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Introduction: Acute thoracolumbar intervertebral disc herniation (IVDH) constitutes an emergency because associated neurological clinical signs can be progressive, with prognosis dependent on preoperative presence of deep pain perception. Pre-anesthetic thoracic radiographs are routinely performed to evaluate for potential pathology that could result in increased risk or change in overall prognosis. However, due to the emergent nature of this disease, the weight of thoracic radiographic findings on treatment plans for these dogs in unknown. The objective of this study was to investigate the clinical benefit of thoracic radiographs prior to advanced spinal imaging and surgery for acute non-ambulatory dogs with suspected T3-L3 myelopathy. Methods: Consecutive dogs presented with presumed acute IVDH between July 2020-July 2022 were identified, and medical records were reviewed retrospectively. Age, body weight, and alteration of treatment plan were compared between the dogs with positive thoracic pathology identified on thoracic radiographs and those with negative thoracic pathology. Results: Only 2/105 dogs had their diagnostic and treatment plans changed due to thoracic radiographic findings. Dogs with radiographic pathology diagnosed (2/16) were more likely to have their treatment plans changed than dogs with no radiographic pathology (0/89) (p = 0.014). The odds of radiographic thoracic pathology were 4.6 times higher in dogs aged 12 years or older [OR 4.6 (95%CI 1.2-17, p = 0.026]. Discussion: Performing routine thoracic radiography prior to advanced (anesthetized) diagnostic spinal imaging in presumed IVDH cases rarely resulted in a change to the treatment plan, thought eh practice may be clinically relevant in dogs 12 years of age or older. [ABSTRACT FROM AUTHOR]

Abstract Background Predicting progression of myxomatous mitral valve disease (MMVD) in dogs can be challenging. Hypothesis/Objectives The mitral regurgitation severity index (MRSI) will predict time to congestive heart failure (CHF) and all‐cause death in dogs with MMVD. Animals Eight hundred sixty‐nine client‐owned dogs. Methods Retrospective study pooling data from 4 previous samples including dogs with MMVD stage B2 or C. MRSI was calculated as: (heart rate [HR]/120) × left atrium‐to‐aorta ratio (LA:Ao) × (age in years/10) × 100. Alternative MRSI formulas substituting radiographic measures of left atrial size were also calculated. Cox proportional hazard modeling and time‐dependent receiver‐operator characteristic curves quantified prognostic performance. Results For Stage B2 pooled samples, MRSI > 156 was predictive of time to CHF (median 407 vs 1404 days; area under the curve [AUC] 0.68; hazard ratio 3.02 [95% CI 1.9‐4.9]; P 173 was predictive of all‐cause death (median survival 868 vs 1843 days; AUC 0.64; hazard ratio 4.26 [95% CI 2.4‐7.5]; P

Background: Predicting progression of myxomatous mitral valve disease (MMVD) in dogs can be challenging. Hypothesis/Objectives: The mitral regurgitation severity index (MRSI) will predict time to congestive heart failure (CHF) and all‐cause death in dogs with MMVD. Animals: Eight hundred sixty‐nine client‐owned dogs. Methods: Retrospective study pooling data from 4 previous samples including dogs with MMVD stage B2 or C. MRSI was calculated as: (heart rate [HR]/120) × left atrium‐to‐aorta ratio (LA:Ao) × (age in years/10) × 100. Alternative MRSI formulas substituting radiographic measures of left atrial size were also calculated. Cox proportional hazard modeling and time‐dependent receiver‐operator characteristic curves quantified prognostic performance. Results: For Stage B2 pooled samples, MRSI > 156 was predictive of time to CHF (median 407 vs 1404 days; area under the curve [AUC] 0.68; hazard ratio 3.02 [95% CI 1.9‐4.9]; P <.001). MRSI > 173 was predictive of all‐cause death (median survival 868 vs 1843 days; AUC 0.64; hazard ratio 4.26 [95% CI 2.4‐7.5]; P <.001). MRSI showed superior predictive value compared to the individual variables of HR, LA:Ao, and age. Variations of the MRSI equation substituting radiographic vertebral left atrial size for LA:Ao were also significantly predictive of outcome in stage B2. MRSI was not consistently predictive of outcome in Stage C. Conclusions and Clinical Importance: MRSI was predictive of outcome (onset of CHF and all‐cause death) in MMVD Stage B2, demonstrating utility as a useful prognostic tool. Echocardiographic LA:Ao can be effectively replaced by radiographically determined LA size in the MRSI formula. [ABSTRACT FROM AUTHOR]

