Use of human intravenous immunoglobulin for the treatment of 12 dogs with newly diagnosed malignant disease and presumed secondary immune-mediated thrombocytopenia

OBJECTIVES

To evaluate the safety and efficacy of human intravenous immunoglobulin in dogs with newly diagnosed malignancy and presumed secondary immune-mediated thrombocytopenia.

MATERIALS AND METHODS

Twelve client-owned dogs with newly diagnosed malignant disease and presumed secondary immune-mediated thrombocytopenia were prospectively enrolled to receive a single infusion of human intravenous immunoglobulin at a dose of 0.5 to 1 mg/kg intravenous over 8 hours. A complete treatment response was defined as a platelet estimation of ≥40,000 platelets/μL within 24 hours and a partial response within 48 hours from the completion of human intravenous immunoglobulin infusion. No treatment response was defined as a platelet estimation remaining <40,000 platelets/μL over 48 hours from the completion of the human intravenous immunoglobulin infusion. This pilot study had a prospective, open-label, uncontrolled design.

RESULTS

Out of the 12 enrolled dogs, seven completed the study. A complete treatment response to human intravenous immunoglobulin was identified in one lymphoma dog and a partial response was noted in another lymphoma dog. The remaining 10 dogs had no response to human intravenous immunoglobulin. No clinically relevant adverse reactions to human intravenous immunoglobulin occurred in any of the 12 initially enrolled dogs during the infusion and over a 3-month follow-up period for the seven surviving dogs.

CLINICAL SIGNIFICANCE

The results of this study suggest that the use of human intravenous immunoglobulin in dogs with newly diagnosed malignant disease and presumed secondary immune-mediated thrombocytopenia appears safe, but not effective for the treatment of thrombocytopenia. Larger multi-centre, prospective, double-blinded, placebo-controlled, outcome-based, malignancy-specific studies are needed to further evaluate these preliminary findings.

A canine case of Ehrlichia canis infection without a history of being in an endemic area in Japan

A mixed-breed, 8-year-old male dog developed neutropenia, thrombocytopenia, and hyperglobulinemia. Bone marrow hyperplasia and splenic plasmacytosis were cytologically observed. The dog had never been outside of Tokyo or Shizuoka Prefecture. Splenectomy was performed to confirm and remove the cause of splenic plasmacytosis. A histopathological diagnosis of splenic plasmacytoma was made; however, serum protein electrophoresis showed polyclonal gammopathy. Further screening was performed, and Ehrlichia canis infection was confirmed. The dog was treated with doxycycline for 5 weeks. After the antibiotic therapy, no relapse of neutropenia, thrombocytopenia, hyperglobulinemia, or positive polymerase chain reaction result of E. canis infection was observed for 3 years. Careful attention should be given to ehrlichiosis when exploring the cause of pancytopenia or hyperglobulinemia, regardless of the travel history.

Retrospective evaluation of leflunomide as an adjunctive therapy in dogs with non-associative immune-mediated thrombocytopenia: 20 cases (2008-2021)

OBJECTIVE

To describe leflunomide as an adjunctive therapy in the treatment of non-associative immune-mediated thrombocytopenia.

MATERIALS AND METHODS

A retrospective study of dogs with a diagnosis of non-associative immune-mediated thrombocytopenia treated with leflunomide March 2008 to September 2021 was conducted. Data collected included signalment, clinical signs, physical examination findings and diagnostic testing performed. Medications administered, duration of hospital stay, time to platelet concentration >150×109/L and adverse events during leflunomide therapy were recorded. Relapses within a year of diagnosis were reported.

RESULTS

A total of 20 client-owned dogs met inclusion criteria. Nineteen of 20 dogs (95%) achieved a platelet concentration >150×109/L with leflunomide and prednisone combination therapy and four dogs (21.1%) relapsed during treatment or shortly after treatment. Adverse effects included diarrhoea (n=5), mild lymphopenia (n=9) and mild intermittent anaemia (n=1). A single dog developed hepatotoxicity presumed to be secondary to leflunomide therapy that resolved after drug discontinuation. One dog was treated for aspiration pneumonia during treatment. Two dogs were euthanased while receiving leflunomide.

CLINICAL SIGNIFICANCE

Length of hospitalisation, time to platelet recovery, treatment response and relapse rate were comparable with alternative treatment protocols. Most adverse effects did not require leflunomide dose adjustment; however, two dogs died while undergoing leflunomide treatment and there is compelling evidence that one of these dogs experienced fatal infection secondary to immune-suppression. Hepatotoxicity remains a known complication of leflunomide treatment and serial biochemistry testing is recommended.

Large granular lymphocyte lymphoma in 65 dogs (2005-2023)

Large granular lymphocyte lymphoma (LGLL) is a rare form of lymphoma in dogs. Limited information exists regarding presentation, treatment response, and outcome. The aim of this single-institute, retrospective study was to characterise clinical presentation, biologic behaviour, outcomes, and prognostic factors for dogs with LGLL. Cytologic review was also performed. Sixty-five dogs were included. The most common breed was the Labrador retriever (29.2%), and the most common presenting signs were lethargy (60.0%) and hyporexia (55.4%). The most common primary anatomic forms were hepatosplenic (32.8%) and gastrointestinal (20.7%). Twenty dogs (30.8%) had peripheral blood or bone marrow involvement. Thirty-two dogs were treated with maximum tolerated dose chemotherapy (MTDC) with a response documented in 74.1% of dogs. Dogs ≥7 years, and those with neutropenia or thrombocytopenia at diagnosis had the reduced likelihood of response to treatment. For dogs treated with MTDC median progression-free interval (PFI) was 17 days (range, 0-481), the median overall survival time (OST) 28 days (range, 3-421), and the 6-month and 1-year survival rates were 9.4% and 3.1%, respectively. On multivariable analysis, monocytosis and peripheral blood involvement were significantly associated with shorter PFI and OST. Long-term survival (≥100 days) was significantly associated with intermediate lymphocyte size on cytology. Dogs with LGLL have moderate response rates to chemotherapy but poor overall survival. Additional studies are needed to further evaluate prognostic factors and guide optimum treatment recommendations.

Identification of asinine gamma herpesviruses in a donkey with interstitial pulmonary fibrosis, pleural effusion and thrombocytopenia

A 23-year-old domestic donkey (Equus asinus) referred for severe respiratory distress due to suspected equine asthma. Ultrasound of the chest revealed bilateral irregular pulmonary consolidation and pleural effusion. Airway endoscopy and tracheal wash cytology showed severe neutrophilic inflammation and bacterial culture was positive for Streptococcus equi subsp. zooepidemicus. Despite aggressive treatment, the donkey died in 48 hours. On post-mortem examination, the lung was whitish, collapsed, and firm, with fibrotic multifocal nodular areas. Pleural effusion and pleuritis were detected. Histologically, the lung architecture was markedly replaced by interstitial fibrosis. The histological features observed were suggestive of a severe chronic fibrosing interstitial pleuropneumonia with type 2 pneumocyte hyperplasia and intralesional syncytial cells. Pulmonary fibrosis was associated with the presence of asinine gammaherpesvirus 2 and 5 infection, confirmed by PCR and sequence analysis. The macroscopic and histological pattern of fibrosis was diffuse and interstitial, and the nodular lesions were consistent with spared lung parenchyma, instead of the canonical nodular distribution of the fibrosis observed in equine multinodular pulmonary fibrosis. Asinine herpesviral pulmonary fibrosis is uncommon, but should be considered by clinicians in the list of differentials in donkeys with chronic respiratory signs.

