Idiopathic pleural effusion in a dog

Idiopathic pleural effusion was diagnosed in a 4-year-old female Poodle. Treatment included giving low doses of furosemide for 5 months and giving low doses of prednisone that eventually were given on alternate days and discontinued 16 months after initial evaluation. Idiopathic pleural effusion in this dog was eosinophilic. The clinical importance and diagnostic value of this finding were not determined. In man, idiopathic pleural effusions have a high correlation with eosinophilic pleural effusions.     

Eosinophilic cerebrospinal fluid pleocytosis associated with neural Angiostrongylus vasorum infection in a dog

A 1‐year‐old, female intact Pug dog was presented to the Small Animal Teaching Hospital of the University of Liverpool with a 4‐week history of progressive multifocal intracranial signs. Magnetic resonance imaging (MRI) detected multiple hemorrhagic lesions in the brain. The Baermann and zinc sulfate flotation tests with centrifugation, performed on fecal samples, were positive for lungworm larvae and an antigenic test confirmed Angiostrongylus vasorum infection. Anthelmintic treatment was started with a consequent marked clinical improvement. Seventy days later, the dog was clinically normal, and no larvae were detected on the Baermann test. Repeat MRI of the brain revealed marked improvement of the hemorrhagic lesions. Cerebrospinal fluid analysis (CSF) showed marked eosinophilic pleocytosis, and anthelmintic treatment was restarted. A follow‐up CSF analysis 4 months after the first presentation revealed resolution of the eosinophilic pleocytosis. This is the first case report of marked eosinophilic pleocytosis associated with neural A vasorum infection in a dog. The CSF eosinophilic pleocytosis persisted for several weeks after treatment, even in the absence of concurrent clinical signs and with a negative A vasorum Baermann test.     

Long-term survival of a dog with Alexander disease

A 1-year- and 11-month-old spayed female toy poodle had showed progressive ataxia and paresis in the hindlimbs since 11 months old. Magnetic resonance imaging revealed high signal intensity on T2-weighted and fluid-attenuated inversion recovery images at the thoracic and lumbar spinal cord. The dog’s neurological condition slowly deteriorated and flaccid tetraparesis was exhibited. At 4 years and 11 months old, the dog died of respiratory failure. On postmortem examination, eosinophilic corkscrew bundles (Rosenthal fibers) were observed mainly in the thoracic and lumbar spinal cord. Histological features were comparable to previously reported cases with Alexander disease. This is a first case report to describe the clinical course and long-term prognosis of a dog with Alexander disease.     

Enucleation or exenteration in two dogs with previous parotid duct transposition: parotid duct ligation versus reverse parotid duct transposition

Two dogs with previous parotid duct transpositions presented with unrelated ocular disease. In both cases, ophthalmic examination revealed the need for enucleation or exenteration. In case 1, systemic coccidioidomycosis was diagnosed with panuveitis and secondary glaucoma of the left eye. In this case, the parotid duct was ligated at the time of enucleation to stop salivary secretions. This dog encountered morbidity in the form of a sialocele that did not resolve for 11 months. In case 2, ultrasound and computed tomography revealed a discrete mass within the left medial orbit that was suspected to arise from the nictitating membrane. A combination of exenteration and parotid duct transposition reversal was performed to avoid morbidity associated with ligation of the parotid duct. The dog encountered no complications from this novel procedure. This case report represents the first report of re‐routing a transposed parotid duct from the ventral conjunctival sac back to the mouth at the time of enucleation or exenteration in the dog.     

Canine cardiac mesothelioma with granular cell morphology

Cardiac mesothelioma with granular cell features was diagnosed in a 10-year-old Golden Retriever presenting with pericardial and abdominal effusions. The diagnosis was based on gross, morphologic, and immunohistochemical features. The immunohistochemical profile of the neoplasm was pancytokeratin positive, vimentin positive, and S-100 negative; most gross and morphologic features were consistent with both mesothelioma and granular cell tumor. To the authors' knowledge, the prognosis for either primary cardiac mesothelioma or granular cell tumor in the dog is unknown. At 4 months after thoracotomy, pericardectomy, and mass excision, this dog was alive and without clinical evidence of pericardial or abdominal effusions. We describe a granular morphologic variant of cardiac mesothelioma in a dog.     

Eosinophilic diseases in two Cavalier King Charles spaniels

This report describes the clinical presentation of two Cavalier King Charles spaniels with different eosinophilic diseases. The first case presented with dyspnoea and a non-productive cough, and investigations demonstrated eosinophilic bronchopneumonopathy. The second dog was referred for the investigation of haemorrhagic vomiting and diarrhoea and was eventually diagnosed with eosinophilic enteritis. Both dogs had concurrent eosinophilic stomatitis, and both responded completely to immunosuppressive glucocorticoid therapy. This report is the first to describe the concurrence of eosinophilic stomatitis and systemic eosinophilic disease in Cavalier King Charles spaniels, and suggest that this breed may be predisposed to eosinophilic syndromes.     

