Acute myeloid leukaemia (M6B: pure acute erythroid leukaemia) in a Thoroughbred foal

A 10-week-old Thoroughbred filly was referred for anaemia of 4 weeks' duration. Haematology revealed severe anaemia and panleucopenia. Cytological examination of bone marrow smears revealed a myeloid to erythroid ratio <0.02:1 (reference range 0.5-2.4:1.0) and an abundance of erythroid precursor cells. The erythroid cell population included rubriblasts, prorubricytes and rubricytes, with only scant numbers of metarubricytes present. There were numerous mitotic erythroid cells, some of which were atypical and megaloblastic. These cytomorphological changes are consistent with pure acute erythroid leukaemia. No treatment was instituted and the filly died three days after presentation. This case illustrates the need to consider both haematology and bone marrow findings to establish a diagnosis of pure erythroid leukaemia. To our knowledge, there is no documented case of acute myeloproliferative disease in horses involving cells of erythroid lineage, but this condition should be considered a differential diagnosis for horses presenting with anaemia.     

Double-outlet right ventricle in a 10-month-old Friesian filly

A 10-month-old Friesian filly had a presentation that was consistent with chronic left- and right-sided congestive heart failure. Clinical pathology findings included abnormal haematological and biochemical variables, abnormal blood gas values and increased serum concentration of cardiac troponin I. Echocardiography revealed cardiac chamber dilation and dextropositioning of the aorta. Radiography revealed a generally enlarged heart and pulmonary interstitial infiltration. These findings were supported at necropsy and the diagnosis of double-outlet right ventricle was confirmed. The pathological changes and physiological responses subsequent to double-outlet right ventricle have not previously been described in detail in horses. Clinical progression closely resembles that seen in humans, in whom antemortem diagnosis relies on echocardiography. In horses, complex cardiac disease presents a diagnostic challenge to the clinician. Appropriate therapy must be based on an accurate diagnosis.     

Systemic lupus erythematosus in a cat: fulfillment of the American Rheumatism Association criteria with supportive skin histopathology

Systemic lupus erythematosus (SLE) was diagnosed in a 9-year-old castrated male Persian cat. The cat described is the first to fulfil four of 11 American Rheumatism Association criteria for the diagnosis of SLE in humans (symmetrical facial dermatitis, thrombocytopenia, positive antinuclear antibodies, oral ulceration) with supportive skin histopathology. Haematological abnormalities included a mild anaemia and severe thrombocytopenia. Skin disease consisted of symmetrical multifocal alopecia with crusting, predominantly on the face. Histopathology of the skin revealed interface dermatitis and interface folliculitis with follicular atrophy. Complete remission was obtained with corticosteroid therapy.     

Sand-induced diarrhea in a foal

A diagnosis of sand enteropathy was made in a 3 1/2-month-old Quarter Horse filly. Clinical signs included diarrhea and weight loss of 2 1/2 months' duration. Abdominal radiographs were useful in diagnosis of the condition and in evaluating response to therapy. The filly responded to treatment with psyllium hydrophilic mucilloid although full recovery took 2 months. Diagnosis and treatment of sand enteropathy is discussed.     

Multiple mandibular ossifying fibromas in a yearling Belgian Draught horse filly

A yearling Belgian Draught horse filly was presented with a history of bilateral, progressive, painful swelling of the mandible, fever and anorexia. Radiographs and computed tomographic images showed an expansile lesion with a coalescing, well‐defined cystic pattern at the level of the horizontal ramii of the mandible. The histopathological findings confirmed the diagnoses of bilateral, multiple ossifying fibroma. This report indicates that ossifying fibroma should be included in a differential diagnosis if multiple expansile lesions of the jaw are present.     

Bleeding disorder (von Willebrand disease) in a quarter horse

Bleeding diathesis in a Quarter Horse filly was caused by von Willebrand disease. Hemorrhage occurred mainly from mucosal surfaces and after trauma. Quantitative and qualitative measurements of plasma von Willebrand factor (vWF) documented a specific deficiency of vWF high molecular weight multimers, and concurrently greater than expected deficiency of vWF activity relative to vWF concentration. These findings are characteristic of type-II von Willebrand disease in human beings. Application of vWF assays used in human and small animal medicine now permits evaluation of vWF and diagnosis of von Willebrand disease in horses with bleeding disorders.     