The effect of ε-aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogs

BACKGROUND

No treatment other than platelet administration is known to protect against spontaneous hemorrhage in thrombocytopenic dogs.

OBJECTIVES

Primary: determine if treatment with ε-aminocaproic acid (EACA) decreases the requirement for blood transfusions and improves outcome in dogs with severe thrombocytopenia. Secondary: find evidence of hyperfibrinolysis and determine the effect EACA administration on rapid (rTEG) and tissue plasminogen activator-spiked (tPA-rTEG) thromboelastography parameters.

ANIMALS

Twenty-seven dogs with severe thrombocytopenia were treated with EACA, and data from an additional 33 were obtained from the hospital database as historical control (HC) cohort.

METHODS

Single arm clinical trial with HCs. The EACA group dogs received EACA (100 mg/kg IV followed by a constant-rate infusion [CRI] of 400 mg/kg/24 hours). Thromboelastography before and during EACA infusion, hospitalization days, number of transfusions, and mortality were compared.

RESULTS

No difference was found in number of transfusions per dog (median, interquartile range; 1, 0-2.5 vs 0.9, 0-2; P = .5) and hospitalization days (4, 4-6 vs 4.5, 3.75-6; P = .83) between HC and EACA groups, respectively, and no difference in survival was identified by log-rank analysis (P = .15). Maximum amplitude on both rTEG and tPA-rTEG increased after EACA administration (rTEG baseline: 23.6, 9.6-38.9; post-EACA: 27.3, 19.8-43.2; P < .001; tPA-rTEG baseline: 23, 10.9-37.2; post-EACA: 24.7, 16.7-44.8; P < .002).

CONCLUSIONS AND CLINICAL IMPORTANCE

Although EACA increased clot strength, there was no effect on outcome. Treatment with EACA at this dosage cannot be recommended as a routine treatment but may be considered for dogs with severe ongoing hemorrhage.

Comparison of timing of relapse in dogs with nonassociative immune-mediated hemolytic anemia, thrombocytopenia, or polyarthritis

BACKGROUND

Relapse is a clinical concern in dogs diagnosed with immune-mediated hemolytic anemia (IMHA), thrombocytopenia (ITP), or polyarthritis (IMPA). The average time to relapse is unknown, and evidence that vaccination is associated with disease relapse is lacking.

HYPOTHESIS/OBJECTIVES

Compare the incidence of relapse in groups of dogs with IMHA, ITP, or IMPA over a 24-month period after diagnosis and compare proportions of dogs that received vaccines in those dogs that did and did not relapse.

ANIMALS

One hundred sixty client-owned dogs (73 with IMHA, 55 with ITP, 32 with IMPA).

METHODS

Medical records of dogs were reviewed with the goal of following cases for a minimum of 2 years. Incidence of relapse was calculated for each disease, and relapse rates in dogs that were or were not vaccinated after diagnosis were compared.

RESULTS

Relapse rates at 12 months differed significantly among disease groups (P = .02), with a higher rate for IMPA (35%) compared to IMHA (11%) or ITP (11%). Relapse rate at 24 months was 41% for IMPA, 18% for IMHA, and 23% for ITP. Ninety percent of IMPA relapses occurred in the first 12 months after diagnosis, compared with 56% for IMHA and 50% for ITP. Vaccine administration after diagnosis was not associated with relapse (P = .78).

CONCLUSIONS AND CLINICAL IMPORTANCE

Risk of disease relapse in IMPA is highest in the first year after diagnosis, with a higher relapse rate compared with IMHA and ITP. The role of vaccination in disease relapse remains unclear.

Potent immunogenicity and neutralization of recombinant adeno-associated virus expressing the glycoprotein of severe fever with thrombocytopenia virus

Severe fever with thrombocytopenia syndrome (SFTS) is an infectious disease caused by a tick-borne virus called severe fever with thrombocytopenia syndrome virus (SFTSV). In recent years, human infections through contact with ticks and through contact with the bodily fluids of infected dogs and cats have been reported; however, no vaccine is currently available. SFTSV has two glycoproteins (Gn and Gc) on its envelope, which are vaccine-target antigens involved in immunogenicity. In the present study, we constructed novel SFTS vaccine candidates using an adeno-associated virus (AAV) vector to transport the SFTSV glycoprotein genome. AAV vectors are widely used in gene therapy and their safety has been confirmed in clinical trials. Recently, AAV vectors have been used to develop influenza and SARS-CoV-2 vaccines. Two types of vaccines (AAV9-SFTSV Gn and AAV9-SFTSV Gc) carrying SFTSV Gn and Gc genes were produced. The expression of Gn and Gc proteins in HEK293T cells was confirmed by infection with vaccines. These vaccines were inoculated into mice, and the collected sera produced anti-SFTS antibodies. Furthermore, sera from AAV9-SFTSV Gn infected mice showed a potent neutralizing ability, similar to previously reported SFTS vaccine candidates that protected animals from SFTSV infection. These findings suggest that this vaccine is a promising candidate for a new SFTS vaccine.

Hyperbetaglobulinemia, anaemia and thrombocytopenia in a domestic ferret (Mustela putorius furo) associated to Leishmania infantum

Leishmaniosis in domestic ferrets is a vector-borne disease caused in Europe by the protozoan parasite Leishmania infantum. There is limited information on clinical signs and laboratory abnormalities in ferrets due to leishmaniosis. This clinical case report described a domestic ferret (Mustela putorius furo) with severe hyperbetaglobulinemia, anaemia, thrombocytopenia, and abnormal renal parameters. A good clinical response following an anti-Leishmania infantum treatment protocol was achieved. However, the presence of pain at the site of injection was the main side effect due to meglumine antimoniate administration. Xanthine crystalluria was not observed in urine sediment with no other urine alterations detected by urine analysis during the follow-up. Initially, clinical signs noted in this ferret could not initially be attributed to leishmaniosis. However, no causes were found that could have caused the hyperglobulinemia in this patient. A reduction of the levels of anti-L. infantum serum antibodies and the concentrations of beta-globulin fraction was detected in this patient after anti-Leishmania treatment administered as well as the disappearance of thrombocytopenia. To extent of the knowledge of leishmaniosis in ferrets, this is the fourth case report of leishmaniosis documented in this species.

Doxorubicin and zoledronate treatment in a dog with hemophagocytic histiocytic sarcoma

A 6-year-old castrated male greyhound dog was referred for hemophagocytic histiocytic sarcoma (HHS) diagnosed following splenectomy. Severe thrombocytopenia, mild hypoalbuminemia, mild hypocholesterolemia, and mild hyperbilirubinemia were present. Abdominal ultrasound findings were concerning for hepatic metastasis. Doxorubicin and zoledronate combination therapy was initiated. The dog improved clinically and its thrombocytopenia, hypoalbuminemia, and hyperbilirubinemia resolved. The dog appeared well for 147 d before tumor progression was noted. The dog was treated with lomustine as a final measure, with no response. The dog survived for 6 mo with chemotherapy. To the authors' knowledge, this is the first report of clinical benefit of chemotherapy for HHS. Key clinical message: Doxorubicin should be considered for treating canine HHS since this variant of the disease is historically refractory to lomustine. Further research regarding efficacy of doxorubicin and zoledronate should be pursued.

Clinical and pathological factors associated with Ehrlichia canis in companion dogs

INTRODUCTION

Canine monocytic ehrlichiosis (CME) is a disease caused by the Gram-negative bacteria Ehrlichia canis, a bacterium that affects domestic dogs but can also infect humans. The diagnosis implies a challenge due to its diversity in clinical manifestations.

