Nonregenerative Anemia Research Articles

Polycystic Kidney Disease in 3 Juvenile Rainbow Lorikeets (Trichoglossus moluccanus).

This case series describes polycystic kidney disease in 3 (2 male, 1 female) 2-month-old, juvenile rainbow lorikeets (Trichoglossus moluccanus). The lorikeets diagnosed with polycystic kidney disease were the progeny of full sibling parents that were being intentionally line bred for the purpose of establishing a rainbow lorikeet with the blue color mutation. Clinically the juvenile lorikeets were presented with clinical signs of lethargy, dehydration, regurgitation, anorexia, polyuria, and pelvic limb paresis. Multiple abnormalities were identified on the complete blood count and plasma biochemistry panel, including a normocytic normochromic nonregenerative anemia, hyperuricemia, hyperphosphatemia, hypercalcemia, and azotemia. Severe renal dysfunction was diagnosed in all birds on the basis of clinical presentation, physical examination, and complete blood count and plasma biochemistry results. Radiographically marked renomegaly was noted in one of the cases. Although intensive critical care and supportive therapy was provided, 1 lorikeet died, and the remaining 2 were euthanatized because of client financial constraints and a rapid deterioration of their clinical condition associated with severe renal dysfunction. Postmortem pathology results found that all birds had marked renomegaly, visceral gout, and polycystic kidney disease. Because of the age of the birds and the line breeding within this group of lorikeets, the disease was believed to be inherited. Polycystic kidney disease should be considered as a possible differential diagnosis in juvenile psittacine birds with a history of line breeding when presented with severe renal dysfunction. From the current case series, polycystic kidney disease appears to carry a grave prognosis in juvenile rainbow lorikeets.

Cellular Elements of the Human's Bone Marrow

Examination of bone marrow may be a valuable diagnostic tool in the differential diagnosis of diseasessuch as:• Diseases associated either with a decrease or increase in cellular elements in the peripheral blood.• The appearance of abnormal cells in the peripheral blood.• When a peripheral blood count indicates the presence of leukopaenia• In cases of nonregenerative anemia• When thrombocytopaenia appear in the peripheral blood.• In confirming a diagnosis of leukemia and in differentiating it from a leukemoid reaction.

AUSTWICKIA CHELONAE IN A WILD GOPHER TORTOISE (GOPHERUS POLYPHEMUS) AND EVIDENCE OF POSITIVE SELECTION ON THE DIPHTHERIA-LIKE TOXIN GENE.

Austwickia (Dermatophilus) chelonae is a filamentous, Gram-positive Actinobacteria in the Dermatophilaceae family. It has caused fatal granulomatous disease in diverse captive reptile species on three continents, but its presence in wild or free-ranging populations was unknown. An adult female gopher tortoise (Gopherus polyphemus) was presented euhydrated, but cachectic and infested with ticks, with two firm, encapsulated masses over the cranioventral neck and right stifle. The tortoise had moderate nonregenerative anemia and evidence of inflammation; plasma biochemistry data was within normal limits. Fine needle aspirate of the neck lesion revealed abundant necrosis and aggregates of cocci. Computed tomography delineated the masses and revealed an additional mass adjacent to the left zygomatic bone. After surgical excision, histology identified chronic granulomas with intralesional filamentous bacteria. Pan-bacterial 16S rRNA PCR and sequencing of the masses identified A. chelonae. Despite treatment with oxytetracycline and ceftazidime, the tortoise deteriorated and was euthanatized. An esophageal lesion consistent with A. chelonae was seen on postmortem examination, although it was determined that the tortoise ultimately succumbed to fungal pneumonia caused by Metarhizium robertsii, an entomopathogenic biotoxin sprayed as insect control. This case reveals A. chelonae is present in free-ranging chelonians in North America. This organism produces a toxin gene similar to diphtheria toxin, one of the most potent known biotoxins, which has not been previously identified outside the genus Corynebacterium. Novel PCR primers were designed for the toxin and rpoB genes, which were amplified and sequenced from two cases and compared with two available genomes. Selection analysis revealed that the toxin gene is under positive selection, which implies it interacts significantly with the immune system, making it a good candidate for immunodiagnostic test development.

