Infective endocarditis with systemic bacterial embolism caused by Staphylococcus aureus in a free-ranging Amami rabbit (Pentalagus furnessi).

The Amami rabbit (Pentalagus furnessi) is found only on the two islands of Amami-Oshima and Tokunoshima in southwest Japan. It has a primitive appearance and ecology, is an evolutionarily valuable animal and has been assigned to the International Union for Conservation of Nature Red List of Threatened Species. We describe a case with mild purulent wounds on the distal digital skin of both forelimbs and multiple nodular lesions in various organs, including the heart and kidney. Microscopically, the heart lesions were characterized by disruption of the mitral valve and multifocal myocardial necrosis and abscesses due to infection with gram-positive cocci. Similar bacterial infarctions were also found in other organs, including the kidneys. The bacteria were identified as Staphylococcus aureus by immunohistochemical and molecular biological examinations. This first report of infective endocarditis and systemic infarctions caused by S. aureus in an Amami rabbit indicates the importance of monitoring purulent injuries, even if mild, to prevent secondary infections in this species.

Trophoblast emboli in the lung of a snowshoe hare (Lepus americanus).

Spontaneous migration of placental trophoblasts into maternal blood vessels and embolization to other organs (ie, lung, adrenal gland, spleen, and liver) occurs in women and certain animals with hemochorial placentation. Although considered incidental in most species, increased incidence and numbers of trophoblast emboli are reported in women with gestational diseases with arterial hypertension (pre-eclampsia and eclampsia). To the best of our knowledge, trophoblast emboli have not been reported in lagomorphs. This case report describes the identification of trophoblast emboli in the lung of a wild snowshoe hare (Lepus americanus). Death of this hare was attributed to pulmonary hemorrhages and hemothorax, but a definitive cause for the hemorrhages was not determined. It is unclear whether trophoblast embolism normally occurs in this species and represents an incidental finding, or whether it possibly contributed to rupture of pulmonary or thoracic blood vessels leading to hemorrhage.

Presumptive fibrocartilaginous embolic myelopathy in a pot-bellied pig.

A case of presumptive fibrocartilaginous embolic myelopathy in a pet pot-bellied pig is described in this report. This case, which was associated with a previous trauma, highlighted the importance of advanced diagnostic imaging in pigs with clinical signs consistent with a myelopathy.

Myélopathie à la suite d'une embolie fibrino-cartilagineuse présumée chez un cochon vietnamien. Ce rapport décrit un cas de myélopathie à la suite d'une embolie fibrino-cartilagineuse présumée chez un cochon vietnamien. Ce cas, qui était associé avec un traumatisme antérieur, met en évidence l'importance de l'imagerie diagnostique avancée chez les porcs avec des signes cliniques compatibles avec une myélopathie.(Traduit par Dr Serge Messier).

Fibrocartilaginous Embolic Encephalopathy in a Pig.

A 1-year-old boar was investigated after presenting with acute onset collapse and obtundance. No significant gross lesions were observed at post-mortem examination. Histopathological investigation revealed a severe bilateral and multifocal necrotizing encephalopathy with an amorphous material, which obstructed neuroparenchymal vessels in the metencephalon and mesencephalon. Alcian blue staining identified the material as of cartilaginous origin and a diagnosis of cerebral fibrocartilaginous embolism was established. No gross evidence of vertebral disc disease was detected and the origin of the embolic material was not found. Although cerebral fibrocartilaginous embolism has been reported in a human, and rarely in animals, it has not been reported previously in the pig.

Aortic thromboembolism in a basset hound-beagle crossbred dog with protein-losing nephropathy.

A 12-year-old neutered male basset hound-beagle crossbred dog with a history of protein-losing nephropathy was presented because of acute weight-bearing right hind limb lameness with hind-end paresis and intermittent splaying. The condition was painful and progressed to non-ambulatory paraparesis. The dog was referred to an emergency and specialty hospital where a diagnosis of aortic thromboembolism was confirmed. This case illustrates the challenge in diagnosing and determining the cause of aortic thromboembolism in dogs.

