Hematuria caused by abdominal abscessation in a foal

A 4.5-month-old Standard-bred filly was referred for evaluation of pigmenturia. Initially, the pigmenturia had resolved with the administration of antibiotics, only to recur after their withdrawal. A dark red urine sample contained numerous RBC, WBC, and gram-negative rods (Escherichia coli). Ultrasonography revealed the right kidney to be large, with multiple cystic structures and a dilated renal pelvis and calices. Cystoscopy revealed a large blood clot within the bladder and urine coming from the left ureteral opening. Urine was not observed coming from the right ureter. It was suspected that the primary infection within the urinary tract was coming from the right kidney, with secondary ureteral obstruction and cystitis. Trimethoprim-sulfamethoxazole treatment was initiated. However, acute depression and abdominal pain developed several days later, and the foal died before assistance could be provided. Necropsy revealed a large abscess that had eroded into the right ureter and aorta and had ruptured, resulting in acute blood loss and death. The location and extensive nature of the lesion would have precluded surgical intervention.     

Septic peritonitis secondary to unilateral pyometra and ovarian bursal abscessation in a dog

A seven-year-old, female entire Labrador retriever was presented for acute-onset vomiting and lethargy, associated with weakness and generalised tremors. The clinical, radiographic, ultrasonographic and histopathological findings revealed septic peritonitis which occurred secondarily to unilateral pyometra and ovarian bursal abscessation. However, in this case, the initial clinical findings, blood parameters, radiographic and ultrasonographic findings did not allow a specific diagnosis. Repeat monitoring was required, and abdominocentesis proved to be the most useful diagnostic test, allowing a definitive diagnosis and the decision to be made as to whether or not to carry out exploratory surgery.     

Successful surgical management of abdominal abscessation secondary to Strongylus edentatus migration

This report describes the successful surgical management of abdominal abscessation secondary to Strongylus edentatus migration. Abdominal abscesses are a relatively common source of recurrent fever in the horse and are primarily managed with long‐term antimicrobial administration. However, identification of the definitive cause, extent of the abscesses and successful resolution in this case were not possible without an exploratory celiotomy to facilitate surgical resection.     

Hepatocellular carcinoma with secondary abscessation in a cat

A 16-year-old castrated male domestic shorthair cat was presented for investigation of weight loss, lethargy, inappetence and polydypsia. On serum biochemical analysis there was evidence of severe hepatocellular damage and cholestasis. Abdominal ultrasonographic examination revealed an irregular lesion of mixed echogenicity in a left hepatic lobe. It was compromised of a hypoechoic periphery surrounding an anechoic central area containing highly echogenic densities with distal acoustic shadowing suggestive of gas formation. On necropsy, the only gross abnormality was a solitary 5 cm x 3 cm x 3 cm multilobulated mass in the left lateral hepatic lobe, containing foul-smelling purulent fluid within a thick fibrous wall. Cytological examination of the fluid revealed numerous degenerate neutrophils and large numbers of Gram-positive spore-forming rods. The histopathological diagnosis was hepatocellular carcinoma with secondary abscessation. The bacterial morphology was consistent with Clostridia sp. Both hepatocellular carcinoma and focal hepatic abscessation are rare in cats. Hepatic abscesses should be included in the differential diagnosis of cats with non-specific signs, even in the absence of biochemical evidence of a hepatopathy.     

Chylous abdominal effusion in a cat with feline infectious peritonitis

A 10-year-old cat was diagnosed with chyloperitoneum based on the effusion characteristics. Feline coronavirus serology was positive. The owner declined further evaluation and elected euthanasia. Necropsy revealed vasculitis with multifocal areas of necrosis and lymphocytic-plasmacytic inflammation in multiple solid organs, most likely due to feline infectious peritonitis (FIP). Immunohistochemistry was negative for FIP antigen. Notwithstanding, the final diagnosis of FIP was based on the characteristic histopathological lesions. Underlying causes of chyloperitoneum in cats and humans are discussed, and possible pathogenesis of the chyloperitoneum in association with a vasculitis such as FIP is discussed.     

