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.     

Candida albicans peritonitis in a dog

Objective – To describe the clinical management of a case of Candida albicans peritonitis in a dog and discuss the pathogenicity of Candida peritonitis along with treatment using the fungistatic agent, fluconazole.
Case Summary – A 15-week-old Papillon developed peritonitis secondary to enterectomy site dehiscence. A pure growth of Candida albicans was obtained from the abdominal fluid. Surgical repair of the dehiscence was performed and antifungal therapy instituted with fluconazole postoperatively. A marked exudative process was noted postoperatively with production of large volumes of fluid from the abdominal drain. Fresh frozen plasma and pentastarch were provided for oncotic support. Recovery was complicated by megaesophagus, however, the patient gradually improved and was discharged 11 days after surgery.
New or Unique Information Provided – To our knowledge, this is the first case report of successful treatment of Candida albicans peritonitis in a dog. A marked exudative process was noted during therapy requiring significant oncotic support. Resolution of the disease process was achieved with surgical intervention and antifungal therapy.     

NODULAR FAT NECROSIS IN THE FELINE AND CANINE ABDOMEN

The radiographic appearance of nodular fat necrosis is described in ten cats and one dog. The most common radiographic sign was the presence of a focal mineralized circular to oval soft tissue mass in the abdominal fat as present in 9 cats. These masses had a distinct eggshell-like rim encapsulating the lesion. In one cat and one dog multiple masses were present, without radiographic signs of mineralization. Abdominal ultrasound was performed in three cats and one dog, findings included the presence of hyperechoic masses with associated acoustic shadowing, some with a hypoechoic centre. Almost all animals were old and obese. In three cats and one dog, changes were confirmed with biopsy or post mortem examination. Lesions having the appearance of those in this paper are most likely incidental findings and should not be confused with abdominal masses of neoplastic origin. Ultrasound can be helpful in identifying such lesions.     

Pseudallescheria boydii species complex fungal rhinitis and sinusitis in a dog

A 9 yr old male castrated Australian shepherd mixed-breed dog with a 3 mo history of intermittent unilateral epistaxis was diagnosed with Pseudallescheria boydii species complex fungal rhinitis and sinusitis. This fungal organism is a rare cause of disease in dogs and an emerging human pathogen. The dog was successfully treated with topical clotrimazole.     

Intra-abdominal cryptococcosis in two dogs

Intra-abdominal cryptococcosis was diagnosed in two young dogs. The first, an entire male border collie, was presented with vomiting. An abdominal mass detected during physical examination proved to be cryptococcal mesenteric lymphadenitis on exploratory laparotomy. The second dog, a female neutered giant schnauzer, was presented with neurological signs suggestive of encephalopathy. Intestinal cryptococcal granulomas were detected in an extensive diagnostic investigation which included abdominal ultrasonography. The gastrointestinal tract was considered the most likely portal of entry for cryptococcal organisms in both cases. Both dogs were treated using surgery and multiagent antifungal chemotherapy. The first case succumbed despite therapy, while the second dog was treated successfully as gauged by return to clinical normality and a substantial decline in the cryptococcal antigen titre which continued to fall after cessation of treatment.     

Abdominal aortic chondrosarcoma in a dog

A 14-year-old, mixed breed dog was presented with acute pain and paresis of the hindlimbs. Ultrasonography revealed an intraluminal mass and an abrupt halt of blood flow signal in the distal abdominal aorta. The mass had homogeneous hyperechoic echotexture compared with blood flow. Although clinical presentation suggested a thromboembolism and pituitary dependent hyperadrenocorticism was suspected as a predisposing cause based on adrenal function tests and ultrasonography, an aortic chondrosarcoma originating from the distal abdominal aorta was diagnosed with histologic examination. Primary aortic sarcoma is extremely rare, and extraskeletal chondrosarcoma is only reported in 2 cases previously. Aortic neoplasm should be included in differential diagnosis when an intraluminal aortic mass is observed on ultrasonography and acute paresis of hindlimbs is shown.     

