REVIEW

INTESTINAL TRACT AND

MESENTERY
Abdominal Small animals with clinical signs of gastro-
ultrasonograDhv intestinal disease such as vomiting or abdominal
pain may be satisfactorily evaluated using survey
abdominal radiography and gastrointestinal
in small akikah: contrast studies. However, abdominal ultrasono-
graphy is emerging as a useful additional screen-
Intestinal tract ing procedure for certain intestinal tract lesions.
Difficulties with ultrasonography include the
presence of gas within the intestinal tract which
and mesenterv, J '
impedes penetration of the ultrasound beam,
obscuring structures beyond it and introducing
kidnevs, 4 '
reverberation, shadowing and comet tail artifacts
(Laing 1983). Gas may be displaced by adminis-
tering water by stomach tube, or it may be avoid-
adrenal glands, - ed to a certain extent by applying the ultrasound
probe to the dependent surface of the abdomen,
uterus and allowing fluid-filled intestinal loops, or mobile
intestinal mass lesions to fall against the abdomi-
nal wall where they may be imaged.
prostate The gastric and intestinal wall has a character-
istic ultrasonographic appearance which is
C. R.Lamb observed when using high frequency transducers.
The wall is made up of five layers of alternating
hyper- and hypoechogenicity which correspond
Department of Surgery, Tufts University School of Veterinary
Medicine, 200 Westboro Road, North Grafton, MA 01536, to the mucosal surface, mucosa, submucosa,
USA

Journal of Small Animal Practice (1990)31,295-304

ABSTRACT
This paper completes a two part review of
abdominal ultrasonography in small animals.
Indications, examination technique and inter-
pretation of abnormal findings are described and
illustrated using clinical cases.

FIG 1. Ultrasonographic appearance of the normal intestine.

Mr Lamb's present address is the Goddard Veterinary Group,
84 New Wanstead, London E l l 2SY
Top: Empty small intestine with the lumen indicated by a
thin strand of echogenic mucus (arrow).Bottom: Small intest-
ine dilated with fluid. The five-layered structure of the wall
is apparent (1 Mucosal surface, 2 Mucosa, 3 Submucosa, 4
Muscularis, 5 Serosa)

295
 C. R. LAMB
I
FIG 2. Transverse ultrasound image of an eccentric thickening
of the jejunal wall due to mastocytoma. There is replacement
of the normal layered appearance by a uniformly hypoechoic
mass. A small amount of gas and mucus marks the intestinal
lumen (1,)
FIG 3. Same case as Fig 2. A chain of enlarged, hypoechoic
mesenteric lymph nodes are seen using the spleen ( S ) as a
window. Local spread of a jejunal mastocytoma was con-
firmed histologically
muscularis and serosa, respectively (Fig 1) (Pen-
ninck and others 1989). The thickness of the nor-
mal gastric wall is highly variable depending on
the degree of gastric distension and so it is some-
what difficult to quantitate unless the stomach
is filled with a standardised quantity of water
(Worlicek and others 1989). Ultrasonography is a
sensitive indicator of gastric wall thickening
caused by pyloric stenosis in children (Ball and
others 1983).
The small intestinal wall is normally 2 to 3 mm
thick in dogs (Penninck and others 1989). Thick-
ening of the intestinal wall, usually associated
with the loss of the normal five-layer pattern, is
observed in small animals with intestinal
neoplasms such as adenocarcinoma (Fig 2) and
lymphosarcoma (Nyland and Kantrowitz 1986,
Penninck and others 1990), and has been reported
in regional enteritis and ischaemia in humans
' (Morgan and others 1980, Fleischer and others
1981). In cases where ultrasonography reveals
thickening of the intestinal wall compatible with
neoplasia, the mesentery may also be conveni-
ently examined for the presence of enlarged
lymph nodes which indicate local tumour spread
296
(Fig 3). Mesenteric lymph node abscessation may
also be identified by abdominal ultrasonography
(Konde and others 1986a, Kleine and Lamb 1989).
Mesenteric fat (and fat in the renal sinus) is
highly echogenic whereas fat deposits in the
falciform ligament or retroperitoneum have a sim-
ilar echotexture to liver. Abdominal lipomas also
may appear similar to liver in echotexture (Fig 4).
In cases of intestinal obstruction, dilated fluid-
filled intestinal loops and reduction in peristalsis
will be apparent on ultrasonography. Intussus-
ception represents a specific, relatively common
cause of intestinal obstruction which may be
identified on abdominal ultrasonography (Fluck-
iger and Arnold 1986, Kantrowitz and others
1988, Kleine and Lamb 1989, Penninck and
others 1990). Intussusception typically appears
ultrasonographically as a tubular, multi-layered
structure often with a concentric ring appearance
in cross section (Fig 5), although other appear-
ances are reported (Alzen and others 1989).
THE KIDNEYS
~
Indications for renal ultrasonography include
abnormal kidney size or shape as detected by
palpation or abdominal radiographs, uraemia,
haematuria and flank pain. In animals with clini-
cal signs of renal disease, inability to palpate the
kidneys or identify them on survey abdominal
radiographs is another indication for ultrasono-
graphy. The left kidney may be examined with
the ultrasound transducer in contact with the
ventral abdominal wall or the flank just caudal to
the last rib. The right kidney is somewhat more
difficult to visualise from a ventral approach,
particularly in deep-chested or large dogs, in
which it may be approached laterally through the
loth to 12th intercostal spaces. The normal kid-
ney has a uniformly echogenic cortex clearly
demarcated from the hypoechoic to anechoic
medulla (Fig 6). Interlobar vessels and renal
diverticula subdivide the medulla. The renal
FIG 4. Ultrasound image of an intra-abdominal lipoma
(arrows indicate the edge of the lesion) in a dog. The
neoplasm has a uniform echotexture similar to liver. Several
lipomas were surgically removed from this dog
 Abdominal ultrusonogruphy in srnall animals

