Disseminated candidiasis secondary to fungal and bacterial peritonitis in a young dog

Objective – To describe a severe case of bacterial sepsis and disseminated candidiasis in a previously healthy dog.
Case Summary – Fungal sepsis was identified in a 2-year-old dog following intestinal dehiscence 4 days after abdominal surgery. Septic peritonitis was identified at admission and evidence of dehiscence at the previous enterotomy site was found during an exploratory laparotomy. Both gram-positive cocci and Candida albicans were cultured from the abdominal cavity. Candida sp. was also subsequently cultured from a central venous catheter. Euthanasia was performed due to failure to respond to therapy. Fungal organisms, morphologically consistent with Candida spp., were found in the lungs and kidney on postmortem histopathologic examination indicating disseminated candidiasis.
New or Unique Information Provided – Candida peritonitis is a well-recognized entity in humans and contributes to morbidity and mortality in critically ill patients. Abdominal surgery, intestinal perforation, presence of central venous catheters, and administration of broad-spectrum antibiotics are all considered to be suspected risk factors. This report describes the first known case of systemic candidiasis occurring secondary to Candida peritonitis and bacterial sepsis in a critically ill dog.     

Colonic vascular ectasia (angiodysplasia) in a juvenile dog

An eight‐month‐old female English springer spaniel was presented with weight loss and severe haematochezia. Upper and lower endoscopy identified small intestinal inflammatory bowel disease and a vascular malformation within the descending colon. The colonic lesion was excised at coeliotomy and identified histopathologically as a colonic vascular ectasia. All clinical signs resolved following surgery and continued dietary management. To the authors’ knowledge this is only the second published report of CVE in a juvenile dog and the first to survive to long term follow up.     

Renal and ureteral duplication in a dog.

Duplication of a kidney and ureter in an 18-month-old male English Bulldog was demonstrated radiographically and was confirmed surgically. Urinary tract infection had been a problem for a year. Antimicrobial therapy resolved the clinical signs of urinary infection but did not eliminate bacteriuria.     

Myocardial perforation by a stick foreign body in a dog

Objective: To report a case of myocardial perforation by a stick foreign body in a dog. Case Summary: A 3‐year‐old castrated male Labrador Retriever was examined because of a puncture wound seen after an unsupervised run in the woods. The wound was suspected to penetrate into the thoracic cavity on the basis of physical exam and radiographs. Uniform ventricular premature complexes (VPCs) and junctional beats were noted on electrocardiogram (ECG). Thoracotomy was performed and a 6‐cm wooden stick was seen protruding from the right ventricle through the pericardium toward the sternum. The stick was removed while purse string sutures were tied around the resultant myocardial defect. Follow‐up echocardiography revealed intact intracardiac structures. VPCs were treated with lidocaine and resolved completely within 24 hours of presentation. New or Unique Information Provided: Thoracic trauma can result in myocardial injury; penetration into the myocardium represents a life‐threatening situation for the emergency clinician. Cardiac injury should be included in the differential diagnoses of penetrating thoracic foreign bodies.     

Symblepharon secondary to ophthalmomyiasis externa in a dog

A 4-month-old crossbred female dog presented with complaints of poor vision and odd appearance of the eyes. At the age of a month, the animal was found lying in a railway road in a very bad condition and was rescued from death. At that time, the patient was presented with severe bilateral ocular discharge, and from both eyes, dipterous fly larvae were extracted. The dog was given symptomatic treatment (deworming, topical and systemic antibiotics, nutritional support) but never regained a normal eye appearance. At the time of the initial presentation, it had severe vision impairment because of bilateral cicatricial symblepharon, total in the left eye and occupying 3/4 of the cornea in the right eye. Surgery was proposed to attempt a resolution. Superficial keratectomy was performed in both eyes. After a midline incision in the cornea, the conjunctiva was dissected away. The conjunctiva was apposed to and sutured to the limbus and secured in the upper and lower conjunctival fornix. Additionally, in the left eye, a lateral canthotomy and canthoplasty were performed to enlarge the size of the eyelid opening. The corneal epithelium healed without complications, the patient regained vision, and after 36 months of follow-up, no recurrences were observed. To the authors' knowledge, this is the first report of symblepharon secondary to ophthalmomyiasis externa in a dog.     

