Müller’s duct persistence syndrome associated with cryptorchidism, Sertoli cell tumor and pyometra in a Miniature Schnauzer

Background: Sexual development disturbances (SDD) are divided in SDD with XX genotype (SDD XX) and SDD with XY genotype (SDD XY). Among SDD XY, the Müller’s duct persistence syndrome (MDPS) is characterized by XY karyotype individuals with male external genitals; however, with internal female reproductive organs such as uterine horns, uterus, and cranial vagina portion. The MDPS cases and their related complications are considered very rare in veterinary medicine. The aim of the present case report is to describe the clinical and pathological aspects of a MDPS case associated with cryptorchidism, Sertoli cell tumor, and pyometra in a Miniature Schnauzer dog. Case: A 7-year-old male Miniature Schnauzer weighting 7 kg was brought to veterinary consultation due to owner’s complain of frequent vomiting, apathy, abdominal algia and progressive scrotal enlargement in the last two months. Physical exam reveals hyperthermia (39.7°C), discrete dehydration, enlarged popliteal lymph nodes as well as scrotum enlargement with only one palpable testicle. A blood sample collected for complete blood count showed regenerative anemia, thrombocytopenia, and neutrophilia with left shift in the leukogram. Abdominal ultrasound examination indicated the presence of a tubular structure filled by anechoic content extending from the scrotum to caudal abdomen. Moreover, a 6.39 x 8.54 cm heterogeneous mass in the medial mesogastric region became evident. The patient was hospitalized and submitted to exploratory laparotomy after 24 h due to rectal temperature increase (41°C), worsened abdominal pain, and intense apathy. There was free purulent liquid in abdominal cavity and two uterine horns were documented. The left uterine horn passes through inguinal ring and both horns were filled by purulent material. At the right uterine horn extremity there was the mass previously document at ultrasound. The structures were removed and sent to histopathological examination. The microscopic exam confirmed testicular and uterine tissue; furthermore, a Sertoli cell tumor and pyometra were also characterized. The dog was kept at the hospital receiving fluid, antibiotics, analgesics, and anti-inflammatory therapy. After five days the animal was discharged with clear clinical recover. A sample for karyotyping was collected from the oral mucosa which reveals a XY karyotype in the dog. By this way it was concluded that the dog suffers from a SDD XY with MDPS associated to cryptorchidism, Sertoli cell tumor and pyometra. Discussion: The MDPS cases are often associated with cryptorchidism and testicular tumors. Miniature Schnauzers is one of the most affected dog breeds with this condition, and the heritability pattern is already described. Most cases are identified in adult to old-aged dogs after vague clinical signs investigation such as apathy, anorexia and abdominal or inguinal enlargement, as observed in the present report. When Sertoli cell tumor are present, the hormone secretion pattern of this neoplasia may influence complications occurrence. Once higher estrogen levels may induce endometrial gland proliferation, hydrometra and pyometra are among these complications, as well as reduced hematopoiesis. Moreover, progesterone levels could be also increased favoring pyometra pathophysiology. By conclusion, despite very rare, MDPS should be investigated in Miniature Schnauzers with vague clinical signs, especially cryptorchidic ones. Karyotyping and histopathology were crucial to confirm the diagnosis. Moreover, no other case with MDPS, cryptorchidism, Sertoli cell tumor, and pyometra was found in the published literature consulted

Systemic Lupus Erythematosus Associated with Neurological Manifestations in a Border Collie Bitch