Body cavity lipomas in six dogs

Histologically confirmed lipomas were surgically removed from the thoracic or abdominal cavities of six dogs. Three dogs had a large intra-abdominal mass causing severe abdominal distension. Two dogs had a mass extending into the pelvic canal, compressing the colon and causing obstipation. One dog with an intrathoracic mass had a history of coughing and intermittent cyanosis. All dogs had complete resolution of signs after surgical resection of the tumour. Recurrence occurred in one dog with an abdominal lipoma, two years after the initial surgery. This recurrent lipoma was treated successfully by surgical resection.     

Metastases of perianal gland carcinoma in a dog: palliative tumor therapy

Palliative radiation therapy may provide significant relief in symptoms in pets with incurable cancer. Therapy is applied over a short period of time, using larger than normal fractional doses. Palliative radiation leads to minimal or no side effects. This case report describes the situation of a miniature poodle that was presented with severe dyschezia as well as fresh blood in the feces. The dog had a large abdominal mass which was diagnosed as lymph-node metastasis of a perianal gland carcinoma. Therapy included palliative radiation as well as chemotherapy. Six months after initial presentation the dog is free of clinical symptoms.     

Renal haemangioma in a dog

A three-and-a-half-year-old, spayed female, crossbred dog was presented with chronic haematuria. Diagnostic tests included abdominal ultrasonography, intravenous urography, cystoscopy and nephrectomy. Renal haemangioma was identified as the cause of the haematuria, which resolved postoperatively. A subcutaneous mass developed one month after the nephrectomy, which was diagnosed by biopsy as a cutaneous cavernous haemangioma. No other masses were reported one year later.     

Vaginal Neurofibroma in a Hysterectomized Poodle Dog

A 15‐year‐old, spayed, female poodle dog was presented for evaluation of a mass of tissue prolapsed from the vulva. The dog had been hysterectomized when it was 5 years old. A vaginal mass had been removed approximately 10 months before presentation. Haematological and serum biochemistry analyses demonstrated mild leucocytosis and glycaemia. A vaginal smear was predominantly made up of parabasal cells and intermediate cells with no neoplastic cells. Thoracal and abdominal radiographic findings were unremarkable. The ovaries could not be identified using abdominal ultrasonography. A midline exploratory laparotomy identified both ovaries that were surgically excised. The vaginal mass was also removed following an episiotomy procedure. Histopathological examination of the mass demonstrated that it was a neurofibroma. Both ovaries had cystic changes. Four months after the surgery, the owner reported that the dog was clinically normal. To the authors’ knowledge, this is the first reported case of a vaginal neurofibroma after an incomplete ovariohysterectomy in the dog.     

Ovarian teratoma in a bitch

An ovarian teratoma in a 5-year-old bitch with a history of vaginal discharge was removed successfully by ovariohysterectomy. The mass was discovered on abdominal palpation and contained multiple mineralized densities that were visualized radiographically. Histologic examination of the mass confirmed the presence of tissues originating from multiple germ-cell layers, characteristic of a teratoma. Clinical findings in dogs with teratomas include abdominal distention, a palpable abdominal mass, and rarely, evidence of reproductive hormonal activity. These neoplasms are uncommon in the dog, and they may exhibit malignant tendencies, with metastasis developing in approximately 33% of the reported cases. Ovariohysterectomy is the preferred treatment for ovarian teratomas, and this procedure was curative in the dog of this report.     

Pancreatic abscess in dogs: six cases (1978-1986)

Pancreatic abscess was diagnosed by exploratory celiotomy in 6 dogs. The most common clinical signs included acute onset of lethargy (n = 5), anorexia (n = 6), vomiting (n = 5), and diarrhea (n = 2). Physical examination revealed pain response to abdominal palpation (n = 5), depression (n = 5), icterus (n = 3), fever (n = 3), and cranial abdominal mass (n = 2). Consistent preoperative clinicopathologic abnormalities included leukocytosis with left shift, observance of toxic neutrophils on the blood smear, hyperlipasemia, hyperamylasemia, hyperbilirubinemia, and increased serum alkaline phosphatase activity. In 5 of 6 dogs, abdominal radiography revealed increased soft tissue density in the cranial portion of the abdomen. Ultrasonography performed on 4 dogs confirmed pancreatic mass. In all dogs, exploratory celiotomy revealed a cavitary pancreatic mass that contained sterile, mucopurulent material. Histopathologic diagnoses included acute necrotizing or chronic-active pancreatitis and steatitis. Two dogs were euthanatized at the time of diagnosis, and the remaining 4 were treated by use of pancreatic debridement(s), open abdominal drainage, and intensive administration of fluids and antibiotics. One dog was euthanatized 4 days after surgery, because of progressive pancreatic abscessation. Three dogs recovered and were discharged.     

