Pulmonary infiltrates with eosinophilia

A seven-month-old collie and a four-year-old Jack Russell terrier were presented with coughing and dyspnoea of varying duration. A peripheral and pulmonary eosinophilia was detected in both dogs. After ruling out heartworm disease, lungworms, fungal pneumonia and drug reactions, a diagnosis of pulmonary infiltrates with eosinophilia was made. Dramatic relief of clinical signs, radiographic infiltrate and peripheral eosinophilia occurred after administration of glucocorticoids.     

Aortic rupture and aorto‐pulmonary fistulation in the Friesian horse: Characterisation of the clinical and gross post mortem findings in 24 cases

Reasons for performing study: In horses, aortic sinus of Valsalva aneurysms or tears in the aortic root are well‐recognised conditions in breeding stallions, often leading to sudden death. A more uncommon form of aortic rupture, located proximal to the ligamentum arteriosum has been reported in 3 Friesian horses. Objectives: The purpose of this study was to phenotypically characterise aortic rupture and aorto‐pulmonary fistulation in Friesian horses in terms of clinical and post mortem data based on 24 cases. Methods: Friesian horses that were diagnosed with aortic rupture and aorto‐pulmonary fistulation over a period of 13 years (1997–2010) at the Department of Equine Sciences of Utrecht University (n = 15) and Wolvega Equine Hospital (n = 9), were included in this study. Case history, results of clinical examination and gross post mortem findings were screened and analysed. Results: Some cases were found dead without prior symptoms, but in several cases signs such as recurrent colic, peripheral oedema and sustained tachycardia were present for several weeks prior to cardiac failure. Clinical examination during hospitalisation revealed increased rectal temperature, peripheral oedema and increased jugular pulse with a bounding arterial pulse. In the majority of horses an aortic rupture of the aortic arch near the ligamentum arteriosum, concurrent with a circumferential cuff of perivascular haemorrhage and aorto‐pulmonary fistulation, was found at post mortem examination. Conclusions: Aorto‐pulmonary fistulation in conjunction with aortic rupture is more common in Friesians than previously estimated. In some cases findings demonstrate a progressive pathology rather than acute cardiac failure and sudden death. An appropriate approach is necessary during post mortem examination of the heart in order not to overlook the diagnosis. Potential relevance: Equine practitioners should realise that in Friesian horses presented with a history of recurrent false colic, coughing, sustained tachycardia and/or peripheral oedema, aortic rupture and aorto‐pulmonary fistulation should be included in the differential diagnosis.     

Aortic body chemodectoma causing pulmonary oedema in a cat

A seven-year-old male domestic shorthaired cat was presented with persistent dyspnoea. Thoracic radiography and echocardiography revealed pulmonary oedema and a mass at the base of the heart. At necropsy the mass was found to be an aortic body chemodectoma that had metastasised to the sternal lymph node. This is a rare tumour in the cat, the third reported case where there was evidence of metastasis, and only the second reported case where there was evidence of lymphocytic infiltration of the primary tumour. Pulmonary oedema is an unusual presentation of this tumour in the cat.     

Aortic valvular endocarditis caused by Bartonella vinsonii subsp. berkhoffii in 2 dogs presenting for fulminant pulmonary edema

Objective: To describe the clinical course of 2 dogs that presented with fulminant cardiogenic pulmonary edema due to aortic valvular endocarditis caused by Bartonella vinsonii subsp. berkhoffii. Case series summary: Two dogs that were presented for respiratory distress had severe pulmonary infiltrates. Mechanical ventilation was required to support the dogs while the cause of the infiltrates was determined. The diagnosis of cardiogenic edema was made based on echocardiographic findings of aortic valve vegetation and severe aortic valvular regurgitation. Values obtained from pulmonary artery catheterization supported this diagnosis. Both dogs were euthanized, one within 24 hours of admission due to severe aortic regurgitation thought to be untreatable, and the other 9 days after admission due to the development of acute renal failure. Histological evaluation of the aortic valves, serology, and polymerase chain reaction confirmed Bartonella vinsonii subsp. berkhoffii as the cause of the aortic endocarditis. New or unique information provided: In medium‐to‐large breed dogs presenting with fulminant pulmonary edema, aortic valvular endocarditis due to Bartonella spp. should be considered as a causal agent.     