Persistent hypoglycemia associated with lipid storage myopathy in a paint foal

A 12‐hours‐old Paint filly was examined because of weakness and dull mentation after birth. Despite IV administered dextrose, the foal remained persistently hypoglycemic with increase in serum activity of muscle and liver enzymes. A postmortem diagnosis of lipid myopathy most similar to multiple acyl‐CoA dehydrogenase deficiency (MADD) was confirmed by findings of myofiber lipid accumulation, elevated urine organic acids, and serum free acylcarnitines with respect to control foals. This report details a case of equine neonatal lipid storage myopathy with many biochemical characteristics of MADD. Lipid storage myopathies should be included as a differential diagnosis in foals with persistent weakness and hypoglycemia.     

Successful treatment and polymerase chain reaction (PCR) confirmation of Tyzzer's disease in a foal and clinical and pathologic characteristics of 6 additional foals (1986-2005)

BACKGROUND: Tyzzer's disease is a rapidly progressive and highly fatal hepatitis of foals caused by Clostridium piliforme. Survival of a confirmed case has not been reported previously. HYPOTHESIS: Successful therapy of C. piliforme infection in foals is possible. Polymerase chain reaction (PCR) can be used to diagnose Tyzzer's disease antemortem or postmortem. ANIMALS: Seven foals were included in the study. METHODS: Retrospective study was made to evaluate the clinical and pathologic characteristics of foals with Tyzzer's disease. Medical records of the Veterinary Medical Teaching Hospital at University of California Davis were reviewed. Foals <3 months old were included in the study if typical clinical signs were present and histologic examination identified multifocal coagulative necrosis and hepatitis with intracytoplasmic filamentous bacilli, consistent with C. piliforme. A real-time TaqMan assay was developed to detect C. piliforme gene sequences in liver tissue from affected foals. RESULTS: Median survival time from onset of disease in nonsurviving foals was 30 hours (mean 34.5 +/- 20.1; range, 16-62 hours). Common clinical findings included lethargy, recumbency, seizures, and fever. Laboratory findings included metabolic acidosis, hypoglycemia and increased activity of hepatobiliary enzymes. Treatment consisted of IV fluids, antimicrobial and antiinflammatory drugs, and parenteral nutrition. One filly survived, whereas 6 died. Postmortem examination of the 6 foals that died disclosed hepatomegaly with multifocal necrosis. Liver tissue from 4 foals was positive for C. piliforme gene sequences using PCR. CONCLUSIONS AND CLINICAL IMPORTANCE: Although the mortality rate of Tyzzer's disease is high, successful outcome is possible if intensive care is initiated promptly. PCR can be used for early and specific diagnosis.     

Measurement of serum antinuclear antibody titer in dogs with and without systemic lupus erythematosus: 120 cases (1997-2005)

OBJECTIVE: To determine serum antinuclear antibody (ANA) titers in dogs with systemic lupus erythematosus (SLE) and in dogs with related clinical and clinicopathologic findings. DESIGN: Retrospective case series. ANIMALS: 120 dogs. PROCEDURES: Information that was evaluated included signalment, clinical signs, results of routine laboratory testing, ANA titer, and diagnosis. RESULTS: The most common clinical signs were arthralgia, myalgia, and stiffness (n = 41 [34.2%]); the most common clinicopathologic abnormality was thrombocytopenia (30 [25%]). Serum ANA titer was < 160 (seronegative) in 89 dogs (74.2%), 160 in 14 dogs (11.7%), 320 in 5 dogs (4.2%), and > or = 640 in 12 dogs (10%). Immune-mediated disease was confirmed in 40 dogs, 18 of which fulfilled the criteria for a definitive or probable diagnosis of SLE. Only 1 of 47 dogs with no major signs compatible with SLE had immune-mediated disease, compared with 26 of 57 dogs with 1 major sign and 13 of 16 dogs with > or = 2 major signs. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that measurement of ANA titer was not a useful diagnostic test in dogs without any major clinical or clinicopathologic abnormalities suggestive of SLE. In contrast, there was a good chance that results of the ANA assay would be positive and that the dog would be found to have immune-mediated disease if at least 2 major signs were evident. Findings suggest that it would be reasonable to limit the use of the ANA assay to those dogs that have at least 1 major sign compatible with a diagnosis of SLE.     