Pneumothorax secondary to pulmonary thromboembolism in a dog

Objective – To describe a case of spontaneous pneumothorax secondary to pulmonary thromboembolism possibly associated with pituitary dependent hyperadrenocorticism.
Case Summary – A 7-year-old spayed female Collie weighing 26 kg was referred for evaluation of spontaneous pneumothorax. An exploratory thoracotomy was performed and revealed 2 lung lobes to be diffusely hemorrhagic and they were resected. Histologic examination of multiple sections documented diffuse thromboembolism. A 2–3 cm thrombus was visualized distal to the bifurcation of the pulmonary artery during an echocardiographic examination postoperatively. The dog was discharged to the owner after recovery from surgery. The thrombus had resolved at the 4-week recheck examination. Diagnosis of pituitary dependent hyperadrenocorticism was confirmed based on follow-up endocrine testing.
New or Unique Information Provided – This is the first report of pulmonary thromboembolism causing spontaneous pneumothorax in the dog.     

Segmental jejunal entrapment, volvulus, and strangulation secondary to intra-abdominal adhesions in a dog

A 4 yr old, castrated male dachshund was presented for lethargy, restlessness, a "hunched" posture, and a painful abdomen. A gastric foreign body had been surgically removed 24 mo previously. Exploratory celiotomy revealed a devitalized segment of jejunum with twisted mesentery. Several adhesions and fibrous bands were present within the abdomen, presumptively from the previous gastric foreign body surgery. Histopathology determined that a fibrous tissue band caused entrapment of the segment of intestine and its mesentery resulting in volvulus and ischemic necrosis of the intestine. This case is unique because it involved a focal area of the jejunum that was incarcerated in fibrous adhesions.     

Cervical syringohydromyelia secondary to a brainstem tumor in a dog

An 11-year-old male Pekingese was evaluated because of a history of head tilt. Neurologic examination revealed a right-sided head tilt, ataxia, scoliosis, and proprioceptive deficits. Diagnostic testing included magnetic resonance imaging (MRI) of the head and neck. After IV administration of gadopentetate dimeglumine, an extra-axial, highly contrast-enhanced mass in the brainstem, cerebellar herniation, and syringohydromyelia were detected via MRI. The dog was treated with corticosteroids and radiation therapy of the mass for 4 weeks (total dose, 42.5 Gy). Magnetic resonance imaging was repeated 9 weeks and 6 months after radiation therapy; compared with the initial findings, a reduction in the size of the brainstem mass was observed in both MRI scans. The third MRI scan also revealed a normal cerebellar shape, no evidence of herniation, and resolution of syringohydromyelia in the dog at that time. It is recommended that whenever syringohydromyelia is observed via MRI, a primary cause (cranial or caudal to the affected region) should be sought.     

Sinus mucocele secondary to craniofacial trauma in a dog

A sinsus mucocele formed in the frontal sinus of a dog secondary to obstruction of the nasofrontal opening. The dog was successfully treated by surgical enlargement of the nasofrontal opening, curettage of the sinus epithelium, and placement of a fat graft and drain in the sinus. Although mucocele formation is uncommon in animals, it should be considered as a differential diagnosis for masses of the sinonasal area. Characteristic radiographic and cytologic findings should alert the clinician to this diagnosis, and along with aggressive treatment, should shorten the diagnostic and treatment delay experienced by the dog in this report.     

Exophthalmos secondary to zygomatic adenocarcinoma in a dog.

An 8-year-old Labrador Retriever developed unilateral exophthalmos over a 1-year period. Contrast radiography, surgical exploration, and histologic examination revealed the cause to be an adenocarcinoma arising from the zygomatic salivary gland or duct.     

Spinal cord injury secondary to electrocution in a dog

A 13‐year‐old, female spayed, crossbreed dog of 32 kg was presented for evaluation of peracute onset of non‐ambulatory tetraparesis after chewing an electrical wire. Neurological examination was consistent with a C1‐C5 myelopathy. Magnetic resonance imaging revealed a focal intramedullary lesion over the C2‐C3 vertebral bodies, which was confirmed to be an acute focal necrotising poliomyelopathy with subarachnoid and subdural haemorrhages on postmortem examination. This report describes the clinical, imaging and histopathological findings of this unusual type of spinal cord injury, and the effects of electrocution in the central nervous system of dogs.     

Imaging diagnosis: pneumothorax and focal peritonitis in a dog due to migration of an inhaled grass awn

A 1-year-old working Kelpie developed pneumothorax and focal peritonitis after inhalation of a grass awn that migrated from the lung, through the diaphragm, into the peritoneal cavity. Radiographic evidence of sternal lymph node enlargement was fundamental in the diagnosis of intraperitoneal disease and prompted abdominal ultrasound leading to definitive diagnosis.     

