Neoplasias mielo e linfoproliferativas em cães e gatos : técnicas de diagnóstico laboratorial

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Primary Erythrocytosis in a Bitch - Clinical and Laboratorial Aspects

Background: Primary erythrocytosis is a rare myeloproliferative disorder in dogs and cats characterized by an autonomous proliferation of erythroid precursors in the bone marrow, with low to normal serum erythropoietin concentration, resulting in elevated red blood cell count, hematocrit and hemoglobin concentration. Clinical signs are associated with increased blood volume and viscosity, and may include erythema, hyperemic mucous membranes and neurological signs such as seizures and ataxia. In veterinary medicine, the diagnosis should be made by exclusion of secondary or relative causes, after complementary exams. This report aims to describe a case of primary erythrocytosis in a bitch. Case: A 4-year-old mixed-breed bitch was referred to the Veterinary Medical Teaching Hospital of the UFRGS with 3 convulsive episodes related by the owner. A previous abdominal ultrasonography revealed splenomegaly and the electrocardiogram showed no abnormalities. No alterations were observed at the physical examination. The laboratorial blood tests demonstrated a persistent erythrocytosis, with high hematocrit, hemoglobin and red blood cells count, thrombocytopenia and neutropenia, and total plasmatic protein was within the reference interval. The bone marrow cytology revealed reduced cellularity, normal myeloid:erythroid ratio, erythroid hyperplasia, mild myeloid hyperplasia and moderate myelofibrosis. The serum erythropoietin measurement was within the reference range, and the blood gas analysis detected a slight decrease in partial oxygen pressure. Therefore, no evidence of secondary conditions was observed and the diagnosis of primary erythrocytosis could be made. Discussion: Since there is no definitive method, the diagnosis of primary erythrocytosis could be based on the exclusion of all secondary and relative causes of erythrocytosis. The absence of clinical signs of dehydration and high serum albumin levels were findings that conduced for the exclusion of the relative form of the disturbance. The echocardiography and the abdominal ultrasonography ruled out any cardiopulmonary condition or kidney neoplasm, the most common causes of absolute secondary erythrocytosis. The persistently high hematocrit levels and red blood cell counts are significant for the suspicion of primary erythrocytosis, although thrombocytopenia and neutropenia are not commonly reported. The clinical signs of seizure were correlated with increased blood viscosity and reduced blood flow at the central nervous system. The blood gas analysis discarded the occurrence of systemic hypoxia, and the normal levels of erythropoietin gives higher evidence of the occurrence of an autonomous proliferation of the erythroid precursors within the bone marrow. The bone marrow cytology confirmed erythroid hyperplasia and the reduced cellularity that could be attributed to myelofibrosis. Myelofibrosis was described in humans with polycythemia vera, but there are no reports in veterinary, and this occurrence must be elucidated. An identical mutation in the JAK2 gene was observed in humans with polycythemia vera and dogs with primary erythrocytosis, and occurs in more than 50% of humans with myelofibrosis. Further investigations are necessary for veterinary medicine. In conclusion, the systematic approach of all organic systems and the assessment of complementary exams are necessary for the diagnostic of primary erythrocytosis in dogs. This condition should be considered in the differential diagnosis of any erythrocytosis, considering the guarded prognosis of this hematologic disorder.   Keywords: myeloproliferative disorders, erythropoietin, myelofibrosi