FIGS. Ultrasound images of a jejunal

intussusception in transverse (a) and
longitudinal section (b) showing the
typical multilayered appearance

sinus usually contains an echogenic fat pad. A
detailed appreciation of the internal anatomy of
the kidney necessitates use of a high frequency
transducer, as fine structural detail will not be
visualised if too low a frequency transducer is
used, or if care is not taken to obtain true dorsal,
sagittal or transverse imaging planes (Fig 6). Sim-
ilarly, precise ultrasonographic measurement of
kidney length requires an accurate sagittal sec-
tion. In the dog and cat an appropriate sagittal
orientation is indicated by visualisation of paral-
lel echogenic bars representing the paired renal
diverticula (Walter and others 1987a). Ultrasono-
graphic measurements tend to slightly underesti-
mate true kidney length because at the poles of
the kidney the capsule is oriented roughly paral-
lel to the ultrasound beam when the kidney is
imaged from its lateral aspect. This prevents pro-
duction of a specular echo from the capsule
which therefore is not clearly visualised. More
accurate kidney length determinations may be
made if the kidneys are imaged from their caudal
poles. Normal kidney length in the cat is 3.8 to
4.4 cm with a cortical thickness of 2 to 5 mm
(Schummer and others 1979). In the dog kidney
length is variable depending on breed; cortical
thickness is normally 3 to 8 mm (Schummer and
others 1979). In dogs undergoing diuresis, the
medulla may increase in size (Konde 1985); this
effect is less apparent in the normal cat (Walter
and others 1987a, c).
Renal abnormalities identified by ultrasono-
graphy may be subdivided into diffuse alter-
ations in tissue echogenicity or architecture and
focal abnormalities. As previously described
with respect to the liver, recognition of a diffuse
change in tissue echogenicity relies on compar-
ison with an adjacent organ which may be
assumed to be normal. For example, the liver
normally has a coarse, hypoechoic echotexture
compared to the spleen. The right kidney may be
conveniently compared with the adjacent caud-
ate lobe of the liver. It has been assumed that the
echogenicity of the renal cortex in dogs and cats
is normally equal to or less than that of the adja-
cent liver (Konde and others 1984, Feeney and
others 1985b), as is the case in most humans
(Rosenfield and Siegel 1981). However, a recent
study has demonstrated that the renal cortex in
normal humans may be hypoechoic, isoechoic, or
hyperechoic compared to the adjacent liver (Platt
and others 1988). Hartzband and others (1989)
have made similar observations in dogs. They
performed ultrasound examinations of the right
kidney and liver in 34 young healthy bitches and
found that at 5 MHz 33/34 dogs had a hypo- or
isoechoic renal cortex compared to the liver; one
dog had a hyperechoic renal cortex. When
imaged at 7.5 MHz 26/34 renal cortices were
more echogenic than at 5 MHz, and 14/34 were
hyperechoic compared to the liver. Wedge and
core biopsies obtained two days later confirmed
that the tissues were normal. Hence, although
there does appear to be a relationship between
renal echogenicity and certain kidney diseases
(Rosenfield and Siegel 1981, Hricak and others
1982, Feeney and others 1985b), comparing the
echogenicity of the kidney cortex to that of the
liver is not a reliable method of diagnosing renal
disease. Furthermore, the transducer frequency
must be known when interpreting the results of
renal ultrasonography.