Background: Systemic lupus erythematosus (SLE) is an immune-mediated and multisystemic disorder which etiology is believed to be multifactorial. Its clinical signs vary accordingly to affected organs, cutaneous lesions being the most frequently observed. There are few reports of SLE in dogs with neurological manifestations. Therefore, the aim of this report is to describe a case of SLE in a dog with indicative signs of nervous system involvement.Case: A 6-year-old Border Collie bitch was referred to the Veterinary Hospital (HVU) of the University of Uberaba (UNIUBE) with a history of  with cluster seizures, inappetence and urinary incontinence. Erythema and flaking of nasal plan were noted on physical examination, and splenomegaly on abdominal palpation. Thrombocytopenia and slightly increased ALT were found on blood tests. Ehrlichiosis was suspected and doxycycline was prescribed together with phenobarbital for the control of seizures. In the follow-up visit, the dog was still presenting urinary incontinence, thrombocytopenia and splenomegaly. Also, an ulcer on the nasal mucocutaneous junction was observed. The patient went through a neurological examination which indicated thalamocortical lesion. Cerebrospinal fluid samples were obtained for cytology, culture and canine distemper test, and serology tests for leishmaniasis, toxoplasmosis and neosporosis were done. No alterations were found in these exams. The histopathology of the nasal lesion was proceeded and showed results consistent with lupus erythematosus. It was prescribed a 15-day course of prednisolone at immunosuppressive dose. The patient showed clinical improvement with this treatment. Azathioprine was started along with gradual removal of prednisolone. After twenty days of discontinuation of this drug, the dog presented epileptic seizures, urinary incontinence, thrombocytopenia, increased ALT and worsened nasal lesion. Prednisolone at immunosuppressive dose was reintroduced and the dose of azathioprine, increased. One week past this, the patient showed inappetence and an extensive hematoma in the thoracic region. Lab exams confirmed drug-induced acute pancreatitis. All medications were interrupted, the patient was hospitalized, and treatment for pancreatitis was initiated, but the dog passed away.Discussion: For involving multiple body systems and for presenting varied clinical signs, diagnosing SLE can be challenging in clinical routine. The dog from this report was a Border Collie; this breed is considered to be predisposed to this disease. The animal had a history of being exposed to solar radiation for a large part of the day, had dyspigmentation of nasal plan and had no application of sunscreen, predisposing the occurrence of SLE. Neurological signs are uncommon in SLE, but the seizures and the urinary incontinence were the main reasons for the dog’s guardian to look for medical assistance. The suspicion for SLE was raised due to cutaneous manifestations and persistent thrombocytopenia along with splenomegaly. Histopathological findings are essential for diagnosing SLE, as well as antinuclear antibody tests. Nonetheless, due to financial limitations, this last test was not performed. Azathioprine is an immunomodulating drug largely used along with glucocorticoids when treating SLE; however, this medication is prone to induce side effects as the ones presented by the dog from this report. Therefore, it is concluded that SLE should be considered as a differential diagnosis in patients showing cutaneous, hematological, systemic and neurological manifestations, considering the variety of signs caused by this disorder.Keywords: seizures, dog, immune-mediated encephalopathy. Lúpus eritematoso sistêmico associado a manifestações neurológicas em cadela da raça Border CollieDescritores: crises epilépticas, cão, encefalopatia imunomediada