Primary erythrocytosis in a bitch : clinical and laboratorial aspects

Background: Primary erythrocytosis is a rare myeloproliferative disorder in dogs and cats characterized by an autonomous proliferation of erythroid precursors in the bone marrow, with low to normal serum erythropoietin concentration, resulting in elevated red blood cell count, hematocrit and hemoglobin concentration. Clinical signs are associated with increased blood volume and viscosity, and may include erythema, hyperemic mucous membranes and neurological signs such as seizures and ataxia. In veterinary medicine, the diagnosis should be made by exclusion of secondary or relative causes, after complementary exams. This report aims to describe a case of primary erythrocytosis in a bitch. Case: A 4-year-old mixed-breed bitch was referred to the Veterinary Medical Teaching Hospital from UFRGS with 3 convulsive episodes related by the owner. A previous abdominal ultrasonography revealed splenomegaly and the electrocardiogram showed no abnormalities. No alterations were observed at the physical examination. The laboratorial blood tests demonstrated a persistent erythrocytosis, with high hematocrit, hemoglobin and red blood cells count, thrombocytopenia and neutropenia, and total plasmatic protein within the reference interval. The bone marrow cytology revealed reduced cellularity, normal myeloid: erythroid ratio, erythroid hyperplasia, mild myeloid hyperplasia and moderate myelofibrosis. The serum erythropoietin measurement was within the reference range, and the blood gas analysis detected a slight decrease in partial oxygen pressure. Therefore, no evidence of secondary conditions was observed and the diagnosis of primary erythrocytosis could be made. Discussion: Since there is no definitive method, the diagnosis of primary erythrocytosis could be based on the exclusion of all secondary and relative causes of erythrocytosis. The absence of clinical signs of dehydration and high serum albumin levels were findings that conduced for the exclusion of the relative form of the disturbance. The echocardiography and the abdominal ultrasonography ruled out any cardiopulmonary condition or kidney neoplasm, the most common causes of absolute secondary erythrocytosis. The persistently high hematocrit levels and red blood cell counts are significant for the suspicion of primary erythrocytosis, although thrombocytopenia and neutropenia are not commonly reported. The clinical signs of seizure were correlated with increased blood viscosity and reduced blood flow at the central nervous system. The blood gas analysis discarded the occurrence of systemic hypoxia, and the normal levels of erythropoietin gives higher evidence of the occurrence of an autonomous proliferation of the erythroid precursors within the bone marrow. The bone marrow cytology confirmed erythroid hyperplasia and the reduced cellularity that could be attributed to myelofibrosis. Myelofibrosis was described in humans with polycythemia vera, but there are no reports in veterinary, and this occurrence must be elucidated. An identical mutation in the JAK2 gene was observed in humans with polycythemia vera and dogs with primary erythrocytosis, and occurs in more than 50% of humans with myelofibrosis. Further investigations are necessary for veterinary medicine. In conclusion, the systematic approach of all organic systems and the assessment of complementary exams are necessary for the diagnostic of primary erythrocytosis in dogs. This condition should be considered in the differential diagnosis of any erythrocytosis, considering the guarded prognosis of this hematologic disorder

Correlação entre lipidose hepática, variação da condição corporal e analitos hepáticos em bovinos leiteiros