FIG 6. Ultrasound images of a normal canine kidney in a water bath. (a) Dorsal plane image showing clear corticomedullary dis-
tinction, radiating diverticula and echogenic fat in the renal sinus (s). (b) Sagittal plane image showing the parallel bars of the
renal diverticula (arrows). This is an appropriate orientation for measurement of kidney length. (c) Transverse plane image show-
ing the diverticula branching around the renal crest (r)

297
 C. K. L A M E

20/23 (87 per cent) cases. With accurate needle

I
FIG 7. Dorsal plane 5 MHz ultrasound image of the caudate
lobe of the liver (L) and adjacent right kidney (K) in a young
dog. The renal cortex is hyperechoic compared to the liver
d u e to oxalate nephrosis secondary to ethylene glycol tox-
icity. Less marked increases in renal cortical echogenicity
may be observed in some normal dogs (see text)
placement, haemorrhage is the most important
potential complication of core biopsy. Haematuria
was observed following the biopsy procedure in
3/23 (13 per cent) cases in this series.
Focal kidney lesions may be subdivided into
hypoechoic and hyperechoic compared to the
normal cortex. Hyperechoic lesions include pri-
mary or secondary neoplasia, and cysts contain-
ing blood or other proteinaceous material. Focal
hypoechoic kidney lesions include renal cyst
(Fig 8) and abscess (Fig 9). Studies in humans
indicate that ultrasonography is relatively insen-
sitive to the presence of renal mass lesions less
than 2 cm in diameter, but is approximately 85
per cent sensitive for lesions larger than 3 cm
(Warshauer and others 1988). In rabbits with
induced VX2 carcinoma of the kidney ultra-
sonography detected 0.5 to 1 cm tumours in 4/8
cases (Ackerman and others 1989).
Ultrasonography is a relatively sensitive detec-
tor of hydronephrosis (Malave and others 1980).
Mild to moderate hydronephrosis produces an
anechoic space within the normally echogenic
renal sinus which is continuous with the prox-
imal ureter (Fig 10). In severe hydronephrosis,

FIG 8. Sagittal 7.5 MHz ultrasound image of the left kidney of

a cat with polycystic disease. The normal kidney architecture
is replawd by several round, anechoic cysts

In cats the fat content of the kidney appears to

be an important factor influencing echogenicity
(Yeager and Anderson 1989). Male and pregnant
female cats have increased renal cortical
echogenicity because of normal fat deposition.
FIG 9. Renal abscess in a dog producing a smooth hypoechoic
Conditions in dogs known to cause a diffuse enlargement of the pole of the kidney. (Transducer frequency
increase in renal cortical echogenicity include 5 MHz]
nephritis, acute tubular necrosis, nephrocalcin-
osis, hypercalcaemic nephropathy and end-stage
kidney disease (Fig 7) (Walter and others 1987b,
Kantrowitz and others 1988, Adams and others
1989, Barr and others 1989). Nephritis, feline
infectious peritonitis and lymphosarcoma may
cause increased cortical echogenicity in cats
(Walter and others 1988). Decreased cortical
echogenicity may also be observed with lym-
phosarcoma (Konde and others 1986b, Walter
and others 1987b, 1988).
Due to the normal variation in renal cortical
echogenicity described above and the non-specific
nature of observed abnormalities, biopsy remains
the only reliable means of diagnosing diffuse renal FIG 10.Moderate hydronephrosis in a dog with a mass invad-
parenchymal disease. Hager and others (1985) ing the bladder trigone resulting in dilation of the renal pelvis
and proximal ureter. The kidney also has a distorted internal
described a series of ultrasound-guided renal core architecture with poor corticomedullary distinction compat-
biopsies which provided diagnostic samples in ible with chronic renal disease. [Transducer frequency 5 MHz)