METHODOLOGY

The frequency of E. canis infection, risk factors, and clinical-pathological parameters associated with seropositivity were calculated with the PROC FREQ TABLES and PROC LOGISTIC procedures of the SAS statistical software.

RESULTS

The study showed a seroprevalence of 26.62% (156/586). Association between seropositivity and risk factors was found. The age and the presence of ticks including clinical signs such as anorexia, seizures, cough, petechiae, epistaxis, and hematochezia, as well as multiple blood and biochemical alterations were analyzed. The logistic regression analysis showed a high predictive power (c = 0.98) for CME for thrombocytopenia, leukopenia, and anemia.

CONCLUSIONS

The high prevalence of E. canis in endemic areas makes its diagnosis difficult. Thus, clinical signs must be considered, along with blood and biochemical alterations, as a possible predictor of the disease.

Evaluation of factors influencing survival time in 77 dogs with lymphoma

Background

Canine lymphoma is one of the most commonly reported hematopoietic tumors.

Aim

A few retrospective studies have involved complex evaluations including diagnostic features and treatment protocols, but these studies infrequently demonstrate variable factors that affect survival time, and comparisons among chemotherapeutic protocols are limited. This study aimed to identify prognostic factors that can be simply detected in dogs with lymphoma, such as abnormalities in physical and hematologic findings, and treatment protocols.

Methods

Clinical records of 77 dogs diagnosed with lymphoma were retrospectively reviewed.

Results

The author newly identified leukocyte and platelet abnormalities as negative prognostic factors. Furthermore, this study suggests that decreased gastrointestinal toxicity and improvements of hematologic abnormalities, such as anemia, thrombocytopenia, and lymphocytosis or lymphoblasts, in peripheral blood during chemotherapy act as positive prognostic factors. Finally, strict adherence to therapeutic protocol and selecting multiple agents as rescue protocol are important to prolong survival time.

Conclusion

This study identified indicators to be used as prognostic factors through survival analysis.

Clinical Assessment of Primary Hemostasis: A Review

Primary hemostatic disorders such as thrombocytopenia and thrombocytopathia are commonly encountered in small animal practice. The key stages of primary hemostasis include platelet adhesion, activation, and aggregation. Understanding the interaction between tissues, platelets, and signaling molecules not only helps clinicians comprehend clot formation but also better recognize thrombocytopathias. Although congenital thrombocytopathia is rare, commercially available platelet function tests allow veterinarians to narrow differentials in many clinical settings. Thrombocytopenia can be easily diagnosed in any clinical setting. In this paper, we review the current understanding of primary hemostasis in veterinary medicine, including the clinical presentation and available diagnostics to identify platelet abnormalities.

Contribution of Hemogram Plan in the Horse's Clinical Evaluation

The interpretation of the blood count is essential to help the equine clinician in the diagnosis, prognosis, patient management, and control of equine diseases. Hematologic alterations often reflect the condition of the individual or an overall response to a pathological situation. A thorough clinical examination of the patient is essential to correctly interpret the hematological results. The most common abnormalities in the erythrogram are mainly anemia and polycythemia. The frequent causes of anemia in horses are acute and chronic blood loss, hemolytic anemia, and anemia caused by chronic disease. Evaluation of leukogram, including a total white cell count, a differential cell count, absolute numbers of specific leukocytes can help identify abnormalities that may suggest specific diseases such as a viral or bacterial infection, inflammatory disorders or even a neoplastic process. The platelet count is most often used to monitor or diagnose conditions that cause too much bleeding related with thrombocytopenia; it can be due to multiple mechanisms such as reduction of thrombopoiesis (myeloptisis, myelofibrosis, myeloproliferative disease, and idiopathic medullary aplasias or due to the effect of mielosuppresive drugs), increased peripheral destruction of platelets (immune mediated thrombocytopenia), consumption (dissemined intravascular coagulation) sequestration of the spleen and loss of platelets by idiopathic origin.

Dose-dependent effect of canine lyophilized platelet on an in vitro hemodilution model

The transfusion of stored platelets has emerged as an efficient method for treating dogs with thrombocytopenia. However, the availability of fresh platelets is limited in veterinary medicine due to demanding storage conditions. Lyophilized platelets have long shelf lives and can be easily stored, increasing their accessibility for thrombocytopenic dogs. Due to the lack of research and information on the dose effect, canine lyophilized platelets are used at a clinical dosage without research-based evidence. This study was to evaluate the dose effect of lyophilized canine platelets on blood coagulability. Three different concentrations of lyophilized canine platelets were added to in vitro hemodilution blood model, increasing the platelet count by 25, 50, and 100 × 10⁶/ml and coagulation profiles were analyzed. The coagulability was evaluated via the plasma fibrinogen concentration, coagulation time, thromboelastography (TEG), and platelet function analyzer (PFA). Higher concentrations of lyophilized platelets showed dose-dependent association with decreased aPTT and R-time of TEG and increased alpha angle and MA of TEG. These results showed the potential that the higher dose of canine lyophilized platelets better improve blood coagulability than the standard dose and provided the basis for further safety and clinical studies.

Clinical features and epidemiology of severe fever with thrombocytopenia syndrome in dogs in the Republic of Korea: an observational study (2019-2020)

Severe fever with thrombocytopenia syndrome (SFTS) is a zoonotic disease with a high mortality rate for humans and cats. The clinical course and prognosis of SFTS in dogs remains unclear. In the present study, we investigated the clinical and epidemiological characteristics of SFTS virus (SFTSV) infection in dogs. All evaluated dogs exhibited an acute course and symptoms including fever (57.1%), anorexia (57.1%), depression (42.9%), and vomiting (35.7%). Thrombocytopenia was present in 45.5% of dogs, while jaundice was not observed. C-reactive protein, alanine transaminase, and alkaline phosphatase were elevated in some cases. Viral clearance occurred within 6 to 26 days. Phylogenetic analysis revealed that the SFTSV sequences were consistent with viruses circulating in the Republic of Korea. As dogs often live in close contact with humans, awareness of the clinical and epidemiological features of SFTS in dogs is crucial. Further large-scale studies are necessary to investigate SFTSV infection in dogs.

Lethal Disease in Dogs Naturally Infected with Severe Fever with Thrombocytopenia Syndrome Virus

Severe fever with the thrombocytopenia syndrome virus (SFTSV) causes fatal disease in humans, cats, and cheetahs. In this study, the information on seven dogs with SFTS was summarized. All dogs showed anorexia, high fever, leukopenia, and thrombocytopenia, two dogs showed vomiting and loose stool, and five dogs had tick parasites. All dogs also had a history of outdoor activity. The SFTSV gene was detected in all dogs. Remarkably, three dogs (43%) died. SFTSV was isolated from six dogs and the complete genomes were determined. A significant increase in anti-SFTSV-IgG antibodies was observed in two dogs after recovery, and anti-SFTSV-IgM antibodies were detected in four dogs in the acute phase. Using an ELISA cut-off value of 0.410 to discriminate between SFTSV-negative and positive dogs, the detection of anti-SFTSV-IgM antibodies was useful for the diagnosis of dogs with acute-phase SFTS. Four out of the ninety-eight SFTSV-negative dogs possessed high anti-SFTSV IgG antibody titers, indicating that some dogs can recover from SFTSV infection. In conclusion, SFTSV is lethal in some dogs, but many dogs recover from SFTSV infection.