Abstract Background Evidence regarding optimal treatment duration in dogs with aspiration pneumonia (AP) and the role of thoracic radiographs (TXR) and lung ultrasonography (LUS) in the long‐term follow‐up of affected dogs is lacking. C‐reactive protein (CRP) is a reliable acute phase protein to monitor bacterial pneumonia in dogs. Hypothesis Investigate the safety of antimicrobial discontinuation based on clinical improvement and serum CRP normalization, as well as the usefulness of TXR and LUS for follow‐up. Animals Dogs diagnosed with AP and treated with antimicrobials. Methods Prospective observational study. Antimicrobials were discontinued based on clinical improvement and serum CRP normalization after 1, 3, or 5 weeks. At each consultation, a quality‐of‐life questionnaire, physical examination, serum CRP, TXR, and LUS were assessed. Short‐ (2 weeks) and long‐term (>1 month) follow‐ups after treatment discontinuation were performed to monitor for possible relapses. Results Seventeen dogs were included. Antimicrobials were discontinued after 1 week in 12 dogs (70.6%) and 3 weeks in the remaining 5 dogs (29.4%). Short‐term relapse was not observed in any dog and long‐term relapse was diagnosed in 3 dogs. Thoracic radiographs and LUS were useful for diagnosis, but did not add additional information during follow‐up, because image normalization lagged behind clinical improvement and serum CRP normalization. Conclusion and Clinical Importance Dogs with AP can be safely and effectively treated using a short‐term antimicrobial regimen discontinued after clinical improvement and serum CRP normalization. Imaging might still be useful for complicated cases with a less favorable response to treatment.

Background: Evidence regarding optimal treatment duration in dogs with aspiration pneumonia (AP) and the role of thoracic radiographs (TXR) and lung ultrasonography (LUS) in the long‐term follow‐up of affected dogs is lacking. C‐reactive protein (CRP) is a reliable acute phase protein to monitor bacterial pneumonia in dogs. Hypothesis: Investigate the safety of antimicrobial discontinuation based on clinical improvement and serum CRP normalization, as well as the usefulness of TXR and LUS for follow‐up. Animals: Dogs diagnosed with AP and treated with antimicrobials. Methods: Prospective observational study. Antimicrobials were discontinued based on clinical improvement and serum CRP normalization after 1, 3, or 5 weeks. At each consultation, a quality‐of‐life questionnaire, physical examination, serum CRP, TXR, and LUS were assessed. Short‐ (2 weeks) and long‐term (>1 month) follow‐ups after treatment discontinuation were performed to monitor for possible relapses. Results: Seventeen dogs were included. Antimicrobials were discontinued after 1 week in 12 dogs (70.6%) and 3 weeks in the remaining 5 dogs (29.4%). Short‐term relapse was not observed in any dog and long‐term relapse was diagnosed in 3 dogs. Thoracic radiographs and LUS were useful for diagnosis, but did not add additional information during follow‐up, because image normalization lagged behind clinical improvement and serum CRP normalization. Conclusion and Clinical Importance: Dogs with AP can be safely and effectively treated using a short‐term antimicrobial regimen discontinued after clinical improvement and serum CRP normalization. Imaging might still be useful for complicated cases with a less favorable response to treatment. [ABSTRACT FROM AUTHOR]

Introduction: Acute thoracolumbar intervertebral disc herniation (IVDH) constitutes an emergency because associated neurological clinical signs can be progressive, with prognosis dependent on preoperative presence of deep pain perception. Pre-anesthetic thoracic radiographs are routinely performed to evaluate for potential pathology that could result in increased risk or change in overall prognosis. However, due to the emergent nature of this disease, the weight of thoracic radiographic findings on treatment plans for these dogs in unknown. The objective of this study was to investigate the clinical benefit of thoracic radiographs prior to advanced spinal imaging and surgery for acute non-ambulatory dogs with suspected T3-L3 myelopathy., Methods: Consecutive dogs presented with presumed acute IVDH between July 2020-July 2022 were identified, and medical records were reviewed retrospectively. Age, body weight, and alteration of treatment plan were compared between the dogs with positive thoracic pathology identified on thoracic radiographs and those with negative thoracic pathology., Results: Only 2/105 dogs had their diagnostic and treatment plans changed due to thoracic radiographic findings. Dogs with radiographic pathology diagnosed (2/16) were more likely to have their treatment plans changed than dogs with no radiographic pathology (0/89) ( p  = 0.014). The odds of radiographic thoracic pathology were 4.6 times higher in dogs aged 12 years or older [OR 4.6 (95%CI 1.2-17, p  = 0.026]., Discussion: Performing routine thoracic radiography prior to advanced (anesthetized) diagnostic spinal imaging in presumed IVDH cases rarely resulted in a change to the treatment plan, thought eh practice may be clinically relevant in dogs 12 years of age or older., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Takedai, Block, Pinal and Frederick.)

