Heinz body anemia in a dog that had been sprayed with skunk musk

A 5-year-old pit bull-type dog was examined because of lethargy and black feces, and a presumptive diagnosis of methemoglobinemia was made on the basis of grossly visible brown discoloration of the mucous membranes and urine. Heinz body formation was seen on examination of blood smears, and severe anemia developed 3 days later. The dog did not have any history of exposure to toxins or drugs that have been associated with Heinz body formation. The only remarkable historical finding was that the dog had been wandering loose the day prior to initial examination and returned home smelling strongly of skunk spray. Skunk spray contains thiols and other compounds that are strong oxidizing agents. It was speculated that the methemoglobinemia and Heinz body anemia were a result of exposure to these compounds. Skunk interactions with dogs usually have malodorous but otherwise harmless results. However, findings in this dog suggest that more serious consequences may develop in isolated cases.     

Heinz body hemolytic anemia associated with high plasma zinc concentration in a dog

Acute zinc toxicosis from the ingestion of pennies was diagnosed in a dog with Heinz body hemolytic anemia (PCV = 14%), leukocytosis (51,000 cells/ml) with a left shift (3,060 band neutrophils; 37,740 segmented neutrophils) and monocytosis (4,080 cells/ml), azotemia (BUN = 60 mg/dl), bilirubinemia (total bilirubin = 5.3 mg/dl), hypokalemia (3.0 mEq/L), high serum alkaline phosphatase activity (691 U/L), high total plasma solids (8.1 g/dl), hemoglobinuria, and proteinuria. Despite aggressive medical treatment, renal failure ensued, and the dog died of cardiac arrest. The clinical signs, clinical course, and laboratory findings in this dog were similar to what has been reported in other cases of acute zinc toxicosis in dogs, with the exception of a history of generalized seizures and the findings of Heinz bodies. Although a causative relationship between plasma zinc values and Heinz body formation cannot be proven, their association suggests that oxidative damage to erythrocyte hemoglobin and cell membrane proteins may be involved in the pathogenesis of zinc-induced hemolysis.     

Idiopathic aplastic anemia in a dog

A case of idiopathic aplastic anemia in a dog was characterized by pancytopenia and bone marrow aplasia. Erythroid colony-forming units (CFU-E) were not detected in bone marrow culture. Addition of the dog's serum to CFU-E culture from control dogs failed to suppress colony formation, suggesting that humorally-mediated suppression at the CFU-E level was not a cause of the aplastic anemia.     

Heinz body haemolytic anaemia in a dog secondary to ingestion of a zinc toy: a case report

A 6-year-old Labrador retriever was referred for investigation of severe lethargy and suspected immune-mediated haemolytic anaemia. Clinical examination revealed pale mucous membranes and jaundice. Haematology demonstrated large numbers of Heinz bodies and a marked anaemia, which was strongly regenerative. Serum zinc concentrations were markedly elevated. Analysis of a metal toy vomited by the dog 3 days prior to presentation revealed it to be composed of almost pure zinc. A diagnosis of haemolytic anaemia secondary to acute zinc toxicity was made and supportive therapy instigated. There was a subsequent decrease in numbers of Heinz bodies and a rise in the haematocrit, and the dog made an uneventful recovery. Acute zinc toxicity resulting in haemolytic anaemia is rarely observed, and this case was also unusual in that the main clinicopathological finding was the presence of numerous Heinz bodies without other evidence of oxidative damage to red blood cells.     

Heinz body hemolytic anemia with eccentrocytosis from ingestion of Chinese chive (Allium tuberosum) and garlic (Allium sativum) in a dog

A 4-year-old, intact male miniature schnauzer was presented with anorexia. The dog had ingested some Chinese steamed dumplings 2 days before, which contained Chinese chive (Allium tuberosum) and garlic (Allium sativum). Hematological examinations revealed severe Heinz body hemolytic anemia with eccentrocytosis and an increased concentration of methemoglobin, which was thought to result from oxidative damage to erythrocytes by constituents in these Allium plants. In this case, eccentrocytosis was a hallmark finding and could be detected easily, suggesting that this hematological abnormality is useful in diagnosing Allium plant-induced hemolysis.     

