Haemostatic abnormalities in canine spirocercosis

Spirocerca lupi (S. lupi) is a nematode that infects the dog’s oesophagus resulting in an inflammatory fibroblastic nodule that progresses to a sarcoma in approximately 25% of cases. Inflammation, coagulation and cancer are exquisitely intertwined and inflammatory changes are known to lead to coagulation abnormalities. The nature and degree of haemostatic alterations in canine spirocercosis are unknown. Evidence of inflammation in dogs with clinical spirocercosis is provided by pyrexia, leucocytosis, increased serum interleukin 8 and C-reactive protein as well as severe inflammatory infiltrates on histopathology of nodules. This study aimed to determine if haemostatic abnormalities exist in canine spirocercosis, and hypothesised that the severity of abnormalities could be used to differentiate non-neoplastic from neoplastic spirocercosis. Thirty-nine client-owned S. lupi-infected dogs and 15 healthy age- and sex-matched control dogs were included in this study. Blood samples were collected at the time of diagnosis. A complete blood count, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen concentration, antithrombin (AT) activity, D-dimer concentration and thromboelastography (TEG) analysis were performed. Hypercoagulability was based on the maximum amplitude (MA) value derived from TEG. Inflammatory parameters were also determined and included C-reactive protein (CRP) and fibrinogen concentrations. The S lupi-infected dogs were divided into a non-neoplastic group (n=24) and a neoplastic group (n=15). Data were compared using the Kruskal-Wallis Test and Dunn’s multiple comparisons applied post-hoc. Correlation was determined using Spearman’s correlation. Hypercoagulabilty was found in the neoplastic and non-neoplastic spirocercosis cases. In addition, the neoplastic group was significantly more hypercoagulable than the non-neoplastic group, and the non-neoplastic group was significantly more hypercoagulable than the control group. The median fibrinogen concentration was significantly higher in the neoplastic group compared to the non-neoplastic group, but there was no significant difference between the non-neoplastic and control group. The median CRP concentration was significantly higher in the neoplastic group compared to the non-neoplastic group, with no significant difference between the non-neoplastic and control group. Compared to the control group the median AT activity was significantly decreased in both the non-neoplastic and neoplastic groups. No significant difference was found between the infected groups. Across the non-neoplastic and neoplastic groups, MA showed positive linear correlation with CRP and fibrinogen. The study showed that spirocercosis is associated with a hypercoagulable state that becomes progressively more severe with neoplastic transformation. Overlap did exist between the median MA values of the non-neoplastic and neoplastic groups, but an MA of >76 mm provided a specificity of 96% and sensitivity of 73% for the differentiation of disease state. Thromboelastography might therefore be used as an adjunctive assay to support the suspicion of neoplastic transformation of the oesophageal nodule as well as to determine the overall haemostatic status of the patient. The MA correlated positively with the indicators of inflammation (CRP&fibrinogen) supporting the hypothesis that an inflammatory state induced by the S. lupi nodule is at least partly responsible for the hypercoagulability. The link between inflammation, coagulation and neoplastic transformation in spirocercosis warrants further investigation to elucidate the exact factors resulting in the hypercoagulable state, whether clinically relevant complications develop and whether or not specific therapy should be instituted to prevent thrombotic sequelae.Dissertation (MMedVet)--University of Pretoria, 2012.Companion Animal Clinical Studiesunrestricte

Tetralogy of Fallot and Atrial Septal Defect in a White Bengal Tiger Cub (Panthera tigris tigris)

A 3-week-old female white Bengal Tiger cub (Panthera tigris tigris) presented with acute onset tachypnoea, cyanosis and hypothermia. The cub was severely hypoxaemic with a mixed acid–base disturbance. Echocardiography revealed severe pulmonic stenosis, right ventricular hypertrophy, high membranous ventricular septal defect and an overriding aorta. Additionally, an atrial septal defect was found on necropsy, resulting in the final diagnosis of Tetralogy of Fallot with an atrial septal defect (a subclass of Pentalogy of Fallot). This report is the first to encompass arterial blood gas analysis, thoracic radiographs, echocardiography and necropsy findings in a white Bengal Tiger cub diagnosed with Tetralogy of Fallot with an atrial septal defect

