Eosinophilic pulmonary granulomatosis in a young dog with prolonged remission after treatment

A two‐year‐old Jack Russell terrier was presented for evaluation of chronic cough and exercise intolerance. Previous treatment with antibiotics and glucocorticoids had only partially ameliorated the clinical signs. During investigation, hypoxaemia, peripheral eosinophilia and an eosinophilic bronchoalveolar lavage fluid were noted. Thoracic radiographs revealed two ovoid clearly delineated soft‐tissue opacities, one in the caudal segment of the left cranial lung lobe (diameter 26 mm) and the other in the right cranial lung lobe (diameter 20 mm). These findings were verified by computed tomography, which identified an additional smaller lesion (diameter 16 mm) dorsally in the right caudal lobe. Ultrasound‐guided fine‐needle aspiration samples confirmed the diagnosis of eosinophilic pulmonary granulomatosis and treatment with prednisolone and azathioprine was initiated. Within 1 month, granulomas were no longer detectable radiographically. All medication was discontinued after 7 months and currently, after 2·5 years, the dog remains free of clinical signs. To the authors’ knowledge this is the first case report to describe prolonged remission from idiopathic canine eosinophilic pulmonary granulomatosis.     

ULTRASONOGRAPHIC EXAMINATION OF CERVICAL MASSES IN THE DOG AND CAT

The ultrasonographic appearance of clinically undifferentiated neck masses for which a definitive diagnosis was eventually obtained in nineteen dogs and one cat is presented in this report. Multiple lesions were seen ultrasonographically in 4 dogs and no cervical abnormalities were seen in 2 dogs resulting in 22 lesions in 20 annuals. Of 7 benign lesions, there were 2 patients with reactive lymph nodes from a regional inflammatory process, and 1 patient each with primary pyogranulomatous lymphadenitis, arteriovenous malformation, foreign body granuloma, cellulitis, and hematoma. Of 15 malignant lesions, 7 were thyroid carcinomas, 3 were lymphomas with submandibular and cervical lymph node enlargement, 3 were lymph node enlargements associated with regional metastasis of malignant tumors, one was a leiomyosarcoma and one was a carotid body tumor. One dog with a diffuse soft tissue swelling of the ventral cervical region had only slight asymmetry of the thyroid lobes on ultrasound examination and no abnormalities of the neck at post mortem. A second dog examined with ultrasound 4 months after surgical removal of a carotid body tumor had no evidence of tumor recurrence. Ultrasonographic examination provided information regarding the character of the lesions, the tissue or organ of origin, and invasion into other anatomic structures. Ultrasound examination in conjunction with fine needle or tissue biopsy provided a definitive diagnosis in those animals in which biopsies were performed.     

Retrobulbar pigmented peripheral nerve sheath tumor in a dog

A 1‐year‐old male castrated Pug was referred for unilateral exophthalmos unresponsive to oral antibiotic and anti‐inflammatory therapy. Clinical findings included exophthalmos of the left eye with lateral strabismus, resistance to retropulsion, and an elevated nictitans. Hematologic and biochemical analyses were within normal limits. Findings following computed tomography (CT) of the head included an expansile retrobulbar soft tissue mass with bony lysis extending into the left nasal cavity and nasopharynx. Ultrasound‐guided fine‐needle aspirates and biopsy samples obtained via rhinoscopy were nondiagnostic. Palliative exenteration was elected; the patient was euthanized 13 weeks following exenteration due to development of neurologic signs and perceived poor quality of life. The histopathologic diagnosis was a malignant pigmented peripheral nerve sheath tumor.     