Diarrhea and hyperammonemia in a horse with progressive neurologic signs

A 2-year-old, Quarter Horse filly was referred to Michigan State University, Veterinary Teaching Hospital with a 2-3 day history of depression and partial anorexia progressing to severe, watery diarrhea with severe neurologic abnormalities, including repetitive muscle fasciculations, muscle stiffening, and collapse. Laboratory findings included severe polycythemia, neutropenia, metabolic acidosis, and electrolyte and fluid loss, consistent with watery diarrhea and endotoxic shock. Increased creatine kinase and aspartate transaminase activities were consistent with recent transport and the muscle abnormalities. Severe hyperammonemia (1369.0 micromol/L; control value, 15.3 micromol/L) was found, without other substantial laboratory evidence of hepatic dysfunction. The horse was euthanized because of poor prognosis and rapid clinical deterioration. Necropsy findings were unremarkable with the exception of severe diffuse colitis. Culture of colonic contents recovered >1000 colony-forming units of Clostridium perfringens. Based on these findings, marked hyperammonemia in this filly was attributed to changes in colonic flora leading to increased bacterial production of ammonia that was readily absorbed through the inflamed bowel wall, exceeding the hepatic capacity for deamination. Intestinal bacteria as a source of hyperammonemia in the absence of hepatic disease has been linked rarely to positive culture results for clostridial organisms.     

Congenital Osteoma of the Frontal Bone in an Arabian Filly

Congenital frontal osteoma has not been previously described in horses. This report records—for the first time—a congenital osteoma of the frontal bone in a 4-month-old Arabian filly. The filly had a frontal hard mass that was present at birth and then showed a slow and continuous growth. This mass appeared as a solitary, painless, oval dense tumor of compact bone, about 2 cm in diameter and 3 cm in length. The tumor was asymptomatic, and the skin over the mass was normal. Radiography revealed a well-defined oval, radio-dense mass projecting from the surface of the right frontal bone with no local invasion. The tumor had a broad-based attachment to frontal bone with normal frontal sinus. The mass caused disfigurement; therefore, it was removed at the owner’s request. The mass was diagnosed histopathologically as osteoma. The surgical excision of the osteoma was successful without any complications, and the filly adapted remarkably well after surgery. No recurrence was reported 20 months after the surgery. In conclusion, osteoma should be listed during the differential diagnosis of the congenital craniofacial masses in horses. Early diagnosis of the frontal osteoma guarantees a successful surgical treatment and consequently prevents the future complications.     

The use of computed tomography in the diagnosis of an ectopic ureter in a Quarter Horse filly

This report describes a 4‐month‐old Quarter Horse filly with an ectopic ureter. The filly presented with signs of urinary incontinence, which had been present since birth. Computed tomography (CT) examination and cystoscopy confirmed a diagnosis of a unilateral ectopic ureter. A nephrectomy of the left kidney was performed and renal function was closely monitored post operatively. The filly was treated for abdominal chylous effusion as a post operative complication. The filly survived to discharge from the hospital, and maintained normal urinary function at 12 months post operatively.     

Urinothorax in a Quarter Horse filly

An 18 h old Quarter Horse filly, while being treated for diarrhoea, was evaluated for a distended abdomen and electrolyte abnormalities. Peritoneal and pleural fluid was detected by ultrasound and a presumptive diagnosis of a ruptured bladder was made. Intravenous fluid therapy was instituted to correct the electrolyte abnormalities prior to surgical repair of the bladder tear. Anaesthetic complications included hypoxaemia and decreased compliance secondary to the pleural effusion; therefore, a thoracocentesis was performed. Analysis of the pleural fluid revealed a pleural fluid to serum creatinine ratio of >1.0, indicative of urinothorax. The filly recovered from anaesthesia and was discharged on systemic antimicrobials. Urinothorax should be considered in cases of uroperitoneum with concurrent pleural effusion. Early detection may decrease patient morbidity and anaesthetic complications.     