Liver lipidosis is a metabolic disorder mostly observed in high yielding dairy cattle, especially during the transition period. The aim of this study was to determine the correlation between hepatic lipid infiltration, biochemical indicators of liver function, and body condition score (BCS) variation in dairy cows. Fifty-one multiparous Holstein cows raised in a confined system were evaluated. Liver biopsies and blood samples were collected, and BCS was measured on days 3 and 28 postpartum. Lipid infiltration was determined by histologic examination. The plasma activity of aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase and concentration of beta-hydroxybutyrate, non-esterified fatty acids, albumin, total bilirubin, and cholesterol were determined. BCS was measured using objective (camera) and subjective (visual) methods. Mild lipid infiltration was found in 3.92% of cows sampled on day 3 and 5.88% on day 28. Bilirubin was significantly higher on day 3 than on day 28 postpartum, and cholesterol was significantly higher on day 28 than on day 3 in all cows. There was no difference in biochemical analytes between cows with and without lipidosis. On day 3, mean subjective BCS was 3.10 and objective BCS was 3.16, while on day 28, these scores were 2.91 and 2.99, respectively. The calculated liver function index (LFI) was found to be a more sensitive indicator of liver function than the hepatic analytes evaluated. No correlation between BCS variation and lipid infiltration was found. Cholesterol and bilirubin levels showed the most remarkable changes during the early postpartum period. LFI is a potential indicator of postpartum liver function.A lipidose hepática é um distúrbio metabólico principalmente observado nos bovinos de leite de alto rendimento, especialmente no período de transição. O objetivo deste estudo foi determinar a correlação entre infiltração lipídica hepática, indicadores bioquímicos de função hepática e variação da condição corporal em bovinos leiteiros. Foram avaliadas cinquenta e um vacas multíparas de raça Holandesa em confinamento. Coletaram-se biopsias de fígado e amostras de sangue, e a condição corporal (BCS) aferiu-se nos dias 3 e 28 pós-parto. A infiltração lipídica determinou-se mediante avaliação histológica. Mensuraram-se a atividade da aspartato aminotransferase, fosfatase alcalina e da gama-glutamil transferase, concentração de beta-hidroxibutirato, ácidos graxos não esterificados, albumina, bilirrubina total e colesterol. A BCS mediu-se utilizando método objetivo (câmera) e subjetivo (visualmente). Observou-se discreta infiltração lipídica em 3,92% dos bovinos amostrados no dia 3 e 5,88% no dia 28. Em todos os bovinos a bilirrubina foi significativamente mais alta no dia 3 do que no dia 28 e o colesterol foi superior no dia 28 do que no dia 3. Não houve diferença nos analitos bioquímicos dos bovinos com e sem lipidose. No dia 3, a média subjetiva da BCS foi 3,10 e a objetiva 3,16, enquanto no dia 28, obtiveram-se valores de 2,91, e 2,99 respectivamente. O índice calculado de função hepática mostrou ser um indicador mais sensível da função hepática do que os analitos avaliados individualmente. Não houve correlação entre a variação do BCS e infiltração lipídica

Low-intensity, high-frequency grazing positively affects defoliating behavior, nutrient intake and blood indicators of nutrition and stress in sheep

The intensity and frequency of grazing affect the defoliating strategy of ruminants, their daily nutrient intake, thus nutrition and physiological status. Italian ryegrass (Lolium multiflorum Lam.) pastures were grazed by sheep either under a low-intensity/high-frequency grazing strategy (Rotatinuous stocking; RN) with nominal pre- and post-grazing sward heights of 18 and 11 cm, respectively, or under a high-intensity/low-frequency strategy (traditional rotational stocking; RT) with nominal pre- and post-grazing sward heights of 25 and 5 cm, respectively. Treatments were arranged under a complete randomized design and evaluated over two periods, in different years. In 2017, the aim was to depict the type of bites that sheep perform during the grazing-down and associate them to the grazing management strategy according to their relative contribution to the diet ingested. In 2018 we estimated the total nutrient intake and evaluated blood indicators of the nutritional status and immune response to stress of sheep. The bite types accounting the most for the diet ingested by RN sheep were those performed on the “top stratum” of plants with around 20, 15, and 25 cm, whereas the type of bites accounting the most for the diet of RT sheep were those performed on “grazed plants” with around 10, 5, and ≤ 3 cm. In 2018, the RN sheep increased by 18% the total organic matter (OM) intake and by 20–25% the intake of soluble nutrients (i.e., crude protein, total soluble sugars, crude fat), digestible OM and of metabolizable energy, and had 17.5, 18, and 6.1% greater blood concentration of glucose, urea nitrogen (BUN) and albumin, respectively, but 17% lower blood neutrophil-to-lymphocyte (N:L) ratio. Sheep grazing vegetative Italian ryegrass pastures under the low-intensity/high-frequency grazing strategy (RN) ingested a diet of better quality from bites allocated on the top stratum of plants, had greater intake of soluble nutrients and blood parameters positively associated with nutritional status and immune response to stress

Prevalence of iodine deficiency in dairy cattle in Rio Grande do Sul and associated factors

