Paraneoplastic leukocytosis in a dog with a renal carcinoma

A 7-year-old male German Shepherd dog in poor body condition had a 3-month history of intermittent hematuria. Nonregenerative anemia, mild leukocytosis, marked hypoalbuminemia, and hematuria were observed. Subsequently, marked neutrophilia and moderate monocytosis were noted; anemia, hypoalbuminemia, and hematuria persisted; and the dog developed disseminated intravascular coagulation. Ultrasonographic examination of the abdomen revealed the presence of an enlarged and irregularly shaped right kidney with a large area of cavitation, and a nephrectomy was performed 30 days after initial examination. Cytologic examination of fine-needle aspirates and imprints of the right kidney revealed a neoplastic cell population suggestive of renal carcinoma. The histopathologic diagnosis was chromophobic cystic-papillary renal carcinoma. The tumor cells expressed granulocytic/macrophage-colony-stimulating factor (GM-CSF), detected by immunohistochemical staining, and elaboration of GM-CSF by the tumor may have mediated the leukocytosis in this dog. Following excision of the tumor, neutrophil and monocyte counts were only mildly increased. The dog died 135 days after initial presentation, and a necropsy was not permitted. Paraneoplastic neutrophilic leukocytosis is an uncommon finding and may be caused by elaboration of CSF by neoplastic cells.     

Clinical outcome and diseases associated with extreme neutrophilic leukocytosis in cats: 104 cases (1991-1999)

OBJECTIVE: To describe diseases, prognosis, and clinical outcomes associated with extreme neutrophilic leukocytosis in cats. DESIGN: Retrospective study. ANIMALS: 104 cats with extreme neutrophilic leukocytosis. PROCEDURE: Medical records from 1991 to 1999 were examined to identify cats that had > or =50,000 WBC/microl with > or =50% neutrophils. Signalment, absolute and differential WBC counts, rectal temperature, clinical or pathologic diagnosis, duration and cost of hospitalization, and survival time were reviewed. RESULTS: Mean age of cats was 8.3 years, mean WBC count was 73,055 cells/microl, and mean absolute neutrophil count was 59,046 cells/microl. Mean duration of hospitalization was 5.9 days, and mean cost of hospitalization was $2,010. Twenty-nine (28%) cats were febrile, and 63 (61%) cats died. Overall median survival time was 30 days. Cats with neoplasia were nearly 14 times as likely to die unexpectedly as cats with other diseases. CONCLUSIONS AND CLINICAL RELEVANCE: Extreme neutrophilic leukocytosis was associated with a high mortality rate. The prognostic importance of extreme neutrophilic leukocytosis should not be overlooked. Cats and dogs have similar diseases, mortality rates, and treatment costs associated with extreme neutrophilic leukocytosis.     

Extensive caudal vena cava thrombosis secondary to unilateral renal tubular cell carcinoma in a dog

A nine-year-old German shorthaired pointer cross was admitted because of partial anorexia, exercise intolerance and haematuria. On clinical examination, subcutaneous oedema, purpura and ascites were detected along with a palpable mass in the right craniodorsal abdomen. Laboratory findings included regenerative anaemia, leucocytosis, thrombocytopenia, azotaemia, increased blood serum alkaline phosphatase and proteinuria. Radiographic and ultrasonographic examinations revealed a large neoplasm involving the right kidney. Computed tomography further showed that the neoplastic tissue had spread into the lymph nodes, the wall of the caudal vena cava, the liver and lungs. The right renal vein, caudal vena cava and iliac veins appeared enlarged and secondarily thrombosed. A diagnosis was made of renal tubular cell carcinoma with secondary venous thrombosis. Gross postmortem examination confirmed the imaging findings, while light and electron microscopic examination revealed that the neoplasm was a solid carcinoma originating from the proximal convoluted renal tubules.     

Leukemoid blood response and bone infarcts in a dog with renal tubular adenocarcinoma

Neutrophilic leukocytosis (136,800 WBC/microliters) and multiple bone infarcts were detected in a dog with renal tubular adenocarcinoma. The causes of the leukocytosis and bone infarcts were not determined, but these syndromes appear to be uncommon manifestations of cancer in animal and human patients.     

Pancreatic beta-cell carcinoma with renal metastasis in a dog

Severe hypoglycemia associated with a metastatic pancreatic beta-cell carcinoma was found in an adult female American Eskimo dog. Metastatic tumor was found in the renal glomeruli as opposed to the more common hepatic metastatic site.     