Comparative evaluation of darbepoetin therapy in non-regenerative anaemia associated with Babesia gibsoni infection in dogs

The present study describes a comparative evaluation of haemato-therapeutic response to darbepoetin therapy in non-regenerative anaemia associated with Babesia gibsoni infection in dogs. A total of 68 dogs, presented at Teaching Veterinary Clinical Complex, Mannuthy with signs of anaemia, weakness, anorexia and pallor of mucous membranes were screened for nonregenerative anaemia. Twenty dogs with a reticulocyte count of < 60,000/μL, haematocrit of < 30 per cent and positive for B. gibsoni were selected for detailed study. The twenty dogs were divided into two groups of ten animals and were subjected to estimation of complete blood count and analysis of serum protein and iron status. Ten dogs brought to the hospital for vaccination or health check-up served as healthy control. Haematological examination revealed significant anaemia and thrombocytopenia in both the groups. Serum total protein, albumin and total iron binding capacity revealed no difference between diseased groups with the healthy control. Serum iron and percentage transferrin saturation were similar in Group I and II, but significantly higher than healthy control. To compare darbepoetin efficacy, Group I dogs were administered with clindamycin and doxycycline for three weeks, whereas Group II was given with darbepoetin at the dose rate of 0.5 μg/kg body weight at weekly intervals for three weeks in addition to clindamycin-doxycycline as in Group I. Dogs of both groups showed complete remission of clinical signs within 10 days of therapy. Statistical analysis revealed no significant difference in haematological parameters between the treatment groups. It can be concluded from this study that there is no added advantage of darbepoetin therapy over conventional therapies against non-regenerative anaemia associated with B. gibsoni infection in dogs.

Molecular detection and control of non- regenerative anaemia associated with Babesia gibsoni and Anaplasma platys co- infection in a dog

Anaemia and thrombocytopenia are the common clinical features of blood parasite infection in dogs. Blood parasites previously identified in dogs in Kerala were Babesia gibsoni, Babesia canis vogeli, Ehrlichia canis and Trypanosoma evansi. A two-year old female Labrador Retriever was brought to the University Veterinary Hospital, Mannuthy, Thrissur, with a complaint of anorexia for the past two weeks. A thorough clinical examination did not give any evidence of involvement of other body systems, except for a splenomegaly which was confirmed by radiography. The dog was negative for microfilaria and intestinal parasites. Haematological findings revealed moderate anaemia and thrombocytopenia. Anaemia was classified as non-regenerative based on reticulocyte count. Blood smear was positive for basophilic intra-erythrocytic inclusions suggestive of small babesia and basophilic inclusions in platelets suggestive of morula of Anaplasma spp. Species-specific PCR on whole blood genomic DNA-showed specific amplification for B. gibsoni and A. platys organisms and negative for B. canis vogeli, E. canis and T. evansi. The present study reports a case of non-regenerative anaemia due to B. gibsoni and A. platys co-infection in a dog and its successful therapeutic management. This is the second report of A. platys infection in dogs in Kerala, India.

Infecção natural e detecção molecular de Cytauxzoon felis em Puma concolor de vida livre no estado de Goiás, Brasil

ABSTRACT: The puma (Puma concolor Linnaeus, 1771), the most widely distributed felid species in the Americas, can be found in all Brazilian biomes. Nevertheless, few studies have focused on hemoparasites in this species. Cytauxzoon felis, a hemoparasite that can infect domestic cats, has also been described in wild felids in Brazil. To the best of our knowledge, this study is the first to diagnose the natural infection and molecular detection of C. felis in a P. concolor in the state of Goiás. This animal presented non-regenerative anemia and inclusion suggestive of piroplasmids within red blood cells. The amplified 551 bp fragment of partial Piroplasmida 18S rRNA gene sequence was 100% identical to corresponding sequences of C. felis available in GenBank. No specific treatment for cytauxzoonosis was administered, and after rehabilitation, the animal was reintroduced into the wild. This finding provides some evidence that P. concolor may act as a natural host of the parasite. The epidemiology, vector and pathogenicity of this hemoparasite in wild and domestic cats in Brazil deserves further investigation.