Chronic granulocytic leukaemia/ eosinophilic leukaemia in a dog?

A suspected case of chronic granulocytic leukaemia (chronic myelogenous leukaemia) with eosinophil differentiation and hepatic involvement is described in a 3–5-year-old rottweiler dog. Neoplastic eosinophilic infiltrates were also present in the lungs, kidneys, mesenteric lymph nodes and peribronchial and prester-nal lymph nodes. Both pleural and abdominal effusions contained predominantly eosinophils and their precursors. The bone marrow showed an increase in the myeloid to erythroid ratio and an increase in the marrow granulocyte reserve. The majority of cells identified within the bone marrow were of the eosinophil series. Myelocytes and promyelocytes predominated.     

Subconjunctival Dirofilaria repens infection in a dog resident in the UK

Dirofilaria repens infection was diagnosed in a 5‐year‐old female German shepherd crossbreed, originally from Romania but brought into the UK in February 2014. The dog presented with conjunctivitis in March 2014 and then again 2 months later with additional ocular and nasal mucopurulent discharge. Bacterial cultures from the nasolacrimal duct were negative for bacterial growth. The case was referred in August 2014 for ophthalmic examination, which revealed abnormalities in both eyes, especially the left. They included mild palpebral conjunctival hyperaemia and marked follicular conjunctivitis, as well as a dorsonasal bulbar conjunctival mass. Serum biochemistry was unremarkable and a conjunctival biopsy taken from the dorsonasal bulbar conjunctival mass revealed eosinophilic/lymphoplasmacytic conjunctivitis. At re‐examination, nematodes were found in the area of the previous biopsy site and in the ventral palpebral conjunctival fornix. Polymerase chain reaction and sequencing confirmed these to be D. repens. Treatment with 10% imidacloprid and 2·5% moxidectin (Advocate Spot‐On) was successful, and clinical signs resolved over a 6‐week period. This case report indicates that D. repens infection should be considered as a possible aetiological cause of ocular lesions in dogs in the UK, especially those with a history of foreign travel. Implications for establishment and spread of D. repens in the UK are discussed.     

Eosinophilic gastroenteritis in a dog

A 9-year-old mixed-breed dog was evaluated for chronic intermittent vomiting, hematemesis, and melena lasting several months. Biopsy specimens obtained during exploratory laparotomy revealed eosinophilic gastroenteritis. Treatment included drug therapy to reduce gastrointestinal inflammation and dietary management to limit antigenic exposure.     

Cytologic identification of fungal arthritis in a Labrador Retriever with disseminated Talaromyces helicus infection

An 8‐year‐old, neutered male Labrador Retriever presented with acute forelimb lameness. Clinical signs progressed over one week. On physical examination, right cubital joint effusion and bilateral axillary lymphadenomegaly were noted, and severe internal lymphadenomegaly was observed ultrasonographically. Granulomatous lymphadenitis with intralesional fungi was noted cytologically, and the dog was ultimately diagnosed with disseminated Talaromyces helicus infection via PCR of a pure isolate. Extensive medical therapy was pursued, and months later, an arthrocentesis was performed due to continued lameness and severe cubital joint effusion. The synovial fluid contained increased numbers of neutrophils, macrophages, and multinucleated giant cells. Frequent fungal hyphae were found both intracellularly and extracellularly. These basophilic organisms were 2‐4 µm in width with internal eosinophilic granules, roughly parallel walls, and occasional to frequent septa. Round to oval yeast‐like forms with thin, clear halos were also occasionally identified. Due to the severity of clinical signs, the right thoracic limb was amputated. Histologic examination of the cubital joint revealed marked granulomatous synovitis, fasciitis, panniculitis, and osteomyelitis, all with intralesional fungi. Talaromyces helicus is a very rare cause of disease, reported only in one other dog. Granulomatous lymphadenitis appears to be a feature of this disease, but this report is the first to describe a significant synovial component.     