Mixossarcoma esplênico em cão

Background: Myxosarcomas (MXS) are malignant mesenchymal neoplasms originated from mainly mucin producing fibroblasts than collagen. Despite malignant neoplasms, MXS is believed to have low metastase generation ability. Myxosarcomas reports in dogs are widespread, usually involving trunk and limbs subcutaneous tissue. The aim of this report is to describe clinical, pathological, and immunohistochemistry aspects of a rare case of splenic myxosarcoma in a dog.Case: A 10-year-old, intact male Basset Hound, weiging 25 kg, showing signals such apathy, dark soft-stooled stools, progressive thinning, and increasing abdominal enlargement, perceived three months ago was brought to clinical consultation. Physical examination showed extremely pale oral and ocular mucosas, in addition to mild dehydration (6%), 35.4°C rectal temperature, and a very bulging abdomen, with no fluids or gases, evidence at abdominal percussion. A complete blood count (CBC) revealed neutrophilic leukocytosis and anemia. Patient´s abdominal cavity ultrasound examination showed an heterogeneous mass, occupying large part of cavity, and apparently from spleen origin. A spleenic multilobulated mass measuring 25 x 12 x 20 cm was obtained after exploratory laparotomy. The mass showed predominantly soft consistency with some firm areas, and no visible mesentery or other abdominal organs adhesions. Mass and spleen histopathological examination were routinely processed for histological analysis with haematoxylin and eosin and alcian blue staining. In addition, fragments of the neoplasm were submitted to immunohistochemistry (IHC) which confirmed myxosarcoma diagnosis. The owner returned to hospital two months after, complaining for apathy, prostration, anorexia, and abdominal pain. A new ultrasound examination were suggestive of liver and kidneys neoplasms. The tutor opted for patient´s euthanasia. However, dog´s necropsy was not authorized.Discussion: Myxosarcomas are malignant tumors considered rare in small animals, affecting mainly middle age or advanced age patients. Corroborating with the present case, the main clinical signs identified in cases of splenic neoplasias, in general, are abdominal distention and algia, emaciation, prostration, anemia, hypothermia, and inappetence. Regarding neutrophilic leukocytosis and anemia in CBC, those alterations are atributable to paraneoplastic syndromes commonly observed in small animals. The diagnosis of myxosarcoma was based on the pathological and IHC findings. The mesenchymal origin of the neoplastic cells was confirmed by the expression of vimentin and by the absence of cytokeratin labeling in the immunohistochemical examination. It was possible to confirm the diagnosis due to the presence of large amount of mucopolysaccharides between the neoplastic cells, demonstrated through Alcian Blue staining. Although rare, there have been reports of metastasis from cardiac myxosarcoma in humans and splenic myxosarcomas in dogs. The patient’s resubmission in two months with a new nonspecific clinical picture and documentation of hepatic and renal masses supports the possibility of agressive metastatic disease in the present case, despite the non-authorization of the autopsy examination. It was concluded by the present case report that MXS, although uncommon in small animals, should be included as a differential diagnosis in cases of abdominal neoplasias. The histopathological analysis and the immunohistochemical examination of neoplasms are important and should be considered in order to establish diagnosis and prognosis in dogs. Despite not confirmed by post-morten examination, agressive metastic disease seems likely in the present report, and emphasize MXS´malignat nature

Müller’s duct persistence syndrome associated with cryptorchidism, Sertoli cell tumor and pyometra in a Miniature Schnauzer

Background: Sexual development disturbances (SDD) are divided in SDD with XX genotype (SDD XX) and SDD with XY genotype (SDD XY). Among SDD XY, the Müller’s duct persistence syndrome (MDPS) is characterized by XY karyotype individuals with male external genitals; however, with internal female reproductive organs such as uterine horns, uterus, and cranial vagina portion. The MDPS cases and their related complications are considered very rare in veterinary medicine. The aim of the present case report is to describe the clinical and pathological aspects of a MDPS case associated with cryptorchidism, Sertoli cell tumor, and pyometra in a Miniature Schnauzer dog. Case: A 7-year-old male Miniature Schnauzer weighting 7 kg was brought to veterinary consultation due to owner’s complain of frequent vomiting, apathy, abdominal algia and progressive scrotal enlargement in the last two months. Physical exam reveals hyperthermia (39.7°C), discrete dehydration, enlarged popliteal lymph nodes as well as scrotum enlargement with only one palpable testicle. A blood sample collected for complete blood count showed regenerative anemia, thrombocytopenia, and neutrophilia with left shift in the leukogram. Abdominal ultrasound examination indicated the presence of a tubular structure filled by anechoic content extending from the scrotum to caudal abdomen. Moreover, a 6.39 x 8.54 cm heterogeneous mass in the medial mesogastric region became evident. The patient was hospitalized and submitted to exploratory laparotomy after 24 h due to rectal temperature increase (41°C), worsened abdominal pain, and intense apathy. There was free purulent liquid in abdominal cavity and two uterine horns were documented. The left uterine horn passes through inguinal ring and both horns were filled by purulent material. At the right uterine horn extremity there was the mass previously document at ultrasound. The structures were removed and sent to histopathological examination. The microscopic exam confirmed testicular and uterine tissue; furthermore, a Sertoli cell tumor and pyometra were also characterized. The dog was kept at the hospital receiving fluid, antibiotics, analgesics, and anti-inflammatory therapy. After five days the animal was discharged with clear clinical recover. A sample for karyotyping was collected from the oral mucosa which reveals a XY karyotype in the dog. By this way it was concluded that the dog suffers from a SDD XY with MDPS associated to cryptorchidism, Sertoli cell tumor and pyometra. Discussion: The MDPS cases are often associated with cryptorchidism and testicular tumors. Miniature Schnauzers is one of the most affected dog breeds with this condition, and the heritability pattern is already described. Most cases are identified in adult to old-aged dogs after vague clinical signs investigation such as apathy, anorexia and abdominal or inguinal enlargement, as observed in the present report. When Sertoli cell tumor are present, the hormone secretion pattern of this neoplasia may influence complications occurrence. Once higher estrogen levels may induce endometrial gland proliferation, hydrometra and pyometra are among these complications, as well as reduced hematopoiesis. Moreover, progesterone levels could be also increased favoring pyometra pathophysiology. By conclusion, despite very rare, MDPS should be investigated in Miniature Schnauzers with vague clinical signs, especially cryptorchidic ones. Karyotyping and histopathology were crucial to confirm the diagnosis. Moreover, no other case with MDPS, cryptorchidism, Sertoli cell tumor, and pyometra was found in the published literature consulted