298
 Abdominal ultrasonography in S J I I U ~onjmals
~

FIG 11. Severe hydronephrosis due to

chronic ureteral obstruction. (a) Ultra-
sound image showing gross dilation of
the renal pelvis which is divided by
septa. There is no discernible surround-
ing cortical tissue. (b) Gross specimen
of the same kidney

the kidney parenchyma is compressed into a thin
layer around the urine containing pelvis, produc-
ing an appearance which could be confused with
a large renal cyst on ultrasonography (Fig 11).
Descriptions of ultrasonographic findings in
pyelonephritis are conspicuously absent from the
veterinary literature, probably reflecting a low
sensitivity of ultrasonography for this condition
similar to that described in humans (Traisman
and others 1986, Sty and others 1987). Cortical
scintigraphy is a more sensitive and specific
screening test for renal infection.
THE ADRENAL GLANDS ~ ~~ ~ remembered that hyperadrenocorticism in dogs
The ultrasonographic appearance and anatomi-
cal landmarks of normal canine adrenal glands
have recently been described (Voorhout 1988).
Identification of the normal adrenal requires
careful examination of the retroperitoneum
medial or just cranial to the cranial poles of the
kidneys. The left adrenal lies slightly caudal, and
the right cranial, to the origin of the cranial
mesenteric artery. Again, a high frequency trans-
ducer provides the best resolution of the adrenal
glands, which are usually less than 3 cm long
and flattened dorsoventrally. The adrenal me-
dulla is hyperechoic compared to the cortex. A
normal canine adrenal gland is shown in Fig 1 2 .
The ultrasonographic appearance of normal
feline adrenals has not been established.
In dogs, the left adrenal gland appears to be
slightly easier to image than the right because
searching for the right adrenal usually requires
an intercostal approach with ribs and respiratory
motion causing difficulties. Hence, although
adrenal ultrasonography may be requested in ani-
mals with signs of hyperadrenocorticism or
phaeochromocytoma, inability to visualise the
gland (particularly the right gland) does not rule
out the possibility of mild enlargement. Similar-
ly, the ultrasonographic finding of a unilateral
adrenal mass does not rule out the possibility of
bilateral adrenal enlargement, for example due
to pituitary-dependent hyperadrenocorticism
(Kantrowitz and others 1986). Finally, it must be
is not always associated with measurable adrenal
gland enlargement (Kelly and others 1971). For
these reasons ultrasonography is not an ideal
technique for the investigation of adrenal gland
disease although it is more sensitive than
survey radiography and, unlike tomography or
computed tomography, does not require general
anaesthesia.
Adrenal masses produce a variety of ultrasono-
graphic appearances, being described as hypo-
echoic (Fig 13), hyperechoic or heterogeneous,
sometimes with echogenic foci due to calcifica-
tion (Kantrowitz and others 1986, Poffenbarger
and others 1988, Voorhout 1988). Adrenal haem-
orrhage may also produce a variety of appear-
ances depending on the duration of the lesion
(Wu 1989). Fig 14 shows invasion of the caudal

FIG 13. Adrenal adenoma (surgically confirmed) in a cat with

FIG 12. Ultrasound image of a normal canine left adrenal clinical signs of hyperadrenocorticism. The mass was situated
gland showing the characteristic flattened shape and hypo- adjacent to the cranial pole of the left kidney (K). Although
echoic cortex surrounding the hyperechoic medulla. This only 0.83 cm in diameter it is readily seen because it is very
gland measured 23 mm in length hypoechoic compared to the surrounding retroperitoneal fat