Evaluation of the cytologic diagnosis of canine prostatic disorders

BACKGROUND: Canine prostatic disease is commonly investigated using cytologic techniques, especially now that ultrasound-guided fine needle cell aspiration (US-FNA) is widely available. Few studies, however, have evaluated the diagnostic accuracy of prostatic cytology. OBJECTIVE: The purpose of this study was to evaluate the usefulness of cytologic investigation of prostatic disease using US-FNA and other methods in comparison with histopathologic diagnosis. METHODS: Cytologic and histopathologic specimens of prostate or paraprostatic tissue from 25 adult dogs were retrospectively evaluated. Cytologic samples were obtained by US-FNA, prostatic massage, or direct impression smears or aspirates of tissue at surgery. Histopathologic sections were obtained from tissue collected by biopsy or at necropsy. RESULTS: Cytologic diagnoses were categorized as nondiagnostic (n = 2); cyst (n = 1); squamous metaplasia (n = 2); inflammation (n = 4); benign prostatic hyperplasia (BPH; n = 5); inflammation and BPH (n = 3); inflammation, BPH, and neoplasia (n = 1); inflammation and neoplasia (n = 3); and neoplasia (n = 4). Cytologic diagnoses agreed with final histologic diagnoses in 20 of the 25 cases (80%). Of those samples collected by US-FNA, 75% were concordant. Four samples obtained by US-FNA and 1 sample obtained by prostatic massage and wash had discordant results. CONCLUSIONS: The results of this study suggest strong agreement between cytologic and histopathologic diagnoses for prostatic conditions. Discordance in results obtained by US-FNA usually was the result of the pathologic process rather than a failure to obtain an appropriate sample.     

What is your diagnosis? Intra‐abdominal mass aspirate from a spayed dog with abdominal pain

Abstract: An 8‐year‐old, spayed female Labrador Retriever was presented for evaluation of unwillingness to exercise. On clinical examination abdominal pain was elicited, and a midabdominal mass was detected in survey radiographs. Ultrasound‐guided fine‐needle aspiration of the intra‐abdominal mass was done. The cytologic findings indicated chronic granulomatous inflammation with reactive fibroplasia, cholesterol crystals, and extracellular foreign material. The foreign material consisted of opaque, basophilic fragments of uniform width (5–10 μm) and variable length (30–180 μm) and was observed extracellularly and within macrophages. The material was birefringent under polarized light. Histologic examination of the excised mass confirmed the cytologic findings and a diagnosis of gossypiboma (textiloma) was made, consistent with retention of a surgical sponge. This case provides a unique example of the utility of fine‐needle aspiration for the diagnosis of gossypiboma.     

Headshaking in a 10-year-old Thoroughbred mare

A 10-year-old Thoroughbred mare was presented with a 2.5-week history of headshaking. Based on a thorough physical examination, blood analysis, and a fine needle aspirate of an enlarged thyroid gland, a tentative diagnosis of seasonal idiopathic headshaking was made. Treatment with cyproheptadine was attempted.     

Comparison of ultrasound‐guided vs. ‘blind’ techniques for intra‐synovial injections of the shoulder area in horses: Scapulohumeral joint,bicipital and infraspinatus bursae

Reasons for performing study: Diagnosis and treatment of pathologies involving synovial structures in the shoulder region are technically difficult. Ultrasound‐guided (UG) injection techniques have been shown to be highly accurate, safe and reliable for various structures in human and equine patients. Objectives: To develop easy‐to‐use and reliable UG injection techniques for the infraspinatus bursa (IB), bicipital bursa (BB) and scapulohumeral joint (SHJ) and to compare them with conventional ‘blind’ methods. Methods: Eight pairs of equine shoulders were positioned on a computed‐tomography (CT) table with left and right shoulders randomly assigned to Operator A (UG) and Operator B (‘blind’). Contrast medium mixed with methylene blue was injected into the target structures. Time and number of attempts for correct needle placement and ease of injection were recorded. A CT scan of each shoulder was performed after every injection to evaluate the location of contrast material. Once injections and CT scans were completed, anatomic dissections were conducted. Statistical analysis was used to compare UG and ‘blind’ techniques with significance set at P<0.05. Results: Intra‐synovial injections using UG techniques were successful in all 24 synovial structures compared with 14/24 with conventional methods. The median number and range of needle repositioning to obtain accurate needle placement was 1 (1–2) for UG and 2 (1–4) for the ‘blind’ techniques. The median time and range required for accurate needle placement was 75.5 s (32–210 s) for UG and 43.5 s (11–140) for ‘blind’ technique. In 31% of all attempts, ease of injection was not indicative of successful intra‐synovial administration. Conclusions: Ultrasound‐guided injections of IB, BB and SHJ proved to be highly reliable and more accurate than conventional ‘blind’ techniques. Potential relevance: Ultrasound‐guided injection techniques may be of great help for equine practitioners in the diagnosis and treatment of pathologies involving synovial structures in the shoulder region. Further work is needed to confirm these results in clinical cases.     