Diagnosis of pulmonary thromboembolism in a cat using echocardiography and pulmonary scintigraphy

A 10-year-old male cat was presented with sudden onset of respiratory difficulties. Clinical examinatlon revealed an acute dyspnoea with cyanosis associated with a left systolic heart murmur. Standard thoracic radiographs excluded pulmonary oedema and showed very few pulmonary changes given the intensity of the respiratory compromlse. Echocardiographic examination revealed hypertrophic cardiomyopathy and a thrombus In the right pulmonary artery. Pulmonary sclntlgraphy confirmed a pulmonary thromboembolism with hypovascularisatlon of the left cranial lobe and of the ventral segment of the right lobe. Conservative treatment was instituted using an antibiotic (doxycycllne), anticoagulants (heparin, coumadine) and a calcium lnhlbitor (diltiazem). The cat was given absolute rest. The general condition of the animal improved.     

Severe haemoptysis associated with seizures in a dog

CASE HISTORY: A 7-year-old, sterilised male German Shepherd dog was presented with a history of three episodes of severe haemoptysis and associated dyspnoea within a 3-week period. A generalised tonic-clonic seizure was witnessed preceding the third episode. CLINICAL FINDINGS: Thoracic radiographs revealed a severe bilateral alveolar lung pattern of the caudodorsal lung fields; extension into the left cranial lung lobe was present but pulmonary vessels were within normal size limits. Frank blood was the only abnormality present at bronchoscopy. A coagulation profile, parasitological screening, thoracic and brain computed tomography (CT), and cerebrospinal fluid (CSF) cytological analysis did not identify any abnormalities. DIAGNOSIS: Haemoptysis due to either severe neurogenic pulmonary oedema or rupture of the pulmonary capillaries secondary to seizures was considered a possible diagnosis. The primary generalised seizures were attributed to late-onset idiopathic epilepsy diagnosed by exclusion of other causes. CLINICAL RELEVANCE: This is the first known case report describing severe haemoptysis associated with seizures in a dog.     

Rhabdomyolysis as a complication of canine babesiosis

Rhabdomyolysis was diagnosed in two dogs with babesiosis. The first animal presented with muscle pain and caramel-coloured urine, and had markedly elevated serum myoglobin and muscle enzymes. Acute renal failure complicated the clinical picture. The second dog exhibited muscle pain and tremors, together with neurological signs and pulmonary oedema, and died soon after admission. Muscle necrosis and haemorrhage were found at necropsy. In human malaria, a disease clinically similar to canine babesiosis, rhabdomyolysis is unusual, but clinically silent muscle damage appears to be common. Likewise, biochemical evidence of muscle damage is readily found in experimental bovine babesiosis. Muscle enzymes were mildly elevated in three dogs with severe babesiosis and pigmenturia but there was no obvious muscle damage, indicating that this might also apply to canine babesiosis. The pathogenesis of infection-associated rhabdomyolysis and acute renal failure remains unclear, but inflammatory cytokines and nitric oxide could play an important role.     

Obstructive, granulomatous tracheitis caused by Onchocerca sp. in a dog

A 3-year-old spayed female dog was admitted with a history of episodes of dyspnoea and coughing. Severe tracheal stenosis was found on radiography. The dog died during an episode of refractory dyspnoea. Necropsy revealed an obstruction of the thoracic part of the trachea because of a chronic granulomatous inflammation protruding into the tracheal lumen. Histological examination revealed nematodes, which were identified as Onchocerca sp. according to their morphological characteristics. In contrast to the common ocular manifestation in dogs, obstructive tracheitis caused by Onchocerca infection has not been reported before.     