299
 C. R. LAMB

structure adjacent to the inner wall of the blasto-

cyst by approximately day 20 to 26. A faint flick-
ering motion in the embryo is the first sign of
cardiac activity, usually observed between days
I 22 and 29. The gestational dates quoted here for
first pregnancy diagnosis are slightly earlier than
those originally described, reflecting improve-
ments both in ultrasound equipment and exper-
tise in recent years.
In the queen, gestational sacs are first detected
11 to 16 days after mating (Fig 15), and beating
fetal hearts by day 16 to 23 (Davidson and others
1986, Stowater and others 1988).
FIG 14. Longitudinal ultrasound image showing a large Once pregnancy is diagnosed, the developing
retroperitoneal mass (M) adjacent to the caudal vena cava
(CVC). Invasion of the vessel is indicated by a small protru- fetus may be examined at regular intervals to
sion of tissue into the lumen (curved arrow). This is a sign of monitor its development. Crown-rump lengths
malignancy. Post mortem confirmed malignant phaeochromo- (Cartee and Rowles 1984) and the normal time
cytoma with invasion of the caudal vena cava
course of internal organ development have been
described (Spaulding and others 1988). The indi-
vena cava by an adrenal mass, which is a sign of vidual cardiac chambers are first apparent usu-
malignancy (Poffenbarger and others 1988, ally by day 37. The normal canine fetal heartbeat
Voorhout 1988). is reported to be 1 2 0 to 140 per minute; rates less
I
I than this may indicate fetal distress (Johnston
and others 1983). Occasionally, a fetal abnormal-
THE UTERUS ~
ity may be identified using ultrasonography (Pof-
fenbarger and Feeney 1986). Absence of fetal
Examination of the uterus for pregnancy heartbeat is a reliable sign of death.
diagnosis was among the first applications of
diagnostic ultrasonography in small animals
(Helper 1970, Lamm 1970). Initial studies used
Doppler ultrasound equipment which produces
an audible signal rather than an image. The
emphasis now is on use of real-time ultrasonog-
raphy which, in addition to pregnancy diagnosis,
provides information on fetal number, size and a
visual assessment of organogenesis (Cubberley
and others 1982, Bondestam and others 1983,
Cartee and Rowles 1984, Inaba and others 1984,
Shille and Gontarek 1985, Taverne and others
1985, Davidson and others 1986, Poffenbarger
and Feeney 1986, Toal and others 1986, Spauld- FIG 15. Ultrasound image of the uterus of a cat 16 days after
ing and others 1988, Stowater and others 1988). mating, showing an anechoic fluid-filled blastocyst (between
cursors) and embryo (curved arrow)
Ultrasonography also enables examination of the
nonpregnant uterus (Poffenbarger and Feeney
1986, Spaulding and others 1988).
In the oestrus bitch, ovarian follicles may be
identified ultrasonographically (Inaba and others
1984, Spaulding and others 1988). The larger fol-
licles rupture; others regress and may still be
identified six to eight days later when they have
a similar apearance to corpora lutea. The uterus
is best examined with a high frequency (7.5 or 10
, MHz) transducer, using the urinary bladder as a
window. During oestrus the uterus is fairly uni-
formly hypoechoic and measures 6 to 7 mm in
diameter in the beagle (Spaulding and others
1988). Pregnancy may be confirmed when a
FIG 16. Ultrasound image of the caudal abdomen of a bitch
blastocyst is identified (usually between days 18 with clinical signs of pyometra. Two segments of a grossly
and 22), appearing as a small, spherical anechoic dilated, fluid-filled uterus (u) are visible. The diagnosis was
structure. The embryo is first seen as a flattened confirmed surgically

