Renal carcinomatosis in a horse

Cancer of unknown primary in a mare: case report and comparative pathology review

A 25-y-old Percheron mare was admitted to the teaching hospital because of lethargy and intractable dyspnea. Thoracoabdominal ultrasound examination identified severe peritoneal effusion, mild bilateral pleural effusion, and a diffuse pulmonary nodular pattern. Cytology of peritoneal fluid revealed a hypercellular sample with clusters of neoplastic polygonal cells and admixed macrophages. Euthanasia was followed by postmortem examination; marked bi-cavitary effusion was present, and innumerable up to 4-cm diameter, round-to-floriform nodules were diffusely evident throughout serosal surfaces as well as the pulmonary and hepatic parenchyma. Disseminated adenocarcinoma, predominantly affecting lung and liver with widespread serosal implantation, was confirmed on light microscopy. Neoplastic cells had strong immunolabeling for pancytokeratin and lacked immunoreactivity to vimentin, napsin A, and Pax8. Cytokeratin 7 and thyroid transcription factor-1 were non-contributory given absent and inconsistent internal control reactivity, respectively. Such results, combined with the lack of a major mass that would indicate a primary site, were supportive of carcinoma of unknown primary site, which remains a conundrum in human oncology, and is poorly explored in veterinary medicine, mainly as a result of clinical and diagnostic limitations.

Presumed Neuroglycopenia Caused by Severe Hypoglycemia in Horses

BACKGROUND

Neuroglycopenia refers to a shortage of glucose in the brain resulting in neuronal dysfunction and death if left untreated. Presumed neuroglycopenia has not been described in horses.

OBJECTIVE

To report neurological signs in horses with presumed neuroglycopenia as the result of severe hypoglycemia.

ANIMALS

Ninety horses (hours to 28 years of age) diagnosed with hypoglycemia (blood glucose concentration < 75 mg/dL [< 4.2 mmol/L]).

METHODS

Retrospective study. Electronic medical records were searched. Signalment, history, complaint, clinical signs, laboratory findings including CSF analysis, electroencephalogram, clinical or definitive diagnosis, and outcome were recorded. Kruskal-Wallis analysis of variance and logistic regression were used to investigate association between blood glucose concentration and data extracted. Statistical significance was set at P < 0.05.

RESULTS

Thirty-eight and 52 horses had mild (50-74 mg/dL [2.8-4.1 mmol/L]), and severe hypoglycemia (< 50 mg/dL [< 2.8 mmol/L]), respectively. Most common causes of hypoglycemia included liver and gastrointestinal (40%) disease, sepsis (33%), neoplasia (7%), and insulin-induced (4%). Most common neurologic deficits included obtundation (100%), seizures (42%), and disorientation (22%). CSF-glucose was severely low (mean 2.5 mg/dL [0.1 mmol/L], median 0 mg/dL). Paroxysmal discharges in support of seizures were identified in the occipital (visual) and parietal (closest to temporal-auditory) cortical regions upon EEG examination (8/8 horses).

CONCLUSIONS AND CLINICAL IMPORTANCE

Neuroglycopenia is presumed to occur in horses as the result of severe hypoglycemia. Subclinical seizures, and intermittent blindness and deafness of cortical origin can occur. Severe altered state of consciousness and seizures can be observed at a blood glucose cut-off value of < 42 mg/dL (< 2.3 mmol/L).

Renal neoplasia in horses - a retrospective study

OBJECTIVE

Being confronted with a case series of renal neoplasia in several horses which was in striking divergence to literature data, we recognized the need of a retrospective study to assess the presence of renal neoplasms in horses.

MATERIAL AND METHODS

Anamnestic animal data, necropsy findings and results of histological and immunohistochemical examinations from 2010 through 2015 were collected and evaluated regarding renal neoplasia.

RESULTS

Data from postmortem examinations of 1069 horses revealed 20 horses with renal tumors constituting a prevalence of 1.87 %. Primary renal neoplasms built the majority of cases (n = 15; 75 % of total renal neoplasms) and comprised nine renal carcinomas, four renal adenomas, one renal neuroendocrine tumor and a single nephroblastoma. Among the five secondary renal neoplasms lymphosarcoma was most common (3/5). Remaining metastatic tumors comprised one melanoma and one hemangiosarcoma. No breed or sex predilections were noticeable. Except for the case of nephroblastoma in a stillborn foal, all horses presenting with renal tumors were more than 10 years of age, often older than 20 years. Anamnestic data and clinical symptoms were inconclusive and not assigned to renal disease in most cases. Merely one horse with renal carcinoma presented with renal insufficiency and two horses showed signs of shock due to severe bleeding after tumor capsule rupture in renal carcinoma.

CONCLUSION AND CLINICAL RELEVANCE

Renal tumors occur more often than anticipated, especially in older horses. Contradictorily to the literature, primary renal tumors significantly outnumbered secondary neoplasms in this study.

Acute lameness associated with osseous metastasis of a peri-renal carcinoma in a horse

We present a case of aggressive metastatic carcinoma in a horse that was initially presented for shoulder lameness. Although radiography and scintigraphy were useful for localising a lesion in the proximal humerus, subsequent development of non-specific signs of systemic disease prompted further evaluation. Haematology and blood biochemistry, urinalysis and ultrasonography were all instrumental in identifying renal involvement. A diagnosis of a peri-renal mass causing secondary renal failure prompted euthanasia of the horse because of the poor prognosis. Antemortem findings were supported by necropsy, with secondary lesions also identified in the spleen, liver, 8th left rib and proximal humerus. Histological examination yielded a diagnosis of undifferentiated metastatic carcinoma.

Urinary tract neoplasia

This article is a review of reports on neoplasia of the equine urinary tract. Clinical signs associated with equine patients with urinary tract neoplasia are summarized along with a description of diagnostic methods used in such patients. The prognosis for treatment of urinary tract neoplasia is guarded. A review of the limited treatments that have been reported to date are also provided in this article.

Clinical and pathological studies in horses with hepatic disease

In horses with hepatic necrosis, lipidosis, neoplasia and cirrhosis, progression of the disease was studied by serial measurements of total serum bile acid concentrations and of plasma glutamate dehydrogenase (GD) and gamma glutamyl transferase (gamma GT) and by liver biopsy. Plasma ammonia concentrations were significantly elevated compared to clinically normal horses, but such changes were not always accompanied by a decline in plasma urea concentration. A fall in plasma glucose concentration carried a guarded prognosis. These were all invaluable aids in early diagnosis and throughout the disease course. The study suggests that other factors, such as hypokalaemia, alkalosis, short chain volatile fatty acids, false and true neurotransmitters, may be important in the pathogenesis of hepatic coma in the horse.