Angiostroneylosis in Cornwall: Clinical presentations of eight cases

Clinical signs in eight dogs with Angiostrongylus vasorum infection included chronic cough, dyspnoea, lumbar pain, hindleg paresis/paralysis, abdominal pain, weakness and collapse; two of the dogs were asymptomatic. Thrombocytopenia was present in two dogs and a mild anaemia in one. Thoracic radiographs showed mild right heart enlargement in two out of three dogs and a pneumothorax in one. At post mortem examination in three dogs, the lungs were swollen with a mottled appearance and there was dilatation of the right ventricle. Adult A vasorum were found in the right heart, the pulmonary artery and its branches. Adult worms were also found in the systemic vasculature in one dog, associated with thromboembolism. Treatment with ivermectin in two dogs and fenbendazole in three dogs resulted in the resolution of clinical signs and no demonstrable larvae in the faeces one to two weeks later.     

Canine parvoviral myocarditis

A 5-week-old crossbred pigdog pup was presented in respiratory distress. It appeared to dry retch, and then died suddenly before a clinical examination was performed; a littermate had died suddenly the week before. Histopathological examination revealed an ongoing lymphocytic myocarditis, characterised by myofibril degeneration and lymphocytic inflammatory infiltrates. In scattered degenerate myofibres, there were large amphophilic intranuclear inclusion bodies distending their nuclei. There was also marked pulmonary oedema. Canine parvoviral myocarditis, due to canine parvovirus type 2, was diagnosed. Further questioning regarding the history of this pup revealed that it had been born to an unvac-cinated dam that had been moved late in her pregnancy from an isolated farm on to another property. It seems likely that the dam was naïve and only became exposed to the virus immediately prior to whelping. The lack of wildlife vectors and a well-controlled population of dogs in rural New Zealand means that there may be isolated areas of the country where dogs can reach maturity without becoming exposed to parvovirus, creating the potential for development of this now uncommon syndrome. When parvovirus first arose in New Zealand, between 1979–;1981, parvoviral myocarditis was relatively common, occurring in neonates when the virus was introduced to breeding kennels that previously had been unexposed.     

Pulmonary Lymphomatoid Granulomatosis in Seven Dogs (1976–1987)

Seven dogs with pulmonary lymphomatoid granulomatosis were reviewed. The disease occurred in six large-breed and one small-breed dogs. The dogs were five to 14 years old (mean, 8.4; median, 7), and four of seven dogs were males. Three dogs had been previously treated with adulticide therapy for canine dirofilariasis. Clinical histories included a progressive respiratory disease characterized by varying degrees of cough, dyspnea, exercise intolerance, and weight loss. Thoracic radiographic features included hilar lymphadenopathy, pulmonary masses of varying sizes, and mixed pulmonary patterns of lobar consolidation with ill-defined interstitial and alveolar pulmonary infiltrates. Cardiovascular changes compatible with chronic dirofilariasis were present in three dogs. The clinical course was usually progressive and fatal. The survival time ranged from six days to four years (mean, 12.5 mos; median, 3 mos). Gross and histologic features included mass lesions with areas of necrosis that replaced normal pulmonary architecture. Cytologically, these lesions were characterized by infiltration with pleomorphic, angioinvasive mononuclear cells that often resulted in vascular obliteration. The infiltrating cells resembled large lymphoid cells that possessed large hyperchromatic nuclei and small amounts of cytoplasm. Systemic lymphoid neoplasia with peripheral lymphadenopathy was diagnosed in two dogs. In both cases, lymph-node cytology was similar to the cellular infiltrates found in the lungs and consistent with a diagnosis of lymphomatoid granulomatosis. These features are compared with previously reported cases of canine lymphomatoid granulomatosis and those features identified in a similar disease described in man.     