Nonresponsive generalized bacterial infection associated with systemic lupus erythematosus in a Beauceron.

A case of concurrent canine systemic lupus erythematosus (SLE) and generalized bacterial infection in a six-year-old female Beauceron is reported. The dog presented with purulent nasal and ocular discharges, skin lesions (including seborrhea, hyperkeratotic areas, and papules as well as ecchymoses around the eyes, on both sides of the pinnae, and on the vulva), generalized lymph node enlargement, a mitral murmur, and lameness. Later, facial swelling, a retrobulbar abscess, and a cough also developed. Occurrence of a generalized bacterial infection was established by culture of group-C, beta-hemolytic Streptococcus from the throat, the mouth, a biopsy site (popliteal lymph node area), the retrobulbar abscess, and the lung. The diagnosis of SLE was based on the clinical signs and particularly on the occurrence of antinuclear antibody (ANA) and antidoublestranded-desoxyribonucleic acid (ds-DNA) antibody. Interestingly, the latter type of antibodies were also detected in two young female puppies whelped by this dog. Salient histological findings included an extreme cell depletion of the lymph nodes and spleen and severe pneumonitis and peribronchiolitis. The results of this case indicate that a definite diagnosis of canine SLE can, at times, be made on the basis of the presence of serum ANA and ds-DNA antibodies.     

Apophyseal avulsion fracture of the greater trochanter of the femur in a Thoroughbred filly

The case report of a 14-month-old Thoroughbred filly with acute onset of severe right hindlimb lameness is presented. The horse had a severe and sudden abduction of the hindlimbs due to a side effect of an overdose of lidocaine, which had been administered in a constant rate infusion after a colic surgery. Transcutaneous ultrasonography and standing radiography of the pelvis revealed proximal and cranial displacement of the greater trochanter and free bone fragments consistent with an apophyseal avulsion fracture of the greater trochanter. The complete diagnosis was obtained with the horse in a standing position. The filly was euthanatized because of deterioration resulting from the colic condition and of the poor prognosis of the fracture of the greater trochanter. Postmortem evaluation confirmed an apophyseal avulsion fracture of the right greater trochanter. To the authors' knowledge, ultrasonographic and radiographic findings of this fracture have not been described in the standing horse. The diagnosis was reached quite easily with the horse in a normal standing position when the characteristic ultrasonographic and radiographic findings were detected.     

Uterine Inertia due to Severe Selenium Deficiency in a Parturient Mare

A 12-year-old, multiparous, parturient show jumper embryo-recipient mare presented at a veterinary hospital, seven days past her due date and with a dilated cervix, for evaluation of mild colic. Gastrointestinal or metabolic abnormalities and fetal maldispositions were excluded as causes of dystocia, and a diagnosis of uterine inertia was made. There was no uterine response to oxytocin treatment. A live filly was delivered via C-section, and severe selenium deficiency was eventually confirmed in the mare, her offspring, and in the herd of origin. The filly was born with severe white muscle disease and required intensive treatment. This report suggests that selenium deficiency is an underlying cause of equine uterine inertia in the absence of other causes of dystocia.     

Epiploic foramen entrapment of the large colon in a 9-month-old Thoroughbred filly

A 9-month-old Thoroughbred filly was presented for colic of a few hours’ duration. Examination revealed tachycardia at 64 beats/min, and a colon displaced to the right with wall oedema on ultrasound. After an hour of intravenous fluid therapy, the filly became restless and exploratory laparotomy was performed. Impaction and incarceration of the large colon up to the caeco-colic fold through the epiploic foramen (EF) were diagnosed. After evacuating the colonic contents through a pelvic flexure enterotomy, the EF entrapment (EFE) was reduced. The large colon appeared congested with a fragile serosa, serosal tear at its antimesenteric aspect, and amotile for the remainder of the surgery. Colon motility resumed as evidenced by ultrasonographic examination on the second day post-surgery, and despite pasty diarrhoea, the filly made a complete and uneventful recovery and was alive at 6 months’ follow-up. Epiploic foramen entrapment of the large colon is very rare but should be included as a differential diagnosis of colon displacements, even in young horses, requiring prompt surgical resolution.     