Budd-Chiari Like Syndrome in a Dog: Hematology, Biochemistry, Histopathology and CT Scan Angiography Findings

A nine months old mix breed dog was presented by lethargy, symptoms of abdominal pain, mild respiratory distress and abrupt onset of massive and hemorrhagic ascitesthat responded to medical treatments partially. The dog had a history of car accidentthree months earlier. Mild non-regenerative microcytic anemia,hypoalbuminemia, hypoproteinemia, elevated liver enzymes, mild pulmonary edema and high protein transudate in abdominal cavity weredetected. Abdominal ultrasonography demonstrated hepatomegaly and intra-abdominal fluid collection. Histopathological examination of the liver biopsy showed a diffuse sinusoidal distension with some area of hepatocyte necrosis. The histopathological findings, together with increased level of liver enzymes, and moderate panhypoproteinemia, high protein transudate and abdominal pain were all in favorof the diagnosis of post-sinusoidal hypertension secondary to obstruction of hepatic venous outflow (Budd-Chiari-like syndrome). CT angiography confirmed a massive thrombosis in caudal vena cava and pulmonary artery. Unfortunately, 24 hours after CT scan study the patient was spontaneously expired. However, because the owner did not give his consent for the autopsy, the detailed data is not acquired. In conclusion, obstruction of venous blood flow and Budd-Chiari like syndrome must be considered in dogs with ascites, hepatomegaly, and symptoms abdominal pain.

High grade tibiofibular canine osteosarcoma in a 5-year-old female rottweiler

Osteosarcoma is a common neoplastic condition of the bone mostly affecting the appendicular bones in dogs. A five-year-old female Rottweiler was presented with a swollen left hind limb. Haematology showed mild nonregenerative anaemia, severe leukocytosis, and moderate neutrophilia with-out left shift, monocytosis, and severe lymphopenia. Fine needle aspirate (FNA) cytology revealed oval to spindle cells with marked cellular pleomorphism, anisocytosis, binucleation, and proteinaceous granules in the background while radiographic examination revealed osteolysis of the tibia and fibular with new bone formation. These findings are consistent with osteosarcoma. A diagnosis of osteosarcoma was made, based on the cytology and radiography. Surgical amputation of the complete left limb was carried out. However, the dog died of leptospirosis one month later. Post mortem examination revealed pulmonary metastasis of the osteosarcoma. Histopathology of the limb growth revealed oval to spindle cells with intracytoplasmic eosinophilic materials and osteoid matrix. Diagnosis and treatment of dogs affected by osteosarcoma should be comprehensive and complete, with adequate follow-up. The marked lymphopenia could be associated with poor prognosis, therefore an index for prognosis in osteosarcoma. The mortality, in this case, could have been related to leptospirosis and associated with the immunosuppression from tumour metastasis.

T-cell lymphoma-associated hemophagocytic syndrome in an American Pit Bull Terrier.

A 3-y-old, intact female, American Pit Bull Terrier was presented because of acute onset of anorexia and a large subcutaneous submandibular mass that had been present for 3 wk. The submandibular mass, 2 engorged black-legged ticks on the dorsum of the neck, pyrexia, and icterus were seen on physical examination. Abnormal laboratory test results included a positive Anaplasma antibody test, severe thrombocytopenia, mild nonregenerative anemia, hyperbilirubinemia, and elevated liver enzyme activities. Cytology of the mass was interpreted as marked septic purulent inflammation with acute hemorrhage. Treatment with doxycycline for anaplasmosis was unsuccessful, and the patient died at an emergency follow-up visit 2 d after the initial presentation. Autopsy and histopathology revealed widespread metastasis of a presumptive histiocytic neoplasm with associated hemophagocytosis seen in lymph nodes (LNs), liver, and spleen. Immunohistochemistry yielded a definitive diagnosis of a CD3+/CD18+ T-cell lymphoma. In this case of canine lymphoma-associated hemophagocytic syndrome, hemophagocytes were observed as >2% of neoplastic cells in the liver, spleen, and LN histologically, a scarce or unreported finding, to our knowledge. The prognosis was grave, with a short survival time after the onset of clinical signs.