Congenital pyloric mucosal fold resulting in an antral valve outflow obstruction in a bull terrier

An under-sized 3 month old female bull terrier was referred with a history of regurgitation since 3 days of age. Thoracic radiographs were unremarkable, while abdominal radiographs showed a distended stomach, despite a 12 hour fast. Abdominal ultrasonography revealed gastric outflow obstruction of unclear aetiology. Coeliotomy was performed, during which an excessive mucosal fold at the pyloric antrum was excised. Histopathology of the pyloric fold revealed mild oedema and fibrosis of the mucosal tissue. The dog made a complete recovery, with resolution of regurgitation and grew to within the expected breed size. In the authors’ opinion, this is the first canine report of congenital antral mucosal valve resulting in gastric outflow obstruction, and only the second report in any species.http://www3.interscience.wiley.com/journal/117961497hb2013mn201

Kasabach-Merritt-like syndrome in a dog secondary to isolated splenic haemangiomatosis

A 13-year-old intact male miniature schnauzer presented with lethargy, distended abdomen and pallor. Pancytopenia was identified on complete blood count with a severe thrombocytopenia. Cavitatory severe splenomegaly was identified on abdominal ultrasound. Two weeks of immunosuppressive therapy had no effect on the thrombocytopenia and a splenectomy was performed. The platelet count returned to normal within 24 hours of splenectomy. Isolated splenic haemangiomatosis was confirmed on histopathology and immunohistochemistry. The anaemia and severe thrombocytopenia in conjunction with the ultrasound findings and histopathology are characteristic of Kasabach-Merritt syndrome in people. This is the first case of Kasabach-Merritt-like syndrome described in the dog.https://bvajournals.onlinelibrary.wiley.com/journal/20526121hj2021Companion Animal Clinical StudiesParaclinical Science

Spirocerca lupi induced oesophageal neoplasia : predictors of surgical outcome

Canine spirocercosis is caused by the nematode Spirocerca lupi. Migration results in oesophageal fibro-inflammatory nodules that may undergo neoplastic transformation. No studies have assessed pre- or post-surgical prognostic indicators in dogs that undergo intervention for S. lupi induced oesophageal neoplasia. This observational, multi-center study aimed to assess the outcome of dogs with Spirocerca induced sarcoma undergoing endoscopic-guided ablation (n = 12) or surgery (n = 18), and identify prognostic indicators. Parameters evaluated included: age, weight, gender, presenting complaints, duration of clinical signs, complete blood count, serum biochemistry, neoplasia size, placement of percutaneous endoscopically-placed gastrostomy tube, histopathological mitotic indices, days to discharge and chemotherapy administration. Kaplan-Meier survival curves showed no difference in survival between ablation and surgery {(median: 73.5 days (range: 0–1511) vs. 108 days (range: 0–1550), respectively (p = 0.982)}. Reduced survival was documented in patients presenting with weight loss (P = 0.027), hypochromasia (MCHC 15 × 109/L, P = 0.017) with a hazard ratio of 2.51 (CI95% = 1.071–6.018, P = 0.034), 2.71 (CI95% = 1.10–6.65, P = 0.03) and 4.39 (CI95%: 1.21–15.97, P = 0.025) respectively. In the dogs surviving more than 21 days, Ht 15.0 × 109/L at presentation were associated with reduced survival (p = 0.016, p = 0.021 respectively) and hazard ratio of 3.29 (CI95% = 1.18–9.2, P = 0.023) and 3.81 (CI95% = 1.15–12.55, P = 0.028) respectively. Intra-intervention-group survival analysis identified increased survival time in dogs receiving chemotherapy, but only within the surgical group (P = 0.02).The hospitalisation time of dogs undergoing ablation (median: 0 days, range: 0–4) was significantly shorter than dogs undergoing surgery (9 days, 1–21) (P < 0.001). In this study, no clear benefit was identified for surgery, thus when ablation is technically possible it should be considered advantageous, as hospitalisation time is significantly shorter. Weight loss, hypochromasia and leucocytosis were identified as long-term prognostic indicators at presentation.http://www.elsevier.com/locate/vetpar2019-01-30hj2018Companion Animal Clinical Studie