Thrombo-embolisme aortique chez un chien croisé basset-beagle affecté de néphropathie avec perte de protéines. Un chien castré croisé basset-beagle âgé de 12 ans avec une histoire de néphropathie avec perte de protéines fut présenté à cause d'une boiterie avec appui du membre postérieur droit d'apparition aiguë accompagnée de parésie du train postérieur et évasement intermittent. La condition était douloureuse et progressa à une paraparésie non-ambulatoire. Le chien fut référé à une clinique d'urgence et de spécialité où diagnostic de thrombo-embolisme aortique fut confirmé. Ce cas illustre le défi que représente de diagnostiquer et déterminer la cause de thrombo-embolisme aortique chez les chiens.(Traduit par Dr Serge Messier).

Sole recombinant Muscovy duck parvovirus infection in Muscovy ducklings can form characteristic intestinal embolism.

Recombinant Muscovy duck parvovirus (rMDPV) has been recently identified as a novel pathogen circulating in Chinese Muscovy duck flocks in the past two decades. Different from classical MDPV, rMDPV infection can form embolism in the intestinal tract of deceased Muscovy ducklings. However, whether rMDPV acts as the sole causative agent involved in the formation of the characteristic embolism in Muscovy ducklings remains unclear. In this study, an infectious plasmid clone pZW containing the complete genome of strain ZW, a previously characterized rMDPV isolate, was constructed, and a single nucleotide mutation was then introduced in the VP1 gene within pZW as the genetic marker. Transfection of pZW in 11-day-old embryonated Muscovy duck eggs via the chorioallantoic membrane route resulted in the rescue of the infectious virus. The rescued virus exhibited similar biological characteristics to its parental strain ZW, as evaluated by the median embryo lethal dose and the replication kinetics in embryonated Muscovy duck eggs. Muscovy duckling infection tests showed that the rescued virus and parental strain can kill all Muscovy ducklings within 7 days post-infection. Postmortem examination revealed that embolism can be observed in the intestinal tracts of deceased ducklings in the rescued and parental virus infection groups. Collectively, the present study demonstrated that sole rMDPV infection of Muscovy ducklings, without participation of other pathogens, is enough to form characteristic embolism in the intestinal tract.

Inflammatory Mammary Carcinoma in a Male Dog-Case Report.

Inflammatory mammary carcinoma (IMC) is a rare and aggressive variant of a malignant mammary tumor. The present report describes the case of a male dog with clinical and histopathologic signs suggestive of IMC. The patient was presented to our clinic with painful and erythematous skin over the ventral abdomen, as well as preputial and left hind limb edema apparently associated with ill-defined nodules in the caudal mammary region. Cytologic examination of the nodules suggested the presence of a malignant epithelial tumor. Histopathology revealed anaplastic carcinoma with embolization in the dermal lymphatics. Immunohistochemistry showed cyclooxygenase-2 and E-cadherin expression in the neoplastic cells. The patient died 35 days after initial evaluation. To the best of our knowledge, this is the first published case describing IMC in a male dog.

Fibrocartilaginous embolism of the cervical spinal cord and cerebellum in a cat.

A 9-year-old castrated male cat presented with sudden onset of paralysis in four limbs. Magnetic resonance imaging revealed an intramedullary lesion at C3, and lesions in the vermis and right hemisphere of the cerebellum, which were hyperintense on T2-weighted imaging. The cat was euthanized, and postmortem examination was performed. Grossly, transverse sectioning of the spinal cord revealed areas of malacia within the gray matter extending from C2 to C3. Histologically, the ventral spinal artery, the spinal intramedullary arteries and the arterioles of arachnoid in the cerebellum contained fibrocartilaginous emboli confirmed by metachromatic staining with toluidine blue. To our knowledge, this is the first report of fibrocartilaginous embolism involving both the cerebellum and cervical spinal cord in a cat.

Magnetic resonance imaging muscle lesions in presumptive canine fibrocartilaginous embolic myelopathy.

