What is your diagnosis? Peritoneal effusion from a dog

Abstract: A 5‐year‐old, female Italian hound dog was presented with progressive weight loss, anorexia, and lethargy. Physical examination abnormalities included poor body condition, abdominal distension, splenomegaly, and areas of crusty alopecia on the head and limbs. Clinicopathologic abnormalities included mild normocytic normochromic anemia, moderate hyperproteinemia and hyperglobulinemia, mild hypoalbuminemia, and hyponatremia, a mild increase in serum alkaline phosphatase activity, and a moderate to marked increase in β‐ and γ‐globulins on serum protein electrophoresis. Abdominal ultrasonography revealed peritoneal effusion. Abdominocentesis yielded ～200 mL of serosanguinous, slightly turbid fluid with 2.6 × 10⁹ nucleated cells/L, and a protein concentration of 32 g/L. Cytologic specimens of the fluid contained a mixed population of inflammatory cells. Intracytoplasmic inclusions identified as Leishmania sp. amastigotes were observed in numerous macrophages and also free in the background. An ELISA for canine Leishmania sp. antibody was positive. The abdominal effusion resolved within a few days of beginning treatment with meglumine antimoniate and allopurinol. Finding Leishmania amastigotes in peritoneal fluid is rare in canine leishmaniasias and allows an easy, quick diagnosis of the disease.