Infarctive purpura hemorrhagica in five horses

Five horses were examined because of signs of muscle stiffness, colic, or both. All 5 had been exposed to Streptococcus equi within 3 weeks prior to examination or had high serum titers of antibodies against the M protein of S equi. Horses had signs of unrelenting colic-like pain and focal areas of muscle swelling. Four horses were euthanatized. The fifth responded to treatment with penicillin and dexamethasone; after 3 weeks of treatment with dexamethasone, prednisolone was administered for an additional 10 weeks. Common hematologic and serum biochemical abnormalities included neutrophilia with a left shift and toxic changes, hyperproteinemia, hypoalbuminemia, and high serum creatine kinase and aspartate transferase activities. Necropsy revealed extensive infarction of the skeletal musculature, skin, gastrointestinal tract, pancreas, and lungs. Histologic lesions included leukocytoclastic vasculitis in numerous tissues and acute coagulative necrosis resembling infarction. These horses appeared to have a severe form of purpura hemorrhagica resembling Henoch-Sch?nlein purpura in humans and characterized by infarction of skeletal muscles. Early recognition of focal muscle swelling, abdominal discomfort, neutrophilia, hypoalbuminemia, and high serum creatine kinase activity combined with antimicrobial and corticosteroid treatment may enhance the likelihood of a successful outcome.     

IMAGING DIAGNOSIS—ULTRASONOGRAPHIC APPEARANCE OF SKELETAL MUSCLE METASTASES IN A DOG WITH HEMANGIOSARCOMA

A 13‐year‐old spayed female German shepherd dog was presented for acute onset of lethargy, anorexia, and disseminated erythematous skin lesions. Thoracic radiographs and abdominal ultrasonographic findings were consistent with metastatic hemangiosarcoma. Multiple, ill‐defined, irregularly shaped hypoechoic nodules were also detected within the thoracic and abdominal wall. Hemangiosarcoma metastases to the skeletal muscle were confirmed based on histopathological examination. Multivisceral involvement was also confirmed by necropsy. Metastatic neoplasia should be considered as a differential diagnosis for dogs with ill‐defined, irregular, hypoechoic, intramuscular nodules.     

Synovial hemangioma in the stifle joint of a dog

Synovial hemangioma was diagnosed in an 8-year-old castrated male Belgian Sheepdog with lameness of 3 months' duration. Pain, soft-tissue swelling, and hemarthrosis were localized to the left stifle joint. Projections of synovial membrane with reddish-purple nodules, excised via arthrotomy, were composed histologically of variably sized vascular channels that were lined by well-differentiated endothelial cells and separated by fibrous septa. Distension of some channels resulted in endothelial disruption, thrombosis, hemorrhage, necrosis, and focal spindle-cell proliferation. The limb was amputated to remove remaining neoplastic tissue. The hemangioma extended focally into the joint capsule and popliteal soft tissue but did not invade skeletal muscle or bone. The dog was free of detectable neoplasia 6 months after amputation. Synovial hemangioma is a rare benign vascular proliferation in people, most commonly in the knee, and should be included in the differential diagnosis for canine synovial tumors.     

Feline lung-digit syndrome: unusual metastatic patterns of primary lung tumours in cats

PRACTICAL RELEVANCE: Feline 'lung-digit syndrome' describes an unusual pattern of metastasis that is seen with various types of primary lung tumours, particularly bronchial and bronchioalveolar adenocarcinoma. Tumour metastases are found at atypical sites, notably the distal phalanges of the limbs; the weightbearing digits are most frequently affected, and multiple-digit and multiple-limb involvement is common. Often primary lung tumours in cats are not detected because of clinical signs referable to the primary tumour; rather, many cases present with signs referable to distant metastases. Other sites of metastases from feline primary lung tumours include the skin, eyes, skeletal muscle and bone, as well as multiple thoracic and abdominal organs. These lesions are thought to arise from direct arterial embolisation from the tumour. Indeed tumour embolisation to the aortic trifurcation is possible. PATIENT GROUP: Primary lung neoplasms are uncommon in the cat. Older animals are most affected (mean age at presentation 12 years, range 2-20 years). There is no apparent sex or breed predilection. CLINICAL CHALLENGES: Feline lung-digit syndrome presents a diagnostic challenge. Typically there is swelling and reddening of the digit, purulent discharge from the nail bed, and dysplasia or fixed exsheathment of the associated nail. While these signs might be suggestive of infection, this could be secondary to a digital metastatic lesion, particularly in a middle-aged or elderly cat. Radiographic evidence of extensive bony lysis of the distal phalanx, which can be trans-articular to the second phalanx, raises the index of clinical suspicion for metastasis of a primary pulmonary tumour. Thoracic radiography is warranted prior to any surgery or digital amputation as the prognosis is generally grave for cats with this syndrome, with a mean survival time of only 58 days after presentation. EVIDENCE BASE: This article reviews the previous literature and case reports of feline lung-digit syndrome and feline primary pulmonary neoplasia in general, discussing the course of this disease and the varying clinical presentations associated with different sites of metastasis.     