Megaloblastic anemia-related iron overload and erythroid regulators: a case report

BackgroundIn ineffective erythropoiesis, hepcidin synthesis is suppressed by erythroid regulators, namely erythroferrone and growth differentiation factor-15. For the first time, the hypothesis that iron overload in megaloblastic anemia may be related to ineffective erythropoiesis is explored by describing the kinetics of hepcidin, erythroferrone, and growth differentiation factor-15 levels in a patient diagnosed with megaloblastic anemia associated with iron overload.Case presentationAn 81-year-old Caucasian male was admitted for fatigue. He had type-2 diabetes previously treated with metformin, ischemic cardiac insufficiency, and stage-3 chronic kidney disease. Vitiligo was observed on both hands. Biological tests revealed normocytic non-regenerative anemia associated with hemolysis, thrombocytopenia, and elevated sideremia, ferritin, and transferrin saturation levels. Megaloblastic anemia was confirmed with undetectable blood vitamin B12 and typical cytological findings like hyper-segmented neutrophils in blood and megaloblasts in bone marrow. The patient received vitamin B12 supplementation. At 3 months, biological parameters reached normal values. Hepcidin kinetics from diagnosis to 3 months inversely correlated with those of erythroferrone and growth differentiation factor-15.ConclusionsThis case suggests that iron-overload mechanisms of dyserythropoietic anemias may apply to megaloblastic anemias.

Gelatinous transformation of bone marrow in a rabbit.

A 9-y-old, spayed female rabbit was presented for evaluation of hypoglycemia and lateral recumbency. The patient was hypothermic and had diffuse muscle wasting; weight loss since a previous visit was also noted. Hematologic abnormalities included progressive nonregenerative anemia and severe heteropenia. Evaluation of a bone marrow aspirate sample revealed active hematopoiesis with abundant pink matrix. The matrix material stained positively with periodic acid-Schiff and alcian blue, and a diagnosis of gelatinous transformation of the bone marrow (GTBM, serous atrophy of fat) was made. Although its precise prevalence remains to be determined, GTBM should be suspected in rabbits with persistent cytopenias following prolonged starvation or gastrointestinal disease.

Atypical Case of Chronic Myeloid Leukemia (CML) in A Native Shepherd Dog in Duhok Province, Iraq

A typical case of a 7-years-old Kurdish male shepherd dog was referred with two weeks history of lethargy, restlessness, anorexia and severe emaciation. Physical examination of the dog revealed generalized lymphadenopathy, strong pale mucous membrane, systolic murmur of the heart, vomiting, bloody diarrhea and fever. Hematological abnormalities indicated moderate to marked leukocytosis characterized by 89% neutrophilia with a left shift to progranulocytes and 1.6% presumptive myeloid blasts, marked thrombocytopenia, marked non-regenerative normocytic hypochromic anemia and dysplasia in platelets and neutrophils. The histopathological examination revealed excessive infiltration with neoplastic myeloid cells that invaded all the internal organs. Bone marrow analysis revealed marked hypercellularity with a predominance of immature cells, marked myeloid 6.2%, dysplasia of neutrophils lineage and rare erythroid progenitors and numerous megakaryocytes. Enlargement of superficial and visceral lymph nodes and internal body organs, especially liver and spleen were observed in the autopsy after animal euthanasia. Our results confirmed that this dog was suffering from chronic myeloid leukemia. Statistically, there was a significant difference (P 0.05) was found between the mean values of leukocytic ratio in peripheral circulation and bone marrow. This is the first case report study that has been recorded in a native shepherd dog in a rural area around Duhok province/ Iraq.