Diagnosis,treatment, and long-term follow-up of bilateral,upper urinary tract infection (UTI) in a cat

A case of bilateral, upper urinary tract infection caused by haemolytic E coli in a female Birman cat is presented. Ultrasonographic examination of the kidneys documented changes in size, outline, echogenicity and architecture. Ultrasound guided fine needle aspiration of fluid from the renal pelvis was used to make the diagnosis. Fluid was submitted for culture and sensitivity and based on the results, antimicrobial therapy was initiated. The treatment was monitored over a 406-day follow-up period. Despite extensive treatment with specific antibiotics and supportive therapy, recurrence of urinary tract infection occurred.     

Cytological identification and quantification of testicular cell types using fine needle aspiration in horses

Fifteen stallions of different breeds, age 3-11 years, had their right testicles evaluated by fine needle aspiration cytology (FNAC). Cytological analysis showed the following spermatogenic cell types: spermatogonia (1.6% +/- 1.1); spermatocyte I (3.4% +/- 2.2); spermatocyte II (0.8% +/- 0.7); early spermatids (25.5% +/- 9.5); late spermatids (37.0% +/- 9.3). Spermatozoal numbers were expressed as the spermatic index (SI = 31.5% +/- 8.5) and Sertoli cells were expressed as the Sertoli cell index (SEI = 20.9% +/- 17.0) (means +/- s.d). Identification of cell types was relatively easy and no immediate adverse effects of aspiration were noted. The results suggest that FNAC of testis may assist clinical diagnosis in the study of male equine infertility.     

Evaluation of the presence of selected viral and bacterial nucleic acids in pericardial samples from dogs with or without idiopathic pericardial effusion

Many viruses have been identified in pericardial fluid and in tissue samples from humans with pericarditis by means of molecular diagnostics. In canine idiopathic pericardial effusion there is as yet no conclusive evidence to support the involvement of an infectious agent. This study was designed to investigate a possible relationship between idiopathic pericardial effusion in dogs and viruses most commonly encountered in humans affected with viral pericarditis. Coxsackievirus B3 RNA, influenza virus type A RNA, human adenovirus type 2 DNA, human cytomegalovirus DNA, and parvovirus B19 DNA were investigated using PCR on pericardial effusion samples and pericardial tissue specimens collected from 14 dogs with idiopathic pericardial effusion. PCR was also used to test for two bacteria, Borrelia burgdorferi and Chlamydia pneumoniae. The same microorganisms were also looked for in pericardial effusions or pericardial washes from 10 dogs with neoplastic pericardial effusion, and in samples collected from 10 dogs which died of a non-cardiac disease. One pericardial effusion sample from a dog with the idiopathic form of the disease tested positive for influenza virus type A and sequencing of the amplicon confirmed the PCR result. In another dog from the same group a cytomegalovirus was detected by PCR in the effusion, but sequencing showed this to be a false-positive result. The genomes of the microorganisms investigated were not detected in neoplastic effusions or pericardial washes. The results indicate that viral and bacterial DNA/RNA of relevance for human pericarditis is rare in pericardial samples from dogs with idiopathic pericardial effusion. The finding of influenza type A viral RNA in pericardial fluid from one dog with the idiopathic form of the disease warrants further investigation.     

