Andrea De Bonis

This study investigates the usefulness of extemporaneous cytological examination performed during imaging-guided biopsies in dogs and cats. In veterinary diagnostics, imaging techniques such as ultrasound and computed tomography are essential for identifying lesions, but they cannot distinguish between inflammatory and neoplastic processes. Biopsies are therefore required, and this study explores whether immediate cytological evaluation of tissue cores, rolled onto slides and examined under a microscope, can help determine sample adequacy and reduce the number of biopsies needed. Seventy-nine animals with soft tissue or bone masses underwent ultrasound or CT-guided biopsies, followed by extemporaneous cytology and histopathological analysis. Cellular material representative of the lesion was identified in 81.1% of cases, allowing clinicians to conclude the procedure without further sampling. The diagnostic accuracy of cytology compared to histology was 68.3%, with particularly high accuracy for lipomas, melanomas, and mast cell tumors. When excluding non-diagnostic samples due to poor preparation or lesion characteristics, the accuracy reaches 92.1%. These findings suggest that extemporaneous cytology is a useful tool for verifying sample adequacy in real time, potentially reducing procedural risks and improving diagnostic efficiency. While histology remains the gold standard, this method offers immediate feedback and may enhance clinical decision-making in veterinary interventional diagnostics.

The integration of artificial intelligence (AI) into chest radiography (CXR) has greatly impacted both human and veterinary medicine, enhancing diagnostic speed, accuracy, and efficiency. In human medicine, AI has been extensively studied, improving the identification of thoracic abnormalities, diagnostic precision in emergencies, and the classification of complex conditions such as tuberculosis, pneumonia, and COVID-19. Deep learning-based models assist radiologists by detecting patterns, generating probability maps, and predicting outcomes like heart failure. However, AI is still supplementary to clinical expertise due to challenges such as data limitations, algorithmic biases, and the need for extensive validation. Ethical concerns and regulatory constraints also hinder full implementation. In veterinary medicine, AI is still in its early stages and is rarely used; however, it has the potential to become a valuable tool for supporting radiologists in the future. However, challenges include smaller datasets, breed variability, and limited research. Addressing these through focused research on species with less phenotypic variability (like cats) and cross-sector collaborations could advance AI in veterinary medicine. Both fields demonstrate AI’s potential to enhance diagnostics but emphasize the ongoing need for human expertise in clinical decision making. Differences in anatomy structure between the two fields must be considered for effective AI adaptation.

Sonoelastography is a rapid and non-invasive ultrasound-based technique to assess tissue elasticity. Interest in this technique’s application in veterinary medicine is progressively increasing, with preliminary reports also available to assess canine testicular parenchyma abnormalities. Since elastographic techniques are different and it is of paramount importance to standardize procedures, this work aimed to compare two different elastographic techniques, SE and 2D SWE, on the same testes and compare the data with the current literature. Thirty healthy canine testes were included, and complete B-mode, color and power Doppler examinations were performed on each one. SE was performed qualitatively through an elastogram evaluation and semiquantitatively comparing the parenchyma with peripheral skin. 2D SWE was performed and m/s measurements were taken. Each measurement was collected in the cranial, middle and caudal portions, considering the sections above and below the mediastinum separately. The healthy testes appeared to be intermediate in stiffness with differences in the various portions for SE and expressed a mean value from 1.3 m/s to 1.4 m/s for 2D SWE, consistent with the previous literature. Considering the technical specifics of the software for the two elastography methods, both of them are valuable in assessing canine testis stiffness and are potentially clinically appliable.

