ultrasonographic examination is currently recommended as an important and useful tool in the diagnosis of dogs with urinary incontinence to detect or rule out congenital anomalies, such as ectopic ureters. Ultrasonography is used in the selection for breeding as it is a reliable screening method with low risk of complications for the evaluation of dogs with an increased risk of ureteral malformation. In the B-mode picture, particular attention should be paid to any dilatation or deviation of the ureters. The precise localisation of the ureteral opening is determined using Doppler procedures to image the ureteric jet profile. A distinction is made between intra-and extravesical deviations of the ureteral opening. This manuscript describes the ultrasonography procedure in detail and gives valuable information on the examination and its interpretation.

An echocardiographic examination was carried out in 71 European tortoises (Testudo spp.) via the cervical-brachial acoustic windows. Simultaneously an electrocardiographic examination was performed. The inflow- and outflow tract of the heart were presented in frontal and sagittal longitudinal sections in B-mode. Within B-mode the size (diameter and area) of the atria and the ventricle (Cavum dorsale), the ventricular wall thickness and the diameter of the origin of the right aorta and of the right Arteria pulmonalis were measured. Also, the fractional shortening (FS%) and a fractional area shortening (FAS%) were calculated for the Cavum dorsale. Standard values for these cardiac parameters were determined for four different tortoise groups (depending on their carapace lengths). The direction of blood flow within the heart could be assessed via colour flow Doppler. By using pulsed-wave Doppler examinations of the inflow- and outflow tract the velocities, pressure gradients, velocity-time-integrals and acceleration- and deceleration times could be determined from the recorded inflow and outflow patterns and standard values were established for these parameters as well.

Zusammenfassung Ziel: Vergleich von Epiduralanästhesie und ultraschallgesteuerter Nervenblockade bezüglich analgetischer Effektivität, klinischer Anwendbarkeit sowie Nebenwirkungen bei orthopädischen Eingriffen an der Hintergliedmaße des Hundes. Material und Methoden: In die prospektive, geblindete, randomisierte klinische Studie gingen 22 Hunde der ASA(American Society of Anesthesiologists)-Stufen I und II ein, bei denen ein orthopädischer Eingriff ab dem distalen Drittel des Femurs erfolgte. Den Hunden wurden randomisiert 0,5 mg/kg Bupivacainhydrochlorid (0,5%) und 0,1 mg/kg Morphinsulfat (1%) epidural (EPI) oder unter Ultraschallkontrolle perineural (LA) verabreicht. Intraoperativ wurden Herzfrequenz, Atemfrequenz, mittlerer arterieller Blutdruck (MAP), endexspiratorische Isoflurankonzentration und die Anzahl der zusätzlich benötigten Fentanyl-Boli (5 µg/kg i. v.) als Rescue-Analgesie protokolliert. Präoperativ sowie postoperativ zu Stunde 2, 4, 6, 12 und 24 nach Extubation wurde der Schmerzgrad mittels der Kurzform des Glasgow Composite Measure Pain Scale (GCMPS) bestimmt. Bei einem GCMPS > 6 erhielten die Hunde Methadon (0,2 mg/kg i. v.) als Rescue-Analgesie. Zur statistischen Auswertung dienten Chi-Quadrat-Test, Fisher-Test, Wilcoxon-Test sowie ein- und zweifaktorielle ANOVA mit Signifikanz bei p < 0,05. Ergebnisse: Während der Anästhesie betrug der mittlere MAP in Gruppe EPI 86,6 ± 8,7 mmHg und in Gruppe LA 111,2 ± 11,2 mmHg. Postoperativ lag der MAP in Gruppe EPI bei 95,2 ±13,1 mmHg und in Gruppe LA bei 119,3 ± 18,2 mmHg. Der MAP der Gruppe EPI war durchgehend signifikant niedriger als der der Gruppe LA (p = 0,0421). Weitere signifikante Unterschiede ergaben sich nicht. Urinretention oder motorische Beeinträchtigungen wurden nicht beobachtet. Schlussfolgerung: Die ultraschallgesteuerte Nervenblockade des N. femoralis und des N. ischiadicus garantieren eine zur Epiduralanästhesie vergleichbare perioperative Analgesie. Die Unterschiede des MAP zeigten klinisch keine Relevanz. Unter stationären Bedingungen ergab sich kein Nachteil bezüglich der Gliedmaßen- und Blasenfunktion.

25 formalin-fixed hearts of different tortoise species (Testudinidae) underwent gross anatomical examination. The aim of the study was to illustrate the specific anatomy of the heart of these species in comparison to the data available in the literature. The examined tortoises showed the well-known basic structure of a reptile heart with two atria and a ventricle composed of three interconnected chambers. The right atrium was consistently slightly larger than the left atrium. The atrioventricular (AV-) valves emerged as double-flap valves, whereby the lateral leaflets were only present in a rudimentary form. Neither papillary muscles nor chordae tendineae could be detected macroscopically. A vertical septum in order to subdivide the dorsal chambers was missing. However, the muscular ridge between Cavum venosum and Cavum pulmonale was well developed. The Cavum pulmonale represented itself as the smallest chamber respectively rather as a small passageway to the Truncus pulmonalis. Apart from two-parted aortic valves also multicuspidated valves of the Truncus pulmonalis could be visualized.