Interpretation of pulmonary radiographs is one of the most difficult aspects of radiology and interobserver variability is high. The aim of this study was to assess variations in interpretation of pulmonary pathology amongst Brazilian veterinarians with different levels of training and experience, using the interpretation by American board-certified radiologists as a reference. We identified areas where interpretation is particularly challenging. Sixty digital canine thoracic radiographic examinations were interpreted by four groups of three Brazilian observers, each group being defined by different levels of training and experience. The radiographic findings of the 4 groups of observers in the study were compared to a reference interpretation established from the findings of three ACVR board-certified radiologists. The degree of discrepancy for each list between each group and the reference interpretation was assessed according to a three-level scoring system: no discrepancy, minor discrepancy, or major discrepancy. Data was analyzed using a Kappa and Cochran-Mantel-Haenszel tests. Brazilian veterinarians with the most training and experience showed the least interobserver variation and best performance when compared to the reference interpretation, followed by those with practical training, but with little work experience in professional practice. The radiographic patterns that were associated with the highest interobserver variability were the vascular, unstructured interstitial and bronchial patterns. Interobserver major discrepancies occurred in all groups, but is more evident in groups with the least training (44.4%) and the general practitioners (26.7%) group. It can be concluded that training positively influences the accuracy of radiographic interpretation and is recommended to reduce erroneous diagnoses.

Leptospirosis in dogs is a multiorgan disease affecting mostly kidneys and liver. The objective was to characterize prevalence, clinical, and radiological features and outcome of dogs with leptospirosis and pulmonary abnormalities. Fifty dogs with leptospirosis. Medical records of dogs diagnosed with leptospirosis at the Small Animal Clinic, Berlin, were reviewed. Diagnosis was based on microscopic agglutination test, blood or urine polymerase chain reaction, and histopathology. Based on clinical and/or radiological signs, patients were grouped into dogs with lung abnormalities (group 1) or without (group 2). Severity of respiratory distress was scored as mild to moderate (grade 1) or severe (grade 2). Thoracic radiographs were scored based on pulmonary changes and location as grade 1 (caudal interstitial pattern), 2 (generalized mild to moderate reticulonodular interstitial pattern), or 3 (generalized severe reticulonodular interstitial pattern with patchy alveolar consolidations). Results of CBC and biochemistry were compared between groups. Thirty-five dogs had radiological pulmonary changes (grade 1: 5; grade 2: 14; grade 3: 16); 31 of them had pulmonary distress (grade 1: 13, grade 2: 18). Sixty-seven percent of the dogs with dyspnea grade 2 were mainly euthanized because of respiratory distress. Fifteen percent of the dogs with dyspnea grade 1 and 21% without clinical respiratory signs were euthanized because of acute renal failure or sepsis. In 70% of dogs with leptospirosis pulmonary changes were detected. Lung involvement represented a severe complication causing increased case fatality depending on the severity of respiratory distress. [ABSTRACT FROM AUTHOR]

DICOM header information is frequently used to classify medical image types; however, if a header is missing fields or contains incorrect data, the utility is limited. To expedite image classification, we trained convolutional neural networks (CNNs) in two classification tasks for thoracic radiographic views obtained from dual-energy studies: (a) distinguishing between frontal, lateral, soft tissue, and bone images and (b) distinguishing between posteroanterior (PA) or anteroposterior (AP) chest radiographs. CNNs with AlexNet architecture were trained from scratch. 1910 manually classified radiographs were used for training the network to accomplish task (a), then tested with an independent test set (3757 images). Frontal radiographs from the two datasets were combined to train a network to accomplish task (b); tested using an independent test set of 1000 radiographs. ROC analysis was performed for each trained CNN with area under the curve (AUC) as a performance metric. Classification between frontal images (AP/PA) and other image types yielded an AUC of 0.997 [95% confidence interval (CI): 0.996, 0.998]. Classification between PA and AP radiographs resulted in an AUC of 0.973 (95% CI: 0.961, 0.981). CNNs were able to rapidly classify thoracic radiographs with high accuracy, thus potentially contributing to effective and efficient workflow., (© 2020 Society of Photo-Optical Instrumentation Engineers (SPIE).)