Transient proximal renal tubular acidosis and Fanconi syndrome in a dog

A 9-year-old spayed female Labrador Retriever was evaluated for anorexia, lethargy, and vomiting of 5 days' duration. Laboratory abnormalities included azotemia, high liver enzyme activities, hyperchloremic metabolic acidosis, glucosuria, ketonuria, proteinuria, and aminoaciduria. These laboratory abnormalities were diagnostic of proximal renal tubular acidosis and Fanconi syndrome. Results of initial and convalescent serologic tests for leptospirosis were negative. The dog was treated with amoxicillin, sodium bicarbonate, and potassium citrate at discharge. Repeated evaluations revealed resolution of the acidosis, azotemia, proteinuria, glucosuria, ketonuria, and high liver enzyme activities. Alkali administration was gradually discontinued, and the dog was clinically normal 8 months after discharge. The dog's clinical condition appeared to have been transient in nature, a phenomenon that is rarely seen in human or veterinary medicine.     

Probable paraneoplastic leukocytosis in a dog with a gastrointestinal stromal tumor

A 9-year-old female spayed Boston Terrier presented for diagnostic investigation of lethargy, poor appetite, weight loss, and a marked leukocytosis. Significant muscle wasting and a palpable abdominal mass were present on physical examination. Abdominal imaging revealed the mass to be of small intestinal origin; consequently, an intestinal resection and anastomosis were performed without complication. The histopathologic diagnosis was a gastrointestinal stromal tumor, verified by immunohistochemical positivity to CD117 (KIT). Two weeks after discharge, the leukocytosis had resolved. Though the exact molecular mediator of the severe leukocytosis was undetermined, resolution following tumor removal suggests a paraneoplastic cause. To the authors' knowledge, this is the first reported case of probable paraneoplastic leukocytosis secondary to a gastrointestinal stromal tumor in the dog. Gastrointestinal tract imaging should be performed when this uncommon hematologic abnormality is present.     

Etiology and outcome of extreme neutrophilic leukocytosis: A multi‐institutional retrospective study of 269 dogs

BackgroundThe magnitude of diagnostic abnormalities can influence the perception of clinical outcome. Extreme neutrophilic leukocytosis (ENL) is an uncommon finding caused by markedly increased granulopoiesis. A lack of recent, large‐scale studies limits our understanding of the importance, causation, and prognosis associated with ENL in dogs.Hypothesis/ObjectivesDescribe disease categories (DC) identified in dogs with ENL and identify variables associated with survival. We hypothesized that factors including fever, segmented and band neutrophil counts, and DC would be negatively associated with survival.AnimalsTwo‐hundred sixty‐nine dogs with ENL (segmented neutrophils ≥50 × 10³ cells/μL) presented to the veterinary teaching hospitals at Auburn University (n = 164), the University of Missouri (n = 81), and Oklahoma State University (n = 24) between January 1, 2009 and December 31, 2019.MethodsRetrospective study. Demographic data and outcome variables including temperature, CBC findings, DC, duration of hospitalization (DOH) and outcome were acquired from the medical record. Statistical analyses included chi‐squared and Kruskal‐Wallis tests, and Pearson product moment correlations with a P < .05 significance level.ResultsMortality was 41%. Survival differed with DC (P = .002). Mortality was higher (P < .05) in dogs with neoplasia (56.2%) vs immune‐mediated disease (20.5%) or tissue damage/necrosis (19%). Weight (P = .001, r = −0.14) and total neutrophil count (P = .04, r = −0.02) were weakly negatively associated with survival whereas DOH was weakly positively associated with survival (P = .03, r = 0.14).Conclusions and Clinical ImportanceMortality in dogs with ENL is high but differed according to DC. Only weak correlations between clinical or clinicopathologic variables and mortality were identified. Extreme neutrophilic leukocytosis should be interpreted in conjunction with the underlying disease process, and not broadly used to predict clinical outcome.     

Paraneoplastic leukocytosis associated with a rectal adenomatous polyp in a dog.

A dog with a rectal adenomatous polyp had extreme neutrophilic leukocytosis, monocytosis, and eosinophilia consistent with a paraneoplastic syndrome. Resolution of the leukogram abnormalities after tumor excision supported this belief. Except for a lack of circulating myeloblasts, the dog had leukogram findings consistent with a neutrophilic leukemoid reaction.     

Extracutaneous neutrophilic inflammation in a dog with lesions resembling Sweet's Syndrome

A 7-year-old-spayed female standard poodle dog presented to the Iowa State University Veterinary Teaching Hospital with an 8-day history of lethargy, left hind limb lameness, ptyalism and peripheral lymphadenomegaly. On physical examination, the dog was lethargic, febrile (40.5 °C) and had multifocal to coalescing erythematous papular to pustular eruptions on the skin of all four limbs, periocularly and on the ventral and lateral thorax and abdomen. Histopathological findings from skin biopsies of the papules revealed a severe diffuse neutrophilic dermatitis with sub- and intra-epithelial pustules. Four days after being admitted the dog died from cardiac and respiratory failure. At necropsy, in addition to the multifocal to coalescing erythematous papules, the skin contained scattered pustules. Additionally, the subcutaneous tissue surrounding the right stifle was diffusely oedematous, and the peripheral and visceral lymph nodes were enlarged. The predominant histologic lesion was neutrophilic inflammation, in the absence of detectable bacteria in the skin, heart, lungs, oesophagus and left tarsus. In the absence of neoplasia or bacteraemia, a syndrome similar to Sweet's Syndrome should be considered as a differential diagnosis in dogs with cutaneous and extracutaneous neutrophilic infiltrates.     

