Systemic AL amyloidosis associated with multiple myeloma in a horse

AL amyloidosis is the most common type of systemic amyloidosis in humans, and it is frequently associated with multiple myeloma. But, AL amyloidosis is very rare in domestic animals. A 16-year-old Quarter horse gelding was diagnosed with systemic AL amyloidosis associated with multiple myeloma. Clinical problems were rapid weight loss, muscle atrophy, soft unformed stool, and ventral edema. Grossly, diffuse gastrointestinal hemorrhage, markedly thickened jejunal mucosa, and splenomegaly were present. Microscopically, diffuse severe amyloid deposits were present in the lamina propria of glandular stomach, duodenum, and jejunum. Much of the spleen and sternal bone marrow was replaced by neoplastic round cells, and multiple foci of amyloid were also present in the spleen and bone marrow. Electron microscopy revealed the neoplastic round cells to be of plasma cell origin, and the amyloid showed a strongly positive immunoreactivity with polyclonal anti-human immunoglobin lambda light-chain antisera. To our knowledge, this is the second report describing systemic AL amyloidosis in domestic animals-associated plasma cell neoplasia and the first associated with multiple myeloma, as is common in humans.     

Systemic AA amyloidosis in the common marmoset

The common marmoset (Callithrix jacchus) is a small New World primate native to Brazil that has been used extensively in biomedical research. A retrospective analysis of archived hematoxylin and eosin-stained tissue sections and clinical records was conducted at the New England Primate Research Center on 86 marmosets more than 1 year of age that were euthanized during the past decade because of morbidity and failure to thrive. Approximately 17% (15 of 86) were found to have amyloid deposits in one or more organs, including the liver, adrenal glands, kidneys, and intestine. This material was shown by amino acid sequence analysis to be composed of serum amyloid A (SAA)-related protein. This type of amyloidosis, designated AA or "secondary," is associated typically with an inflammatory process that induces elevated levels of the SAA amyloidogenic precursor molecule. Notably, there were no significant pathologic differences or other distinguishing features in animals with amyloid versus those without; furthermore, on the basis of the limited number of serum specimens available for analysis, the SAA concentrations in the two groups were comparable, thus suggesting the possible inheritable nature of the disorder. In this respect, the common marmoset provides a unique experimental model for study of the pathogenesis and treatment of AA and other forms of systemic amyloidosis.     

Systemic cutaneous and subcutaneous amyloidosis in the horse]

A 9-year-old horse had numerous firm, painless nodules of the skin and subcutis. Moderately vascular granulation tissue with numerous uni- or multinuclear reticuloendothelial cells was in the nodules and the regional lymph nodes but not in the viscera. By using special stains and electron microscopy, widespread amyloid deposits, mainly in the cytoplasm of reticuloendothelial cells, were identified. Amyloid was probably produced within the reticuloendothelial cells, then expelled from the dying cell and deposited in the intercellular space.     

Choledocholithotripsy in a mare

Obstructive choledocholithiasis in a 12-year-old mare was corrected surgically by choledocholithotripsy. The mare had a history of chronic weight loss, intermittent fever, partial anorexia, jaundice, recurrent abdominal pain, and an abdominal mass palpable per rectum. Values for alkaline phosphatase, bilirubin, gamma-glutamyl transferase, sorbitol dehydrogenase, and bromsulpthalein half-life were increased and bilirubinuria was evident before surgery. Two liver biopsies revealed periportal and portal fibrosis, bile duct proliferation, cholestasis, and variable amounts of hepatocellular necrosis, with infiltration by polymorphonuclear cells. Immediate clinical improvement was seen after surgery, and results of selected liver function tests gradually returned to normal. Since surgery, the mare has returned to her normal weight, has remained clinically normal for liver disease for 28 months, and has been useful as a broodmare.     

Thecoma in a mare

A 4-year-old crossbred Thoroughbred mare was referred to the University of Tehran Veterinary Medical Teaching Hospital for evaluation of a mass in the pelvic cavity. The mare had been partially anorectic and pyrexic. On clinical examination, the mare was thin and depressed, with body temperature of 38°C, a pulse rate of 38 beats/minute, and a respiratory rate of 10 breaths/minute. Palpation per rectum revealed a large, smooth and tense mass in the anterior part of the pelvic cavity. Ultrasound examination confirmed the presence of a soft tissue mass with a thick wall. The inner surface of the mass had a villous-like appearance. The stroma of the mass was mottled, with accumulation of speckled and hypoechoic to slightly hyperechoic fluid. Hormone assays revealed low serum concentration of testosterone. Serum progesterone concentration indicated that active luteal tissue and serum estradiol concentration was 24 pg/ml. On histological examination, the sections from the tumor were composed of oval- or spindle-shaped cells loosely arranged in diffuse sheets or irregularly interlacing fascicles. On the basis of these histological findings, the large tumor mass of the left ovary was considered to be a thecoma. To our knowledge, the details of the clinical, ultrasonographic, endocrinologic, and histologic findings of this tumor in the mare have not been described in the veterinary literature.     