Effect of anaemia and erythrocyte indices on canine glycated haemoglobin.

The major fraction of glycated haemoglobin (HbA1c) depends on blood glucose concentration and erythrocyte lifespan, and consequently erythrocyte indices may affect HbA1c; our objective was to study this effect in dogs. Blood samples from two (healthy and anaemic) age- and sex-matched, normoglycaemic populations were prospectively included. Advia 120 and Capillarys 2 flex-piercing were used for the haematological and HbA1c analyses, respectively. Lower mean HbA1c was found in dogs with regenerative (n = 8, 0.88 ± 0.58%) and non-regenerative anaemia (n = 12, 1.36 ± 0.56%) compared to healthy ones (n = 40, 1.68 ± 0.48%); the difference was significant (p < 0.001) between the healthy dogs and those with regenerative anaemia. HbA1c was significantly correlated (p < 0.05) with red blood cell count (r = 0.506), haemoglobin (r = 0.474), haematocrit (r = 0.467), mean corpuscular volume (r = -0.289), mean corpuscular haemoglobin concentration (r = 0.284), red cell distribution width (r = -0.286) and reticulocytes (rs = -0.542). Anaemia, particularly if regenerative, can lower HbA1c. The significant correlation between HbA1c and erythrocyte indices likely reflects the effect of erythrocyte turnover on HbA1c.

Mechanistic Evaluation of Black Cohosh Extract-Induced Genotoxicity in Human Cells.

Black cohosh extract (BCE) is marketed to women as an alternative to hormone replacement therapy for alleviating menopausal symptoms. Previous studies by the National Toxicology Program revealed that BCE induced micronuclei (MN) and a nonregenerative macrocytic anemia in rats and mice, likely caused by disruption of the folate metabolism pathway. Additional work using TK6 cells showed that BCE induced aneugenicity by destabilizing microtubules. In the present study, BCE-induced MN were confirmed in TK6 and HepG2 cells. We then evaluated BCE-induced DNA damage using the comet assay at multiple time points (0.5-24 h). Following a 0.5-h exposure, BCE induced significant, concentration-dependent increases in %tail DNA in TK6 cells only. Although DNA damage decreased in TK6 cells over time, likely due to repair, small but statistically significant levels of DNA damage were observed after 2 and 4 h exposures to 250 µg/ml BCE. A G1/S arrest in TK6 cells exposed to 125 µg/ml BCE (24 h) was accompanied by apoptosis and increased expression of γH2A.X, p-Chk1, p-Chk2, p53, and p21. Conditioning TK6 cells to physiological levels of folic acid (120 nM) did not increase the sensitivity of cells to BCE-induced DNA damage. BCE did not alter global DNA methylation in TK6 and HepG2 cells cultured in standard medium. Our results suggest that BCE induces acute DNA strand breaks which are quickly repaired in TK6 cells, whereas DNA damage seen at 4 and 24 h may reflect apoptosis. The present study supports that BCE is genotoxic mainly by inducing MN with an aneugenic mode of action.

Kangaroos at maximum capacity: health assessment of free-ranging eastern grey kangaroos on a coastal headland

Sprawling urban development is fragmenting the landscape and native wildlife habitats on the Australian east coast. The impact of this rapid urbanization on wildlife health is largely unknown. This study surveyed the health of a high-density (5.4 individuals per ha) population of eastern grey kangaroos (Macropus giganteus) affected by urban encroachment and prolonged drought. Blood parameters (hematological and serum protein), trace element and heavy metal concentrations, and parasite counts (fecal worm egg counts, ticks, and mites) are reported for a sample of ≤ 54 kangaroos at Look at Me Now Headland, New South Wales, Australia. These parameters were compared to lower density kangaroo populations from other sites in New South Wales. We found the health and welfare of this population to be severely compromised, with nonregenerative anemia and nutritional deficiencies evident. Our results indicate that high-density kangaroo populations isolated by urban encroachment are at significant health risk. To prevent further decline in this population’s health, we discuss management strategies that could be employed, concurrent with ongoing health and disease monitoring, to mitigate the poor health outcomes in this population. We conclude that it is essential to retain habitat connectivity when altering land use in areas with resident kangaroo populations if managers are to maintain healthy populations.