Subcutaneous lesions in dogs are common in clinical practice. This prospective clinical study aims to compare B-flow and CEUS for the characterization of subcutaneous lesions evaluating their usefulness to distinguish benign subcutaneous lesions from malignant ones. Dogs were enrolled and ultrasound cine-loops were achieved in B-mode, Colour Doppler, Power Doppler, B-flow and CEUS. Lesions vascularisation highlighted through B-flow and CEUS were classified into five patterns: P1, absence of contrast uptake; P2, enhancement only in the peripheral area of the lesion; P3, thin (5/field); P5 enhancement with a reticular aspect and both thick and thin bands inside. Patterns highlighted with B-flow and CEUS were compared to a histological diagnosis of subcutaneous lesions. A total of 24 dogs and 30 subcutaneous nodules were included and divided into three groups: 3 non-neoplastic, 16 benign tumours and 11 malignant tumours. There was a statistically significant difference for B-flow and CEUS to differentiate benign tumours from malignant tumours. B-flow and CEUS had an excellent agreement. B-flow and CEUS displayed similar ability to evaluate different patterns and could be helpful in the evaluation of subcutaneous nodules.

Strain elastography (SE) evaluates tissue stiffness, providing qualitative and semiquantitative evaluation, with a strain ratio (SR) > 1 indicating that the target lesion is stiffer than the reference tissue. The patellar tendon has been described as soft in healthy dogs and hard in dogs with cranial cruciate ligament rupture, but SR usefulness has not been assessed. Dogs were divided into healthy (G1) and at least 1 month after surgery (G2) groups. Thickness was recorded, and a B-mode score of 0–3 was determined based on the abnormality’s severity. SE was qualitatively performed with a score of 1–4, and EI was recorded on the whole ligament and in proximal, intermediate and distal areas; SR was collected with the fat pad and cutis/subcutis. G1 was significantly thinner, with a lower score than G2 and a more elastic pattern. EI for G1 was significantly lower than G2 for the whole tendon and the single portions, and EI for the distal portion was significantly lower than the proximal and intermediate one in G2. SR was 1 in G2 for both the fat pad and cutis/subcutis. These data suggest that after surgery, the tendon may become non-uniformly stiffer. The cutis/subcutis appears to be a more reliable reference tissue than the infrapatellar fat pad.

Cats are often easily stressed and uncooperative. The use of sedative agents in the feline species is widely used to perform even minor clinical and diagnostic procedures. The aim of this study is to assess the impact on tear film production of the intrarectal route (IR) administration of a mixture of dexmedetomidine, ketamine and midazolam in comparison with the intramuscular (IM) one. A group of twenty cats were involved in a randomized and blinded clinical trial. A clinical and ophthalmological examination was conducted on the cats. The IR group received dexmedetomidine 0.003 mg kg⁻¹, ketamine 4 mg kg⁻¹ and midazolam 0.4 mg kg⁻¹; the IM group received dexmedetomidine 0.003 mg kg⁻¹, ketamine 2 mg kg⁻¹ and midazolam 0.2 mg kg⁻¹. A Shirmer tear test I (STT- I) was conducted 1 h before sedation and 2′, 10′, 20′, 30′, 40′, and 80′ post drug administration. The reaction to STT-I administration was also evaluated. The IM group has a lower mean tear production than the IR group for all time points evaluated. Cats in the IM group showed less reaction to STT-I administration. This study may suggest that the effect of sedative agents administered by the IR route has a lower incidence on tear production than the IM one. The use of eye lubricant is recommended in any case.

Palatine tonsils are lymphoid organs, whose anatomic localization gives them a role against antigens entering the body during feeding and breathing. In human medicine, MRI is used to investigate tonsillar diseases. In veterinary medicine, a recent study on healthy dogs described the MRI appearance of canine palatine tonsils, with no available reports about feline ones. Due to the similarities between animals and humans, and based on the study on canine tonsils, the authors aimed to evaluate the feasibility of low-field MRI to detect and describe presumed normal features of feline palatine tonsils, assessing the finding’s reproducibility. Low-field MRI of the heads of 14 cats was reviewed, and qualitative findings (visualization, shape, margins, signal intensity, and pattern) and size of each tonsil were recorded. Each observer recorded 71% of the expected tonsils. Most of them were classified as oval, ill-defined, and hyperintense structures with both homogeneous and heterogeneous signal patterns; the overall agreement was considered good. Low-field MRI is potentially a useful imaging modality to visualize palatine tonsils in cats, and their normal appearance has been described for the first time. The authors recommend the evaluation of tonsils in the transverse plane and consider the most accurate estimation of the short axis.

