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Rectal Scraping 1157

Causes of Interstitial Nodules and Masses Causes of an Unstructured Interstitial Pattern
VetBooks.ir Finding Cause Prevalence Cause Prevalence
Common
Poor radiographic technique
Metastasis
Multiple solid nodules
Common
Mycosis
Varies with region
Common
Poor ventilation
Septic emboli
Rare
Body habitus Common
Solitary solid mass Primary tumor Common
Abscess Rare Cardiogenic edema Common
Multiple cavitary nodules Metastasis Rare Lymphoma Uncommon
Parasite Rare Solid tumor metastasis Uncommon
Bullae Uncommon
Deep mycosis Uncommon
Solitary cavitary mass Primary tumor Common
Abscess Rare Adapted from Thrall DE: The canine and feline lung. In Thrall DE, editor: Textbook of veterinary
Bulla Uncommon diagnostic radiology, ed 6, St. Louis, 2013, Saunders.
From Thrall DE: The canine and feline lung. In Thrall DE, editor: Textbook of veterinary diagnostic Procedures and Techniques
radiology, ed 6, St. Louis, 2013, Saunders.
• Use the extrapleural sign to distinguish Alternatives and Their Relative • Echocardiography: characterizes cardiac
extrathoracic lesions from pulmonary lesions. Merits structure and function.
A broad-based mass extending into the thorax • CT: precludes superimposition, can better
is likely of body wall or extrapleural origin. characterize anatomic relationships, and SUGGESTED READING
A thoracic mass contacting the body wall is better able to detect pulmonary metas- Thrall DE, editor: Textbook of veterinary diagnostic
at an acute angle is likely intrathoracic or tasis. Routine CT is not ideal for cardiac radiology, ed 7, St. Louis, 2018, Saunders.
pulmonary in origin. evaluation. AUTHOR: Aisha N. Young, DVM, MVSc, DACVR
• Ultrasound: further characterizes lesions, EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
Postprocedure guides fine-needle aspiration, and evaluates Thompson, DVM, DABVP
Additional imaging studies or other diagnostic blood flow; reverberation artifact makes
tests may be required for a definitive disease investigation of intrathoracic lesions
diagnosis. difficult.

Rectal Scraping

Difficulty level: ♦ animals with pain on rectal palpation • Splintered or sharp edges of the tongue
or for animals with an uncooperative depressor should be smoothed or covered
Synonyms temperament. with a gloved finger.
Rectal scrape, rectal cytologic analysis • Wooden tongue depressor (alternatively,
cotton-tipped applicator or blunt-tipped Procedure
Overview and Goal metal spatula such as those for pharmacy • Depending on the size of the patient, the
The goal of rectal scraping is to obtain use) tongue depressor may be left intact or broken
samples of mucosal tissue for cytologic • Exam glove lengthwise to a smaller width.
examination. • Lubricant
• Microscope slides
Indications
• Animals with signs of disease of the rectum Anticipated Time
or distal colon, such as hematochezia and 5-10 minutes
tenesmus, especially when rectal mucosa has
a diffusely thickened or cobblestone feel on Preparation: Important
rectal palpation Checkpoints
• Most commonly indicated for the diagnosis The rectum should be empty of formed fecal
of rectal histoplasmosis, protothecosis, matter. Allowing the animal to defecate shortly
pythiosis, or neoplasia before the procedure or manual evacuation of
the rectum is sufficient (i.e., bowel cleansing
Contraindications or enemas are not required).
Suspicion of rectal perforation or deep RECTAL SCRAPING One side of a tongue depressor
ulceration Possible Complications and is covered with a gloved finger before insertion of the
Common Errors to Avoid lubricated finger and the depressor approximately 2
Equipment, Anesthesia • Rectal perforation is possible with vigorous inches (5 cm) into the rectum. Once in the rectum,
gentle pressure is used to move the depressor
• Often performed without anesthesia or scraping or overzealous insertion of the in an arcing motion to obtain tissue for cytologic
sedation. Sedation may be required for instrument. examination.

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