Unilateral limb enlargement in a dog with a malignant peripheral nerve sheath tumor

A 3- to 4-month-old female Golden Retriever dog presented with right hind limb enlargement. Physical examination of the limb and radiographic findings initially included soft tissue swelling with elongation, bowing, and cortical irregularity of the femur and tibia. During a period of approximately 7 months, pathology in the limb progressed to include tarsal laxity, muscle atrophy, avulsion of the gastrocnemius muscle, and luxation of the patella. During surgical intervention to shorten the limb and repair the patellar luxation, a large soft tissue cyst was identified along the caudal aspect of the femur and stifle. The limb was later amputated, and a final diagnosis of malignant peripheral nerve sheath (PNS) tumor of the sciatic nerve and surrounding soft tissues was made. The unilateral limb enlargement in this dog appears to have been because of the development and progression of a malignant PNS tumor. The presentation and associated pathologic changes in the limb are unusual for canine PNS tumor but have similarities with neurofibromatosis in the limbs of humans.     

Dorso-medial ante-brachiocarpal luxation with radio-ulna luxation in a domestic shorthair

An 8-year-old domestic shorthair was admitted with non-weight bearing left forelimb lameness. Examination and radiographs revealed dorso-medial ante-brachiocarpal luxation with palmar luxation of the distal radio-ulnar joint. Primary repair was performed and stabilised using an arthrodesis wire and type Ia Kirschner-Ehmer (K-E) external skeletal fixator (ESF). The cat regained excellent pain-free limb function by 14 weeks with only minor reduction in range of movement. This is the first case report of a cat with distal radio-ulnar joint luxation associated with ante-brachiocarpal luxation. Primary repair of carpal luxation in the cat should be considered before arthrodesis.     

Lymphoma(s) showing epitheliotropism and diffuse skeletal muscle involvement presenting as a polymyopathy in a young dog

A 3-year-old dog presented with a severe polymyopathy and subsequently developed nodular skin lesions. The disease in this dog was caused by lymphoma, showing cutaneous epitheliotropism as well as infiltration of skeletal muscle in conjunction with polymyositis.     

Masseter myodegeneration as a cause of trismus or dysphagia in adult horses

The medical records of eight horses with histological evidence of myodegeneration of the masseter muscles were examined. While they were alive their most common clinical signs had included difficulty in eating or opening their mouths, weight loss, difficulty in moving, and noticeable atrophy of the masseter muscles. The serum activities of muscle enzymes were abnormally high in all of the horses. Whole blood and/or liver selenium and vitamin E concentrations were less than the reference ranges in some of the horses. The lesions varied with the stage of the disease and consisted of swelling and discoloration, or muscle atrophy and fibrosis. Histologically, the muscle changes ranged from acute to subacute degeneration, with regenerative changes accompanying ongoing degeneration, to chronic degeneration with fibrotic replacement of muscle tissue. There were changes in the masseter muscle of all the horses, but some had widespread lesions in skeletal muscle, and a few also had myocardial lesions.     

MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF LYMPHOMA INVOLVING THE BRACHIAL PLEXUS IN A CAT

An 11-year-old, neutered, female Domestic Long Hair cat had a 3-week history of left forelimb lameness. Conscious proprioception and postural reflexes were absent on the left thoracic limb. The cat had slightly reduced placing and hopping responses on the left pelvic limb, absent cutaneous trunci muscle reflex on the left side, and left triceps muscle atrophy. Magnetic resonance imaging revealed a 2 x 2 x 2 cm mass in the region of the left brachial plexus. The cat was treated by left forelimb amputation and hemilaminectomy. Histopathology of the brachial plexus revealed lymphoma.     

Myonecrosis and cutaneous infarction associated with Salmonella serovar Infantum infection in a horse

A 5-year-old Quarter Horse mare was referred for evaluation of oral ulcers, limb edema, weight loss, and weakness. There was marked diffuse swelling extending from the stifle region to the tarsal region of the left hind limb, and the horse had a left hind limb lameness. Firm swellings ranging from 2 to 15 cm in diameter and consisting of nodules, plaques, and discrete masses were palpated on both sides of the neck, over the right shoulder region, over the left elbow region, and over the left caudoventral aspect of the abdomen. Laboratory abnormalities included hypoproteinemia, neutrophilia, and hyperfibrinogenemia. Results of ultrasonographic examination of the left hind limb and masses were suggestive of muscle edema, necrosis, and hemorrhage. Histologic examination of a biopsy specimen from a subcutaneous mass revealed necrotizing, suppurative myositis. The horse's condition gradually deteriorated, and the horse was euthanatized. Necropsy revealed myonecrosis, cutaneous infarcts, hepatic abscesses, and cholangitis. Salmonella serovar Infantum was cultured from liver and muscle lesions, and a diagnosis of Salmonella myonecrosis was made.     

Use of a hybrid external skeletal fixator for repair of a periarticular tibial fracture in a Patagonian cavy

An 8-week-old female Patagonian cavy was examined because of acute right hind limb lameness; radiography revealed a moderately displaced, comminuted fracture of the proximal third of the tibia. The fracture was stabilized with a hybrid external skeletal fixator. Two Kirschner wires were placed in the main proximal fragment, parallel to the tibial plateau and at right angles to each other. These wires were connected to a partial circular external fixator ring. Three half pins were placed in the distal fragment, and a straight connecting rod positioned on the medial side of the limb was connected to these pins and the fixator ring. A second connecting rod was positioned on the craniomedial side of the limb and was connected to the fixator ring and a fourth half pin in the distal fragment. The fracture healed without complications, and the fixator was removed 3 weeks after surgery. Hybrid external skeletal fixators combine the benefits of circular and linear external skeletal fixation methods, enabling rigid fixation of periarticular long bone fractures without adversely affecting mobility of the adjacent joint.     

Malignant Lymphoma with Severe Infiltrative Growth into Skeletal Muscles in WBN/Kob Rats

Although spontaneously occurring neoplasms have been reported repeatedly in F344, SD and Wistar rats, which are commonly used strains for routine toxicologic and carcinogenicity studies, there are only a few reports of malignant lymphoma or lymphatic leukemia except for large granular lymphocytic leukemia (LGL) in F344 rats. Malignant lymphoma (lymphosarcoma) is thought to be uncommon in F344 rats. The authors encountered malignant lymphomas of the non-LGL leukemia type with characteristic pathologic features in WBN/Kob rats. The mean age at onset of the disease in all 13 affected rats (8 males and 5 females) was about 60 weeks. Common and characteristic clinical signs were abnormal gait with hind limb paralysis. Macroscopically, the enlargement of the lymph nodes, spleen and liver was slight to moderate. Scattered multiple white-to-gray nodules encompassed the aorta and assumed a bead-like appearance near the thoracic and lumbar vertebrae. Histopathologically, neoplastic proliferative changes were predominant in the bone marrow tissue of the entire body, and many tumor cells infiltrated the spleen and several lymph nodes. The most striking histological features were constant and severe infiltration of tumor cells in the adipose tissue and skeletal muscle adjacent the thoracic and lumber vertebrae. Immunohistochemically, all tumor cells were positive for B-cell markers (PAX-5, CD79a and CD45) and negative for CD3. From the results of immunohistochemistry and morphological examination, these tumors were diagnosed as malignant B-cell lymphomas.     