Clinical and Histopathological Features of Renal Maldevelopment in Boxer Dogs: A Retrospective Case Series (1999-2018).

Simple SummaryThis study describes clinical findings in Boxer dogs with renal maldevelopment and proposes a possible mode of inheritance. Medical records of 9 female Boxer dogs, older than 5 months and with a clinical diagnosis of proteinuric chronic kidney disease prior to one year of age, showed the presence of polyuria and polydipsia, decreased appetite, weight loss, lethargy and weakness in all affected dogs. Common laboratory findings were proteinuria and diluted urine, non-regenerative anemia, azotemia, hyperphosphatemia, hypoalbuminemia and hypercholesterolemia. Histopathology of the kidneys identified the presence of immature glomeruli in all dogs. In 7 out of 9 related dogs, the pedigree analysis showed that a simple autosomal recessive trait may be a possible mode of inheritance. Renal glomerular immaturity should be suspected in Boxer dogs with a history of polyuria, polydipsia, decreased appetite, weight loss, lethargy, weakness and proteinuria. A prompt diagnosis of renal maldevelopment, potentially hereditary, may help to evaluate if relatives of the affected dogs might be at risk, thus assisting clinicians in reaching an early diagnosis. A routine clinical renal screening evaluation in this breed, especially when this disease is suspected, should be strongly recommended.Renal maldevelopment (RM) has been proposed to replace the old and sometimes misused term “renal dysplasia” in dogs. Although renal dysplasia has been described in Boxers, hereditary transmission has only been hypothesized. This study reports clinical and renal histological findings in Boxer dogs with RM, proposing a possible mode of inheritance. Medical records of 9 female Boxer dogs, older than 5 months and with a clinical diagnosis of chronic kidney disease prior to one year of age, were retrospectively reviewed. Polyuria and polydipsia (PU/PD), decreased appetite, weight loss, lethargy and weakness were described in all affected dogs. Common laboratory findings were proteinuria, diluted urine, non-regenerative anemia, azotemia, hyperphosphatemia, hypoalbuminemia and hypercholesterolemia. Histopathology of the kidneys revealed the presence of immature glomeruli in all dogs, which is consistent with RM. In 7 related dogs, the pedigree analysis showed that a simple autosomal recessive trait may be a possible mode of inheritance. Renal maldevelopment should be suspected in young Boxer dogs with a history of PU/PD, decreased appetite, weight loss, lethargy, weakness and proteinuria. Due to its possible inheritance, an early diagnosis of RM may allow clinicians to promptly identify other potentially affected dogs among the relatives of the diagnosed case.

Characteristic vacuolisation of granulocytic and erythroid precursors associated with VEXAS syndrome.

A 78-year-old man with Sweet’s syndrome was referred for progressive anaemia. The full blood count showed macrocytic non-regenerative anaemia (haemoglobin concentration 82 g/l, mean cell volume 107 fl, reticulocytes 34 × 109/l) without neutropenia or thrombocytopenia. Bone marrow examination (images, ×100 objective) showed isolated dyserythropoiesis with basophilic stippling (top left), nuclear budding (bottom left), giant erythroblasts with nuclear:cytoplasmic asynchrony (bottom left) and 22% ring sideroblasts (Perls stain, top centre), without blast excess. This result was indicative of a myelodysplastic syndrome with ring sideroblasts and single lineage dysplasia (MDS-RS-SLD). Moreover, large vacuoles were observed in 20% of granulocytic (top right and bottom centre) and 10% of erythroid precursors (bottom right) but not in lymphocytes. Next-generation sequencing (NGS) did not reveal any classical MDS mutations but identified a UBA1 (ubiquitin-activating enzyme 1) M41L mutation (variant allele frequency 71%).