Splenic myxosarcoma in a dog

Background: Myxosarcomas (MXS) are malignant mesenchymal neoplasms originated from mainly mucin producing fibroblasts than collagen. Despite malignant neoplasms, MXS is believed to have low metastase generation ability. Myxosarcomas reports in dogs are widespread, usually involving trunk and limbs subcutaneous tissue. The aim of this report is to describe clinical, pathological, and immunohistochemistry aspects of a rare case of splenic myxosarcoma in a dog. Case: A 10-year-old, intact male Basset Hound, weiging 25 kg, showing signals such apathy, dark soft-stooled stools, progressive thinning, and increasing abdominal enlargement, perceived three months ago was brought to clinical consultation. Physical examination showed extremely pale oral and ocular mucosas, in addition to mild dehydration (6%), 35.4°C rectal temperature, and a very bulging abdomen, with no fluids or gases, evidence at abdominal percussion. A complete blood count (CBC) revealed neutrophilic leukocytosis and anemia. Patient´s abdominal cavity ultrasound examination showed an heterogeneous mass, occupying large part of cavity, and apparently from spleen origin. A spleenic multilobulated mass measuring 25 x 12 x 20 cm was obtained after exploratory laparotomy. The mass showed predominantly soft consistency with some firm areas, and no visible mesentery or other abdominal organs adhesions. Mass and spleen histopathological examination were routinely processed for histological analysis with haematoxylin and eosin and alcian blue staining. In addition, fragments of the neoplasm were submitted to immunohistochemistry (IHC) which confirmed myxosarcoma diagnosis. The owner returned to hospital two months after, complaining for apathy, prostration, anorexia, and abdominal pain. A new ultrasound examination were suggestive of liver and kidneys neoplasms. The tutor opted for patient´s euthanasia. However, dog´s necropsy was not authorized Discussion: Myxosarcomas are malignant tumors considered rare in small animals, affecting mainly middle age or advanced age patients. Corroborating with the present case, the main clinical signs identified in cases of splenic neoplasias, in general, are abdominal distention and algia, emaciation, prostration, anemia, hypothermia, and inappetence. Regarding neutrophilic leukocytosis and anemia in CBC, those alterations are atributable to paraneoplastic syndromes commonly observed in small animals. The diagnosis of myxosarcoma was based on the pathological and IHC findings. The mesenchymal origin of the neoplastic cells was confirmed by the expression of vimentin and by the absence of cytokeratin labeling in the immunohistochemical examination. It was possible to confirm the diagnosis due to the presence of large amount of mucopolysaccharides between the neoplastic cells, demonstrated through Alcian Blue staining. Although rare, there have been reports of metastasis from cardiac myxosarcoma in humans and splenic myxosarcomas in dogs. The patient’s resubmission in two months with a new nonspecific clinical picture and documentation of hepatic and renal masses supports the possibility of agressive metastatic disease in the present case, despite the non-authorization of the autopsy examination. It was concluded by the present case report that MXS, although uncommon in small animals, should be included as a differential diagnosis in cases of abdominal neoplasias. The histopathological analysis and the immunohistochemical examination of neoplasms are important and should be considered in order to establish diagnosis and prognosis in dogs. Despite not confirmed by post-morten examination, agressive metastic disease seems likely in the present report, and emphasize MXS´malignat nature