[Occurrence of canine babesiosis in dogs in the Rhine-Main area of Hesse, Germany - a case study of 81 dogs]

OBJECTIVE

Canine babesiosis, an infectious disease transmitted by Dermacentor reticulatus, is exhibiting growing importance in Germany. The aim of this study was to display the increased incidence of canine babesiosis in the Rhine-Main area in Hesse, with special focus on the accumulation in the district of Groß-Gerau.

MATERIAL AND METHODS

The retrospective study included dogs presented to the veterinary hospital between October 2018 and December 2020 and diagnosed with canine babesiosis on the basis of a positive Babesia spp.-PCR.

RESULTS

A total of 697 dogs were tested by Babesia spp.-PCR during this time period. Of these, 81 (12 %) were positive.Sequencing was performed in 14 of the 81 dogs (17 %) (B. canis n = 13, B, vulpes n = 1). A simultaneous anaplasmosis infection was detected in 2 dogs. Strikingly, babesiosis cases occurred throughout the year with accumulations in March/April as well as in October.Evaluation of a complete blood cell count revealed pancytopenia in 44 of the 81 animals (54 %). Anemia was present in 66 (82 %), thrombocytopenia in 76 of the 81 patients (94 %). Only 2 of the 81 positive cases showed no hematological changes. Hyperbilirubinemia was found in 66 of 73 measured bilirubin levels (90 %).All animals were treated with two injections of imidocarb-diproprionate (Carbesia^®) in 14-day intervals. Follow-up PCR was performed in 37 of the 81 patients (46 %). In the majority of cases (92 %), successful therapy was confirmed by a negative Babesia-PCR. A total of 6 of the 81 patients (7 %) were euthanized during the treatment period. The reasons for euthanasia were progressive renal disease, high-grade intravascular hemolysis necessitating multiple blood transfusions, and development of splenic and renal abscesses.

CONCLUSION

In dogs with clinical signs such as apathy, pyrexia and hemoglobinuria, as well as hematologic abnormalities comprising anemia, thrombocytopenia as well as pancytopenia, babesiosis needs to be included in the list of differential diagnoses. Testing should be initiated accordingly regardless of the season, however especially in spring and autumn.

A case report of fatal feline babesiosis caused by Babesia canis in north western Spain

BACKGROUND

In Europe, Babesia infections in cats are sporadic and only partial knowledge is currently available since the number of described cases including both the clinical presentation and the molecular identification of the Babesia species involved is limited. In the present case report, the clinical signs, the epidemiological data and the molecular results suggest that this is the first reported fatal case of feline babesiosis caused by Babesia canis.

CASE PRESENTATION

A six month old female European shorthair cat from north-western Spain died after being hospitalized for two days. This animal was pregnant and showed anorexia, lethargy, weakness, jaundice and fever with increased respiratory and heart rates. Haematological analysis revealed haemolytic regenerative anaemia, thrombocytopenia and leukocytosis. The presence of piroplasms was assessed using a PCR targeting the 18S rRNA gene of Babesia spp. and Theileria spp.; the sample resulted positive and B. canis was identified by DNA sequence analysis. The possible existence of co-infections with other vector-borne pathogens such as Anaplasma spp., Bartonella spp., Borrelia burgdorferi s.l., Cytauxzoon spp., Ehrlichia spp., Hepatozoon canis, Mycoplasma spp. or Rickettsia spp. was excluded by qPCR.

CONCLUSIONS

Our results together with previous reports on Babesia infections in cats from Europe suggest that feline babesiosis should be included in the differential diagnosis of animals with anaemia, thrombocytopenia, anorexia and lethargy, especially in young or immunocompromised animals from endemic areas for canine babesiosis.

Management of fluorouracil toxicity in a Labrador retriever-poodle crossbred dog

A juvenile, neutered male, Labrador retriever-poodle crossbred dog was brought to a veterinary hospital for overnight care after ingesting fluorouracil 5.0% (5-FU) topical solution. The exposure occurred the night before and involved an unknown amount of fluorouracil. The dog survived the acute toxicity but developed status epilepticus requiring control with general anesthesia and spent multiple days hospitalized in a comatose state, eventually waking with sensory deficits in both vision and smell which resolved over time. Blood samples taken at a recheck visit 1 week after ingestion, showed the dog had developed severe thrombocytopenia and moderate leukopenia. Ten days after initial intoxication, the dog developed progressive alopecia which eventually affected the entire body.

Increased risk of select glucocorticoid adverse events in dogs of higher body weight

There are limited data on glucocorticoid treatment in dogs. The purpose of this study was to investigate whether dogs of higher body weight experienced more adverse events when receiving glucocorticoid therapy. Data pertaining to glucocorticoid therapy was abstracted from the records of 61 dogs that were prescribed glucocorticoids for treatment of immune-mediated thrombocytopenia or hemolytic anemia from 2014 to 2019. The odds of developing muscle atrophy and polyphagia during therapy were increased by 30% for each 5 kg of additional body weight. Almost half of the dogs (44.3%) fluctuated > 15% from baseline weight during therapy. Dogs whose body condition scored as above ideal were at increased risk (odds ratio = 4.2) for being diagnosed with urinary tract infection. Our findings suggest that standard linear glucocorticoid dosing may place higher body weight dogs at increased risk of developing adverse events. Accelerated glucocorticoid tapering and/or alternative dosing schemes in dogs with higher body weights may be prudent in efforts to improve tolerance and client compliance.

Retrospective evaluation of thrombocytopenia and tumor stage as prognostic indicators in dogs with splenic hemangiosarcoma

OBJECTIVE

To identify physical examination and perioperative CBC variables in dogs with splenic hemangiosarcoma (HSA) that could aid in predicting progression-free interval (PFI) and overall survival time (OST) in affected dogs.

ANIMALS

70 client-owned dogs with splenic HSA treated with splenectomy and chemotherapy between September 2004 and October 2016.

PROCEDURES

A retrospective search of the University of Minnesota Veterinary Medical Center medical records database was performed to identify dogs with splenic HSA treated with splenectomy and with evidence in the medical records of intent to treat with chemotherapy. Data collection included dog signalment and body surface area, results from CBCs performed within 6 days before to 2 days after splenectomy, whether dogs had hemoabdomen or received transfusions, and tumor stage. Hematocrit, WBC count, and platelet count were treated as categorical variables (divided into terciles: above, within, or below reference limits) because of variation among reference intervals for the numerous analyzers used. Associations between variables and PFI or OST were investigated with Cox regression analyses, and hazard ratios (HRs) for a shorter PFI or OST were reported. Population Pearson correlation coefficient (ρ) analysis was performed to identify potential associations between variables of interest.

RESULTS

Stage 3 HSA was identified as a negative prognostic indicator of PFI (HR, 6.6) and OST (HR, 4.5). Perioperative thrombocytopenia was similarly associated with shorter PFI (HR, 2.2) and OST (HR, 2.0). Results for Hct correlated (ρ = 0.58) with those for platelet count, and although our findings did not indicate a notable association between anemia and shorter PFI, such could not be ruled out.

CONCLUSIONS AND CLINICAL RELEVANCE

The prognostic value of thrombocytopenia warrants further substantiation to understand causal and mechanistic connections, and the presence of thrombocytopenia ultimately may prove valuable in guiding treatment recommendations for dogs with splenic HSA.

[Thrombocytopenia in horses]

OBJECTIVE

The retrospective study aimed to evaluate the prevalence of true thrombocytopenia and ethylenediaminetetraacetic acid (EDTA)-induced pseudothrombocytopenia in horses and ponies and to assess the diagnostic and prognostic utility of true thrombocytopenia.