Clinical and diagnostic features of portosystemic shunt in a foal

Portosystemic shunt was diagnosed in a 6-month-old Quarter Horse filly with acute onset of apparent blindness and a 3-month history of depression, lethargy, and ataxia. Clinicopathologic test results indicated slightly high gamma-glutamyl transpeptidase activity and serum total bilirubin concentration. Sulfobromophthalein half time was prolonged, and plasma ammonia and serum bile acid concentrations were high as well. Histopathologic findings of percutaneous liver biopsy included widespread hepatocyte atrophy and numerous prominent small arterioles in the area of the portal triad. On the basis of history, clinical findings, and clinicopathologic abnormalities, a presumptive diagnosis of portosystemic vascular anomaly was made. To confirm the tentative diagnosis, nuclear hepatic scintigraphy and operative mesenteric portography were performed. Medical treatment was unsuccessful, and the foal was euthanatized. Portosystemic shunts have been described in dogs and cats, but few cases have been reported in large animal species. Other, more common causes of neurologic abnormalities in foals, such as trauma, vertebral body abscesses, brain abscesses, and meningitis, must be ruled out before portosystemic shunt is considered.     

Feather-picking psittacines: histopathology and species trends

Histologic findings are described for 408 feather-picking or self-mutilating psittacines with the use of biopsies from clinically affected and unaffected skin. Inflammatory skin disease was diagnosed in 210 birds, and traumatic skin disease was diagnosed in 198 birds. Criteria used for the diagnosis of inflammatory skin disease included the presence of perivascular inflammation in the superficial or deep dermis of clinically affected and unaffected sites. The primary histologic criteria for the diagnosis of traumatic skin disease were superficial dermal scarring with or without inflammation in the affected sites and an absence of inflammation in the unaffected sites. The inflammatory cells associated with the lesions were typically lymphocytes and occasionally plasma cells, histiocytes, and granulocytes. A preponderance of inflammatory skin disease was seen in macaws (Ara spp.) and Amazon parrots (Amazona spp.). A preponderance of traumatic skin disease was seen in cockatoos (Cacatua spp.) and African grey parrots (Psittacus erithacus). The prevalence of each was approximately equal in several other species, including conures (Aratinga and Pyrrhura spp.), eclectus parrots (Eclectus roratus), quaker parrots (Myiopsitta monachus), cockatiels (Nymphicus hollandicus), parakeets (Cyanorhamphus and Psittacula spp.), and caiques (Pionites spp.). No geographic or gender-based trends were identified. These findings could be helpful for identifying and treating birds with feather-picking disorders.     

Bilateral ureterocystostomy to correct left ureteral atresia and right ureteral ectopia in an 8-month-old standardbred filly

OBJECTIVES: To report the diagnosis and outcome after surgical correction of bilateral distal ureteral anomalies in a Standardbred filly. STUDY DESIGN: Clinical case report. ANIMAL: An 8-month-old, 310 kg Standardbred filly with left ureteral atresia and right ureteral ectopia. METHODS: The filly was admitted for evaluation of incontinence since birth and severe urine scalding of the hindquarters. Diagnosis was made by both direct (cystoscopy and vaginoscopy) and indirect (intravenous pyelography, ultrasonography, and scintigraphy) evaluation of the ureters and bladder. The filly had left ureteral atresia, hydronephrosis, and decreased left-sided renal function and right ureteral ectopia before surgery. Surgical correction was performed on the left by an end-to-side stapled anastomosis technique and on the right by a side-to-side hand-sewn anastomosis technique. RESULTS: Surgical correction was successful. The filly had no postoperative complications and remained continent 18 months after surgery. Left renal function improved. CONCLUSION: Ureteral anomalies can be successfully repaired in larger (>300 kg) foals and some renal function may be restored after surgical correction. CLINICAL RELEVANCE: Scintigraphy should be considered in diagnosis of ureteral anomalies, assessing renal function, and determining prognosis for horses with hydronephrosis caused by ureteral ectopia and atresia.