Central Nervous System Infiltration in Acute Lymphoblastic Leukemia in a Dog

Background: Acute lymphoblastic leukemia (ALL) is a malignant neoplasia in which there is proliferation of lymphoid progenitor cells in the bone marrow, blood, and extramedullary sites. This disorder has a fast and progressive development; in dogs, cases of infiltration of ALL cells in the central nervous system (CNS) are uncommon and rare. Diagnosis can be achieved with the help of the clinical history and physical, radiographic, hematological, myelographic, and cerebrospinal fluid (CSF) tests in patients with or without neurological clinical signs. The present report aims to describe a case of ALL and the presence of lymphoblasts in the CSF of a dog with neurological clinical signs.Case: An 8-year-old Lhasa Apso dog was examined at the Veterinary Hospital of Universidade Federal do Paraná, Curitiba campus. At the physical examination, the animal exhibited apathy and paralysis of pelvic limbs, which progressed to tetraplegia. Abdominal palpation revealed presence of hepatosplenomegaly and absence of lymphadenomegaly. No alterations were observed in radiographs of the cervical, thoracic or lumbar spine. A complete blood count revealed presence of non-regenerative anemia (hematocrit = 22%), extreme lymphocytosis (185,229 cells/µL), lymphoblasts at a level of 72% (133,364 cells/µL), and thrombocytopenia (66,000 platelets/µL). The biochemical tests revealed increased alkaline phosphatase (859 IU/L). The levels of alanine aminotransferase, creatinine, urea, total protein, albumin, and globulin were normal. The diagnosis of ALL was achieved with the help of a myelogram. The myelogram findings included 39% of mature lymphocytes and 59% of lymphoblasts exhibiting large size, spherical shape, poorly delimited borders, with a high nucleus/cytoplasm ratio, marked cytoplasmic basophilia, and 2 to 3 evident nucleoli; metarubricytes (1%) and promyelocytes (0.6%) were also observed. The CSF contained an increased number of nucleated cells (27 cells/µL) comprising lymphocytes (43%), macrophages (33%), and segmented neutrophils (24%). Of the 11.6 lymphocytes per µL of CSF, 8.1 were lymphoblasts, which indicates infiltration of ALL cells in the CNS. The animal died one day after collection of bone barrow and CSF. Discussion: Relevant alterations observed in this case included the neurological signs caused by the infiltration of neoplastic cells in the CNS, severe leukocytosis and lymphocytosis, with large amounts of lymphoblasts in the blood and predominance of lymphoblasts in the bone marrow, which are alterations typically found in ALL. The animal also exhibited non-regenerative anemia and thrombocytopenia, which were secondary to infiltration of leukemic cells in the bone marrow. The CSF exhibited pleocytosis (27 cells/ µL), and 30% of the cells observed were lymphoblasts. Lymphoblast infiltration in the CNS of leukemic dogs is rare, and other studies have reported absence of neurological signs or neurological signs different from those observed in the present study. CSF analysis in indicated in cases of leukemia to assess leukemic cell infiltration in the CNS. In the case reported here, the plasma level of alkaline phosphatase was increased (859 IU/L) as a consequence of hepatomegaly and hepatic cholestasis. ALL is a very aggressive, proliferative neoplasia, and the resulting lymphoblasts infiltrated the CNS of the animal. In cases of ALL, performing complete blood count, myelogram, and CSF analysis is indicated whether the patients exhibit neurological signs or not.