Intracardiac foreign body in a dog

A dog that was referred to the University of Florida Veterinary Medical Center was discovered to have a bamboo skewer within the right atrium and right ventricle, traversing the tricuspid valve. The skewer was ingested approximately four months prior to referral and was partially removed via gastrotomy. The presenting complaint at the time of referral included coagulopathy, anemia and leukocytosis. A linear, hyperechoic structure was identified in the right heart during an echocardiogram. The foreign body was suspected to be a portion of the skewer that the patient had previously ingested. Cardiopulmonary bypass was performed and the foreign body was removed successfully. Complications following surgery included the development of tricuspid valve and ventricular wall thrombi, atrial flutter and amiodarone toxicity. Many indications have been described in the veterinary literature for cardiopulmonary bypass. However, to the best of the authors' knowledge, successful removal of an intracardiac foreign body with cardiopulmonary bypass has not been reported in a veterinary patient. This represents a new indication for cardiopulmonary bypass in veterinary medicine.     

Zinc-induced hemolytic anemia in a dog caused by ingestion of a game-playing die

A 16-month-old spayed female mixed breed dog was presented with a 1-week history of anorexia, lethargy, diarrhea, vomiting, and difficulty rising. Hematologic evaluation indicated a marked macrocytic hypo-chromic, markedly regenerative anemia. A metallic foreign object in the gastrointestinal tract was identified on abdominal radiographs. Serum zinc concentration was markedly increased.     

Contribution of propylene glycol-induced Heinz body formation to anemia in cats

Propylene glycol (PG) is a common preservative and source of synthetic carbohydrates in soft-moist pet foods. Propylene glycol was fed to cats for 5 weeks at concentrations found in commercial diets (1.6 g/kg of body weight; 12% of diet on a dry-weight basis) and for 3 weeks at concentrations exceeding usual intake (8 g/kg; 41% of diet). There was a dose-dependent increase in Heinz body percentage to 28% in cats fed the low dose of PG and to 92% in cats fed the high dose. Erythrocyte half-life, measured using [14C]-cyanate hemoglobin (Hb), decreased significantly (P less than 0.05) by 18.8% and 60% in cats fed the low and high PG doses, respectively. The PCV in cats fed the low dose was unaffected, whereas cats fed the high dose had a mean (+/- SEM) decrease in PCV from 33.5 +/- 1.05% to 26.3 +/- 1.45%, accompanied by punctate reticulocytosis and bone marrow erythroid hyperplasia. A dose-dependent increase in iron pigment was found in the liver and spleen of all cats. In cats fed the low dose of PG, erythrocyte reduced glutathione concentration actually increased from 7.02 +/- 0.56 to 9.74 +/- 0.69 mumol/g of Hb, but decreased to 2.96 +/- 0.27 mumol/g of Hb in cats fed the high dose. There was no significant increase in methemoglobin concentration. These results indicated that PG cannot be considered innocuous even at concentrations consumed by cats eating commercial diets. Heinz body-induced acceleration of RBC destruction develops in a dose-dependent manner, so that cats with greater food intake, ie, lactating queens and nursing kittens, are at greater risk for development of PG-induced Heinz body hemolytic anemia.     

Spurious,marked leukocytosis in 2 cats with Heinz body hemolytic anemia

Two domestic shorthair cats were presented with anorexia and dehydration following ingestion of caramelized onions. Shared key findings from a CBC (ADVIA 2120), serum biochemistry, and urinalysis included a spurious, marked leukocytosis with discordant basophil (BASO) channel and peroxidase channel WBC counts, normal manual leukocyte counts, mild, non-regenerative anemia with discrepancies between automated and manual reticulocyte counts, an abundance of large Heinz bodies (HBs), and highly irregular scattergrams. Case 1 also demonstrated a markedly elevated mean corpuscular hemoglobin concentration (MCHC) and discrepancies between RBC hemoglobin indices. Spurious leukocyte results were confirmed through re-analysis of samples (including the acquisition of a new sample, use of an alternate analyzer (Sysmex XT-2000iV; Case 1 only), and evaluation of scattergrams and blood films (Cases 1 and 2). Repeatedly discrepant reticulocyte counts were also identified. In both cases, the erroneous BASO WBC counts, discrepancies in reticulocyte counts and RBC indices, and atypical scattergrams were interpreted to result from various effects of the HBs. These cases emphasize the importance of reviewing blood films, interpreting scattergrams, and the usefulness of duplicate methods for determining various measurands on hematology analyzers.     