This retrospective cohort study reports the observation of magnetic resonance imaging (MRI) epaxial muscle hyperintensity in dogs diagnosed with presumptive fibrocartilaginous embolic myelopathy (FCEM) (n = 61). It further reports the observation of vertebral column hyperesthesia lasting > 12 hours. The hypothesis tested was that the finding of MRI epaxial muscle hyperintensity correlated with dogs presenting with hyperesthesia. Client-owned dogs diagnosed with presumptive FCEM by specific MRI criteria were included. Statistical analysis was performed using Fisher's exact test. Twenty-three percent (14/61) of MRIs displayed abnormal muscle hyperintensity and 43% (26/61) exhibited vertebral column hyperesthesia. No relationship was found between muscle hyperintensity and pain persisting beyond 12 hours. The muscle hyperintensity remains of unknown significance. That 43% of presumptive FCEM cases have prolonged signs of pain is a higher prevalence than previously reported, and may affect clinical differential diagnoses. This is especially significant in cases in which MRI is not possible and a presumptive diagnosis must be based on the clinical signs.

Imagerie par résonance magnétique des lésions des muscles dans la myélopathie embolique fibrocartilagineuse canine présumée. Cette étude rétrospective de cohorte signale les observations de l'imagerie par résonance magnétique (IRM) pour l'hyperintensité du muscle épaxial chez les chiens diagnostiqués avec une myélopathie embolique fibrocartilagineuse (MEFC) présumée (n = 61). Elle signale aussi l'observation de l'hyperesthésie de la colonne vertébrale durant > 12 heures. L'hypothèse qui a été testée était qu'il y avait une corrélation entre l'observation de l'hyperintensité du muscle épaxial par IRM et les chiens présentés avec de l'hyperesthésie. Les chiens appartenant à des clients pour lesquels un diagnostic présomptif de MEFC avait été posé à l'aide du critère spécifique de l'IRM ont été inclus. L'analyse statistique a été réalisée en utilisant le test exact de Fisher. Vingt-trois pour cent (14/61) des IRM affichaient une hyperintensité anormale du muscle et 43 % (26/61) présentaient de l'hypersthésie de la colonne vertébrale. Aucun lien n'a été trouvé entre l'hyperintensité musculaire et la douleur persistant au-delà de 12 heures. La signification de l'hyperintensité musculaire est toujours inconnue. Le taux de 43 % de cas présomptifs de MEFC affichant des signes de douleur prolongée représente une prévalence supérieure aux données déjà signalées et pourrait affecter les diagnostics cliniques différentiels. Ce fait revêt une importance particulière lorsque l'IRM n'est pas possible et qu'un diagnostic présomptif doit se baser sur les signes cliniques.(Traduit par Isabelle Vallières).

Outcome comparison in dogs with a presumptive diagnosis of thoracolumbar fibrocartilaginous embolic myelopathy and acute non-compressive nucleus pulposus extrusion.

Dogs with fibrocartilaginous embolic myelopathy (FCEM) or acute non-compressive nucleus pulposus extrusion (ANNPE) are reported to have a fair prognosis; however, persistent motor/autonomic deficits are possible. Specific MRI patterns have been suggested to differentiate these diseases although never been validated with histopathology in large studies. The aim of this retrospective study was to evaluate if these MRI patterns are associated with different clinical outcomes in dogs with peracute non-progressive T3-L3 myelopathy. Two hundred and one dogs were included. Outcome data were obtained via medical records and telephone questionnaires. MRIs were blindly reviewed by three board-certified observers, obtaining substantial to almost perfect interobserver agreement on diagnoses (κ=0.635-0.828). Presumptive ANNPE and FCEM were diagnosed in 157 and 44 dogs , respectively. Ambulatory function was regained in 99 per cent of cases, with persistent motor deficits in 83.6 per cent and 92.5 per cent of dogs with presumptive ANNPE and FCEM, respectively. The presumptive diagnosis was not associated with motor function recovery, recovery times or urinary continence. Faecal incontinence was five times more likely in dogs with presumptive ANNPE (23 per cent) compared with presumptive FCEM (7.5 per cent).Distinguishing between MRI patterns of presumptive ANNPE or FCEM in dogs with peracute non-progressive T3-L3 myelopathy may help predict the risk of developing faecal incontinence.

Clinical characteristics of canine fibrocartilaginous embolic myelopathy (FCE): a systematic review of 393 cases (1973-2013).

