Cestode infection in 2 dogs: cytologic findings in liver and a mesenteric lymph node

Mesocestoides cestode infections in dogs are well known for causing severe peritonitis with larvae or larval fragments (metacestodes, tetrathyridia, or calcareous corpuscles) frequently observed cytologically in peritoneal fluid samples. This case report describes the cytologic and clinical features of 2 dogs infected with cestode larvae, with one case confirmed and the other presumed to be Mesocestoides sp. In these 2 unusual cases, cestode larvae or larval fragments were found in fine‐needle aspirates of the liver and a mesenteric lymph node, but no organisms were found in peritoneal fluid samples. The data presented in this report indicate that clinical pathologists should not rule out Mesocestoides sp cestodiasis based on the absence of larvae in peritoneal fluid samples from dogs.     

Clinical, cytological and molecular evidence of Mesocestoides sp. infection in a dog from Italy

A 12-year-old, 13 kg, mixed-breed male dog was referred for anorexia and depression. The dog showed discomfort on abdominal palpation. Abdominal ultrasound examination revealed multiple, small, round anechoic cystic structures. Cystic fluid obtained with fine needle aspiration contained several 2-4 mm white motile flecks. Microscopic examination of the fluid revealed numerous irregularly shaped organisms measuring several hundred microns to 3 mm, the morphology of which was suggestive of intact and fragmented acephalic metacestodes of the genus Mesocestoides sp. Molecular analysis confirmed that the peritoneal infection was caused by Mesocestoides sp.     

Scrotal cestodiasis in a dog

Scrotal cestodiasis was diagnosed from a surgical biopsy specimen from an 8-year-old Miniature Poodle. Peritoneal cestodiasis with secondary scrotal cestodiasis was suspected and could be explained by migration of the parasite along the vaginal tunics. Subsequent necropsy confirmed severe peritoneal cestodiasis due to Mesocestoides sp. It appears that scrotal cestodiasis may be an early indicator of peritoneal cestodiasis in male dogs and diagnostic pathologists and clinicians should be aware of this condition.     

ULTRASONOGRAPHIC FEATURES OF PERITONEAL CESTODIASIS CAUSED BY MESOCESTOIDES SP. IN A DOG AND IN A CAT

Peritoneal infections caused by Mesocestoides spp. are rare in dogs and cats. Little data exist on the role of abdominal ultrasonography for diagnosis and therapy management of the disease. We describe the ultrasonographic features of peritoneal cestodiasis in a dog and in a cat. In the dog, abdominal ultrasound allowed both a presumptive diagnosis and the collection of tissue samples to confirm peritoneal larval infection. Ultrasound was also very useful for therapy management. In the second patient the ultrasonographic features of tetrathyridial infection in a cat in which the parasite was observed as an incidental finding during ovariohysterectomy are described.     

Evaluation of Abdominal Fluid: Peripheral Blood Creatinine and Potassium Ratios for Diagnosis of Uroperitoneum in Dogs

Objective: To determine the clinical efficacy of abdominal fluid to peripheral blood ratios of creatinine and potassium concentrations to diagnose uroperitoneum in dogs.
Design: Records of 13 dogs with confirmed uroabdomen were retrospectively analyzed. Prospective evaluation of 8 dogs with nonrenal ascites provided data for a control population.
Setting: Veterinary Medical Teaching Hospital.
Animals: Client owned dogs.
Interventions: None
Measurements and Main Results: Abdominal fluid potassium (mEq/L) and creatinine concentrations (mg/dl) were recorded. Peripheral blood potassium and creatinine concentrations were also recorded. Ratios were calculated based on these values. An abdominal fluid creatinine concentration to peripheral blood creatinine concentration ratio of > 2:1 was predictive of uroabdomen in dogs (specificity 100%, sensitivity 86%). An abdominal fluid potassium concentration to peripheral blood potassium concentration of > 1.4:1 is also predictive of uroabdomen in dogs (specificity 100%, sensitivity 100%). All dogs with uroabdomen had an abdominal fluid creatinine concentration that was at least 4 times normal peripheral blood levels.
Conclusion: Abdominal fluid to peripheral blood potassium and creatinine ratios provide a means to diagnose uroperitoneum in dogs without elevated peripheral blood creatinine.     

