Spooky Skeletons and Icky Innards

posted on October 05, 2016 by Dr. Jamie Hartman

This is the month of halloween, and skeletons, goblins, and guts will make their annual appearance.  In medicine, we tend to see bones and organs in a different way that this freaky holiday portrays however.

screen-shot-2016-10-05-at-2-19-14-pm

Dog bones costume

Since the skeleton and organs are on the inside of the body, we often require some means of diagnostic
imaging to see them.  Diagnostic imaging can include a variety of tools-the most common being x-rays (radiographs) and ultrasound.  Others include things such as CT scans, MRI scans, endoscopy (and it’s many branches), fluoroscopy, or PET scans.

Radiographs or x-rays are one of the most commonly used diagnostic imaging tools used.  They take a two dimensional picture of an area of the body.  They can see bones and metal as bright white, and gas or air as dark black, and fluid, fat, and other soft tissues as other shades of gray.  It can reveal the outline of organs as well seeing some of the contents in the stomach or intestines.  X-rays can be used to see if there is heart enlargement, fluid buildup, foreign body ingestions, tumors, fractures, bladder stones, or infections present.  X-rays are not the best at seeing inside some of the other organs such as the liver, kidneys, spleen, or pancreas.

screen-shot-2016-10-05-at-2-13-33-pmRadiograph of abdomen of a male dog.

Ultrasound is another common tool used to image the inside of a pet’s body.  The ultrasound is a real time movie of the organ’s insides, and can show blood flow and movement.  It has a hard time determining overall size of an organ, so x-rays are still often used to determine if a liver or heart for example are enlarged.  An echocardiogram is an ultrasound of the heart, and can be used to see the values, wall thickness, and look for turbulent blood flow (murmurs).  Abdominal ultrasounds are able to look inside the liver, gall bladder, spleen, kidneys, bladder and intestines.  It can find small organs not visible on x-rays such as the adrenal glands, lymph nodes, and the pancreas.  However, ultrasounds cannot see through gas, so it has a difficult time seeing all of the intestinal tract and stomach, and cannot be used well to look at the lungs.

screen-shot-2016-10-05-at-2-12-47-pmUltrasound of abdomen.  Spleen across top, left kidney in the center of the photo.

Pets can undergo CT or MRI scans as well.  They have to be anesthetized to have these performed, but these diagnostic tools give a better look inside the body.  They can be used to look at the brain, spinal cord, look for pinched nerves/slipped discs or intervertebral disc disease and for this reason are useful in planning back surgeries.  They can be used to look for tumors and tumor spread, and can often be used to plan surgical removal or or radiation treatment of certain types of cancer.

screen-shot-2016-10-05-at-2-26-14-pmMRI machine at the University of Minnesota

Another diagnostic imaging tool available is endoscopy.  This involved using a camera scope to look inside certain organs such as the GI tract (endoscopy or colonoscopy), inside the airways (bronchoscopy), inside the nose (rhinoscopy), inside the ears (otoscopy) or inside the joints (arthroscopy).  Small samples of tissues can often be taken when using a scope to help get a diagnosis.  Sometimes removal of foreign material or tumors or polyps can also be performed with a scope.

Fluoroscopy is very similar to x-rays, but it is a live movie like x-ray.  It is used for things that are dynamic, such as collapsing tracheas or swallow studies.  This is only done at specialty clinics.

Lastly, some animals can have a PET scan done.  PET scans are a specialized test where a radioactive medication is given, and images are taken to see where the medication travels in the body and where there is uptake.  For instance, thyroid cancers tend to uptake radioactive iodine medications.  This is a very specialized type of diagnostic imaging that is only used in certain cases and is performed by specialists.

Overall, with the variety of diagnostic imaging tools available in the medicine field, we are able to diagnose a variety of diseases, perform surgery or start medications to help manage, treat, or even cure these diseases, and to monitor progress.  Through imaging, we are able to offer better medicine for our pets!

Don’t let a bum knee bum out your pet (Part II)

posted on September 03, 2013 by Dr. Jamie Hartman

The most common injury to a dog’s knee is an ACL tear, which stands for anterior cruciate ligament tear.  In dogs, the more correct term is cranial cruciate ligament tear or rupture, CCLR.  This is simply because of the fact that dogs walk on all fours instead of upright, but the ligament is the same and serves the same function regardless of what it is called.

The ACL attaches at the rear of the femur, and crosses to the front of the knee to attach to the front of the tibia.  It’s function is to prevent abnormal forward movement of the tibia relative to the knee joint.  When torn, a veterinarian may be able to demonstrate this forward movement, called a drawer sign upon physical examination.

A pet that has torn it’s ACL may suddenly become non weight bearing lame on a rear leg, or may only toe touch with that leg.  If left alone, the pet seems to improve in a week or two, but this is simply because the body starts to make changes to the knee joint to try to stabilize it.  There are usually significant arthritic changes that occur if the torn ligament is not repaired.  In addition, dogs that tear one ligament are more likely to tear the other one, so repairing the first tear to prevent additional strain on the non-torn ligament is recommended.

There are a number of different methods to repair a torn ACL.  The choice is based on the pet’s age, activity level, degree of arthritis, size, and other factors.  Options for repair include:

  • Extracapsular repair
  • TPLO, or tibial plateau leveling osteotomy
  • TTA, or tibial tuberosity advancement

After surgery, anti-inflammatory pain medications or NSAIDs are often used.  Long term use of glucosamine and chondroitin are often recommended.  Rehabilitation exercises and restrictions of activity may be recommended as well.  Keeping the pet at a lean weight helps decrease strain on the joints.

If your pet has injured their knee, a veterinarian visit is in order.  X-rays or radiographs may be recommended, and if a torn ACL is diagnosed, a discussion with the specialty surgeon and your pet’s lifestyle will determine which type of surgery will be recommended.  Together we can help your pet regain as much function as possible and decrease the likelihood of arthritis in the future.  Call us today to discuss the options available to your pet!