GM2 Gangliosidosis Variant 0 (Sandhoff‐Like Disease) in a Family of Toy Poodles

Background: GM2 gangliosidosis variant 0 (human Sandhoff disease) is a lysosomal storage disorder caused by deficiencies of acid β‐hexosaminidase (Hex) A and Hex B because of an abnormality of the β‐subunit, a common component in these enzyme molecules, which is coded by the HEXB gene. Objective: To describe the clinical, pathological, biochemical, and magnetic resonance imaging (MRI) findings of Sandhoff‐like disease identified in a family of Toy Poodles. Animals: Three red‐haired Toy Poodles demonstrated clinical signs including motor disorders and tremor starting between 9 and 12 months of age. The animals finally died of neurological deterioration between 18 and 23 months of age. There were some lymphocytes with abnormal cytoplasmic vacuoles detected. Methods: Observational case study. Results: The common MRI finding was diffuse T2‐hyperintensity of the subcortical white matter in the cerebrum. Bilateral T2‐hyperintensity and T1‐hypointensity in the nucleus caudatus, and atrophic findings of the cerebrum and cerebellum, were observed in a dog in the late stage. Histopathologically, swollen neurons with pale to eosinophilic granular materials in the cytoplasm were observed throughout the central nervous system. Biochemically, GM2 ganglioside had accumulated in the brain, and Hex A and Hex B were deficient in the brain and liver. Pedigree analysis demonstrated that the 3 affected dogs were from the same family line. Conclusions and Clinical Importance: The Sandhoff‐like disease observed in this family of Toy Poodles is the 2nd occurrence of the canine form of this disease and the 1st report of its identification in a family of dogs.     

Percutaneous balloon pericardiotomy as a treatment for recurrent pericardial effusion in 6 dogs

Percutaneous balloon pericardiotomy (PBP) has been performed in people and in a small number of dogs as a treatment for recurrent pericardial effusion with tamponade (PET). We performed this technique on 6 dogs with recurrent PET (5 with heart base tumors and 1 with no identifiable mass). Under general anesthesia and fluoroscopic guidance, a balloon-dilating catheter (diameters 14-20 mm) was introduced percutaneously at the 5th intercostal space through a sheath-introducing catheter, positioned across the parietal pericardium, and inflated 3 times. No dog experienced serious complications. The procedure was considered successful in 4 of 6 dogs. One dog is still alive without recurrence of PET 1 year after the procedure. Three dogs died of unrelated disease without recurrence of PET 5. 19, and 32 months after the procedure. The procedure was not beneficial in 1 dog that was euthanized 9 weeks later because of recurrence of pleural and abdominal effusion thought to be secondary to PET. One dog may have temporarily benefited but developed symptomatic PET 6 months after PBP. PBP appears to be a safe, economical, and potentially effective palliative treatment for recurrent PET and is a reasonable, less invasive alternative to surgery for dogs with recurrent PET, especially effusions caused by heart base tumors and possibly idiopathic pericardial effusion. Premature closure of the stoma is a potential cause for long-term failure and was thought to have been responsible for the recurrence of clinical signs in 2 dogs.     

Clinical remission of idiopathic hypereosinophilic syndrome in a Rottweiler

Idiopathic hypereosinophilic syndrome (HES) is a rare syndrome for which Rottweilers appear to over-represent the canine cases. A 6-month-old female entire Rottweiler presented with seizures following a traumatic incident. The dog was identified as having a marked, sustained eosinophilia and investigations did not identify an underlying cause. Concurrently, the dog had chronic eosinophilic hepatitis with impaired liver function and mesenteric eosinophilic lymphadenitis. The dog went on to have spontaneous resolution of HES and normal liver function was subsequently documented. To date, the dog is still alive, more than 4 years after initial presentation. The diagnosis of idiopathic HES in Rottweilers may not carry a poor prognosis and the condition may spontaneously resolve, even in cases with documented organ damage.     

Disseminated nocardiosis caused by Nocardia abscessus in a dog

Abstract: A 4‐year‐old female spayed Bichon Frise dog that had been receiving cyclosporine A per os 3 times per week for 2 months to control allergic dermatitis developed lethargy, anorexia, fever, and multiple firm subcutaneous masses. Pyogranulomatous inflammation with branching nonseptate filamentous organisms approximately 2 μm in diameter, presumptively fungal organisms, was diagnosed by cytologic evaluation of fine‐needle aspirates from several masses. A partially acid‐fast actinomycete was cultured from 2 of the masses. The organism was identified as Nocardia abscessus (formerly Nocardia asteroides type 1) based on 16S ribosomal DNA sequencing of samples extracted from cultures and unstained cytologic smears. Immunosuppression caused by long‐term administration of cyclosporine A likely predisposed the dog to disseminated infection. To our knowledge, this is the first report of N. abscessus infection in a dog. This case demonstrates that N. abscessus may be mistaken for a fungal organism based on its cytologic appearance and underscores the importance of using molecular techniques for the diagnosis of suspected fungal diseases.     

