Generalized calcinosis cutis associated with probable leptospirosis in a dog

A 6.5-year-old male German Shepherd acutely developed renal and hepatic disease. Serology revealed high concentrations of antibodies against Leptospira copenhageni, and a presumptive diagnosis of leptospirosis was made. The dog was successfully treated with antibiotics and supportive care over a 12-day period. Sixty-two days after the initial presentation, alopecia predominantly involving the dorsum and perineal areas developed. The skin lesions expanded over a 20-day period. Histology revealed generalized calcinosis cutis with follicular atrophy. An injection of 0.01 mg kg-1 dexamethasone suppressed serum cortisol concentrations. No treatment was given and lesions resolved over the following 30 days. This is the third case of generalized calcinosis cutis that has developed in an adult dog after severe systemic disease. Both previous cases developed calcinosis cutis in association with blastomycosis. To the authors' knowledge, this is the first report of generalized calcinosis cutis in an adult dog in association with a presumptive bacterial infection.     

Severe calcinosis cutis associated with treatment of hypoparathyroidism in a dog.

A 6-month-old, female border collie was referred for evaluation of hypocalcemia, hyperphosphatemia, fever, and painful ventral abdominal skin. She had recently been treated intravenously and subcutaneously (SC) with a diluted 10% calcium gluconate solution. The medical evaluation supported the diagnosis of primary hypoparathyroidism, but the subsequent hospital course was complicated by severe calcinosis cutis, which caused extensive skin necrosis and marked debilitation. This patient illustrates that administration of a calcium gluconate solution SC can be associated with extensive morbidity when administered to hyperphosphatemic patients.     

Temporary remission of disseminated paecilomycosis in a German shepherd dog treated with ketoconazole

Disseminated mycosis caused by Paecilomyces varioti in a female German shepherd dog presented with chronic forelimb lameness is described. Radiographs of the swollen carpal joint revealed geographic lysis of the radial epiphysis. Diagnosis was based on cytological demonstration of fungal hyphae and chlamydiospores, as well as fungal culture of fluid obtained by arthrocentesis. Temporary remission was characterised by markedly improved clinical signs and laboratory parameters, following treatment with ketoconazole. The dog was euthanased 9 months after the initial diagnosis, following the diagnosis of multifocal discospondylitis. This appears to be the longest described period of temporary remission obtained with treatment in dogs with paecilomycosis. Clinical, clinicopathological and necropsy findings of this disease in another German shepherd dog are briefly described.     

Metastatic calcinosis (including calcinosis cutis) in a young dog with multiple urinary tract abnormalities

Metastatic calcinosis associated with chronic renal failure and multiple urinary tract abnormalities was diagnosed in a 6-month-old Brittany spaniel that was presented with calcinosis cutis. This case report highlights the importance of skin as an indicator of systemic disease. The aetiopathogenesis of the four main types of tissue calcification is defined and discussed with an emphasis on metastatic calcinosis.     

Systemic paecilomycosis in a dog

Disseminated paecilomycosis was diagnosed in an adult dog without underlying immunosuppressive disease. During the 3-month illness (before euthanasia), the dog had ulcerative granulomatous inguinal lymphadenitis, fever, anorexia, dyspnea, generalized lymphadenopathy, retinochoroiditis, and seizures. Fungal organisms isolated from inguinal and prescapular lymph nodes before the dog was euthanatized were identified histologically. Paecilomyces variotii was isolated from the prescapular lymph node specimen. Paecilomyces variotii may be more pathogenic (once it has gained bodily entry) than previously thought.     

Iatrogenic hyperadrenocorticism, calcinosis cutis, and myocardial infarction in a dog treated for IMT

An 8 yr old male English bulldog receiving treatment for immune-mediated thrombocytopenia was diagnosed with calcinosis cutis 90 days after initiation of corticosteroid therapy. Twenty-four days later, the patient presented in a comatose state after collapsing and was euthanized. Postmortem examination revealed coronary arteriosclerosis and myocardial infarction leading to congestive heart failure. Calcinosis cutis and myocardial necrosis were most likely complications associated with administration of corticosteroids in this dog. Important implications regarding the classification of calcinosis cutis and the use of immunosuppressive doses of corticosteroids are discussed.     

Tumoral calcinosis in a dog with chronic renal failure

A 2-year-old male German shepherd dog in poor bodily condition was evaluated for thoracic limb lameness due to a large, firm mass medial to the left cranial scapula. Radiography revealed several large cauliflower-like mineralized masses in the craniomedial left scapula musculature, pectoral region and bilaterally in the biceps tendon sheaths. Urinalysis, haematology and serum biochemistry showed that the dog was severely anaemic, hyperphosphataemic and in chronic renal failure. The dog was euthanased and a full post mortem performed. A diagnosis of chronic renal failure with secondary hyperparathyroidism was confirmed. The mineralised masses were grossly and histopathologically consistent with a diagnosis of tumoral calcinosis. Tumoral calcinosis associated with chronic renal failure that does not involve the foot pads is rarely seen.     

Haemophagocytic syndrome with disseminated intravascular coagulation in a dog

Clinical signs and haematological abnormalities of haemophagocytic syndrome of unknown origin are described for a male, nine-year-old rottweiler referred because of weakness, depression, mild weight loss and relapsing fever. Mucous membranes were pale and the spleen was enlarged. Ultrasonography revealed diffuse irregular structures in the enlarged spleen, and cytologlcal examination of multiple fine needle aspirates of the spleen demonstrated extramedullar haematopoiesis. Haematological examination revealed pancytopenia and disseminated intravascular coagulation. A bone marrow smear contained numerous marrow macrophages with a cytologically benign appearance, containing phagocytosed haematopoietic cells. The dog died one week after referral. The differential diagnosis is discussed.     