Gastrointestinal tract perforations caused by ingestion of multiple magnets in a dog

Objective – To describe a case of gastrointestinal tract perforation, septic peritonitis and coagulopathy caused by ingestion of multiple magnets in a dog. Case Summary – An 8‐month‐old castrated male Rottweiler, weighing 30.5 kg was presented for evaluation of vomiting and weakness. Abdominal radiography and abdominal ultrasonographic examination identified a metallic foreign object within the gastric lumen, presence of free peritoneal gas, and peritoneal effusion. Septic peritonitis was diagnosed by abdominal fluid analysis. Exploratory celiotomy revealed the presence of an omental abscess, and gastric and colonic perforations. Four magnetic foreign objects were found within the lumen of the perforated stomach. Surgical management including removal of the magnets, abscess debridement and excision, perforation repair, and abdominal drainage combined with intensive medical therapy resulted in complete recovery of this dog. New or Unique Information Provided – This report describes in detail the case management of a dog that developed both gastric and colonic perforations and severe morbidity secondary to ingesting multiple magnets.     

Hemolysis and Heinz body formation associated with ingestion of red maple leaves in two alpacas

Two adult female alpacas were evaluated for acute onset of weakness, pale mucous membranes, and signs of depression of unknown etiology. Both alpacas had intravascular hemolysis, anemia, and Heinz body formation and had been fed wilted red maple leaves. Clinical signs developed several days after ingestion of the leaves. No other toxin exposure was reported, and no parasites were detected. Dietary copper and nitrate-nitrite concentrations were evaluated and determined to be within reference limits. Both alpacas continued to become profoundly anemic with continued hemolysis. This necessitated blood transfusion as a life-saving intervention; however, prior to whole blood being available, transfusion with bovine hemoglobin glutamer was necessary. Both alpacas recovered without complications.     

Idiopathic dyserythropoiesis in a dog

Idiopathic dyserythropoiesis in a dog was characterized by chronic nonregenerative normocytic normochromic anemia, cellular marrow and abnormal morphology of erythroid precursors. Serum concentrations of Vitamin B(12), folate and iron were inconsistent with secondary causes of dyserythropoiesis. The disorder appeared to be distinct from myelodysplastic syndromes described previously.     

Association of maximum voluntary dietary intake of freeze-dried garlic with Heinz body anemia in horses

OBJECTIVE: To characterize hematologic and clinical consequences of chronic dietary consumption of freeze-dried garlic at maximum voluntary intake in horses. ANIMALS: 4 healthy sex- and age-matched horses. PROCEDURE: An initial garlic dose (0.05 g/kg, twice daily) was fed to 2 horses in a molasses carrier as part of their normal ration and was gradually increased to maximum voluntary intake (0.25 g/kg, twice daily) over 41 days. Dietary supplementation then continued for a total of 71 days. Two control horses were fed molasses with no garlic with their ration. Blood samples were collected weekly and analyzed for hematologic and biochemical changes, including the presence of Heinz bodies. Recovery of affected blood values was followed for 5 weeks after termination of dietary supplementation with garlic. RESULTS: At a daily dose of > 0.2 g/kg, horses fed garlic developed hematologic and biochemical indications of Heinz body anemia, as characterized by increases in Heinz body score (HBS), mean corpuscular volume (MCV), mean corpuscular hemoglobin, platelet count, and serum unconjugated and total bilirubin concentrations and decreases in RBC count, blood hemoglobin concentration, mean corpuscular hemoglobin concentration, and serum haptoglobin concentration. Recovery from anemia was largely complete within 5 weeks after termination of dietary supplementation with garlic. Heinz body score and MCV remained high at the end of the 5-week recovery period. CONCLUSIONS AND CLINICAL RELEVANCE: Horses will voluntarily consume sufficient quantities of garlic to cause Heinz body anemia. The potential for garlic toxicosis exists when horses are chronically fed garlic. Further study is required to determine the safe dietary dose of garlic in horses.     

Zinc-induced hemolytic anemia in a dog

A dog ingested a zinc nut that was retained in the stomach and caused a life-threatening hemolytic crisis with renal, gastrointestinal, and hepatic dysfunction. The dog was stabilized by blood transfusion and was anesthetized, and the zinc nut was removed with a fiberoptic endoscope. With continued supportive care, the dog recovered. Metallic zinc is found in high concentrations in nuts, bolts, and pennies. Zinc toxicosis should be considered in cases of unexplained hemolytic anemia.