O iodo é um mineral essencial no metabolismo dos animais, e a sua deficiência em humanos tem sido amplamente estudada mundialmente, devido aos efeitos deletérios que produz no desenvolvimento físico e cognitivo dos indivíduos. Em contraste, os estudos sobre o status de iodo nos demais mamíferos são escassos, desconhecendo dados atualizados em relação à prevalência de deficiência ou possível excesso de suplementação. Uma das principais fontes de suplementação de iodo na dieta das pessoas é o leite, além de seus produtos derivados. O presente estudo tem como objetivo realizar uma avaliação transversal no status de suficiência de iodo nos bovinos leiteiros do estado de Rio Grande do Sul, além de identificar fatores que possam influenciar nesses valores, tais como o tempo após o parto, estação do ano e uso de produtos iodados na rotina da ordenha. Foram coletadas 268 amostras de urina, de vacas de raça Holandesa em produção, provenientes de quatro fazendas do estado, nos meses de março e agosto. A concentração média de iodo na urina em ambas as estações foi superior a 10 μg/dL, concentração mínima estabelecida pela Organização Mundial da Saúde para definir status de suficiência, sendo 12,17 μg/dL no verão e 14,06 μg/dL no inverno. No entanto, a proporção de animais com deficiência leve foi de 31,5% e 28,26%, enquanto 9,45% e 2,9% apresentaram deficiência moderada em cada estação, respectivamente. Nenhum animal apresentou deficiência severa. A iodúria apresentou correlação com a estação do ano, sendo em média 1.9 μg/dL superior no inverno, mas não significativamente com a idade, número de partos e dias pós-parto dos animais avaliados.Iodine is an essential mineral in the metabolism of animals, and its deficiency in humans has been widely studied worldwide, due to the harmful effects it produces on the physical and cognitive development of individuals. In contrast, studies on the status of iodine in other mammals are scarce, ignoring updated data in relation to the prevalence of deficiency or possible excess of supplementation. One of the main sources of iodine supplementation in people's diets is milk, in addition to its derived products. The present study aims to carry out a cross-sectional assessment of iodine sufficiency status in dairy cattle in the state of Rio Grande do Sul, in addition to identifying factors that may influence these values, such as time after calving, season and use of iodized products in the milking routine. A total of 268 bovine urine samples were collected from Holstein cows in production, from four farms in the state, during March and August. The average concentration of urinary iodine at both seasons was over 10 μg/dL, minimum concentration established by the World Health Organization to define sufficiency status, being 12.17 μg/dL in summer and 14.06 μg/dL in winter. Nevertheless, the proportion of animals with mild deficiency was 31.5% and 28.26%, while 9.45% and 2.9% presented moderate deficiency in each season respectively. None of the animals had severe deficiency. Ioduria was correlated with seasonality, being an average of 1.9 μg/dL higher in winter, but not significantly with age, number of deliveries and postpartum days of evaluated animals