Splenic myxosarcoma in a dog

Background: Myxosarcomas (MXS) are malignant mesenchymal neoplasms originated from mainly mucin producing fibroblasts than collagen. Despite malignant neoplasms, MXS is believed to have low metastase generation ability. Myxosarcomas reports in dogs are widespread, usually involving trunk and limbs subcutaneous tissue. The aim of this report is to describe clinical, pathological, and immunohistochemistry aspects of a rare case of splenic myxosarcoma in a dog. Case: A 10-year-old, intact male Basset Hound, weiging 25 kg, showing signals such apathy, dark soft-stooled stools, progressive thinning, and increasing abdominal enlargement, perceived three months ago was brought to clinical consultation. Physical examination showed extremely pale oral and ocular mucosas, in addition to mild dehydration (6%), 35.4°C rectal temperature, and a very bulging abdomen, with no fluids or gases, evidence at abdominal percussion. A complete blood count (CBC) revealed neutrophilic leukocytosis and anemia. Patient´s abdominal cavity ultrasound examination showed an heterogeneous mass, occupying large part of cavity, and apparently from spleen origin. A spleenic multilobulated mass measuring 25 x 12 x 20 cm was obtained after exploratory laparotomy. The mass showed predominantly soft consistency with some firm areas, and no visible mesentery or other abdominal organs adhesions. Mass and spleen histopathological examination were routinely processed for histological analysis with haematoxylin and eosin and alcian blue staining. In addition, fragments of the neoplasm were submitted to immunohistochemistry (IHC) which confirmed myxosarcoma diagnosis. The owner returned to hospital two months after, complaining for apathy, prostration, anorexia, and abdominal pain. A new ultrasound examination were suggestive of liver and kidneys neoplasms. The tutor opted for patient´s euthanasia. However, dog´s necropsy was not authorized Discussion: Myxosarcomas are malignant tumors considered rare in small animals, affecting mainly middle age or advanced age patients. Corroborating with the present case, the main clinical signs identified in cases of splenic neoplasias, in general, are abdominal distention and algia, emaciation, prostration, anemia, hypothermia, and inappetence. Regarding neutrophilic leukocytosis and anemia in CBC, those alterations are atributable to paraneoplastic syndromes commonly observed in small animals. The diagnosis of myxosarcoma was based on the pathological and IHC findings. The mesenchymal origin of the neoplastic cells was confirmed by the expression of vimentin and by the absence of cytokeratin labeling in the immunohistochemical examination. It was possible to confirm the diagnosis due to the presence of large amount of mucopolysaccharides between the neoplastic cells, demonstrated through Alcian Blue staining. Although rare, there have been reports of metastasis from cardiac myxosarcoma in humans and splenic myxosarcomas in dogs. The patient’s resubmission in two months with a new nonspecific clinical picture and documentation of hepatic and renal masses supports the possibility of agressive metastatic disease in the present case, despite the non-authorization of the autopsy examination. It was concluded by the present case report that MXS, although uncommon in small animals, should be included as a differential diagnosis in cases of abdominal neoplasias. The histopathological analysis and the immunohistochemical examination of neoplasms are important and should be considered in order to establish diagnosis and prognosis in dogs. Despite not confirmed by post-morten examination, agressive metastic disease seems likely in the present report, and emphasize MXS´malignat nature