300
 Abdominal ultrasonography in small animals

Overall, ultrasonography is a highly accurate

method of pregnancy diagnosis, but is less accur-
ate at estimating fetal number (Toal and others
1986). The principal difficulty in counting occurs
when a large number of fetuses are distributed
throughout the abdomen in late pregnancy, mak-
ing it difficult to avoid counting the same fetus
repeatedly as one scans back and forth. The
period between the 28th and 35th day of
gestation is considered the best time for counting
(Bondestam and others 1983).
Ultrasonography is a useful method of diagnos-
ing pathological enlargement of the uterus. For
FIG 18. Sagittal ultrasound image of an enlarged prostate in a
example, pyometra is usually readily identifiable seven year old dog. The outline of the gland is well seen
as a tubular structure with anechoic or hypo- because the prostate is uniformly slightly hyperechoic due to
echoic contents in the caudal abdomen originat- benign hypertrophy
ing dorsal to the bladder (Fig 16). However,
depending on the consistency of the purulent
material in the uterus, a uniform parenchyma-
like echotexture also may be observed (Poffen-
barger and Feeney 1986). Ultrasonographic diag-
nosis of mucometra (van Haaften and Taverne
1989) and uterine stump granuloma have been
described (Poffenbarger and Feeney 1986). Fig 1 7
shows enlargement of an ovary due to neoplasia.

THE PROSTATE

Indications for prostatic ultrasonography
include prostatomegaly, signs of urinary tract
infection, haematuria, haemospermia and caudal
abdominal pain, As described for the ovary and
uterus, satisfactory ultrasonographic examination
of the prostate requires a high frequency trans-
ducer. In man, rectal ultrasound probes provide
the best images of the prostate (Lee and others
1987). Use of rectal ultrasound transducers has
been described for examination of the canine
prostate (Miyashita and others 1984); however,
the high cost of rectal probes specifically for
prostatic imaging has inhibited their use by
veterinary ultrasonographers.
FIG 17. Ultrasound image of a large, complex mass adjacent
to the urinary bladder. Ovarian cystadenoma was removed at
laparotoiny
FIG 19. Longitudinal ultrasound image of the prostate of a
castrated dog without clinical signs of prostatic disease. The
gland is smaller than in the intact male (approximately 2.4
cm in this case) and is uniformly hypoechoic compared to the
surrounding pelvic tissues
The canine prostate is usually examined by
applying a sector transducer cranial to the pubis
and directing the beam caudally. In large dogs, a
linear-array probe designed for large animal use
may be inserted into the rectum. Using the blad-
der as an anatomical landmark, the prostate may
be identified just caudal to the bladder neck,
encircling the urethra. The flimsy prostatic cap-
sule of the dog is not well seen, making it diffi-
cult to define the exact borders of the gland on
ultrasonography unless it has a distinctly differ-
ent echotexture to the surrounding pelvic tissues.
The normal prostate is a symmetrical structure of
uniform echotexture except in cases where a
periurethral or hilar echogenic zone is apparent.
Benign prostatic hypertrophy, which occurs in
50 per cent of dogs over four years and approxi-
mately 90 per cent over five years (Berry and oth-
ers 1986), may produce a diffuse, mild increase
in echogenicity (Fig 18). In the castrated male the
prostate is small and hypoechoic (Fig 19).
Previous reviews of canine prostatic ultra-
sonography described changes common to a
variety of prostatic diseases (Feeney and
others 1985a, 1987). For example, prostatic