A survey of veterinarians’ knowledge,attitudes and practices regarding an emerging disease: Coccidioidomycosis in Washington State

Coccidioides immitis is an emerging fungal pathogen in Washington State (WA). While the geographical boundaries of C. immitis in WA have not been well characterized, human infections have resulted from exposure in the south‐central region of the state. Since 2010, only one dog has been identified as a probable locally acquired animal case, despite pilot canine serological surveys from south‐central WA revealing a 9.8% seroprevalence. On the suspicion that clinical animal cases may be underdiagnosed and/or underreported, we assessed WA veterinarians’ knowledge, attitudes and practices regarding coccidioidomycosis. All veterinarians with active licenses in WA were invited to complete a self‐administered, web‐based survey from November 2018 to January 2019. Four hundred and twenty‐five of 2,211 (19.2%) veterinarians returned the survey and were eligible for inclusion in the final analysis. Nearly, all respondents (98.8%) had heard of coccidioidomycosis, but only 31.5% and 25.6% knew that locally acquired animal and human cases, respectively, had been reported in WA. Only half (52.6%) of participants knew that the disease was reportable. Fewer than 20% of respondents reported confidence that their knowledge of coccidioidomycosis was up to date, and 76.9% “never” or “rarely” considered the risk of disease in their patients. A statistically significant predictor of a high knowledge score (≥70%), however, included practicing in endemic counties where the Washington State Department of Health had previously delivered outreach and education services. While the results suggest some success with these activities, it is clear that information on the emergence of coccidioidomycosis is not adequately reaching veterinary practitioners in WA. The data support that more frequent CE opportunities, and dissemination of public health communications through veterinary‐specific modalities, would help fill the knowledge gap. In turn, improved diagnosis and reporting of animal cases would assist in our overall understanding the epidemiology of coccidioidomycosis in WA.     

Pulmonary and hepatic eosinophilic granulomas and epistaxis in a horse suggestive of multi‐systemic eosinophilic epitheliotropic disease

Multi‐systemic eosinophilic epitheliotropic disease (MEED) is a relatively uncommon disease characterised by eosinophilic infiltration of more than one organ system, with the skin and gastrointestinal tract most commonly affected. This case report describes a gelding that presented for weight loss, increased respiratory rate and effort and chronic intermittent epistaxis. During post mortem examination diffuse eosinophilic granulomatous lesions were identified in the lung and liver, leading to a diagnosis of MEED. Veno‐occlusive pulmonary remodelling was also discovered, believed to be the cause of the chronic epistaxis and a result of the pulmonary fibrosis and eosinophilic granulomas.     

Treatment of Coccidioidomycosis Osteomyelitis with ltraconazole in a Horse

Itraconazole, a tricyclic azole effective against a number of deep mycotic diseases, was used to treat a Quarter Horse filly with coccidioidomycosis. The horse was almost normal after 90 days of treatment. Five months after discontinuing itraconazole treatment, the filly had severe neck pain and neurologic signs from recurrence of coccidioidomycosis and was treated with itraconazole for an additional 6 months. Her clinical condition improved to almost normal and the filly has remained normal for 2 years. There was no evidence of drug toxicity.     

Colorectal basidiobolomycosis in a dog

A 7-year-old castrated male French Bulldog was examined for chronic large intestinal enteropathy. A colonic mass and thickened rectal mucosa were identified, and histopathologic examination of endoscopic biopsy specimens disclosed eosinophilic proctitis with large (5-20 μm), irregularly shaped, pauciseptate hyphae that were Gomori methenamine silver and periodic acid-Schiff positive. Amplification and sequencing of ribosomal DNA extracted from paraffin-embedded tissues yielded a sequence with 97% identity to GenBank sequences for Basidiobolus ranarum. After itraconazole, terbinafine, and prednisone administration, clinical signs resolved rapidly, and sonographic lesions were largely absent after 6 weeks. Treatment was discontinued by the owner 15 weeks after diagnosis. Three weeks later, the dog collapsed acutely and was euthanized. Necropsy identified metastatic islet cell carcinoma and grossly unremarkable colorectal tissues. However, histopathology of the rectum disclosed multifocal submucosal granulomas with intralesional hyphae morphologically similar to those previously observed. This report is the first to describe medical treatment of gastrointestinal basidiobolomycosis in a dog.     

Septic pericardial effusion associated with pulmonary and pericardial botryomycosis in a dog

The authors report a case of septic pericardial effusion resulting in cardiac tamponade associated with intrathoracic botryomycosis in a dog. Septic pericarditis and a pulmonary mass were diagnosed, and subtotal pericardiectomy and lobectomy of the affected pulmonary areas were carried out. Histopathology of the excised tissue showed changes supportive of botryomycosis--namely a pyogranulomatous inflammation with neutrophils centred around amorphous homogeneous eosinophilic material and club-like bodies containing Gram-positive bacterial cocci present in the centre. The patient recovered well following surgery and antibiotic therapy. To the authors' knowledge, this is the first report of pulmonary botryomycosis in the dog and the first report of this condition presented with pericardial involvement and cardiac tamponade in any species.