RADIOGRAPHIC AND ULTRASONOGRAPHIC FEATURES OF RETAINEDSURGICAL SPONGE IN EIGHT DOGS

The radiographic and ultrasonographic signs in eight dogs with a surgical or pathologic diagnosis of retained surgical sponge were reviewed. The most frequent previous surgery was ovariohysterectomy, either as an elective procedure or to treat pyometra. The median elapsed time between surgery and diagnosis of retained surgical sponge was 9.5 months (range 4 days to 38 months). Five dogs had a draining sinus; four had a palpable abdominal mass. Radiologic signs included localized, speckled or whirl-like gas lucency, abdominal mass, and non-focal soft tissue swelling. Survey radiography and sinography were considered diagnostic for retained surgical sponge in 4/7 (57%) and 3/5 (60%) dogs, respectively. The combined use of survey radiography and sinography enabled detection of 6/7 (86%) sponges. In each dog that had ultrasonography, a hypoechoic mass was found that had an irregular hyperechoic centre. The possibility of retained surgical sponge should be considered in animals with a history of previous surgery and a sinus or abdominal mass.     

Angiotrophic intravascular lymphosarcoma presenting as bi-cavity effusion in a dog

A 9-year-old German Shepherd cross was presented with a history of dyspnoea, decreased activity, episodic collapse and abdominal distention. Cytological examination of thoracic and abdominal fluid demonstrated neoplastic cells, either round or mesenchymal in nature. The dog was found to have a mass in the heart-base region. Exploratory thoracotomy was performed to identify the exact nature of the mass histologically, and to determine if it was the source of neoplastic cells seen in the effusions. Histological diagnosis of the mass was mesothelioma. Postoperatively the dog developed thrombocytopenia, probably immune-mediated, which was treated with prednisone therapy. The dog developed signs of respiratory distress shortly before discharge and, due to its deteriorating condition, was euthanased. A necropsy was performed and tissues were collected for histological examination. The histological diagnosis was angiotropic intravascular lymphosarcoma. Diagnosis of mesothelioma was not confirmed.     

Mandibular ossifying fibroma in a dog

An aged mongrel dog was admitted for hemimandibulectomy as treatment for a mandibular mass that had been diagnosed as osteosarcoma. The fibro-osseous mass that surrounded the first molar tooth and replaced alveolar and cortical bone was reclassified as ossifying fibroma on the basis of anatomic location and histologic features. The tumor was composed of isomorphic fusiform cells with few mitotic figures. Tumoral stroma contained trabeculae of woven bone that were bordered by a single layer of osteoblasts. Excision was deemed complete with no evidence of extension or metastasis by computed tomography of the skull or thoracic and abdominal radiography. The dog was reportedly healthy 6 months after initial presentation. Though far less common than osteosarcoma as a primary canine bone tumor, ossifying fibroma should be included in the differential diagnosis for fibro-osseous proliferations, especially those of the jaw. Although benign, en bloc excision may be necessary for surgical cure.     

Malignant pheochromocytoma presenting as a bradyarrhythmia in a dog

Objective: To describe a case of atrioventricular block and syncope secondary to systemic hypertension in a dog with malignant pheochromocytoma. Case Summary: A 13‐year‐old spayed female mixed‐breed dog presented following an acute onset of collapse. The dog was hypertensive and had paradoxical high‐grade second‐degree atrioventricular block with concurrent syncope. Initial emergent therapy included a nitroprusside infusion for the systemic hypertension and vagolytic therapy for the bradyarrhythmia. A left adrenal mass was seen on abdominal ultrasound and was further characterized by MRI. Following medical stabilization with phenoxybenzamine and propantheline, a left adrenalectomy was performed. Histological diagnosis was consistent with a malignant pheochromocytoma. Following tumor removal there has been no further hypertension, atrioventricular block or syncope. Unique information provided: This is the first documented case of a malignant pheochromocytoma presenting as syncope secondary to hypertension induced atrioventricular block.     