Type C botulism in American Foxhounds

Diffuse lower motor neuron dysfunction developed in a group of American Foxhounds while they were hunting. Of 19 dogs, 10 became weak and 9 became quadriplegic. Three of the quadriplegic dogs died before treatment could be instituted. The remaining quadriplegic dogs recovered after being given supportive treatment, with (4 dogs) or without (2 dogs) trivalent (types A, B, E) botulinal antitoxin. The 10 dogs that were weak recovered without treatment. A markedly decreased amplitude of evoked potentials and increased chronaxy were found by electromyographic examination of 2 of the quadriplegic dogs. A toxic substance that was neutralized by type C botulinal antitoxin in mouse inoculation tests was in the serum and feces of the most severly affected dog presented alive and in a fecal extract of another affected dog. In the one dog necropsied, neither gross nor histologic lesions were found in the central or peripheral nervous systems or in the skeletal musculature. The history, clinical signs, electromyographic findings, toxin neutralization tests in mice, and absence of histologic abnormalities in the neuromuscular system provided evidence for the diagnosis of C botulism.     

An unusual presentation of suspected oedema disease of swine in Kenya

From a group of 11 recently weaned pigs, 4 were reported to be sick. Clinical examination of the sick pigs revealed marked dyspnoea, bluish-red discolouration of the skin, incoordination and difficulty in walking. Bacteriological examination of the gut contents of 2 pigs that had died earlier yielded pure cultures of haemolytic Escherichia coli. Post mortem examination of the remaining 2 pigs that died subsequently revealed progressive pulmonary collapse. One of these also showed subcutaneous oedema of the head and marked oedema of the mesentery of the spiral colon and oedema of the brain. Microscopically there was pulmonary alveolar collapse and degenerative changes in the liver. On the basis of the clinical signs, isolation of haemolytic E. coli and the post mortem findings, a diagnosis of oedema disease was made.     

RADIOGRAPHIC FINDINGS IN TEN DOGS WITH THORACIC ACTINOMYCOSIS

The radiographic findings in ten dogs with thoracic actinomycosis are presented. Radiographic findins varied, but pleural effusion, pulmonary infiltrates and mediastinal masses were most commonly found. Rib involvement, commonly accompanying actinomycosis in man, was present in only one dog. The differential diagnosis of actinomycosis includes many disease entities, but based on the radiographic signs it may be possible to narrow down the number of possiblities considerably. A combination of mediastinal or pulmonary masses, pleural effusion and encapsulated fluid is strongly indicative for actinomycosis. For confirmation a bacteriological examination is indicated.     

Surgical correction of gastro‐oesophageal intussusception with bilateral incisional gastropexy in three dogs

Three dogs presented for evaluation of acute onset tachypnoea and dyspnoea following episodes of vomiting and/or regurgitation. Thoracic radiographs were suggestive of a gastro‐oesophageal intussusception in all three dogs; one dog also showed evidence of aspiration pneumonia. All three dogs underwent surgical correction with a bilateral incisional gastropexy. All dogs recovered from anaesthesia uneventfully and were discharged from the hospital 3 days after presentation. Persistent megaoesophagus was evident in all three dogs, and they are being chronically managed with a strict feeding regime and pro‐motility agents.     

Radiographic findings in dogs with pulmonary blastomycosis: 125 cases (1989-2006)

OBJECTIVE: To identify radiographic patterns in dogs with pulmonary blastomycosis and radiographic factors associated with outcome. DESIGN: Retrospective case series. ANIMALS: 125 dogs with pulmonary blastomycosis. PROCEDURES: Medical records were reviewed, and for each lung lobe, the primary radiographic pattern and percentage of lobar involvement at the time of initial examination were recorded. RESULTS: 79 dogs survived, 38 died, and 8 were euthanized without treatment. The initial radiographic pattern was variable and not significantly associated with outcome. Mean half-time for radiographic resolution of pulmonary infiltrates was 41.4 days for all patterns except masses, for which mean half-time to resolution was 90.8 days. Transient radiographic worsening was seen in 20 of 87 (23%) dogs but was not associated with a poor prognosis. Pulmonary bullae were seen in 20 (16%) dogs, most often in association with an alveolar pattern. Accuracy of using percentage of right caudal lung lobe involvement ( 20%) to predict outcome was 74.4%; accuracy of using number of affected lobes (< 4 vs >or= 4) to predict outcome was 65.8%. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that a nonuniform distribution of pulmonary infiltrates was equally as likely as a diffuse nodular interstitial pattern in dogs with pulmonary blastomycosis. On the basis of half-time for resolution of pulmonary infiltrates, follow-up radiography should be performed no more often than every 4 to 6 weeks in clinically stable patients. Transient radiographic worsening that occurred during the initial weeks of treatment was not associated with a poorer prognosis.     