Circulating markers of endothelial activation in canine parvoviral enteritis

The data that support the findings of this study are available from the corresponding author, B.K. Atkinson, upon reasonable request.BACKGROUND : Canine parvovirus (CPV) is a common cause of enteritis, immune suppression and systemic inflammation in young dogs. Endothelial markers, such as intercellular adhesion molecule 1 (ICAM-1) and vascular cell adhesion molecule 1 (VCAM-1), and molecules that upregulate their expression, such as high mobility group box 1 protein (HMGB-1), provide insight into the state of the endothelium during inflammation. OBJECTIVES : This study aimed to determine if circulating concentrations of ICAM-1, VCAM-1 and HMGB-1 were altered in CPV enteritis compared to healthy controls, and whether a correlation existed between these molecules and the degree of inflammation METHODS : Thirty dogs with naturally occurring CPV enteritis and ten control dogs were included. Physical examinations, complete blood count and C-reactive protein (CRP) measurements were performed on all dogs at presentation. The concentrations of ICAM-1, VCAM-1 and HMGB-1 were measured using commercially available canine-specific enzyme-linked immunosorbent assay (ELISA) kits. RESULTS : In dogs with CPV enteritis, ICAM-1 concentrations were significantly lower (median: 5.9 [IQR: 4.3-8.3]) and CRP higher (134 [IQR: 85-195]) compared to controls (8.0 [IQR: 6.9-10.3], p = 0.008; 1 [IQR: 0-7], p < 0.001). No significant difference was found for VCAM-1 and HMGB-1. A strong correlation was identified between VCAM-1 and segmented neutrophil count (r = 0.612, p < 0.001). CONCLUSION : Despite the presence of systemic inflammation in CPV enteritis, evidenced by high CRP concentrations, our results suggest circulating concentrations of ICAM-1, VCAM-1 and HMGB-1 failed to show an increase. Endothelial activation with subsequent leukocyte adhesion and transmigration through the endothelium may be affected in CPV enteritis and these findings require further investigation.http://www.jsava.co.zaam2023Companion Animal Clinical Studie

Mean platelet volume and platelet volume distribution width in canine parvoviral enteritis

Bacterial translocation from the damaged intestinal tract, reported in canine parvoviral (CPV) enteritis, is thought to be responsible for the systemic inflammatory response resulting from coliform septicemia, which could ultimately progress to septic shock and death. Alterations in platelet indices, specifically mean platelet volume (MPV), is a consistent finding in critically ill people and dogs with and without sepsis. Increased MPV has been reported to be an indirect indicator of platelet activation and of bone marrow response in people and dogs with sepsis. The study aim was to compare admission MPV and platelet volume distribution width (PVDW) in dogs with CPV enteritis to that of healthy aged-matched control dogs. Forty-eight dogs with CPV enteritis and 18 healthy age matched control dogs were included. CPV infection was confirmed with electron microscopy and concurrent blood-borne infections were excluded using PCR. EDTA whole blood samples were analyzed on an automated cell counter, ADVIA 2120, within 30-60min from collection. There was no significant difference for platelet count between the groups. The MPV for CPV infected dogs (median: 14.0; IQR: 12.2–15.1) was significantly higher compared to controls (11.3; IQR: 10.3–13.1, P = 0.002). The PVDW for CPV infected dogs (66.9; IQR: 64.2–68.8) was significantly higher compared to controls (63.3; IQR: 60.2–65.1, P < 0.001). These findings suggest that significant platelet activation is present in dogs with CPV enteritis which may play a role in the disease outcome, similar to people with sepsis. Further studies are required to investigate the prognosticating ability of MPV in dogs with CPV enteritis.Health and Welfare Sector Education and Training Authorityhttps://www.frontiersin.org/journals/veterinary-science#am2022Companion Animal Clinical Studie

