Guidelines for resident training in veterinary clinical pathology. IV: Laboratory quality management-Teaching domains, competencies, and suggested learning outcomes.

BACKGROUND: The 2019 ASVCP Education Committee Forum for Discussion, presented at the annual ASVCP/ACVP meeting, identified a need to develop recommendations for teaching laboratory quality management principles in veterinary clinical pathology residency training programs. OBJECTIVES: To present a competency-based framework for teaching laboratory quality management principles in veterinary clinical pathology residency training programs, including entrustable professional activities (EPAs), domains of competence, individual competencies, and learning outcomes. METHODS: A joint subcommittee of the ASVCP Quality Assurance and Laboratory Standards (QALS) and Education Committees executed this project. A draft guideline version was reviewed by the ASVCP membership and shared with selected ACVP committees in early 2022, and a final version was voted upon by the full QALS and Education Committees in late 2022. RESULTS: Eleven domains of competence with relevant individual competencies were identified. In addition, suggested learning outcomes and resource lists were developed. Domains and individual competencies were mapped to six EPAs. CONCLUSIONS: This guideline presents a framework for teaching principles of laboratory quality management in veterinary clinical pathology residency training programs and was designed to be comprehensive yet practical. Guidance on pedagogical terms and possible routes of implementation are included. Recommendations herein aim to improve and support resident training but may require gradual implementation, as programs phase in necessary expertise and resources. Future directions include the development of learning milestones and assessments and consideration of how recommendations intersect with the American College of Veterinary Pathologists training program accreditation and certifying examination.

Epidural myelolipoma in a Silken Windhound.

A 12-year-old female spayed, Silken Windhound dog was presented with a 3-month history of lethargy and cervical and lumbosacral spinal pain. No significant abnormalities were noted on CBC or serum biochemical assays. Magnetic resonance imaging of the spine demonstrated a soft tissue mass within the ventral and right epidural space at the level of the L7 vertebra. During surgery, a pale brown mass was identified within the epidural fat. Cytologic and histopathologic examinations demonstrated that the mass was composed of adipose tissue and hematopoietic elements, consistent with a myelolipoma. The lumbosacral spinal pain resolved after surgery. Epidural myelolipomas are rarely reported in the human and veterinary literature.

Prevalence and progression of macroscopic lesions in Orbicella annularis and O. faveolata on shallow fringing reefs of St. Kitts.

The endangered corals Orbicella annularis and O. faveolata are crucial to Caribbean reefs because of their large size and contribution to reef framework. The objective of this study was to describe the prevalence and progression of macroscopically evident lesions affecting Orbicella spp. in shallow fringing reefs in St. Kitts. Cross-sectional surveys in the spring of 2017 demonstrated 8 predominant lesion patterns affecting 59% of corals (95% CI: 55.8-62.1%), including annular yellow-brown pigmentation, focal brown pigmentation, focal bleaching, diffuse bleaching, annular black surface deposit, focal tissue loss with skeletal erosion, focal grey pigmentation, and growth anomaly. Longitudinal surveys of 47 tagged corals were performed from August 2016-May 2017 to track lesion progression. The 2 most common lesions, annular yellow-brown pigmentation (n = 30), and focal brown pigmentation (n = 21), showed mean (±SD) partial colony mortality growth of 0.26 ± 0.5 and 0.21 ± 0.45 cm2 d-1, respectively. Annular pigmentation progression severity was associated with a marginating band of bleaching (ordinal odds ratio [OOR] = 11.0), and yellow rather than brown color (OOR = 3.8). Bleaching lesions (n = 13), occurring during a time of elevated sea surface temperature, were most severe during October-December 2016, and persisted through April 2017, months after heat stress had subsided. Annular black surface deposits (n = 3) were associated with rapid progression of acute tissue loss, whereas focal tissue loss with skeletal erosion (n = 2) regressed within months, and focal grey pigmentation (n = 2) was quiescent for the length of the study. This study enforces concern for the extent to which Orbicella spp. are declining due to disease.

Hematologic and biochemical RIs for an aged population of captive African Green monkeys (Chlorocebus aethiops sabaeus).