301
 C. K. LAMB
FIG 20. Tranverse ultrasound image of the prostate in a dog
with prostatornegaly, straining and dyuria. The gland is
enlarged and contains two large, irregular anechoic cavities.
The prostate was explored surgically and abscesses drained.
The histological diagnosis was chronic prostatitis
FIG 21. Transverse ultrasound image of the prostate in a dog
with prostatomegaly, pain and haematuria. The gland has an
uneven echotexture throughout. A hypoechoic zone is visible
in the near field (open arrow). A small echogenic focus (solid
arrow) with acoustical shadowing is compatible with calcifi-
cation. Histology revealed cystic hyperplasia in combination
with chronic prostatitis
FIG 22. Transverse ultrasound image of the neck of the blad-
der surrounded by a cluster of anechoic structures deter-
mined to be paraprostatic cysts at laparotomy
adenocarcinoma may produce either a focal or
diffuse hyperechoic pattern similar to that
observed with bacterial prostatitis or benign
hypertrophy (Feeney and others 1987). Hence,
ultrasonography alone is an unreliable means of
302
differentiating prostatic inflammatory disease
from hyperplasia or neoplasia.
An asymmetrical or irregular prostate may be
observed in cases of adenocarcinoma, transi-
tional cell carcinoma invading from the urethra,
prostatic abscess or cyst. Abscess or cyst may be
differentiated from neoplasia by their characteris-
tically well-defined rounded hypoechoic or ane-
choic appearance (Fig 20). In dogs echogenic foci
with acoustical shadowing are usually associated
with prostatic adenocarcinoma (Feeney and
others 1987); they probably represent dystrophic
calcification of the gland. However, calcification
may also occur in chronic prostatitis (Fig 21).
Prostatic biopsy (either ultrasound-guided or via
laparotomy) is recommended for definitive
diagnosis of prostatic abnormalities detected
by ultrasonography (Hager and others 1985).
However, even the histological diagnosis may
be complicated by hypertrophic, metaplastic,
inflammatory or neoplastic diseases occurring in
combination.
Paraprostatic cysts generally present as caudal
abdominal mass lesions that may or may not be
closely associated with the prostate. Although
the ultrasonographic features of paraprostatic
cysts are somewhat variable (in contrast to clas-
sical descriptions of cysts), they typically present
as single or multiple anechoic structures close to
the bladder (Fig 22) (Stowater and Lamb 1989).
Many cysts contain internal septa. In a propor-
tion of cases, abnormalities in the prostatic
parenchyma, or direct communication between
intraprostatic cysts and the paraprostatic cyst
ACKNOWLEDGEMENTS
cavity, will also be observed (Stowater and Lamb
1989).
The author acknowledges the contributions
made towards collection of case material by
Radiology Residents Dr Lori Hartzband and Dr
Amy Tidwell. Mr Dave Willman of Tufts Educa-
tional Media Center produced the figures.
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BOOK REVIEW
Abnormalities of the young cat
and dog
Veterinary Pediatrics: dogs and cats from birth
to six months.
J. D. Hoskins. Published by W. B. Saunders,
Philadelphia. Price €36.00, 556 pages, hardback
1990.
Several chapters provide information which is
not otherwise readily accessible, for example, the
changes in haematology and blood biochemistry
during the growth period.
304
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diseases in dogs: 32 cases (1981-1986). Journal of the
American Veterinary Medical Association 191,999-1007
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(1987~)Renal ultrasonography in healthy cats. American
Journal of Veterinary Research 48, 600-607
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(1988) Applications of ultrasonography in the diagnosis of
parenchymal kidney disease in cats: 24 cases (1981-1986).
Journal of the American Veterinary Medical Association
192,92-98
WARSHAUER, D. M., MCCARTHY, S. M., STREET, L., BOOKBINDER,
M. J., GLICKMAN, M. G . , RICHTER, J., HAMMERS, L., TAYLOR, C.
& ROSENFIELD, A. T. .(1988) Detection of renal masses: sens-
itivities and specificities of excretory urography/linear
tomography, US, and CT. Radiology 169,363-365
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of Clinical Ultrasound 17,5-14
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hemorrhage: report of a case simulating solid tumor. Jour-
nal of Clinical Ultrasound 1 7 , 4 5 4
YEAGER,A. E. &ANDERSON, W. I. (1989) Study of association
between histologic features and echogenicity of architec-
turally normal cat kidneys. American Journal of Veterinary
Research 50,860-863
and digestive systems provide well balanced
reviews of the major congenital defects. This
information is, however, readily available in the
majority of standard text books on the subject.
The chapter on preventive medicine consists
largely of lists of American vaccines is of little
relevance in the UK.
I would have liked to see a chapter linking
together information provided by the various
contributors and devoted to the problem of the
fading puppy. Certain areas lend themselves
more than others to discussion under the defini-
tion of paediatrics, however, the remit of each
contributor appears unclear. The chapter on the
eye covers many conditions which are uncom-
mon in the animal up to six months of age, while
that on the musculoskeletal system is very perti-
.nent to the book title. This is true for several
chapters where the amount of text reflects the
overall importance of conditions rather than the
importance in the young animal.
There is no discussion of the reproductive sys-
tem even though conditions such as cryp-
torchidism and juvenile vaginitis are frequently
encountered in general practice.
The book provides up to date information con-
cerning the majority of organ system abnormali-
ties met in the young dog and cat although much
of this is available in other works. At a cost of
€36 it offers good value for money but I am
unsure of the market at which it is directed.
G. W. England