Successful treatment of early cutaneous squamous cell carcinoma with hypofractionated radiation therapy in an African lion (Panthera leo)

Cutaneous squamous cell carcinoma (SCC) is a slow growing but locally invasive neoplasm, most commonly caused by prolonged exposure to ultraviolet (UV) radiation. Whilst SCC accounts for 15% of skin tumours in domesticated cats, cutaneous SCC in non-domesticated felids (apart from captive snow leopards) appears to be uncommon, with only three reports in the literature to date. In this report, a captive African lion (Panthera leo) presented with two ulcerative lesions on the nasal planum. Histopathology of the lesions revealed epidermal keratinocyte dysplasia and neoplastic basal- and supra-basal epithelial cells with dyskeratosis and evidence of basement membrane breaching and dermal invasion, consistent with a diagnosis of SCC. There was also evidence of laminar fibrosis and inflammation of the subjacent dermis suggesting that the SCC most likely resulted from UV-induced neoplastic transformation of the epidermal squamous epithelium following actinic keratosis. The lion was treated with hypofractionated radiation therapy and remained in remission until his death (euthanised 17 months later because of age-related chronic renal failure). This is the first report of cutaneous SCC in a lion with evidence of actinic damage and resolution after radiation therapy.L.v.d.W. was supported by the Wellcome Trust grant 20619.http://www.jsava.co.zaam2022Centre for Veterinary Wildlife StudiesCompanion Animal Clinical StudiesParaclinical SciencesProduction Animal Studie

The prevalence of intra-tumoral and distant thrombi, as well as tumour-cell emboli in canine neoplasia

Macroscopic thromboembolic disease has been associated with canine neoplasia, whereas prevalence studies of concurrent microthrombi and tumour-cell emboli are lacking. This retrospective study investigated microthrombi and tumour cell emboli by reviewing pathology records of dogs diagnosed with lymphoma, sarcoma, carcinoma and mast cell tumours with a concurrent description of thrombi or emboli. Pathology reports and medical records of cases with either tumour biopsies and/or post mortems with a diagnosis of neoplasia were reviewed for the presence of microthrombi, macrothrombi and/or tumour-cell emboli and the association with tumour type. Of the 28 895 canine cases in the database, 21 252 (73.5%) were antemortem biopsy specimens and 7643 were post mortems (26.5%); 2274 solid tumours were identified, 2107 (92.7%) were antemortem biopsy diagnoses and 167 (7.3%) were post mortem diagnoses. The prevalence of solid tumour types in the database (28 895 cases) was 872 (3.0%) lymphoma, 722 (2.5%) sarcoma, 455 (1.6%) carcinoma and 225 (0.8%) mast cell tumour. The prevalence of microthrombi associated with these tumours was 58/2274 (2.6%). Intra-tumoral microthrombi were reported in 53/2274 (2.3%) cases, the majority in sarcomas (37/53, 69.8%). No macrothrombi were reported. Tumour-cell emboli were identified in 39/2274 (1.7%) cases, 31/39 (79.5%) were extra-tumoral or distant emboli, and carcinoma the most commonly associated tumour (29/39; 74.4%). Microthrombi were reported in 2.6% of cases, the majority in sarcomas and tumour-cell emboli were identified in 1.7% of cases, the majority carcinomas. Prospective investigations are necessary to explore the potential clinical and prognostic implications of microthrombi and tumour-cell emboli in canine neoplasia.SUPPORTING INFORMATION : Table S1. Therapeutic interventions, previously described to interfere with haemostasis, identified in the case population and the associated tumour.http://wileyonlinelibrary.com/journal/vco2022-07-27hj2022Companion Animal Clinical Studie

Theileriosis in six dogs in South Africa and its potential clinical significance

Please read abstract in the article.http://www.jsava.co.zaam201