Three cases of canine bile peritonitis with mucinous material in abdominal fluid as the prominent cytologic finding

Background: Bile peritonitis is a severe, nonseptic inflammatory response to bile in the peritoneal cavity. It may result from generalized or localized leakage of bile due to spontaneous rupture of the biliary system or as a complication of biliary tract inflammation, obstruction, manipulation, or trauma. Cytologically, bile in abdominal fluid appears as golden-green granular pigment.
Objective: The purpose of this report is to describe the atypical cytologic features of abdominal fluid in 3 dogs with bile peritonitis.
Methods: As part of a diagnostic workup, abdominal fluid was obtained from 3 dogs with bile peritonitis and analyzed. In 2 dogs, fluid bilirubin concentration was determined and Hall's bile stain, Alcian blue-periodic acid-Schiff stain, and Mayer's mucicarmine stain were applied to direct smears of the fluid.
Results: Acellular mucinous fibrillar material in clumps and lakes was the prominent cytologic finding in the abdominal fluid from all 3 dogs. Bile pigment was not observed. Fluid from the 3 dogs contained increased numbers of inflammatory cells, predominantly neutrophils. Total protein concentration ranged from 2.9 to 5.6 g/dL. Fluid total bilirubin concentration was greater than twice that of the concurrent serum bilirubin concentration. Based on results of the special stains, the amorphous material was positive for mucosubstances, but was negative for bilirubin. In all dogs, bile peritonitis originated from a rent in the common bile duct.
Conclusions: Bile peritonitis with fibrillar mucinous material in abdominal fluid has not been described previously in dogs. The material was similar to "white bile" observed in humans and experimentally in dogs as a sequela to extrahepatic biliary tract obstruction. When mucinous material is observed in abdominal fluid from dogs and the fluid bilirubin concentration is greater than twice the serum bilirubin concentration, rupture of the extrahepatic biliary tract should be suspected.     

Splenic foreign body in a cat

An 8-year-old domestic shorthair cat was evaluated for a several day history of anorexia and vomiting. Abdominal distention was noted on physical examination and diagnostics including abdominal radiographs and abdominal ultrasound demonstrated the presence of free fluid in the peritoneal cavity. Septic peritonitis was diagnosed on cytologic evaluation of the peritoneal fluid. The cat was taken to surgery and a foreign body composed of plant material was found embedded within the spleen. A splenectomy was performed and both open and active peritoneal drainages were used to successfully treat this case.     

Evaluation of postceliotomy peritoneal drain fluid volume, cytology, and blood-to-peritoneal fluid lactate and glucose differences in normal dogs

Objective: To describe peritoneal drain fluid volume, fluid cytology, and blood‐to‐peritoneal fluid lactate and glucose concentration differences after exploratory celiotomy in normal dogs. Study Design: Prospective study. Animals: Healthy Beagle dogs (n=10). Methods: After exploratory celiotomy, a peritoneal drain was placed, and peritoneal fluid was recorded every 6 hours for 7 days. Fluid was submitted for cytologic examination, and fluid and blood glucose and lactate concentrations were recorded every 12 hours. On day 7, drains were removed and drain tips submitted for aerobic bacterial culture. Results: Mean peritoneal fluid volume decreased from 2.8 mL/kg/day (day 1) to 0.6 mL/kg/day (day 7). All dogs had degenerate neutrophils in peritoneal fluid throughout the 7 days. Four dogs developed contaminated drains. Blood‐to‐peritoneal glucose concentration differences>20 mg/dL occurred after day 4. By day 7, 5 of 7 dogs with patent drains had blood‐to‐peritoneal lactate concentration differences70% of dogs had differences consistent with septic peritonitis each day. Postoperative blood‐to‐peritoneal fluid glucose and lactate difference may not be reliable indicators of septic peritonitis when evaluating abdominal fluid collected with closed suction drains.     