MATERIAL AND METHODS

In 3592 patients (2008-2015) hematological data (ADVIA® 2120, Siemens) were reviewed. Inclusion criteria were platelet counts < 90 x 109/l (EDTA-blood) and/or < 84 x 109/l (citrate blood). Thrombocytopenia was classified as true, EDTA-induced, and questionable. Patients with true thrombocytopenia were assigned to nine groups according to their history and four groups depending on the main diagnosis (inflammatory disorders, neoplasia, non-inflammatory intestinal disease, others). The frequencies of diagnoses were compared to the overall clinic population.

RESULTS

Thrombocytopenia was diagnosed in 123/3592 patients (3.4 %) and classified as true in 60/123 (49 %), EDTA-induced in 6/123 (5 %), and questionable in 57/123 (46 %) of cases. In true thrombocytopenia, the most common reasons for referral were lethargy (23/60, 38 %), fever (19/60, 32 %), and colic (17/60, 28 %). In these patients inflammation, neoplasia, non-inflammatory intestinal disease, and others were diagnosed in 25/60 (42 %), 11/60 (18 %), 10/60 (17 %), and 14/60 (23 %) of cases, respectively. Compared with the overall clinic population, there was an increased frequency of neoplasia (18 % versus 1 %). The mortality rate was significantly higher at 38 % in comparison with the overall population. Remarkably high mortality rates of 32 % and 82 % were observed in patients with inflammatory and neoplastic diseases, respectively.

CONCLUSION AND CLINICAL RELEVANCE

True thrombocytopenia is relatively rare in horses with internal medical conditions and should be verified by measurement in samples with citrate as anticoagulant. Thrombocytopenia is rarely the primary reason for referral and is a negative prognostic factor in neoplastic and inflammatory diseases.

[Immunosuppressive therapy in dogs and cats. Properties of drugs and their use in various immune-mediated diseases]

Veterinarians are regularly faced with the diagnosis and therapy of immune-mediated diseases. More frequently occurring immune-mediated diseases are immune-mediated hemolytic anemia, immunemediated thrombocytopenia and polyarthritis. Glucocorticoids are commonly used as first-line treatment because of their availability, efficacy and rapid action. Nevertheless, some patients do not respond to glucocorticoid therapy alone. Others require a rapid dose reduction because of severe side effects from glucocorticoid treatment. These patients benefit from adjuvant therapies. Ciclosporin preparations are licensed for use in veterinary medicine. The use of azathioprine, mycophenolate mofetil and human immunoglobulin therapy has also been documented. This article describes the mode of action of certain immunosuppressive agents and their use in selected diseases from recent literature.

Estrogen-induced myelotoxicity in a 4-year-old golden retriever dog due to a Sertoli cell tumor

A 4-year-old, unilateral cryptorchid golden retriever dog was presented to the Ontario Veterinary College Health Sciences Centre with gynecomastia, dribbling urine, lethargy, neutropenia, and thrombocytopenia. A Sertoli cell tumor was diagnosed in a cryptorchid testicle with estrogen-induced myelotoxicity. The tumor was removed and bone marrow regenerated within 4 months.

Flow cytometric assessment of activation of peripheral blood platelets in dogs with normal platelet count and asymptomatic thrombocytopenia

Platelets play a crucial role in hemostasis. Their activation has not yet been evaluated in healthy dogs with a normal and low platelet count. The aim of this study was to determine the influence of activators on platelet activation in dogs with a normal platelet count and asymptomatic thrombocytopenia. 72 clinically healthy dogs were enrolled. Patients were allocated into three groups. Group 1 consisted of 30 dogs with a normal platelet count, group 2 included 22 dogs with a platelet count between 100 and 200×109/l and group 3 consisted of 20 dogs with a platelet count lower than 100×109/l. Platelet rich-plasma (PRP) was obtained from peripheral blood samples using tripotassium ethylenediaminetetraacetic acid (K3-EDTA) as anticoagulant. Next, platelets were stimulated using phorbol-12-myristate-13-acetate or thrombin, stabilized using procaine or left unstimulated. The expression of CD51 and CD41/CD61 was evaluated. Co-expression of CD41/CD61 and Annexin V served as a marker of platelet activation. The expression of CD41/CD61 and CD51 did not differ between the 3 groups. Thrombin-stimulated platelets had a significantly higher activity in dogs with a normal platelet count than in dogs with asymptomatic thrombocytopenia. Procaine inhibited platelet activity in all groups. In conclusion, activation of platelets of healthy dogs in vitro varied depending on the platelet count and platelet activator.

Lymphocyte Apoptosis and Thrombocytopenia in Spleen during Classical Swine Fever: Role of Macrophages and Cytokines

Thirty-two Large White X Landrace pigs, 4 months old, were inoculated with the classical swine fever (CSF) or hog cholera virus strain “Alfort” in order to identify the mechanism responsible for the lymphopenia and thrombocytopenia observed in the spleen during the experimental induction of disease, by immunohistochemical and ultrastructural techniques. Results showed a progressive depletion of splenic lymphoid structures and evidence of platelet aggregation processes. Lymphoid depletion was due to lymphocyte apoptosis, which could not be ascribed to the direct action of the virus on these cells; direct virus action could play only a secondary role in the death of these cells. Absence of severe tissue and endothelial damage, together with moderate procoagulant cytokine levels in the serum, suggest that these pathologies can be ruled out as the cause of platelet aggregation and thrombocytopenia in CSF. Monocyte/macrophages were the main target cells for the CSF virus, and they exhibited phagocytic and secretory activation leading to the synthesis and release of tumor necrosis factor α, which proved to be the chief mediator, followed by IL-6, IL-1α, and C1q complement component. In view of their characteristics, TNF-α and, to a lesser extent, IL-1α and IL-6 appear to be the major cytokines involved in the pathogenesis of lymphocytopenia and thrombocytopenia; a clear spatial and temporal relationship was observed between these two phenomena.

Outcome based on treatment protocol in patients with primary canine immune-mediated thrombocytopenia: 46 cases (2000-2013)

This study investigated the relationship between treatment protocol, survival to discharge, and relapse in 46 dogs diagnosed with primary immune-mediated thrombocytopenia (ITP) at the Western College of Veterinary Medicine between 2000 and 2013. Treatment was at the discretion of the attending clinician and consisted of either a corticosteroid alone or a corticosteroid plus a secondary therapy. There was no association between survival to discharge and treatment protocol (P = 0.23). Of the surviving in-patients, 39% experienced a relapse. Our study failed to show a significant difference in survival and relapse based on treatment protocol.

Simian Immunodeficiency Virus Infection of Chimpanzees (Pan troglodytes) Shares Features of Both Pathogenic and Non-pathogenic Lentiviral Infections

The virus-host relationship in simian immunodeficiency virus (SIV) infected chimpanzees is thought to be different from that found in other SIV infected African primates. However, studies of captive SIVcpz infected chimpanzees are limited. Previously, the natural SIVcpz infection of one chimpanzee, and the experimental infection of six chimpanzees was reported, with limited follow-up. Here, we present a long-term study of these seven animals, with a retrospective re-examination of the early stages of infection. The only clinical signs consistent with AIDS or AIDS associated disease was thrombocytopenia in two cases, associated with the development of anti-platelet antibodies. However, compared to uninfected and HIV-1 infected animals, SIVcpz infected animals had significantly lower levels of peripheral blood CD4+ T-cells. Despite this, levels of T-cell activation in chronic infection were not significantly elevated. In addition, while plasma levels of β2 microglobulin, neopterin and soluble TNF-related apoptosis inducing ligand (sTRAIL) were elevated in acute infection, these markers returned to near-normal levels in chronic infection, reminiscent of immune activation patterns in ‘natural host’ species. Furthermore, plasma soluble CD14 was not elevated in chronic infection. However, examination of the secondary lymphoid environment revealed persistent changes to the lymphoid structure, including follicular hyperplasia in SIVcpz infected animals. In addition, both SIV and HIV-1 infected chimpanzees showed increased levels of deposition of collagen and increased levels of Mx1 expression in the T-cell zones of the lymph node. The outcome of SIVcpz infection of captive chimpanzees therefore shares features of both non-pathogenic and pathogenic lentivirus infections.