Fibrocartilaginous embolic myelopathy (FCE) is common in dogs; however, there is conflicting information in the veterinary literature regarding clinical characteristics and data on recovery in severe cases is sparse. A systematic review of canine FCE was performed to delineate the natural history of this disease. 322 previously reported cases and 71 previously unreported cases were identified for inclusion. Source publications were identified via PubMed central search and by references from review articles. Previously unreported cases were identified via computerised medical records search at two veterinary institutions. FCE was most common in middle-aged large breed dogs (30 per cent); however, the miniature schnauzer was the most frequently reported individual breed and small breeds comprised 24 per cent of all reported cases. The most common neuroanatomical localisation was a T3-L3 myelopathy (33.1 per cent). Prognosis for recovery of ambulation was good to excellent with 85 per cent of cases regaining the ability to walk unassisted, most within 3 weeks. Persistent neurological deficits were common in patients that recovered ambulation (49.1 per cent). When nociception was absent in the affected limbs at initial presentation, rate of recovery was lower (10 per cent); however, this data is likely biased by limited follow-up in more severe cases. Future prospective studies should evaluate prognosis for more severely affected patients.

IATROGENIC MICROCHIP ARTERIAL EMBOLISM IN A CHILEAN FLAMINGO (PHOENICOPTERUS CHILENSIS).

Aberrant microchip migration has been reported in domestic animal species, but in most cases, this migration is atraumatic to the patient. Reports of microchip-associated trauma and sarcoma development also have been reported in a variety of mammal species. This report describes accidental arterial microchip insertion causing obstruction of the iliac artery in a Chilean flamingo (Phoenicopterus chilensis). Diagnostic imaging included digital radiography and pre- and post-contrast computed tomography to determine the location of the microchip. Surgical removal of the microchip was attempted; however, the flamingo died intraoperatively. Postmortem evaluation found trauma to the epicardium, without penetration of the ventricle. The descending aorta was found traumatized and identified as the most likely insertion point leading to the embolism.

Cardiogenic embolism in the cat.

Cardiogenic embolism (CE) in the cat, which has also been referred to as arterial thromboembolism, feline arterial thromboembolism, and saddle thrombus has been identified clinically in cats for decades and is an important clinical development and cause of death in cats with underlying heart disease. While a better understanding of this condition has been developed over the decades it is extremely frustrating to clinicians that there have not been dramatic changes in prevention or outcome. Only recently has the first prospective thromboprophylactic study on CE in cats been completed. While new antithrombotic drugs are developed for humans on a regular basis, it has been challenging to get pharmaceutical companies to focus on the feline species. Additionally, there remains an absence of clinical data to identify cats at risk for developing CE aside from the simple fact that they have underlying heart disease. This review will attempt to present a summary of where we stand in 2015 with regards to clinical presentation, survival, thrombotic risk, and prevention.

Comparison of cross sectional area and fat infiltration of the epaxial muscles in dogs with and without spinal cord compression.

This study investigated the cross sectional area (CSA) and fat infiltration of the epaxial muscles in Dachshunds with compressive spinal cord lesions due to intervertebral disc herniation (IVDH) and in dogs with non-compressive spinal cord lesions with fibrocartilaginous embolism (FCE). The CSA and fat infiltration of the multifidi and longissimus dorsi muscles were determined from T1 weighted magnetic resonance images. Difference in CSA and fat infiltration between the lesion- and non-lesion side in the Dachshunds was assessed using mixed model analysis. Difference in CSA and fat infiltration between Dachshunds and FCE dogs was analysed with independent sample t-tests. There was no difference in CSA or fat infiltration between sides in the Dachshunds. FCE dogs had greater CSA (multifidus P = 0.036, longissimus P < 0.001) and less fat infiltration compared to Dachshunds (longissimus P = 0.017). Duration of neurological deficits, age, body size and conformation are likely to have influenced the difference between the groups.

Percutaneous transplantation of human umbilical cord-derived mesenchymal stem cells in a dog suspected to have fibrocartilaginous embolic myelopathy.