Sensitivity and specificity of cytologic evaluation in the diagnosis of neoplasia in body fluids from dogs and cats

Sensitivity and specificity were determined for the cytologic detection of malignant tumors in canine and feline body cavity effusions. In a prospective study, 424 body cavity effusions from dogs and cats were collected and evaluated, including 70 pleural and 163 peritoneal effusions from dogs, and 77 pleural and 114 peritoneal effusions from cats. Final diagnoses were confirmed in 339 of the 424 cases by clinical follow-up, necropsy, and in the case of malignant tumors, Histopathology. Malignant tumors were found in 18% of canine and 25% of feline body cavity effusions. Approximately one-half of tumors in both dogs and cats were carcinomas. Discrete cell tumors accounted for 56% of feline neoplastic effusions. The sensitivity of cytologic evaluation for the detection of malignant tumors in body cavity effusions was 64% for dogs and 61% for cats. Specificity was 99% for canine and 100% for feline effusions. Sensitivity and specificity were comparable to those obtained with cytologic evaluation of human samples.     

The role of the subterranean rodent Ctenomys talarum (Rodentia: Octodontidae) in the life cycle of Taenia taeniaeformis (Cestoda: Taeniidae) in urban environments

This work is the first report of subterranean rodent Ctenomys talarum (Rodentia: Octodontidae) as intermediate host of Taenia taeniaeformis in urban areas of Mar de Cobo (Buenos Aires Province, Argentina) and to experimentally reproduce in domestic dogs the adult stage of this parasite. Prevalence, mean abundance and mean intensity of infection with T. taeniaeformis larvae in the liver and peritoneal cavity of C. talarum were 64%, 15.3 and 9.8, respectively. Ten adults of T. taeniaeformis were obtained from experimentally infected dogs. Information about the role of subterranean rodents in the life cycle of this parasite is also given. The above mentioned data indicate that T. taeniaeformis is a frequent parasite of this species of rodents, at least within the study area. Also explanations for the high prevalence of larval forms of this parasite in C. talarum populations are given.     

Secretory/excretory antigens produced by tetrathyridia of Mesocestoides corti defined by SDS--PAGE and HPLC

Antigens derived from culture medium in which metacestodes of Mesocestoides corti Hoeppli, 1925, had been maintained were studied by sodium-dodecyl-sulfate--polyacrylamide gel electrophoresis (SDS--PAGE) and high performance liquid chromatography (HPLC). By SDS--PAGE a minimum of 18 Coomassie-staining bands were discerned, of which 4 major bands and 4 major peaks by HPLC of similar molecular weights were observed. The HPLC eluate peaks were analyzed for antigenic activity in vitro by double diffusion in two dimensions, and in vivo in a rabbit. The rabbit had been artificially sensitized with a dialyzable leukocyte extract, showing transfer-factor-like activity, from peritoneal exudate cells removed from mice infected with tetrathyridia. All of the HPLC fractions reacted with rabbit antibody prepared against secretory/excretory antigens, but the sensitized rabbit responded only to two fractions. It is now possible by HPLC to fractionate complex antigens without denaturing them and to elucidate further the role they play during infection.     

Ascites and the anatomy of the peritoneal sacs of broilers

Although the ascites syndrome of broilers is well documented, all the authors fail to describe exactly in which of the various coelomic cavities ascitic fluid is found. Determination of the precise location of this fluid is essential if the pathogenesis of the syndrome is to be understood and explained. Post-mortem examinations were done on 100 broilers that had ascites or had died of the ascites syndrome. In all of them large quantities of fluid were found in the ventral hepatic peritoneal cavities, moderate amounts in the right dorsal hepatic peritoneal cavities and small amounts in the intestinal peritoneal and pericardial cavities. No ascitic fluid was found in the left dorsal hepatic peritoneal cavity. The amount of ascitic fluid effusing from the liver was directly proportional to the surface area of the liver in a given peritoneal cavity.     