Perisuspensory abscessation in eight horses with hindlimb cellulitis

This study reports a distinct presentation of cellulitis, which involved formation of perisuspensory abscessation in eight horses. Medical records of horses presented for cellulitis unresponsive to medical treatment were reviewed. Cases in which perisuspensory abscesses were diagnosed were included. All abscesses formed between the cannon bone and suspensory ligament and extended around one or both suspensory branches. Abscesses were diagnosed via ultrasonography upon admission in three horses and developed within a few days following admission in five horses. All horses were treated with broad-spectrum antibiotics, anti-inflammatories, topical therapies and regional limb perfusions; however, only partial improvement of clinical signs was observed with medical therapy alone. Full resolution of clinical signs was obtained in all cases once the abscess was surgically lanced and drained. The surgical drainage was performed standing in seven cases and under general anaesthesia in one. In all cases, Staphylococcus aureus was cultured. Six out of eight isolates showed at least some level of antibiotic resistance, and penicillin and trimethoprim sulfonamides were most commonly involved. Short-term complications included skin necrosis in two cases and mild impaction colic in two cases and were successfully treated. All horses were discharged from the hospital within 4–13 days and were sound upon discharge. All Thoroughbreds (n = 7) were able to return to their intended use, and the Standardbred was unraced prior to the cellulitis event and remained unraced afterwards.     

Septic epiglottic chondritis with abscessation in 2 young Thoroughbred racehorses

Septic epiglottic chondritis with abscessation diagnosed in 2 Thoroughbred racehorses. Infected cartilage removed videoendoscopically followed by systemic antibiotics. The infectious process was successfully controlled, but permanent dorsal displacement of the soft palate (DDSP) with a shortened, deformed epiglottic cartilage developed. Surgery for the DDSP using bilateral partial sternothyroidectomy or laryngeal tie-forward failed.     

Standing laparoscopic abdominal lavage using a suction-irrigation device in 2 horses with primary suppurative peritonitis

The use of a laparoscopic suction-irrigation device in 2 standing horses for lavage of the abdomen for the treatment of primary suppurative peritonitis is reported. Two horses were presented with a 1- to 2-week history of weight loss. Abdominocentesis revealed highly elevated total nucleated cell count. Peritoneal lavage systems were placed in both horses, but complications prevented adequate lavage. Both horses underwent standing laparoscopy; the dorsal abdomen was explored and the abdomen was profusely lavaged, using a suction-irrigation device. The procedure was efficient and allowed adequate visualization of the dorsal abdomen and lavage. A successful outcome was achieved in both cases.Key clinical message:Lavage of the abdomen of horses with peritonitis can be achieved under standing sedation, using a laparoscopic technique. In appropriately selected cases, this allows for adequate visualization of the dorsal abdomen and efficacious abdominal lavage.     

Surgical treatment of septic peritonitis without abdominal drainage in 28 dogs

The purpose of this study was to evaluate the surgical outcomes of 28 dogs with generalized septic peritonitis treated without postoperative abdominal drainage. The overall mortality rate was 46%, with most cases of peritonitis being caused by leakage of the gastrointestinal tract (75%). Etiology of peritonitis, abdominal cytopathology, total white blood cell count, packed cell volume, total protein, and results of serum biochemistries were not statistically different between survivors and nonsurvivors. The mortality rate of 46% is similar to other studies in which the abdomen was left open postoperatively for the management of septic peritonitis, although more advanced medical treatment than that used in earlier studies may have positively affected the outcome. The results of this study show that closure of the abdomen after the source of contamination has been successfully corrected, in combination with thorough intraoperative peritoneal lavage and appropriate postoperative medical management, may be an acceptable alternative method for the management of septic peritonitis.     

Feline infectious peritonitis presenting as a tumour in the abdominal cavity

This paper describes six cases of feline infectious peritonitis (FIP) in which an abdominal tumour had been suspected clinically. Pathological changes were mainly restricted to the massive enlargement of a mesenteric lymph node due to necrogranulomatous lymphadenitis. FIP was diagnosed on the basis of the immunohistological demonstration of coronavirus antigen in intact macrophages within the necrogranulomatous lesions. In the affected lymph node lymphoid tissue was either almost completely effaced or restricted to follicles composed mainly of variable numbers of blasts. From one to many plasma cells positive for coronavirus-specific antibodies were present in the marginal sinuses or capsules. In addition, necrogranulomas were present in the gut-associated lymphoid tissue of the caecum of one cat, and adjacent to the affected lymph node of another.     

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.