The HIV-1/AIDS pandemic is the result of cross-species transmission of simian immunodeficiency virus (SIVcpz) from chimpanzees to humans. Many African primates are infected with SIV, but those studied in captivity generally do not develop disease. However, wild chimpanzees infected with SIVcpz are at increased risk of death and may develop an AIDS-like disease. It has therefore been suggested that the viral features which SIVcpz and HIV-1 share, that differentiate them from other species’ SIV, may be critical in the development of disease in both humans and chimpanzees. Here, we present a long-term follow-up of 7 SIVcpz infected chimpanzees, housed in primate centres in the US and Europe, under similar conditions to other studied models. These animals did not develop an AIDS-like disease, after up to 25 years of infection, and showed features similar to other species where disease rarely develops, such as limited immune activation in the blood. However, they also had significantly reduced CD4+ T-cells and disruption to the secondary lymphoid tissues, normally associated with pathogenic primate lentiviral infections. Thus, while SIVcpz infection of chimpanzees shares features of both pathogenic and non-pathogenic infections, disease has not developed in captivity.

In-clinic laboratory diagnosis of canine babesiosis (Babesia canis canis) for veterinary practitioners in Central Europe

OBJECTIVE

Haematological changes in dogs and climatic conditions favourable for the vector may assist in the quick in-house diagnosis of canine babesiosis.

MATERIAL AND METHODS

Blood samples from 358 dogs suspected to have canine babesiosis were evaluated. The diagnosis was confirmed in 113 dogs by detection of Babesia canis by microscopic examination of a stained blood smear using the concentration line technique.

RESULTS

Thrombocytopenia was present in all 113 dogs. Red blood cell count, packed cell volume and haemoglobin values were below the reference range in 62.8%, 61.1% and 46.0% of affected dogs, respectively. An increased reticulocyte count was apparent in five Babesia canis -positive dogs. Leukopenia, lymphopenia, neutropenia and monocytosis were present in 54.9%, 47.8%, 30.4% and 6.5% of the dogs, respectively. Evaluating haematological parameters by CART-analysis revealed a predictive model (accuracy= 93.5%) for canine babesiosis, when using the leucocyte, thrombocyte, and reticulocyte count. Climatic conditions present at the most probable time of Babesia canis- infection accounted for biseasonal occurrence. Changes of climatic factors during the year influence the vector activity and in conclusion should highlight babesiosis in the ranking of differentials for veterinarians.

CONCLUSION

The results demonstrate that a tentative diagnosis of canine babesiosis can be made based on typical haematological changes. The results recorded match well with the seasonality of the tick vector and were confirmed here by the month of sample submission.

Facial paralysis and lymphocytic facial neuritis in a rhesus macaque (Macaca mulatta) positive for simian retrovirus type D2

Simian retrovirus type D (SRVD) is a naturally occurring betaretrovirus in nonhuman primates of the genus Macaca. Infection can lead to a variety of clinical, hematologic, and histopathologic abnormalities. We report an unusual clinical presentation of facial paralysis and histologic lymphocytic neuritis in an SRVD type 2 (SRVD2)-infected rhesus macaque (Macaca mulatta) with a catheter-associated vena caval thrombus, anemia, thrombocytopenia, and multisystemic lymphoid hyperplasia. At initial presentation, a right atrial mass was detected by echocardiography. The macaque was clinically asymptomatic but had persistent anemia, thrombocytopenia, hyperglobulinemia, and later neutropenia. It was seropositive for SRV and PCR-positive for SRVD 2. Approximately 1 mo after initial presentation, the macaque developed right facial paralysis and was euthanized. Histologic lesions included lymphoplasmacytic aggregates affecting multiple organs, consistent with SRV-related lymphoid hyperplasia. The right facial nerve showed lymphoplasmacytic inflammation. The nerve itself was negative immunohistochemically for SRV antigen, but antigen was present infrequently in pericapillary lymphoid cells within the facial nerve and abundantly within lymphoid aggregates in the adjacent parotid salivary gland, bone marrow, and soft tissue. Known neurotropic viruses could not be identified. Given the widespread inflammation in this macaque, particularly in the area surrounding the facial nerve, lymphocytic neuritis and facial paralysis likely were an indirect effect of SRV infection due to local extension of SRV-related inflammation in the surrounding tissue.

Comparison of platelet clumping and complete blood count results with Sysmex XT-2000iV in feline blood sampled on EDTA or EDTA plus CTAD (citrate, theophylline, adenosine and dipyridamole)

False thrombocytopenia may result from platelet aggregation, especially in feline ethylenediamine tetra-acetic acid (EDTA) blood specimens. Citrate, theophylline, adenosine and dipyridamole (CTAD) was added to 46 feline EDTA specimens to test its anti-aggregation action. Platelet aggregation was estimated from blood films and a complete blood count was performed with a Sysmex XT-2000iV analyser. Platelet aggregation score was >2 in 11/46 EDTA tubes and only in one EDTA+CTAD specimen. The platelet count was higher in all CTAD-supplemented tubes except one, medians measured by cytometry being 225.5 × 10(9)/l and 249.0 × 10(9)/l in EDTA and EDTA+CTAD, respectively (P = 0.007). Adding CTAD had statistically and analytically significant but moderate effects on other blood variables, the most intense variations being observed for reticulocytes (about 3% higher in EDTA specimens) and reticulocyte indexes. Addition of CTAD to EDTA when sampling feline blood is a useful option to reduce platelet clumping.

Glucocorticoid-dependent hypoadrenocorticism with thrombocytopenia and neutropenia mimicking sepsis in a Labrador retriever dog

Glucocorticoid-deficient hypoadrenocorticism (GDH) with immune-mediated-neutropenia (IMN) and -thrombocytopenia (IMT) were diagnosed in a 3-year-old Labrador retriever dog. Glucocorticoid-deficient hypoadrenocorticism is rare and diagnostically challenging as clinical signs and laboratory abnormalities are often nonspecific. Immune-mediated cytopenias and other autoimmune disorders, as part of an autoimmune polyglandular syndrome have been reported with hypoadrenocorticism in humans. This is the first reported case of hypoadrenocorticism and bicytopenia in a dog.