Urinary obstruction secondary to an ossifying fibroma of the os penis in a dog

A 13-year-old, 25-kg, castrated male border collie was referred for evaluation of pollakiuria, stranguria, and a decreased urine stream. A calcified periurethral mass near the caudal aspect of the os penis was identified on survey abdominal radiographs. A retrograde contrast urethrocystogram demonstrated that the mass was compressing the penile urethra. The mass was surgically resected. A histopathological diagnosis of an ossifying fibroma of the os penis was made. This report describes an atypical presentation of a rare tumor, an ossifying fibroma, that caused a urinary obstruction in a male dog. A review of the incidence, histopathological features, and behavior of ossifying fibromas is included.     

Ectopic spleen presenting with anemia and an abdominal mass in a dog

An 11.5-year-old, neutered male, golden retriever dog that had previously had a splenectomy for benign disease 2 years prior to presentation was diagnosed with anemia and a large abdominal mass. Necropsy and histopathology identified the abdominal mass as ectopic splenic tissue.     

Thoracic, Abdominal and Vertebral Actinomycosis

The clinical, laboratory, radiographic, and histologic features and the response to therapy in three dogs with actinomycosis are reported. One dog (dog 1) had a 12-cm nonresectable mass extending from the ventrolateral chest wall into the left ventricular myocardium. Another dog (dog 2) had a diffuse peritonitis with "sulfur granules" and two large masses. One of these masses was nonresectable involving adjacent abdominal structures. A third dog (dog 3) had a subvertebral mass at T1-3 producing quadraplegia. Two dogs had periosteal reactions involving adjacent sternebrae (dog 1) or ribs and vertebral bodies (dog 3) that are characteristic of Actinomyces spp infections. In dogs 1 and 2 the diagnosis was based on the morphologic and tinctorial properties of free sulfur granules and/or tissue granules. Culture results were variable. Tissue from dog 1 yielded no growth, while polymicrobial infections, which included Actinomyces spp, were identified in dogs 2 and 3. Actinomyces odontolyticus was isolated from dog 3. Although the actinomycotic granulomas were either not excised or only partially excised from dogs 1 and 2, both animals were cured by the oral administration of high doses of penicillin G for 19 and 6 months, respectively. Dog 3 responded dramatically to the same antibiotic therapy given for 5 months. However, within 4 months of discontinuing treatment an abscess and draining fistulous tracts developed in the left axillary region. Two surgical fistulectomies and additional penicillin therapy were required to cure this animal. These cases and the current veterinary and human literature on actinomycosis are used to propose a rational approach to the treatment of actinomycosis in the dog.     

Abdominal fluid from a dog

A 2-year-old intact female mixed-breed dog with a 1-month history of lethargy and anorexia was evaluated for abdominal distension and an abdominal mass. The dog's last heat cycle, her third, was 1 month prior to presentation, and no reproductive cycle abnormalities were noted at any time. Hematologic and serum biochemical abnormalities were consistent with hemorrhage and inflammation. Ultrasonographic examination confirmed a large midabdominal mass and a moderate amount of abdominal fluid. Cytologically, the fluid showed evidence of pyogranulomatous inflammation, hemorrhage, and mesothelial reactivity, as well as ciliated columnar cells and free cilia that were interpreted as likely of oviductal origin. The mass was removed surgically, and the histopathologic interpretation was oviductal hamartoma with marked stroma formation and acute hemorrhage. To the authors' knowledge, this is the first reported case of oviductal hamartoma in any species and the first reported case detailing the finding of ciliated columnar epithelial cells in the abdominal fluid of a dog. Ciliated columnar epithelial cells in abdominal fluid should be considered indicative of a likely underlying oviductal lesion.