Diagnosis of canine lymphoid neoplasia using clonal rearrangements of antigen receptor genes

Although the diagnosis of canine leukemia and lymphoma in advanced stages is usually uncomplicated, some presentations of the disease can be a diagnostic challenge. In certain situations, lymphoma and leukemia can be difficult to distinguish from a benign reactive proliferation of lymphocytes. Because clonality is the hallmark of malignancy, we have developed an assay that uses the polymerase chain reaction to amplify the variable regions of immunoglobulin genes and T-cell receptor genes to detect the presence of a clonal lymphocyte population. The assay detected clonally rearranged antigen receptor genes in 91% of the 77 dogs with lymphoid malignancy. Of the 24 dogs tested, that were either healthy or had clearly defined conditions not related to lymphoid malignancy, a clonally rearranged antigen receptor gene was found in one (a dog with Ehrlichia canis infection). Gene rearrangement was appropriate for the immunophenotype (immunoglobulin gene rearrangement in B-cell leukemias and T-cell receptor gene rearrangement in T-cell leukemias). Dilution analysis showed that the clonal rearrangement could be detected when 0.1-10% of the DNA was derived from neoplastic cells, depending on the source tissue. Potential applications of this assay include the diagnosis of lymphoma or leukemia in biopsy samples, cavity fluids, fine needle aspirates, bone marrow and peripheral blood; the determination of lineage (B or T cell); staging of lymphoma; and detection of residual disease after chemotherapy.     

Cytological diagnosis of mandibular salivary gland adenocarcinoma in a dog

A case of mandibular salivary gland adenocarcinoma in a 9-year-old female dog is described. Material collected by fine needle aspiration underwent cytological examination and after the diagnosis of salivary carcinoma the mass was surgically excised and then was processed for histological examination. The aim of this work is to describe the cytopathological features of this carcinoma and to emphasize the usefulness of fine needle aspiration technique, which is an effective, inexpensive and minimally invasive method of diagnosis that can be performed before incisional biopsy or even before surgical excision.     

Orbito-nasal cyst in a young European short-haired cat

Purpose To describe a case of an orbito‐nasal cyst in a cat. Procedure An 18‐month‐old male European short‐haired cat was presented to the Ophthalmology service of the Vetsuisse Faculty, University of Zurich for a subcutaneous swelling in the medial canthal region of the right eye (OD). Ophthalmologic, ultrasound and CT examinations, and fine needle aspiration were performed. After lesion excision, the removed tissue was submitted for histopathology. CT examination was repeated 5 months after removal of the cyst. Results Ophthalmologic examination revealed a large fluctuant swelling inferonasal to OD. Despite patent lacrimal puncta, only the first few mm of the lacrimal canaliculi could be cannulated. A normal globe with moderate enophthalmos was present. Ultrasound examination showed a well‐defined lobulated cyst‐like structure in the right orbit, inferonasal and anterior to the eye. CT examination revealed extension of this lesion through the medial orbital wall into the right nasal cavity. Fine needle aspiration confirmed the cystic nature of the lesion. An orbito‐nasal cyst was diagnosed. The orbital part of the cyst was dissected from the surrounding tissue and excised from the periosteum in the medial orbital wall defect. Part of the maxillary bone was removed to allow removal of the cyst from the nasal cavity. Histologically, the cyst wall consisted of a single to multilayered, mostly cuboidal epithelium and surrounding connective tissue. Follow‐up revealed a good functional result and no recurrence 7 months after cyst removal. Conclusions Similar orbito‐nasal cystic structures were reported in dogs but not in cats.     

Testicular fine needle aspiration cytology as a diagnostic tool in dog infertility

The results of testicular aspirate cytology taken from clinical patients with a history of infertility were compared with the clinical and histological findings. Azoospermia was the most common and the most rewarding indication for the examination. Samples were also taken from cases with suspected testicular tumours, orchitis, epididymitis, severe oligo- and teratozoospermia, lack of libido and unilateral testicular atrophy. Histological and cytological findings were found to correlate well. Identification of cell types from normal germinal epithelium was relatively easy. No Immediate adverse effects of aspiration were noted. Five normospermic dogs were monitored for two to six months after aspiration, and there were no marked deleterious effects on testicular consistency, testicular histology or semen characteristics. Testicular cytology obtained by fine needle aspiration may, at least to some extent, be used to assist clinical diagnosis, especially In azoospermlc dogs and dogs with palpable changes of testicular tissue.     