Atypical Spleen Hemophagocytic Histiocytic Sarcoma in a Dog

Background: The histiocytic sarcoma (HS) complex is a set of malignant neoplasms originating from interstitial dendritic cells or macrophages. When it involves macrophages of the splenic red pulp and bone marrow, it is referred to as hemophagocytic histiocytic sarcoma (HHS). HHS behaves more aggressively than HS and is usually fatal. HHS can be diagnosed by cytological and histopathological examination of neoplastic tissue. HHS is confirmed by immunohistochemistry using an anti-CD11d antibody. This neoplasm is often confused with immune-mediated hemolytic anemia or Evans syndrome due to erythrophagocytosis and platelet consumption. The clinical presentation of the animals progresses with evident anemia and thrombocytopenia, leading to signs such as prostration, inappetence, and pale mucosa, making diagnosis challenging and often late. This study aimed to report the clinic-pathological aspects of a canine with atypical hemophagocytic splenic HS.Case: A 4-year-old male Shih-Tzu canine was referred to the Veterinary Hospital with a history of prostration and anorexia. Pale mucous membranes were observed on physical examination. Blood tests revealed non-regenerative anemia, leukopenia, and thrombocytopenia. Serum protein levels were below the reference values for the species in biochemical examinations. Hemoparasitosis was suspected; however, the result of the polymerase chain reaction was negative. Abdominal ultrasound revealed a splenomegaly with heterogeneous parenchyma and a slightly irregular surface, but no visible mass in the spleen. Due to the difficulty of stabilizing the patient, even after successive transfusions, the animal underwent exploratory laparotomy with medial access and posterior splenectomy. Subsequently, the spleen was surgically removed, fixed in 10% buffered formalin, and processed routinely. Macroscopically, it had an irregular reddish-brown capsular surface. Histopathological examination of the spleen revealed a densely cellular neoplasm composed of round to spindle cells (histiocytes) arranged haphazardly in variably sized sheets separating the pre-existing spleen stroma. These histopathological findings were consistent with a histiocytic malignant neoplasm. Immunohistochemical analysis was performed to better define the origin of the histiocytic neoplasm. Neoplastic cells showed positive immunostaining of more than 80% of tumor cells for the CD11d antibody and weak immunostaining for CD11c and lysozyme. The patient survived for less than 30 days after the first hospital visit.Discussion: The diagnosis of HHS was based on the histological characteristics and positive immunostaining of more than 80% of the tumor cells for the CD11d antibody. HHS is an extremely aggressive and rare tumor that affects elderly dogs of any breed. In this study, HHS had atypical histologic characteristics, in which erythrophagocytosis and hemosiderin were not observed within macrophages. HHSs arise from macrophages of the red pulp of the spleen or bone marrow and express the b2 integrin, CD11d, and have low expression of CD1 and CD11c, which are predominantly expressed by non-hemophagocytic HS. The hematological and biochemical changes observed in this case were similar to those described in other dogs with HHS. Treatment of HHS is only palliative. Erlichia ewingii, E. canis, Anaplasma phagocytophilum, A. platys, Borrelia burgdorferi, Dirofilaria immitis, Leishmania infantum and immune-mediated hemolytic anemia are the main differential diagnoses because they cause anemia and thrombocytopenia accompanied by splenomegaly.Keywords: histiocytic sarcoma, spleen, immunohistochemistry, splenectomy, erythrophagocytosis.

A case of chronic lymphocytic leukemia masked by Cushing's disease in a dog.

A 12-year-old, 3.5-kg, intact female dog was presented with polyuria, polydipsia, and a pendulous abdomen. Laboratory examinations showed elevated hepatobiliary enzyme levels and neutrophilic leukocytosis. The adrenocorticotropic hormone stimulation test confirmed hyperadrenocorticism (HAC). Trilostane therapy managed the clinical condition and cortisol concentration. However, lymphocytosis and nonregenerative anemia developed after HAC remission. Bone marrow aspiration analysis revealed a lymphoproliferative disorder with a clonal T-cell population. Accordingly, the patient was diagnosed with T-cell chronic lymphocytic leukemia (CLL) and concurrent HAC. Thereafter, chemotherapy was initiated, which improved the lymphocytosis. However, euthanasia was performed because of worsening quality of life at 45 weeks after the first presentation. These results suggested that CLL could be masked by excessive endogenous cortisol and discovered after HAC remission.