Comparison of peritoneal fluid and peripheral blood pH,bicarbonate, glucose,and lactate concentration as a diagnostic tool for septic peritonitis in dogs and cats

OBJECTIVE: To establish a reliable diagnostic tool for septic peritonitis in dogs and cats using pH, bicarbonate, lactate, and glucose concentrations in peritoneal fluid and venous blood. STUDY DESIGN: Prospective clinical study. ANIMALS: Eighteen dogs and 12 cats with peritoneal effusion. METHODS: pH, bicarbonate, electrolyte, lactate, and glucose concentrations were measured on 1- to 2-mL samples of venous blood and peritoneal fluid collected at admission. The concentration difference between blood and peritoneal fluid for pH, bicarbonate, glucose, and lactate concentrations were calculated by subtracting the peritoneal fluid concentration from the blood concentration. Peritoneal fluid was submitted for cytologic examination and bacterial culture. Peritonitis was classified as septic or nonseptic based on cytology and bacterial culture results. RESULTS: In dogs, with septic effusion, peritoneal fluid glucose concentration was always lower than the blood glucose concentration. A blood-to-fluid glucose (BFG) difference > 20 mg/dL was 100% sensitive and 100% specific for the diagnosis of septic peritoneal effusion in dogs. In 7 dogs in which it was evaluated, a blood-to-fluid lactate (BFL) difference < -2.0 mmol/L was also 100% sensitive and specific for a diagnosis of septic peritoneal effusion. In cats, the BFG difference was 86% sensitive and 100% specific for a diagnosis of septic peritonitis. In dogs and cats, the BFG difference was more accurate for a diagnosis of septic peritonitis than peritoneal fluid glucose concentration alone. CONCLUSIONS: A concentration difference > 20 mg/dL between blood and peritoneal fluid glucose concentration provides a rapid and reliable means to differentiate a septic peritoneal effusion from a nonseptic peritoneal effusion in dogs and cats. CLINICAL RELEVANCE: The difference between blood and peritoneal fluid glucose concentrations should be used as a more reliable diagnostic indicator of septic peritoneal effusion than peritoneal fluid glucose concentration alone.     

Diagnosis and treatment of peritonitis caused by a larval cestode Mesocestoides spp., in a dog.

Infection of the peritoneal cavity with cestode larvae, presumptively diagnosed as tetrathyridia of the genus Mesocestoides, was found by exploratory celiotomy in a dog with clinical signs consisting of episodic anorexia, vomiting, and depression. Lymphopenia and hypoalbuminemia were associated clinicopathologic abnormalities. Dystrophic calcification and midline duodenal displacement were found on abdominal radiographs. Therapy with mebendazole was instituted after recurrence of the initial episodic clinical signs postoperatively. Daily use of mebendazole for intermittent periods of up to 3 months led to remission of gastrointestinal signs for 30 months. However, 17 months after the initial diagnosis, infection of the vaginal tunic of the testicle with similar cestode larvae necessitated castration and removal of the vaginal tunic to the inguinal ring. Mebendazole therapy was reinstituted and continued for 31/2 months postoperatively. The dog was free of clinical signs of infection during and for the 16 months since this period of treatment.     

Peritoneal d-Dimer Concentration for Assessing Peritoneal Fibrinolytic Activity in Horses with Colic

Background: Plasma d -dimer concentration is a useful marker to assess systemic coagulation and fibrinolytic activities in humans, dogs, and horses. Peritoneal fibrinolytic activity increases in horses with colic, especially in horses with endotoxin in the peritoneal fluid.
Hypothesis/Objectives: Peritoneal d -dimer concentration can be used to assess peritoneal fibrinolytic activity in horses with severe gastrointestinal (GI) disorders and altered peritoneal fluid.
Animals: Two hundred and twenty-one colic horses and 15 control horses.
Methods: Prospective observational clinical study. Blood and peritoneal fluid were collected on admission. Horses were grouped according to diagnosis, peritoneal fluid analysis, and outcome. Peritoneal d -dimer concentration was determined, together with peritoneal tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI-1) activities. Plasma d -dimer concentration also was measured.
Results: Peritoneal d -dimer concentration was significantly higher in all colic groups compared with controls, and in horses with enteritis, peritonitis, and ischemic disorders compared with horses with large intestinal obstructions. Peritoneal d -dimer concentration was significantly higher in horses with altered peritoneal fluid (modified transudate and exudate) compared with horses with normal peritoneal fluid analysis. Plasma d -dimer concentration also was significantly higher in the peritonitis group, and in horses with altered peritoneal fluid analysis. Peritoneal and plasma d -dimer concentrations also were significantly higher in nonsurvivors. Peritoneal d -dimer concentration was significantly correlated with decreased peritoneal t-PA activity and increased peritoneal PAI-1 activity.
Conclusions and Clinical Importance: Peritoneal d -dimer concentration is markedly higher in severe GI disorders, and it can be used to assess peritoneal fibrinolytic activity in horses with colic.     