Primary hypoparathyroidism in a cat complicated by suspect iatrogenic calcinosis cutis.

An adult male cat presented to the Ontario Veterinary College after having a seizure at the humane society. The cat was diagnosed with primary hypoparathyroidism and was treated with calcium and vitamin D3 supplementation. Calcium supplementation included subcutaneous (SC) administration of diluted calcium gluconate according to protocols described in recent literature. Seven days after SC calcium administration, firm SC masses developed in the intrascapular area where the injections were given and in the dependent axillary area. These areas became raised, formed crusts, necrosed, and left scars. Although not histopathologically confirmed, the author postulates that this was a direct reaction to SC calcium gluconate administration.     

P-60 Hypercalcaemia associated with disseminated Lagenidium spp. infection in a dog: case report

Opportunistic dermatoses can occur in case of immunosuppressive diseases. The first case was a 12-year-old domestic short-haired cat suffering from diabetes with a phaeohyphomycosis due to Scytalidium spp. associated with cutaneous hemangiosarcoma. A painless and ulcerated nodule was observed on a digit with fistulous tracts over the metatarsal joint. Histopathological examination of the nodule revealed a hemangiosarcoma in which brownish fungal colonies were found. Itraconazole (5 mg/kg twice daily), then amputation, allowed 12 months of survival (pulmonary metastases). The second case concerned a 13-year-old Siamese cat with cheyletiellosis associated with spontaneous Cushing's disease and diabetes mellitus. This cat exhibited scales and miliary dermatitis on the trunk associated with polyuria, polydipsia and a pot-belly. Acetate tape impression showed Cheyletiella blakei mites and eggs. Blood analysis revealed diabetes mellitus and spontaneous hyperadrenocorticism. The owner refused treatment. The third case was a 14-year-old domestic short-haired cat with generalized demodicosis associated with iatrogenic Cushing's disease and diabetes mellitus. Long-acting glucocorticoids had been used for treatment of plasma cell stomatitis for 5 years. This cat exhibited erythema, scales, self-induced alopecia, thin skin and moderate pruritus associated with polyuria and polydipsia. Cutaneous lesions principally developed on the abdomen and flanks. Skin scrapings and trichogram showed numerous Demodex cati mites. Routine blood work demonstrated diabetes mellitus and iatrogenic Cushing's disease. Treatment was based on insulin therapy, milbemycin oxime (1 mg/kg once daily) and chlorambucil (0.2 mg/kg once daily). The demodicosis was cured after 4 months, but the cat died of cutaneous and ocular herpesvirus infection 10 months later.
Funding: Self-funded.     

Cutaneous paecilomycosis in a cat

A cat was presented for a 2-year history of a recurrent, soft-tissue swelling of the left metacarpal region. The mass was excised and submitted for aerobic and anaerobic bacterial culture, fungal culture, and histopathological examination. Cultures revealed the organism Paecilomyces lilacinus, and histopathological examination showed a nodular mycotic granuloma. Itraconazole (10 mg/kg body weight, per os [PO], q 24 hours) was administered and continued for a total of 60 days, with a swelling of the upper lip occurring 3 months after the initial presentation. Subsequent surgical excisions and debridements along with treatment with itraconazole (20 mg/kg body weight, PO, q 24 hours) for a total of 4 months were curative.     

Generalized metastatic intestinal and cutaneous calcinosis in a Hovawart puppy with leptospirosis

A 10-week old male Hovawart presented with acute renal failure. Based on clinical symptoms, blood analysis results and serology, a diagnosis of leptospirosis was made. Besides being acotemic, the puppy was initially also severely hypercalcemic. The dog was treated successfully, but developed widespread cutaneous and visceral calcifications. Severe pyloric calcification resulted in functional pyloric obstruction, which was successfully treated by pyloromyotomy. All skin lesions were cured with topical therapy within a few weeks. To the authors' knowledge, this is the first report of generalized intestinal and cutaneous calcification associated with acute renal failure due to Leptospirosis.     

Mammary gland carcinoma in a dog with peripheral blood and bone marrow involvement associated with disseminated intravascular coagulation

A 7-year-old female Leonberger dog was referred to the National Veterinary School of Lyon Teaching Hospital with a 2-day history of anorexia and bleeding. A mammary mass had been removed 7 months earlier, but histologic examination was not performed. On physical examination, the dog was depressed and had pale mucous membranes and numerous petechiae and hematomas. Significant laboratory findings were moderate thrombocytopenia, prolonged prothrombin, activated partial thromboplastin, and thrombin times, hypofibrinogenemia, and increased concentration of fibrin(ogen) degradation products. A peripheral blood smear, buffy coat preparation, and bone marrow aspirate contained low numbers of large atypical cells that had moderate nuclear:cytoplasmic ratios, oval nuclei with multiple prominent nuclei, and basophilic cytoplasm with villous projections. A small nodule was found in the left inguinal mammary gland, and a fine-needle aspirate contained cells similar to those in blood and bone marrow. In samples of blood, bone marrow, and the mammary mass, the neoplastic cells were immunoreactive for cytokeratin. The diagnosis was mammary carcinoma with secondary disseminated intravascular coagulation (DIC) and disseminated tumor cells in bone marrow and circulating tumor cells in blood; this diagnosis was not confirmed by histopathologic examination. Owing to clinical deterioration and the poor prognosis, the dog was euthanized and a necropsy was not performed. This is the first report of a canine mammary carcinoma with circulating tumor cells and secondary DIC.