Pain Management Dr. J.M. Roesner, DVM, DABVP Dr. Vanessa Lee, DVM.
SMALL ANIMAL RADIOLOGY CASE DISCUSSIONS Sarah Jones, DVM
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SMALL ANIMAL RADIOLOGY CASE DISCUSSIONSSarah Jones, DVM
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CASE 1
• 11 YO MN Beagle
• Acute onset pelvic limb lameness
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WHAT WOULD YOU RECOMMEND?
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DIAGNOSTICS/OUTCOME
• Ultrasound guided bone aspirate was inconclusive
• Recommended bone scan to rule out other polyostotic lesions
• Ultimately amputation
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CASE 2
• 3 month old M Boxer
• Chronic history of vomiting and diarrhea
• Acute worsening 2 days ago
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WHAT WOULD YOU RECOMMEND?
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DIAGNOSTICS/OUTCOME
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CASE 3
• 3 YO MN GSD
• 6 month history of back pain
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WHAT WOULD YOU RECOMMEND?
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DIAGNOSTICS/OUTCOME
• Abdominal ultrasound
• Suspected pyelonephritis and ureteritis.
• Aortic wall thickening and thrombosis
• Sublumbar lymphadenopathy
• FNA sublumbar lymph nodes
• Cytology: Neutrophilic inflammation with fungal sepsis
• Aspergillus Ag Positive
• Cryptococcus Negative
• Urine cultured fungal organisms
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ANOTHER EXAMPLE: DISCOSPONDYLITIS
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CASE 4
• 1 YO FS Pit Bull
• Vomiting
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WHAT WOULD YOU RECOMMEND?
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ULTRASOUND
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ULTRASOUND
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ULTRASOUND
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ULTRASOUND
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DIAGNOSIS/OUTCOME
• ULTRASOUND: Retroperitoneal effusion
• Cytology: Neutrophilic exudate with hemorrhage and lipid, no infectious organisms seen
• OUTCOME: Discharged home with supportive pain management
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CASE 5
• 7 YO MN Chihuahua
• Chronic cough
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CASE 6
• 6 MO FS DSH
• Respiratory distress
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DIAGNOSIS/OUTCOME
• Pneumothorax, likely tension pneumothorax
• Therapeutic thoracocentesis
• Supportive care: Pain medication, antibiotics, IVF
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ANOTHER EXAMPLE: PNEUMOTHORAX
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QUESTION 1
• What are some radiographic features of aggressive osseous lesions?
1. Cortical disruption
2. Permeative osteolysis
3. Long zone of transition
4. Interrupted, irregular periosteal reaction
5. Poorly demarcated
6. Rapid rate of change
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WHICH FEATURES OF THIS LESION COULD BE CHARACTERIZED AS AGGRESSIVE?
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QUESTION 2
• What are your differentials for diffusely dilated small intestines?
1. Functional ileus (e.g. enteritis)
2. Distal mechanical obstruction (e.g. foreign body, distal annular neoplasia)
• What does a “gravel sign” indicate?
1. Chronic, partial obstruction
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QUESTION 3
• What are a few radiographic differences between spondylosis deformans and discospondylitis?
Discospondylitis: Vertebral end plate irregularity/lysis with surrounding sclerosis
Spondylosis deformans: No end plate lysis. Smoothly marginated periosteal new bone bridging vertebral bodies usually along the ventral and lateral aspects.
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QUESTION 4
• How does retroperitoneal effusion appear radiographically?
Border effacement of the kidneys, soft tissue opacity within the retroperitoneal space, ventral deviation of the colon
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QUESTION 5
• Define tension pneumothorax. How does it differ from a “routine” pneumothorax on radiographs?
Tension pneumothorax: Progressive build-up of air within the pleural space without escape of air.
On radiographs, tension pneumothorax results in mediastinal shift with collapse of the ipsilateral lung and compression of the contralateral lung.
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THANK YOU!!• Questions?
• FEEL FREE TO EMAIL ME WITH SUGGESTIONS FOR NEXT TIME
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