Coagulation profile, haematological and biochemical changes in kids naturally infected with peste des petits ruminants

The aim of this study was to examine the coagulation profile in peste des petits ruminant (PPR) in kids. Five kids from a group of 150 animals (72 goats and 78 kids) were brought to the Veterinary Medical Teaching Hospital from a farm in Burdur province (Turkey) with nasal and ocular discharges and diarrhea. Fifteen goats and 41 kids had died due to diarrhea and three kids were presented to the Department of Pathology for diagnosis. Blood samples were taken from 12 ill animals (infected group) for haematological and biochemical analysis. In addition, five healthy kids were examined from another healthy flock (control group). Leukocyte and lymphocyte numbers of infected group showed significant declinations in comparison to control group (≤0.001). Haemorrhages in all organs of digestive system and small haemorrhagic areas in liver were caused to decrease in erythrocyte and haematocrit values (p ≤ 0.001) in infected group. Concentrations of blood urea nitrogen (BUN) (p ≤ 0.01) and creatinine (p ≤ 0.001) in infected group were significantly higher than control group. Compared to control group, significant increases were determined in serum concentrations of alkaline phosphatase (ALP) (p ≤ 0.01), aspartate aminotransferase (AST) (p ≤ 0.001) and alanine aminotransferase (ALT) (p ≤ 0.001) in the infected group. No significant differences were observed between the infected and control groups for serum gamma glutamyl-transferase (GGT) concentration value. In our study, thrombocytopenia (p ≤ 0.001) together with prolonged activated partial thromboplastin time (APTT; p ≤ 0.01) and prothrombin time (PT; p ≤ 0.001) may show that disseminated intravascular coagulopathy which can occur in kids with PPR.

[Clinical and laboratory-diagnosed parameters in 21 dogs with primary immune-mediated thrombocytopenia]

OBJECTIVE

Characterization of clinical and clinicopathological parameters as well as the treatment and course of the disease in dogs with suspected primary immune-mediated thrombocytopenia (pIMT), and identification of characteristics in comparison to secondary IMT (sIMT).

MATERIAL AND METHODS

Medical records of thrombocytopenic dogs with a positive platelet-bound-antibody (PBA)-test performed between 2003 and 2008 were evaluated retrospectively. Dogs were suspected of having pIMT by exclusion of other diseases potentially associated with sIMT, and sIMT was diagnosed when an associated disease could be detected. Dogs with an incomplete follow-up were excluded from the study.

RESULTS

Thirteen of 21 dogs (62%) suspected of having pIMT were male. Median age of the affected dogs was 6.6 years (1.6-13.5 years [MINIMUM-maximum]). Spontaneous bleeding was observed in 18 dogs (86%) mainly in the form of surface bleeding. Nineteen dogs (91%) with pIMT had platelet counts below 20,000/μl. All dogs with pIMT, for which platelet volume analysis was available, displayed a mean platelet volume (MPV) within or below the reference range. Fourteen of 15 dogs in which bone marrow analysis was performed had an increased megakaryopoiesis. Comparison of two different treatment regimes (prednisolone versus prednisolone and azathioprine) did not result in a significantly different platelet count recovery time. There was no significant difference regarding age and sex distribution between dogs with pIMT and sIMT. Platelet count and MPV were significantly lower in dogs with pIMT than in dogs with sIMT. Increased megakaryopoiesis was more frequently detected in dogs with pIMT compared to dogs with sIMT.

CONCLUSION AND CLINICAL RELEVANCE

Dogs with a positive PBA-test and additionally a severe thrombocytopenia, low MPV and activated megakaryopoiesis are likely to have pIMT.

Severe thrombocytopenia in aged rhesus macaques (Macaca mulatta) infected with simian varicella virus

Simian varicella virus was diagnosed in 2 geriatric rhesus macaques (Macaca mulatta). The macaques presented with typical skin lesions as well as severe thrombocytopenia as a result of infection. Idiopathic thrombocytopenic purpura is a known complication of varicella zoster virus infection in humans; however, this condition has not been reported previously as a complication of SVV infection. This case report discusses the clinical presentation, pathology, and thrombocytopenia of the affected macaques.

The use of lithium carbonate to prevent lomustine-induced myelosuppression in dogs: a pilot study

This was a preliminary investigation of the use of lithium to prevent lomustine-induced myelosuppression. Four 10 to 11 kg beagles received lomustine 20 to 30 mg, PO, q3wk, with cephalexin prophylaxis. Two dogs also received lithium, 150 to 300 mg, PO, q12h. Lithium blood concentrations fluctuated in and out of therapeutic interval. Lithium was discontinued in one dog in week 13, and in the other dog in week 38, due to toxicoses. All dogs developed grade 1 to 4 neutropenia after each lomustine treatment. In dogs receiving lomustine only, platelet concentrations decreased from 274 and 293 × 10(9)/L in week 1, to 178 and 218 × 10(9)/L in weeks 38 and 13, respectively. In dogs receiving lomustine and lithium, platelet concentrations decreased from 351 and 288 × 10(9)/L in week 1, to 214 and 212 × 10(9)/L, in weeks 36 and 13, respectively. Lithium did not prevent lomustine-induced myelosuppression and had important side-effects.

A case of splenic torsion with progressive anemia and thrombocytopenia

A 4-year-old male, castrated Saint Bernard was evaluated for acute onset of lethargy and collapse. Moderately severe anemia and splenomegaly were noted. Immune mediated hemolytic anemia was initially suspected. Abdominal ultrasound demonstrated an absence of splenic blood flow. Splenic torsion was confirmed on exploratory laparotomy and a splenectomy was performed.

Estrogen-induced myelotoxicity in dogs: A review

Exogenous estrogens used for therapeutic purposes or endogenous estrogen sources such as functional Sertoli cell or ovarian granulosa cell tumors may cause bone marrow toxicity in dogs. The condition is characterized by hematologic abnormalities including thrombocytopenia, anemia, and leukocytosis or leukopenia. Despite intensive therapy with blood or platelet-rich transfusions, broad-spectrum antibiotics, steroids, and bone marrow stimulants, prognosis is unfavorable. Due to the the risk of stimulating the development of uterine diseases and the potential for inducing aplastic anemia, estrogen use in dogs is best avoided where possible. This paper describes the causes of estrogen-induced myelotoxicity, the clinical presentation of the patients, the diagnosis, and the treatment options in the dog.

Thrombocytopenia as a characteristic trait in the Polish ogar dog

The study was undertaken to ascertain if the normal thrombocyte count in Polish ogar dog differs from normal values in other dog breeds. The reason for this study was constatation that during routine blood analysis in healthy Polish ogar dogs, thrombocytopenia, not related to the clinical state of the animals, was frequently encountered. The study was carried out on 38 Polish ogar dogs. The control group consisted of 80 dogs of various breeds. All the animals were clinically healthy. A full hematological analysis was performed. The mean platelet value in all dog breeds without the Polish ogar dogs was 344.4 +/- 6.85, while the mean number of platelets in the Polish ogar dogs amounted to 167 +/- 11.6 G/l. The limited genetic material used to rebuild the Polish ogar breed after its drastic decline during the Second World War could be the reason for various, including hematological, abnormalities that with time became a normal characteristic traits for this breed.

Veterinary autoimmunity: autoimmune diseases in domestic animals

The first spontaneous animal model of autoimmunity was the New Zealand black mouse, discovered in 1959. Interestingly, although several models of induced autoimmunity were demonstrated in a variety of rodents, the recognition of autoimmune disease in dogs came somewhat later. Dog breeding and selection of traits within certain dog breeds have become an important enterprise with intensive husbandry and selection criteria being applied to each breed standard. This has resulted in breeding for specific phenotypic characteristics. This selection has inadvertently led to the propagation of a number of autoimmune diseases in dogs. For example, systemic lupus erythematosus (SLE), autoimmune hemolytic anemia and thrombocytopenia, autoimmune myasthenia gravis, and diabetes mellitus are now fairly common. In the final analysis, the appearance of autoimmunity in dogs reflects their breeding selection and illustrates the importance of genetics in the development of autoimmune disease.

Comparison of methods for determining platelet numbers and volume in Cavalier King Charles spaniels

OBJECTIVE

The purpose of this study was to compare platelet concentration in cavalier King Charles spaniels (CKCS) measured by different methods commonly used in veterinary hospitals and commercial laboratories.