Vestibulovaginal leiomyosarcoma in a mare

A 14-year-old Quarter Horse mare presented for a mass within the vestibule and vagina resulting in external compression and incomplete occlusion at the external urethral opening with subsequent difficulty urinating. Examination revealed an approximately 15 × 10 cm lobulated mass within the vestibule and caudal vagina attached via a broad base dorsally. Histopathology of the mass identified a low-grade leiomyosarcoma. Complete resection was not possible, and surgical debulking of the mass was performed during standing sedation using a vessel-sealing and dividing device. The mare was discharged 3 days post-operatively without any complications. Recheck examinations performed at 1 month and 8 months’ post-surgery revealed excellent healing of the surgical site and no apparent tumour regrowth.     

Pneumonia in a Paso-Fino mare

A 5-year-old Paso-Fino mare was presented for severe respiratory distress. The mare had foaled 2 months prior to presentation. The horse was in poor body condition with a dull hair coat. A mild fever was noted during physical examination and increased bronchovesicular sounds were auscultated. Thoracic radiographs showed an interstitial pattern and an alveolar infiltrate with distinct air bronchograms. Moderate purulent inflammation with increased mucus was observed in tracheal wash fluid, but no infectious agents were identified. A bronchoalveolar lavage (BAL) contained a large amount of mucus and reactive mononuclear phagocytes with variable numbers of intracellular fungal organisms morphologically consistent with Pneumocystis carinii. The mare had undetectable levels of immunoglobulin M (IgM) and decreased IgG levels in the serum. Immunophenotyping revealed decreased expression of major histocompatability complex (MHC) class II molecules. Moderate to marked hyperplasia of type II epithelial cells was present throughout histologic sections of lung, but the fungal organisms were not observed. A culture system has not been developed for diagnosis of P carinii infection. Instead, diagnosis of P carinii pneumonia is achieved by microscopic identification of characteristic morphologic features of the pathogen. Cytologic examination of BAL fluid is the preferred method used to diagnose human infection with P carinii. In humans, the diagnostic sensitivity of cytology is significantly higher than the sensitivity of histopathologic examination of lung biopsies. The difference in sensitivity between BAL cytology and lung histopathology may also apply to the diagnosis of P carinii pneumonia in horses. (MacNeill AL, Alleman AR, Franklin RP, Long M, Giguère S, Uhl E, López-Martinez A, Wilkerson M. Pneumonia in a Paso-Fino mare [ Pneumocystis carinii pneumonia].     

Shivering in a thoroughbred mare

An 11-year-old mare presented with neuromuscular deficits and what resembled shivering in the left hind limb. On necropsy, there was no evidence of denervation atrophy of the left hind gastrocnemius muscle. The spinal cord had a small, right-sided lesion at C3-C4 and C4-C5. Tests for equine herpesvirus-1 and Sarcocystis spp. were negative.     

Arrhenoblastoma in a mare.

An ovarian neoplasm measuring 10 by 8 by 6 cm was surgically removed from a 14-year-old Appaloosa mare. For 2 years prior to surgery, the mare had manifested marked behavioral changes, becoming aggressive toward other broodmares. Histologically, the tumor was found to be an arrhenoblastoma. Preoperative endocrinologic findings (high serum testosterone and low serum estradiol concentrations) supported the diagnosis.     

Uterine rupture in a mare

This report involves uterine rupture in a mare, which was unique because it was not associated with assisted or difficult foaling. We describe an alternative to surgical correction of the condition and illustrate the need for luminal uterine palpation, so that uterine rupture does not go undiagnosed.     

Uterine hematoma in a mare

An 8-year-old grey Arabian mare was presented for reproductive evaluation with a history of failing to become pregnant during two previous breeding seasons. An enlargement was identified on the right uterine horn on rectal examination which was confirmed as a fluid-filled nonechogenic mass on ultrasonography. Subsequent examination procedures and laparotomy revealed an old hematoma in the wall of the uterine horn.     

Endometrial adenocarcinoma in a mare

An endometrial adenocarcinoma with metastases to the lung, liver, spleen, mesentery and serosal peritoneal surfaces was found in an 11-year-old Arabian mare. Clinical signs included generalized weight loss, depression, anorexia, ventral edema and abdominal distension. Ascites was due to thrombosis of the caudal vena cava. The diagnosis of endometrial adenocarcinoma was based on the histological appearance of uterine glandular epithelium and the presence of similar tissue in the metastatic tumors.