Presumptive hepatotoxicity and rhabdomyolysis secondary to phenazopyridine toxicity in a dog

Objective – To describe a rare, but potential clinical manifestation of phenazopyridine (PAP) toxicity in a dog. Case Summary – A 6‐year‐old spayed female Chihuahua was evaluated for ataxia and dysphagia after ingestion of 200 mg (66 mg/kg) of PAP hydrochloride. The dog was presented to the hospital with shifting leg lameness involving all 4 limbs, which progressed to reluctance to walk and severe diffuse muscle hyperesthesia. Clinical laboratory abnormalities included marked increases in serum alanine aminotransferase, aspartate aminotransferase, creatine kinase, mild increases in alkaline phosphatase, and increased c‐Tnl‐troponin concentration. Treatment included administration of intravenous fluids, muscle relaxants, pain medications, and hepatoprotectants for 5 days in the hospital, and medical management at home for an additional 5 days. Follow‐up examinations performed 1 and 6 months after initial presentation revealed the dog to be clinically healthy with serum biochemical profiles within reference intervals. New or Unique Information Provided – The purpose of this report is to describe an unusual manifestation of PAP toxicosis in a dog, which has not been previously reported in the literature. A review of the ASPCA Animal Poison Control Center database revealed 347 cases of PAP exposure in dogs during 2000–2009 underscoring the importance of being aware of this toxicity in the dog.     

Unilateral periorchitis with a secondary peritonitis in a Standardbred stallion

A 6‐year‐old Standardbred stallion presented for evaluation of progressive diffuse scrotal swelling of 5 days' duration. Physical examination was within normal limits apart from pitting ventral oedema and severely enlarged fluid filled scrotum. Rectal examination did not reveal any abnormalities in the palpable intestinal tract, spleen, kidneys or internal inguinal rings. Testicular ultrasound examination showed evidence of abnormal right testicular parenchyma that was displaced proximally by a heteroechoic region of possible abscessation. The left testis was surrounded by a large amount of hypoechoic fluid. Abdominocentesis was performed and was indicative of peritonitis. Broad‐spectrum antimicrobials and analgesics were administered preoperatively and a bilateral open orchidectomy with closure of the external inguinal ring in addition to scrotal ablation was performed. Post operative peritoneal lavage was performed once a day for 3 days. There were no complications associated with recovery or within the immediate post operative period. The horse was released to the care of his owners 5 days following surgery and has returned to his previous racing performance level.     

Ligneous conjunctivitis secondary to a congenital plasminogen deficiency in a dog

CASE DESCRIPTION: A 7-month-old 16.6-kg (36.5-lb) sexually intact female Golden Retriever was evaluated because of progressive severe bilateral membranous conjunctivitis, oral lesions, nasal discharge, and cough. CLINICAL FINDINGS: Histologic examination of conjunctival biopsy specimens revealed findings consistent with ligneous conjunctivitis. Circulating plasminogen activity was repeatedly low, and congenital plasminogen deficiency was identified as the underlying cause of the ocular, oral, and respiratory lesions. TREATMENT AND OUTCOME: Topical and subconjunctival administrations of fresh frozen plasma (FFP), topical administration of cyclosporine, and oral administration of azathioprine had no effect on the conjunctival membranes. Excision of the membranes followed by intensive treatment with topical applications of heparin, tissue plasminogen activator, corticosteroid, and FFP and IV administration of FFP prevented membrane regrowth. Intravenous administration of FFP increased plasma plasminogen activity to within reference limits, improved respiratory and oral lesions, and resulted in weight gain; discontinuation of this treatment resulted in weight loss, signs of depression, and worsening of lesions. After euthanasia because of disease progression, necropsy findings included mild hydrocephalus; multifocal intestinal hemorrhages; and fibrinous plaques in the oral cavity, nasopharynx, trachea, esophagus, and pericardium. Microscopically, the plaques were composed of fibrin and poorly organized granulation tissue. Fibrin thrombi were present within vessels in the lungs, oral cavity, and trachea. CLINICAL RELEVANCE: In dogs, congenital plasminogen deficiency can occur and may be the underlying cause of ligneous conjunctivitis. A combination of surgical and medical treatments may improve conjunctival membranes, and administration of FFP IV appears to be effective in treating nonocular signs of plasminogen deficiency.