Hypertrophic osteopathy associated with renal pelvis transitional cell carcinoma in a dog

A 6-year-old male, Belgian shepherd dog was presented with lethargy, oliguria, hematuria, and reluctance to move. The dog developed hypertrophic osteopathy secondary to renal pelvis transitional cell carcinoma. A nephrectomy was performed and after a year, the dog was completely asymptomatic, and no evidence of metastatic disease was present.     

Exophthalmos due to sterile neutrophilic dermatosis in a dog

An 8‐year‐old castrated male Bichon Frise was presented to the Kansas State University Veterinary Health Center for evaluation of unilateral right‐sided exophthalmos, suspected secondary to a retrobulbar abscess. The dog had acutely developed right‐sided periorbital swelling, exophthalmos with pain on retropulsion, as well as multiple cutaneous exudative plaques on the feet and tail base. On ophthalmic examination, the dog also exhibited mild left‐sided exophthalmos with decreased, nonpainful retropulsion. Orbital ultrasound and CT were performed to evaluate the extent of bilateral orbital disease. Incisional biopsies were obtained from the affected right periorbital tissues and skin of the feet, and histopathology revealed severe neutrophilic inflammation of the dermis with no organisms detected. Histologic changes were consistent with sterile neutrophilic dermatosis. The dog achieved clinical remission following treatment with initial immunosuppressive doses of corticosteroids and subsequent long‐term maintenance therapy using oral cyclosporine.     

Paraneoplastic leukocytosis with mature neutrophilia in a cat with pulmonary squamous cell carcinoma

A 13-year old cat had 3-day duration of vomiting, lethargy, and anorexia. A complete blood count revealed a severe neutrophilia (126.9 x 10(3) cells/microl). Thoracic radiographs demonstrated a large solitary lung mass. A bone marrow aspirate documented myeloid hyperplasia. A left intercostal thoracotomy was performed and left cranial and caudal lung lobectomies were performed in order to remove the mass in its entirety. Histological diagnosis was squamous cell carcinoma of the lung. Following surgery, the severe neutrophilia began to decrease. It was in the normal range approximately 6 weeks postoperatively. The presence of a primary lung tumor combined with a mature neutrophilia with resolution following surgical resection suggests a paraneoplastic syndrome.     

Sertoli cell tumours associated with feminization, prostatitis and squamous metaplasia of the renal tubular epithelium in a dog

A case of bilateral Sertoli cell tumours in a 7-year-old cryptorchid male Newfoundland dog is described. The dog showed clinical signs of feminization viz. bilateral alopecia, enlargement of the nipples, and flaccidity of the prepuce.
Necropsy revealed developmental anomalies of the genital duct system, squamous metaplasia of the prostatic epithelium, purulent prostatitis, and widespread acute thromboembolism, apparently caused by the prostatic inflammation. Focal squamous metaplasia of the renal tubular epithelium was also found in this case. The connection between this lesion and the Sertoli cell tumour-feminization complex is discussed.     

Persistent hematuria in a dog with renal hemangioma

Persistent hematuria in a neutered male Collie failed to resolve after treatment for adult Dirofilaria immitis. Excretory urography revealed normal opacification and an hourglass-shaped right kidney, with distortion of the renal pelvis and diverticula. After ureteronephrectomy, recovery was uncomplicated, and hematuria ceased 2 weeks after surgery. The middle of the excised kidney had been replaced with blood-filled spaces that were consistent with histopathologic diagnosis of hemangioma.     

Distal renal tubular acidosis in a cat with pyelonephritis

A four-year-old castrated male domestic shorthair cat with recent onset of lethargy and depression was found to have hypokalaemia, low plasma bicarbonate concentration and a urine pH of 7. Subsequent findings of hyperchloraemic metabolic acidosis with failure to produce acid urine led to a diagnosis of distal renal tubular acidosis. Pyelonephritis associated with Escherichia coli infection of the urinary tract was also diagnosed. The urinary tract infection was eliminated by antibiotic treatment. For two years subsequently, the clinical effects of distal renal tubular acidosis have been controlled by oral administration of potassium bicarbonate, although some biochemical abnormalities have persisted.     

Polycythemia associated with renal fibrosarcoma in a dog

A 10-year-old Beagle-type dog with intermittent vomiting and anorexia had an absolute polycythemic condition. A renal mass was detected and removed by total nephrectomy. After surgery, the hematologic values returned to normal, suggesting that the tumor was the cause of the polycythemia. The histologic diagnosis was fibrosarcoma. In dogs, secondary polycythemia has otherwise been reported with renal carcinoma and lymphosarcoma.