Ascites in a 13‐year‐old miniature horse mare with an ovarian granulosa theca‐cell tumour: A manifestation of Meigs' syndrome?

A 13‐year‐old miniature horse mare presented for evaluation of ascites. Abdominal ultrasound showed severe free peritoneal fluid accumulation as well as a caudal abdominal mass. The peritoneal fluid was characterised as a transudate with no evidence of sepsis. Surgical exploration of the abdomen was performed; copious free peritoneal fluid and a large right ovarian mass were discovered. The abnormal ovary was removed, and the mass was determined histologically to be a benign granulosa theca‐cell tumour. Although there was mild peritoneal fluid accumulation in the immediate post operative period, the ascites effectively resolved with removal of the tumour, and the mare returned to a normal lifestyle. This is similar to reports of Meigs' syndrome in human women, in which a benign ovarian mass of significant size causes ascites that resolves once the mass is removed.     

Sclerosing encapsulating peritonitis in three dogs

A condition resembling human sclerosing encapsulating peritonitis was identified in 3 young large-breed dogs. All 3 dogs had similar clinical signs: ascites, vomiting, and excessive borborygmus. The condition was discovered at laparotomy and confirmed histologically. Laparotomy revealed a sac-like formation totally or partially occupying the peritoneal cavity. The predominant histologic abnormality was marked peritoneal and serosal fibrosis. None of the dogs had a favorable response to treatment, and euthanasia was performed because of development of abdominal distention.     

Multilobulated "flower" cells in a subcutaneous mass aspirate from a cat

An 8-year-old intact male cat was presented with a subcutaneous mass in the region of the right jugular vein. Cytologic and histopathologic examinations revealed cells with multilobulated nuclei (flower cells). Immunochemistry using a panel of markers showed vimentin-positivity on cytologic specimens, and postive staining for CD79a and BLA36 on histologic specimens. The final diagnosis was lymphoma of B-cell origin. We have observed similar multilobulated cells in ascites fluid, thoracic fluid, and peripheral blood from dogs and cats with a variety of lymphoid and myeloid neoplasms. Cells with multilobulated nuclei that resemble flower petals also have been described in humans. These cells are infrequently observed in canine and feline cytology specimens and require immunochemistry to determine their cell of origin.     

Changes in pH of peritoneal fluid associated with carbon dioxide insufflation during laparoscopic surgery in dogs

OBJECTIVE: To evaluate changes in pH of peritoneal fluid associated with CO2 insufflation during laparoscopy in dogs. ANIMALS: 13 client-owned dogs and 10 purpose-bred teaching dogs. PROCEDURES: Laparotomy was performed on control dogs; peritoneal fluid pH was measured at time of incision of the abdominal cavity (time 0) and 30 minutes later. Laparoscopic insufflation with CO2 was performed and routine laparoscopic procedures conducted on the teaching dogs. Insufflation pressure was limited to 12 mm Hg. Intraperitoneal fluid pH was measured by use of pH indicator paper at 4 time points. Arterial blood gas analysis was performed at the same time points. RESULTS: Peritoneal fluid pH did not change significantly between 0 and 30 minutes in the control dogs. For dogs with CO2 insufflation, measurements obtained were a mean of 8.5, 24.5, 44.5, and 72.0 minutes after insufflation. The pH of peritoneal fluid decreased significantly between the first (7.825 +/- 0.350) and second (7.672 +/- 0.366) time point. Blood pH decreased significantly between the first (7.343 +/- 0.078), third (7.235 +/- 0.042), and fourth (7.225 +/- 0.038) time points. The PaCO2 increased significantly between the first (39.9 +/- 9.8 mm Hg) and fourth (54.6 +/- 4.4 mm Hg) time points. Base excess decreased significantly between the first and all subsequent time points. CONCLUSIONS AND CLINICAL RELEVANCE: Pneumoperitoneum attributable to CO2 insufflation caused a mild and transient decrease in peritoneal fluid pH in dogs. Changes in peritoneal fluid associated with CO2 insufflation in dogs were similar to those in other animals.