BACKGROUND: Established RIs for geriatric African Green monkeys (Chlorocebus aethiops sabaeus) are critical for clinical differentiation of normal aging from disease-related changes in this population. OBJECTIVE: The aim of this study was to establish hematologic and serum biochemical RIs for a Caribbean captive population of geriatric (≥ 15 years of age) African Green monkeys, or Vervets. METHODS: Inclusion and exclusion criteria were defined for a cohort of 109 healthy, aged (15- to 30-year-old, median 19-year-old) Vervets. Both male (34) and female (75) monkeys were included in RI generation. Complete manual and analyzer-generated blood counts and serum biochemistry profiles were performed at Ross University School of Veterinary Medicine, West Farm, St. Kitts, West Indies. All results were evaluated using Reference Value Advisor. Isolated outliers were identified using Dixon's outlier range statistic and not included in determination of RIs for individual analytes. Reference intervals were determined using parametric and nonparametric methods depending on the distribution. Data, including mean, median, maximum, and minimum values, were tabulated. RESULTS: Of the 109 animals, 12 monkeys were excluded due to abnormal physical examination results (2 monkeys), and ≥ 2 confirmed outliers (9 monkeys), or evidence of disease based on laboratory data (one monkey). CONCLUSIONS: This study provides useful RIs for assessment of hematology and serum biochemical variables in a geriatric population of African Green monkeys in the Caribbean.

Paraganglioma, pituitary adenoma, and osteosarcoma in a dog.

An 11-year-old neutered male Alaskan Malamute mixed-breed dog was presented with a complaint of polyuria/polydipsia (PU/PD), weight loss, tachypnea, regurgitation, and a previous history of nontreated osteosarcoma of the right distal radius, diagnosed 21 months prior. On physical examination, an abdominal mass was palpated. The abdominal mass was aspirated and cytologically diagnosed as a neuroendocrine tumor, suspected to be a pheochromocytoma. Laboratory examination revealed a mild anemia and thrombocytopenia, markedly elevated ATP and ALP activities, and moderate hypercalcemia. A low-dose dexamethasone suppression test and endogenous adrenocorticotropic hormone (ACTH) concentration were compatible with pituitary hyperadrenocorticism. On urinalysis, proteinuria was noted as well as a high urine metanephrine/creatinine ratio, consistent with a diagnosis of pheochromocytoma. The dog was treated with supportive care and euthanized 6 months later due to decreasing quality of life. On necropsy, an extra-adrenal pheochromocytoma (paraganglioma) was diagnosed in the caudal abdomen, and a pituitary adenoma and an osteosarcoma of the right distal radius were confirmed.

Transient cold agglutinins associated with Mycoplasma cynos pneumonia in a dog.

This report details a case of reversible cold agglutinins in a dog with Mycoplasma cynos pneumonia. An 11-month-old female spayed Rhodesian Ridgeback was presented for lethargy and cough. Thoracic radiographs revealed an alveolar pattern present bilaterally in the cranioventral lung lobes. Septic neutrophilic inflammation with suspected Mycoplasma sp. organisms was noted on cytologic examination of a trans-tracheal wash, and the dog was treated empirically with IV ampicillin/sulbactam and enrofloxacin pending culture results. Red blood cell agglutination was noted unexpectedly on several blood film reviews during hospitalization; however, the dog never developed clinical or laboratory evidence of hemolysis. Cold agglutinins were demonstrated based on the results of a saline dilution and cold agglutinin test that showed agglutination at 4°C but not at room temperature (21°C) or 37°C. Based on a positive culture for M cynos, the dog was treated for 8 weeks with oral enrofloxacin. After clinical and radiographic resolution of the pneumonia, repeated saline dilution and cold agglutinin tests of peripheral blood were negative at all temperatures. Reversible, asymptomatic cold agglutinins are common in human patients with mycoplasma pneumonia, but this is the first reported case in a dog.

Hematologic and biochemical reference intervals for adult Friesian horses from North America.

BACKGROUND: Established breed-specific reference intervals (RI) are an important tool for monitoring the health of horses. There is a lack of published work on breed-specific RI for Friesian horses. OBJECTIVES: The goal of this project was to determine hematologic and biochemical RI for Friesian horses residing in North America. METHODS: Strict inclusion and exclusion criteria were established for selection of reference subjects and for blood specimen collection and handling. Blood samples from 123 healthy, adult (range 3-18 years, median 8 years) Friesian horses of both sexes (70 mares, 45 geldings, and 8 stallions) were used to determine RI. Complete blood counts (CBC) and biochemistry profiles were performed on the Sysmex XT-2000iV hematology and Olympus AU400 biochemistry analyzers, respectively, at IDEXX Laboratories Inc. (Columbus, OH, USA). Results were analyzed using Reference Value Advisor. According to the guidelines of the ASVCP, nonparametric RI with 90% confidence intervals were determined. RESULTS: IDEXX equine RI are transferrable to Friesian horses for 30 of 36 analytes. Friesian-specific RI (medians) are recommended for the following variables: RBC 5.02-8.74 × 10(6) /µL (6.66), HCT 27-42% (34), HGB 9.0-14.3 g/dL (11.4), lactate dehydrogenase 299-866 U/L (493), direct bilirubin 0.3-0.7 mg/dL (0.5), and anion gap 7-18 mEq/L (12). CONCLUSIONS: The RI established in this study provide a useful baseline for the assessment of hematologic and biochemical data in Friesian horses residing in North America.