METHODS

Blood samples obtained from 41 CKCS [corrected] were analysed by impedance cell counter, laser cell counter and microscopic estimation. Quantitative buffy coat analysis was performed only on 17 samples, selected from CKCS [corrected] that had low platelet counts detected by cell counters. Platelet counts, platelet estimations and platelet parameters using these different methods were compared.

RESULTS

The median platelet number was lower when estimated using impedance cell counter (1363x10(9)/I) with respect to laser cell counter (1723x10(9)/I), microscopic estimation (238x10(9)/I) [corrected] or quantitative buffy coat analyser (292x10(9)/I) [corrected] (P<0.01). Although impedance cell counter, laser cell counter and microscopic estimation were positively correlated, there was no acceptable agreement among methods. CKCS [corrected] with macrothrombocytes in blood smears had significantly lower counts on impedance cell counter, laser cell counter and microscopic estimation. The percentages of CKCS [corrected] with platelet count < 100x10(9)/I [corrected] were 34.1 per cent (impedance cell counter), 26.8 per cent (laser cell counter), 22.0 per cent (microscopic estimation) (not statistically different) and 5.8 per cent (quantitative buffy coat analyser) (P<0.05).

CLINICAL SIGNIFICANCE

CKCS [corrected] with macrothrombocytosis have low platelet counts on impedance cell counters, laser cell counters and microscopic estimation. CKCS [corrected] with low platelet counts may have a normal platelet crit detected by a quantitative buffy coat analyser and thus a normal circulating platelet mass.

B-cell lymphoma in a dog with ehrlichiosis (Ehrlichia canis) and systemic histoplasmosis (Histoplasma capsulatum)

A mixed breed dog treated for ehrlichiosis and systemic histoplasmosis developed a refractory thrombocytopenia. When an abdominal mass was detected, exploratory laparotomy and biopsies confirmed lymphoma, which on immunohistochemical stains was determined to be of B-cell origin. Conceivably, the B-cell lymphoma in this dog was associated with chronic inflammation from ehrlichiosis, histoplasmosis, or both.

Hematologic changes associated with half-body irradiation in dogs with lymphoma

BACKGROUND

Reports describe the technique and efficacy of half-body irradiation (HBI) of dogs with lymphoma, but few describe the distinctive toxicoses associated with the combination of HBI and chemotherapy.

HYPOTHESIS

HBI would transiently affect myelocytic and erythroid variables as assessed by serial analysis of complete blood counts.

ANIMALS

Twenty-nine dogs with lymphoma treated with HBI during 2002 and 2003.

METHODS

A retrospective study of medical records of 29 dogs was performed. Two HBI protocols were used, resulting in delivery of either 6 Gy or 8 Gy to each half of the body, 1 month apart. Dogs received chemotherapy before, during, or after irradiation, or at multiple times. Serial hematology was available for all dogs. Data were analyzed between collection periods by analysis of variance (ANOVA) RESULTS: The mean granulocyte count significantly (P < .01) decreased from 10,017 cells/microL (data range 3,001-20,170 cells/ microL) before the first radiation treatment to 3,250 cells/microL (820-4,400 cells/microL) at week 5 (P < .01). Three weeks after this nadir, the mean increased to 10,150 cells/microL (900-26,700 cells/microL). The hematocrit did not change (36-38%). Thrombocytopenia (<100,000/microL) occurred in 10 dogs. Two dogs died because of complications associated with thrombocytopenia. No significant difference in toxicity was found between the 6 Gy and 8 Gy group.

CONCLUSIONS AND CLINICAL IMPORTANCE

HBI was myelosuppressive but effects were short term and resolved in 22 of 24 dogs. Further studies are needed to elucidate the safety and role of HBI in the treatment of dogs with lymphoma.

Phase I evaluation of low-dose suramin as chemosensitizer of doxorubicin in dogs with naturally occurring cancers

BACKGROUND

Low and nontoxic concentrations (10-50 microM) of suramin, which is a nonspecific inhibitor of multiple growth factors, including fibroblast growth factors, enhances the activities of cytotoxic chemotherapeutic agents, such as doxorubicin and paclitaxel, both in vitro and in vivo. Suramin has not been evaluated as a chemosensitizing agent in dogs with cancer.

HYPOTHESIS

Nontoxic suramin can be used safely as a chemosensitizer in dogs.

ANIMALS

Sixteen dogs of various breeds with measurable tumors were treated; 1 dog that had undergone amputation for osteosarcoma received adjuvant therapy.

METHODS

The dogs received 53 courses of treatment with suramin in combination with doxorubicin. The suramin dosage was 6.75 mg/kg IV 3 h before standard doxorubicin administration every 2 weeks. The pharmacokinetics and clinical efficacy were determined.

RESULTS

The pharmacokinetics of low-dose suramin followed a 2-compartment model with half-lives of 2 h and 6 days. The distribution volume was a 0.34 +/- 0.12 L/kg, and clearance was 1.86 +/- 0.76 mL/kg/h. During the time interval that doxorubicin was present at therapeutically active concentrations (ie, from the start of infusion to 24 hours), the plasma concentrations were maintained within 20% of the target range (8-60 microM) in 72% of the treatments. The toxicity of the suramin/doxorubicin combination was mild and comparable to the toxicity expected for doxorubicin monotherapy. Objective partial responses were observed in 2 out of 16 evaluable dogs (13%). All 5 dogs that previously received doxorubicin showed improved responses to the suramin/doxorubicin combination.

CONCLUSIONS AND CLINICAL IMPORTANCE

A fixed, low-dose suramin regimen yields the desired target plasma concentrations in most dogs, and appears to enhance the activity of doxorubicin without enhancing toxicity.

Dexamethasone, melphalan, actinomycin D, cytosine arabinoside (DMAC) protocol for dogs with relapsed lymphoma

BACKGROUND

In general, treatment of relapsed lymphoma is associated with a lower probability of response and shorter duration of remission. The purpose of this study was to evaluate the efficacy of the combination chemotherapy protocol DMAC (dexamethasone, melphalan, actinomycin D, and cytosine arabinoside) for reinduction of remission in dogs with relapsed lymphoma.

HYPOTHESIS

That DMAC would be an effective reinduction protocol for dogs with relapsed lymphoma.

ANIMALS

Fifty-four dogs.

RESULTS

Seventy-two percent of the dogs achieved remission (44% complete remission [CR] and 28% partial remission [PR]), 11% had stable disease (SD), and 17% had progressive disease (PD). The median remission duration was 61 days (range, 2-467+ days). The median remission durations for dogs with CR, PR, and SD were 112, 44, and 27 days, respectively. Factors that affected the response rate were previous treatment with doxorubicin and an inability to achieve remission with the previous protocol. Thrombocytopenia occurred in 56% of the dogs (grade 1 in 3 dogs, grade 2 in 6 dogs, grade 3 in 7 dogs, and grade 4 in 7 dogs) and neutropenia in 17% of the dogs (grade 2 in 1 dog, grade 3 in 2 dogs, and grade 4 in 4 dogs). Gastrointestinal toxicosis occurred in 22% of the dogs (grades 1 in 5 dogs, grade 2 in 3 dogs, and grade 3 in 1 dog).

CONCLUSIONS AND CLINICAL IMPORTANCE

The DMAC protocol is an effective rescue protocol for dogs with relapsed multicentric lymphoma. Although thrombocytopenia is a common manifestation of toxicity, in general, the protocol is well tolerated.