Hiperadrenocorticismo atípico canino asociado a hipotireoidismo

ABSTRACT Hyperadrenocorticism (HAC) is one of the most common endocrinopathies in dogs, caused by excessive synthesis of cortisol. Atypical or occult HAC is a syndrome characterized by the presentation of clinical, biochemical, and imaging alterations compatible with hypercortisolism, but normal results in endocrine tests that are conventionally used for HAC diagnosis. However, these patients present high serum concentrations of precursors or other corticoadrenal hormones. The present study describes the case of an 8 years old female canine, Bichón Frisé, epileptic and treated with phenobarbital, presenting clinical signs associated with HAC, in which the low-dose dexamethasone suppression test and stimulation with ACTH resulted within normal values. The measurement of adrenal steroids, after ACTH stimulation, showed abnormal elevation of estrogen and progesterone, the latter persisting after the patient was spayed. Treatment with trilostane allowed the reduction of progesterone levels and the partial resolution of clinical signs. However, full clinical recovery was only achieved after the diagnosis and treatment of concomitant hypothyroidism. The challenge that represent the diagnosis of atypical HAC highlights the importance of performing and having availability of panels that include measurement of adrenal steroid hormones other than cortisol, as well as considering the occurrence of other concomitant endocrine metabolic diseases.RESUMEN El hiperadrenocorticismo (HAC) es una de las endocrinopatías más frecuentes en caninos, producida por la síntesis excesiva de cortisol. El HAC atípico u oculto es un síndrome caracterizado por la presentación de alteraciones clínicas, bioquímicas e imagenológicas compatibles con hipercortisolismo, pero con resultados normales en las pruebas endocrinológicas utilizadas convencionalmente para diagnóstico de HAC. Sin embargo, estos pacientes presentan elevada concentración sérica de precursores u otras hormonas corticoadrenales. El presente estudio describe el caso de una canina hembra, Bichón Frisé de 8 años de edad, epiléptica y tratada con fenobarbital, presentando signos clínicos asociados a HAC, en la que el test de supresión con dexametasona a dosis bajas y de estimulación con ACTH arrojaron valores normales. La medición de esteroides adrenales, post estimulación con ACTH, mostró elevación anormal de estrógenos y progesterona, persistiendo esta última después de que la paciente fuera esterilizada. El tratamiento con trilostano permitió la disminución de los niveles de progesterona y la resolución parcial de los signos clínicos. Sin em bargo, la recuperación clínica en su totalidad sólo se obtuvo después del diagnóstico y tratamiento del hipotiroidismo concomitante. El desafio que representa el diagnóstico del HAC atípico resalta la importância de realizar y disponer de paneles que incluyan medición de hormonas esteroideas adrenales diferentes al cortisol, además de considerar la ocurrencia de otras enfermedades endocrinas metabólicas concomitantes

Hiperadrenocorticismo atípico e hipotiroidismo canino

Hyperadrenocorticism (HAC) is one of the most common endocrinopathies in dogs, caused by excessive synthesis of cortisol. Atypical or occult HAC is a syndrome characterized by the presentation of clinical, biochemical, and imaging alterations compatible with hypercortisolism, but normal results in endocrine tests that are conventionally used for HAC diagnosis. However, these patients present high serum concentrations of precursors or other corticoadrenal hormones. The present study describes the case of an 8 years old female canine, Bichón Frisé, epileptic and treated with phenobarbital, presenting clinical signs associated with HAC, in which the low-dose dexamethasone suppression test and stimulation with ACTH resulted within normal values. The measurement of adrenal steroids, after ACTH stimulation, showed abnormal elevation of estrogen and progesterone, the latter persisting after the patient was spayed. Treatment with trilostane allowed the reduction of progesterone levels and the partial resolution of clinical signs. However, full clinical recovery was only achieved after the diagnosis and treatment of concomitant hypothyroidism. The challenge that represent the diagnosis of atypical HAC highlights the importance of performing and having availability of panels that include measurement of adrenal steroid hormones other than cortisol, as well as considering the occurrence of other concomitant endocrine metabolic diseases.El hiperadrenocorticismo (HAC) es una de las endocrinopatías más frecuentes en caninos, producida por la síntesis excesiva de cortisol. El HAC atípico u oculto es un síndrome caracterizado por la presentación de alteraciones clínicas, bioquímicas e imagenológicas compatibles con hipercortisolismo, pero con resultados normales en las pruebas endocrinológicas utilizadas convencionalmente para diagnóstico de HAC. Sin embargo, estos pacientes presentan elevada concentración sérica de precursores u otras hormonas corticoadrenales. El presente estudio describe el caso de una canina hembra, Bichón Frisé de 8 años de edad, epiléptica y tratada con fenobarbital, presentando signos clínicos asociados a HAC, en la que el test de supresión con dexametasona a dosis bajas y de estimulación con ACTH arrojaron valores normales. La medición de esteroides adrenales, post estimulación con ACTH, mostró elevación anormal de estrógenos y progesterona, persistiendo esta última después de que la paciente fuera esterilizada. El tratamiento con trilostano permitió la disminución de los niveles de progesterona y la resolución parcial de los signos clínicos. Sin embargo, la recuperación clínica en su totalidad sólo se obtuvo después del diagnóstico y tratamiento del hipotiroidismo concomıtante. El desafío que representa el diagnóstico del HAC atípico resalta la importancia de realizar y disponer de paneles que incluyan medición de hormonas esteroideas adrenales diferentes al cortisol, además de considerar la ocurrencia de otras enfermedades endocrinas metabólicas concomitantes