(1) Background: Strain elastography (SE) is an ultrasound-based technique able to non-invasively assess tissue elasticity, with malignant tissues being stiffer than normal tissues. The purpose of the study was to evaluate the diagnostic performance of SE to differentiate feline mesenteric benign and malignant lymph nodes (LNs) using a multivariate approach including both SE results and B-mode ultrasound and color Doppler findings. (2) Methods: Feline enlarged mesenteric LNs were evaluated using B-mode ultrasound, color Doppler ultrasonography, and SE. Short-to-long axis ratios, borders, echogenicity, hilum, vascular flow distribution, elastographic patterns, and strain ratios were recorded. Histological and/or cytological diagnosis was available for each LN. (3) Results: A total of 88 LNs were included, 46 (52.3%) benign and 42 (47.7%) malignant; in the benign group, 40 LNs had a diagnosis of reactive hyperplasia (group A) and 6 eosinophilic sclerosing lymphadenitis (group B), while in the malignant group 42 had a diagnosis of lymphoma (group C). The principal component analysis approach showed evidence that by combining B-mode- and color Doppler-based scores with SE scores, the three groups of LNs can be accurately distinguished. (4) Conclusions: Our results demonstrate that a multivariate sonographic approach combining B-mode ultrasound, color Doppler ultrasonography, and SE can accurately distinguish benign from malignant LNs, thus helping in the clinical advice of feline patients.

Chronic non-septic pleural effusion is a condition that frequently may occur because of lung or pleural neoplasia, or chylothorax refractory to surgical treatment, in dogs. Effusion management can be performed with multiple pleurocenteses or the application of chest drains. New modified vascular devices have been used for patients with chronic diseases; they offer the advantage of allowing home management and do not require hospitalization. Eight PleuralPort^TM devices were applied in seven dogs during thoracoscopic exploration and biopsy procedures; five were affected by mesothelioma; one by lung metastases from a mammary carcinoma; and one by chronic chylothorax. The median time of surgical procedure was 51 min; one developed pneumothorax post-operatively that resolved within 12 h after repeated drainage; one device was obstructed after 45 days and was successfully managed by flushing. All patients were discharged after 24 h. The median duration of port insertion in cancer patients was 5 months and those dogs were euthanized because of tumor progression; in the dog with chylothorax, the device was removed after 1 year when the effusion had resolved.

In humans and dogs, loco-regional anesthesia is associated with lower peri-operative opioid consumption and less related side effects. The combination of transversus abdominis plane (TAP) and intercostal blocks can be used to desensitize the entire abdominal wall in dogs. The aim of this study was to evaluate the effectiveness of TAP and intercostal blocks in bitches undergoing laparoscopic ovariectomy. Twenty client-owned bitches were enrolled in this double-blinded randomized controlled trial. After premedication with dexmedetomidine, methadone and ketamine, the animals were randomized into two groups. Dogs in the TAP group received intercostal blocks from T8 to T10 and a TAP block with ropivacaine. Dogs in the FEN group received a fentanyl bolus and a constant rate infusion for the entire duration of the procedure. Intra-operative cardiovascular stability, post-operative pain scores, rescue opioid requirement, dysphoria during recovery, time to attain sternal recumbency and interest in food at 6 h post-extubation were compared. Bitches in the TAP group received a statistically significant lower amount of rescue fentanyl intra-operatively and methadone post-operatively. Pain scores were lower in the TAP group until 6 h post-extubation. No difference was found for dysphoric recoveries, time to attain sternal recumbency and appetite at 6 h post-extubation. No adverse event was recorded for any of the dogs. The combination of TAP and intercostal blocks can be part of an effective multi-modal analgesic strategy in bitches undergoing laparoscopic ovariectomy.