Spastic syndrome in a Holstein bull: a histologic study

A 4-year-old Canadian holstein bull developed the spastic syndrome, an episodic but progressive disorder causing pelvic limb muscular spasms. A post-mortem study, including morphometry of skeletal muscles and teased peripheral nerve fibers of the pelvic limb, revealed mild type II skeletal muscle fiber atrophy and minimal, focal segmental demyelination with remyelination, and axonal degeneration in peripheral nerves. Such alterations are probably incidental or age-associated. Idiopathic muscular cramps is the most probable explanation of the clinical disease and is consistent with the absence of significant morphologic pathologic lesions.     

Comparative analysis of mechanical stretch-induced activation activity of back and leg muscle satellite cells in vitro

It has previously been shown that mechanical stretch induces activation of cultured quiescent satellite cells by rapid release of hepatocyte growth factor (HGF) from its extracellular association with satellite cells and its subsequent presentation to the c‐met receptor. The present study provides evidence that the stretch activation activity varies according to the origin of satellite cells from back and leg skeletal muscles in vitro. Satellite cells were isolated from three muscle groups, back (BK), upper hind limb (UL) and lower hind limb (LL) muscles, of adult male rats and stretch activation activities were compared. In response to stretch, lower hind limb satellite cells showed significantly greater response than upper hind limb and back muscles (LL > UL > BK). Immunoblots of stretched culture media revealed a higher HGF‐releasing capacity of lower hind limb satellite cells than back muscle satellite cells. In addition, lower hind limb satellite cells exhibited a greater activation activity in response to exogenous HGF added to culture media than compared to satellite cells from back and upper hind limb (LL > UL > BK). The increased ability to release HGF and the increased cellular responsiveness might account for higher stretch activation activities of lower hind limb satellite cells. Electrophoretic analysis of myosin heavy chain isoforms verified a higher content of slow muscle fibers in lower limb muscles (LL > UL > BK), suggesting a difference in stretch‐induced activation activity between satellite cells associated with fast and slow muscle fibers.     

Light and electron microscopic changes in cardiac and skeletal muscle of sheep with experimental monensin toxicosis

Monensin toxicosis was induced in lambs by either a single oral dose of 12 mg/kg or six daily doses of 8 mg/kg. Clinical signs of toxicosis consisted of depression, dyspnea, stiffness of gait, reluctance to move, and recumbency. Serum creatine phosphokinase activity was increased. Samples of skeletal and cardiac muscle were obtained over a six-day period and examined by light and electron microscopy. Light microscopic changes in cardiac and skeletal muscles consisted initially of vacuolation and intracellular edema of muscle cells followed by segmental necrosis. Interstitial fibrosis was present on days 5 and 6 postexposure. Muscle fiber necrosis was more severe in skeletal than cardiac muscles and most severe in sheep given 8 mg/kg of monensin daily. Macrophages were seen only in areas of severe necrosis. The earliest ultrastructural change was severe swelling of mitochondria. Secondary changes consisted of lipid accumulation and myofibrillar alterations. Myoblast proliferation was present as early as four days after initial exposure to monensin.     

Retrospective study of the clinical features of limb cellulitis in 63 horses

A retrospective study of 63 horses diagnosed with limb cellulitis between 1994 and 2005 was conducted. They all had an acute onset of painful, generalised limb swelling, and a clinical diagnosis of limb cellulitis was made by the attending clinician. None of the horses had more than one limb affected. Hindlimbs were significantly more often affected than the forelimbs (P<0.05). Thoroughbreds were significantly over-represented compared with the general distribution of breeds examined at the hospital. Blunt limb trauma, limb surgery and limb injections were associated with the cellulitis in most of the horses, but no plausible cause could be determined in 27 (43 per cent) of the cases. Staphylococcus aureus and Streptococcus species were frequently isolated, although mixed bacterial infections were also common. All the horses were treated with broad spectrum antimicrobials and non-steroidal anti-inflammatory agents, and ultrasound-guided surgical drainage was also applied in 14 cases. Fifty-six of the 63 horses (89 per cent) were discharged from the hospital. Laminitis affecting the contralateral limb was the most common reason for the euthanasia of the other seven horses.     