Myxosarcoma in the eye and brain in a dog

A male mixed breed dog of unknown age was presented with sudden onset of blindness and a slightly exophthalmic right eye. Ophthalmoscopically, a spherical, pinkish mass protruding from the region of the optic disc into the vitreous was seen in the right eye. Ultrasound and computer tomography demonstrated an extension of the mass into the right retrobulbar space, continuing intracranially to the optic chiasm. Cytologic findings, obtained by ultrasound-guided fine needle aspiration from the retrobulbar space, were consistent with myxosarcoma. On the basis of these findings of a well-delineated mass in the brain stem area, irradiation was planned as the therapy of choice. The dog was treated under general anesthesia using a proton beam at the Paul Scherrer Institute (PSI, Villigen, Switzerland). A curative protocol (56 Gy in 16 fractions over 4 weeks, 3.5 Gy/fraction) was used. Twenty-seven days post radiation therapy the dog was euthanized, as clinical symptoms progressed. Enlargement of the intracranial tumor was seen on a CT study repeated on the day of euthanasia. A gross pathologic and histologic examination were performed and confirmed the diagnosis of a myxosarcoma involving the eye, retrobulbar space of the right side, and the optic chiasm. Post-mortem examination failed to identify any abnormalities or metastases elsewhere in the body.     

Clinical course, diagnostic findings and necropsy diagnosis in dyspneic cats with primary pulmonary parenchymal disease: 15 cats (1996–2002)

Objective: Correlate the necropsy diagnosis with the history, diagnostic findings, and clinical course of dyspneic cats with primary lung parenchymal disease. Design: Retrospective study. Setting: Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania. Animals: Client‐owned cats over 6 months of age hospitalized in the Intensive Care Unit (ICU) with a primary problem of respiratory distress that had pulmonary parenchymal disease on thoracic radiographs, and a complete necropsy. Interventions: None. Measurements and main results: Cats included were assigned into 2 groups based on the pulmonary histopathology: inflammatory (n=8) and neoplastic (n=7) disease. No statistical difference was found between the groups with regard to age, body weight, clinical signs, duration of clinical signs, physical examination findings, thoracic radiography, duration of hospitalization, treatment, and outcome. Cats with neoplasia had a statistically higher mean total white blood cell count (26.60 k/μL±10.41) than those with inflammatory lung disease (11.59 k/μL±4.49; P=0.026). Cats with bacterial or viral pulmonary disease had a significantly shorter median duration of illness (5 days, range 1–7 days) than all other cats (30 days, range 7–365 days; P=0.0042). Ultrasound guided pulmonary fine‐needle aspiration (FNA) provided an accurate diagnosis in 5/5 cases. Conclusions: Forty‐seven percent of cats with pulmonary parenchymal disease had neoplasia. The clinical diagnosis was difficult to obtain ante‐mortem; lung FNA appeared to be the most helpful diagnostic tool in these cases.     

Acquired cardiac diseases in the dog: a retrospective analysis

To document the frequency of the different acquired cardiac diseases in the referring area of the University of Zurich, records of 474 dogs were retrospectively analysed. Most common were valvular diseases, predominantly atrioventricular valve endocardiosis (49.4%), myocardial diseases, predominantly dilated cardiomyopathy (21.1%), pericardial effusion (12.4%), mainly due to neoplasia or idiopathic pericarditis, and cardiac neoplasia without pericardial effusion (7.0%). Rare to very rare diagnoses were dirofilariosis (2.5%), endocarditis (1.1%, only 2 of these valvular), hypertrophic cardiomyopathy (0.6%) and infectious pericarditis (0.4%). Arrhythmias were found in 145 dogs, mainly tachyarrhythmias, and most commonly associated with dilated cardiomyopathy. Relevant concomitant diseases were tracheobronchial collapse and hyperadrenocorticism in dogs with mitral endocardiosis. Knowing prevalence and causes of the various cardiac and the complicating non-cardiac diseases with clinical similarities is important for formulating diagnosis and differential diagnosis.