Polymyositis associated with Ehrlichia canis infection in two dogs

Clinical, haematological, biochemical, electrophysiological and pathological features of two dogs infected with Ehrlichia canis and with concurrent signs of polymyositis are presented. Both dogs had a history of relatively acute onset, progressive tetraparesis, hyporeflexia and generalised muscle wasting. Skeletal muscles were atrophic and characterised histologically by plasmocytic, lymphocytic and immature lymph-oreticular cellular infiltrates with accompanying areas of necrosis. Histopathological similarities between ehrlichiosis and polymyositis are noted and a probable aetiological relationship is inferred.     

Chronic dilatative myocarditis caused by Trypanosoma cruzi in two dogs

Trypanosoma cruzi was believed responsible for causing chronic dilatative myocarditis in 2 female hunting dogs. Clinical signs included ascites, respiratory distress, thoracic effusion, cyanosis, and weak pulse with ventricular arrhythmias. Electrocardiography indicated first-degree heart block, chamber enlargement, and ventricular-based arrhythmias unresponsive to treatment. M-mode echocardiography of 1 dog confirmed bilateral cardiac enlargement and septal and left ventricular free wall thinning. Multifocal infiltrates of plasma cells, lymphocytes, and histiocytes, cardiocyte degeneration, and multifocal fibrosis were the predominant histologic lesions. Trypanosoma cruzi pseudocysts were infrequently found.     

Diseases associated with pronounced eosinophilia: a study of 105 dogs in Sweden

Records of 105 dogs with pronounced eosinophilia (>2.2 X l0⁹ eosinophils/litre) were evaluated in a retrospective study to determine diseases associated with the abnormality in dogs in Sweden. Inflammatory disease in organs with large epithelial surfaces, such as the gut, lungs or skin, was found in 36 per cent of the dogs. A further one-quarter of the 105 cases were placed in the 'miscellaneous' category, which comprised various diseases found at low frequency. The most well defined diagnosis was pulmonary infiltrates with eosinophils in 12 per cent of the dogs. A further 11 per cent had parasitic disease caused by either sarcoptic mange or nasal mite. No atopic dog was found and rottweilers were over-represented in most disease groups. Pronounced eosinophilia, in many cases transient, seems to be associated with a variety of disorders in dogs. In the present study, rottweilers appeared to be more prone to a high eosinophil response than other breeds.     

Non-cardiogenic pulmonary oedema complicating balloon valvuloplasty and stent angioplasty of severe pulmonary valve stenosis in four dogs

In dogs, balloon valvuloplasty is considered the treatment of choice for severe pulmonary valve stenosis, and this technique is currently performed routinely in specialist referral practices with low morbidity and mortality. Stent angioplasty has also been recently proposed as a viable treatment option. The present case series describes the clinical course of four dogs with severe pulmonary valve stenosis, treated with balloon valvuloplasty or stent angioplasty at four different institutions, which developed non-cardiogenic pulmonary oedema perioperatively after apparently successful dilation of the pulmonary valve. In three cases, there was evidence of some degree of pulmonary hypertension before ballooning. Despite intensive care, the complication proved fatal in three cases. Clinicians should therefore be aware of this life-threatening complication, previously undescribed in dogs.