Primary Erythrocytosis in a Bitch - Clinical and Laboratorial Aspects

Background: Primary erythrocytosis is a rare myeloproliferative disorder in dogs and cats characterized by an autonomous proliferation of erythroid precursors in the bone marrow, with low to normal serum erythropoietin concentration, resulting in elevated red blood cell count, hematocrit and hemoglobin concentration. Clinical signs are associated with increased blood volume and viscosity, and may include erythema, hyperemic mucous membranes and neurological signs such as seizures and ataxia. In veterinary medicine, the diagnosis should be made by exclusion of secondary or relative causes, after complementary exams. This report aims to describe a case of primary erythrocytosis in a bitch. Case: A 4-year-old mixed-breed bitch was referred to the Veterinary Medical Teaching Hospital of the UFRGS with 3 convulsive episodes related by the owner. A previous abdominal ultrasonography revealed splenomegaly and the electrocardiogram showed no abnormalities. No alterations were observed at the physical examination. The laboratorial blood tests demonstrated a persistent erythrocytosis, with high hematocrit, hemoglobin and red blood cells count, thrombocytopenia and neutropenia, and total plasmatic protein was within the reference interval. The bone marrow cytology revealed reduced cellularity, normal myeloid:erythroid ratio, erythroid hyperplasia, mild myeloid hyperplasia and moderate myelofibrosis. The serum erythropoietin measurement was within the reference range, and the blood gas analysis detected a slight decrease in partial oxygen pressure. Therefore, no evidence of secondary conditions was observed and the diagnosis of primary erythrocytosis could be made. Discussion: Since there is no definitive method, the diagnosis of primary erythrocytosis could be based on the exclusion of all secondary and relative causes of erythrocytosis. The absence of clinical signs of dehydration and high serum albumin levels were findings that conduced for the exclusion of the relative form of the disturbance. The echocardiography and the abdominal ultrasonography ruled out any cardiopulmonary condition or kidney neoplasm, the most common causes of absolute secondary erythrocytosis. The persistently high hematocrit levels and red blood cell counts are significant for the suspicion of primary erythrocytosis, although thrombocytopenia and neutropenia are not commonly reported. The clinical signs of seizure were correlated with increased blood viscosity and reduced blood flow at the central nervous system. The blood gas analysis discarded the occurrence of systemic hypoxia, and the normal levels of erythropoietin gives higher evidence of the occurrence of an autonomous proliferation of the erythroid precursors within the bone marrow. The bone marrow cytology confirmed erythroid hyperplasia and the reduced cellularity that could be attributed to myelofibrosis. Myelofibrosis was described in humans with polycythemia vera, but there are no reports in veterinary, and this occurrence must be elucidated. An identical mutation in the JAK2 gene was observed in humans with polycythemia vera and dogs with primary erythrocytosis, and occurs in more than 50% of humans with myelofibrosis. Further investigations are necessary for veterinary medicine. In conclusion, the systematic approach of all organic systems and the assessment of complementary exams are necessary for the diagnostic of primary erythrocytosis in dogs. This condition should be considered in the differential diagnosis of any erythrocytosis, considering the guarded prognosis of this hematologic disorder.   Keywords: myeloproliferative disorders, erythropoietin, myelofibrosi