Carpal hyperextension in a Percheron mare caused by a palmar carpal ligament tear

A Percheron mare was presented for acute, severe lameness and marked swelling of the right forelimb after being cast. The mare was initially diagnosed with cellulitis of the forelimb but as her condition improved and the affected limb was able to bear more weight it became apparent that the limb was hyperextended at the level of the carpus. Widening of the palmar aspect of the middle carpal joint was observed radiographically. During ultrasonographic examination, excessive fluid in the carpal sheath and perithecal swelling were noted and tearing of the palmar carpal ligament was suspected. A dynamic brace was fabricated to prevent hyperextension of the carpus. After discontinuation of systemic antibiotics, the mare became febrile and forelimb lameness worsened. Cytology of fluid from the middle carpal joint confirmed joint sepsis and the mare was anaesthetised for arthroscopic examination. A tear in the palmar carpal ligament, characterised by focal fibre disruption and fibrillation, was identified during arthroscopic and tenoscopic examination. Communication between the carpal flexor tendon sheath and middle carpal joint was identified during these procedures. Both the middle carpal joint and carpal flexor tendon sheath were lavaged with physiological saline solution. Post operatively, swelling and lameness slowly resolved. Four months after discharge, the mare was sufficiently sound to be maintained at pasture. Viewed from its lateral aspect, the limb no longer appeared to be hyperextended from the carpus.     

Effects of a quantitative trait locus for muscle hypertrophy from Belgian Texel sheep on carcass conformation and muscularity

A QTL for muscle hypertrophy has been identified in the Belgian Texel breed. A population of F2 and backcross lambs created from crosses of Belgian Texel rams with Romanov ewes was studied. Effects on carcass traits and muscle development of the Belgian Texel breed polygenes and Belgian Texel single QTL were compared. In both cases, carcass conformation and muscularity were improved. The Texel polygenic environment improved conformation mainly through changes in skeletal frame shape. Segments were shorter and bone weight lower. Muscles were more compact, shorter, and thicker. The single QTL affected muscle development. Thickness and weight of muscles were increased. Composition in myosin changed toward an increase of fast contractile type. The relative contribution of hind limb joint to carcass weight was increased. Differences in skeletal frame morphology among the three genotypes of the single QTL were small. Conformation scoring was mainly influenced by leg muscularity. Back and shoulder muscle development, which largely contributed to variability of muscularity, were less involved in the conformation scoring. Lastly, the QTL explains a small part of differences between these Belgian Texel and Romanov breeds for conformation or muscle development. A large part of genetic variability remains to be explored.     

Secondary bone tumours in the dog.

During a 2 1/2-year period 209 dogs with 218 malignant tumours were examined for skeletal metastases. There were 77 malignant tumours without visceral or skeletal metastases. Twenty-four (17%) of the 141 tumours with visceral metastases also had skeletal metastases. Ninety-eight of these tumours were of epithelial origin, and of these 21 (21.4%) had skeletal metastases. In 14 dogs, more than one bone had a metastatic tumour. The humerus, femur and vertebral column were most frequently involved. The lung was the most frequent site of metastatic tumours; then, in order, the liver, kidney and skeleton. The incidence of primary and secondary bone tumours was similar. Metastatic bone disease in the dog is far more common than is generally realized.     

Pleomorphic rhabdomyosarcoma in a cow

In a 5-year-old Holstein cow, a neoplasm composed of a large intramuscular mass and multiple metastases in the lungs and lymph nodes was diagnosed as a pleomorphic rhabdomyosarcoma. This neoplasm was characterized by marked variation in tumor cell size and giant cells with single bizarre nuclei. Although the presence of cross striations and myoglobin could be confirmed, expression of alpha-smooth muscle actin (SMA) was also recognized in a few cells. Neoplastic cells showing intense staining for desmin, vimentin and proliferating cell nuclear antigen irrespective of their size differed from those in an embryonal rhabdomyosarcoma that exhibited a wide spectrum of differentiation, reminiscent of normal skeletal myogenesis. The cellular pleomorphism and SMA expression seemed to be characteristic of deviation from normal muscle cells or satellite cells in adult muscle.