Real-time three-dimensional echocardiography (RT3DE) enables accurate volume determination of the left ventricle (LV), since measurements in foreshortened depicted views are avertable. Different analyzing programs are available for this RT3DE. The commonly used semi-automatic software 4D-AutLVQ™ showed underestimation of LV volumes in comparison with CMRI in healthy anesthetized dogs (Am J Vet Res 74(9):1223–1230, 2013). TomTec 4D LV-Function™ is an offline analysis program for morphological and functional analyses of the left ventricle by using manual measurement optimization, showing excellent agreement with CMRI in human medicine (Echocardiography 27(10):1263–1273, 2010; Eur J Echocardiogr 11(4):359–368, 2010; Echocardiography 24(9):967–974, 2007). The aim of the present study was to compare these different RT3DE analyzing software programs to test the possibility of one performing better than the other by assessing accuracy and reproducibility in comparison with the reference method cardiac magnetic resonance imaging (CMRI) by determining the left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF).

Harnabsatzstörungen zählen zu den bei Katzen häufigsten Krankheitskomplexen und werden unter dem Begriff Feline Lower Urinary Tract Disease (FLUTD) zusammengefasst. Idiopathische Zystitis und Kristallurie sind die häufigsten Grunderkrankungen, bakterielle Zystitis und Neoplasie mögliche Differenzialdiagnosen. Die klinische Symptomatik besteht vorwiegend aus Dysurie, Periurie, Pollakisurie, Hämaturie oder Strangurie und ermöglicht keine sichere Differenzierung. Blutuntersuchungen und ein Harnstatus sind wichtiger Teil der diagnostischen Abklärung, in der Regel kann aufgrund dieser Befunde jedoch keine endgültige Diagnose gestellt werden. Die Sonografie ermöglicht die korrekte Diagnose vieler Harnblasenerkrankungen sowie verschiedene Interventionen und erleichtert somit die optimale Therapieplanung. Daher ist die Sonografie ein wichtiger Bestandteil der Diagnostik bei Harnblasenerkrankungen der Katze. Ziel dieses Artikels ist es, die fundierte sonografische Untersuchung der Harnblase sowie die korrekte Beurteilung der möglichen Pathologien und die hieraus folgenden Therapieentscheidungen für den normalen Praxisalltag herauszustellen.

Chronic degenerative valve disease (CDVD) is the most common cardiac disease in dogs, usually resulting in mitral valve insufficiency (MVI). The goal of this study was to investigate the occurrence of MVI in clinically healthy Beagle populations. A total of 79 adult healthy Beagles (41 females and 38 males; age: 5.6 ± 2.7 years, range 1.4 to 11.7 years) were examined. The diagnosis of MVI was based on the detection of a systolic murmur heard above the mitral valve, and was confirmed by colour flow Doppler (CFD) echocardiography. Systolic mitral valve murmurs were detected in 20/79 dogs (25.3%), of them 11 males and 9 females with no statistically significant gender difference (P = 0.6059). The strength of the murmur on the semi-quantitative 0/6 scale yielded intensity grade 1/6 in 10 dogs, grade 2/6 in 4 dogs, and grade 3/6 in 6 dogs. Mild to moderate MVI was detected by CFD in all these 20 dogs with systolic murmurs. Of them, 17 dogs had mild and 3 demonstrated moderate MVI, showing 10-30% and 30-50% regurgitant jets compared to the size of the left atrium, respectively. The age of dogs with MVI was 7.1 ± 2.3 years, which was significantly different from that of dogs without MVI (5.1 ± 2.7 years, P = 0.0029). No significant differences in body weight (P = 0.1724) were found between dogs with MVI (13.8 ± 2.8 kg) and those without MVI (12.8 ± 3.0 kg). Mitral valve disease causing MVI is relatively common in Beagle dogs, just like in other small breed dogs reported in the literature.

BACKGROUND:Right ventricular (RV) volume and function are important diagnostic and prognostic factors in dogs with primary or secondary right-sided heart failure. The complex shape of the right ventricle and its retrosternal position make the quantification of its volume difficult. For that reason, only few studies exist, which deal with the determination of RV volume parameters. In human medicine cardiac magnetic resonance imaging (CMRI) is considered to be the reference technique for RV volumetric measurement (Nat Rev Cardiol 7(10):551-563, 2010), but cardiac computed tomography (CCT) and three-dimensional echocardiography (3DE) are other non-invasive methods feasible for RV volume quantification. The purpose of this study was the comparison of 3DE and CCT with CMRI, the gold standard for RV volumetric quantification.RESULTS:3DE showed significant lower and CCT significant higher right ventricular volumes than CMRI. Both techniques showed very good correlations (R > 0.8) with CMRI for the volumetric parameters end-diastolic volume (EDV) and end-systolic volume (ESV). Ejection fraction (EF) and stroke volume (SV) were not different when considering CCT and CMRI, whereas 3DE showed a significant higher EF and lower SV than CMRI. The 3DE values showed excellent intra-observer variability (<3%) and still acceptable inter-observer variability (<13%).CONCLUSION:CCT provides an accurate image quality of the right ventricle with comparable results to the reference method CMRI. CCT overestimates the RV volumes; therefore, it is not an interchangeable method, having the disadvantage as well of needing general anaesthesia. 3DE underestimated the RV-Volumes, which could be explained by the worse image resolution. The excellent correlation between the methods indicates a close relationship between 3DE and CMRI although not directly comparable. 3DE is a promising technique for RV volumetric quantification, but further studies in awake dogs and dogs with heart disease are necessary to evaluate its usefulness in veterinary cardiology.