The use of human umbilical cord blood-derived mesenchymal stem cells for cell transplantation therapy holds great promise for repairing spinal cord injury. Here we report the first clinical trial transplantation of human umbilical cord (hUCB)-derived mesenchymal stem cells (MSCs) into the spinal cord of a dog suspected to have fibrocartilaginous embolic myelopathy (FCEM) and that experienced a loss of deep pain sensation. Locomotor functions improved following transplantation in a dog. Based on our findings, we suggest that transplantation of hUCB-derived MSCs will have beneficial therapeutic effects on FCEM patients lacking deep pain sensation.

Mielomalácia hemorrágica progressiva em 14 cães / Progressive hemorrhagic myelomalacia in 14 dogs

Progressive hemorrhagic myelomalacia (PHM) is a rare and fatal disorder which is characterized by acute and progressive ischemic necrosis of the parenchyma of the spinal cord, leading to its liquefaction. It may occur after intervertebral disc extrusion, spinal trauma or fibrocartilaginous embolism. The aim of this study was to evaluate cases of progressive hemorrhagic myelomalacia in dogs in the Veterinary Hospital of Universidade Estadual de Londrina between 2000 and 2011, through the analysis of medical records and following of cases. There were certain criteria to include a patient in this study, such a history of paraplegia with upper motor neuron signs, worse of signs progressing to flaccid tetraplegia, progressive clinical changes and/or changes in complementary exams. There were analyzed several aspects, such as epidemiological (breed, age and sex), clinical (progress of clinical and neurological signs), laboratory (cerebrospinal fluid analysis - CSF), radiographic (conventional radiography and contrasted) and elapsed time since the onset of clinical signs until death or euthanasia. The most affected breed was Teckel (43%), the average age was 5.04 years and the neurological syndrome observed initially was the thoracolumbar syndrome grade V. Another commons signs observed were hyperpathia and cranial progression of decreased cutaneous trunci reflex. In seven dogs the cause of the PHM was the thoracolumbar intervertebral disc disease, in a dog the cause was spinal cord trauma, in two dogs PHM was due to lymphoma and in four dogs the likely cause was intervertebral disc disease. CSF analysis, myelography changes and progress of clinical and neurological examinations were extremely important to diagnose PHM. Six animals progressed to tetraplegia and four dogs had already flaccid tetraplegia at the initial care. In four other patients, the identification of signs suggestive of PHM before this progression has led to indication for euthanasia. The prognosis is poor and causes animal suffering, so the clinician should be aware of the history of paraplegia with subsequent change of upper motor neuron syndrome to lower motor neuron, cranial decreased reflex panniculus and presence of abdominal breathing. Some alterations in complementary exams found in this study may also help in early diagnosis, as xanthochromic CSF with increased protein, erythrocytes and pleocytosis. Spinal cord edema and the presence of contrast within the nervous tissue together with clinical signs and CSF alterations are suggestive of PHM.

A mielomalácia hemorrágica progressiva (MHP) é uma afecção rara e fatal, em que ocorre necrose aguda isquêmica e progressiva do parênquima da medula espinhal, levando à liquefação da mesma. Pode ocorrer após extrusão do disco intervertebral, trauma medular ou embolismo fibrocartilaginoso. Este estudo teve como objetivo avaliar casos de mielomalácia hemorrágica progressiva em cães atendidos no Hospital Veterinário da Universidade Estadual de Londrina entre os anos 2000 e 2011, realizando-se a análise dos prontuários de atendimento e acompanhamento dos casos. Os animais do presente estudo atendiam a alguns critérios de inclusão, como histórico de paraplegia com sinais de neurônio motor superior, piora dos sinais progredindo para tetraplegia flácida, alterações clínicas progressivas e/ou alterações nos exames complementares. Foram analisados os aspectos epidemiológicos (raça, idade e sexo), clínicos (evolução dos sinais clínicos e neurológicos), laboratoriais (análise do líquido cefalorraquidiano), radiográficos (radiografias simples e contrastadas) e o tempo decorrido desde o início dos sinais clínicos até óbito ou eutanásia. A raça Teckel foi a mais acometida (43%), a média de idade foi de 5,04 anos e no atendimento inicial a síndrome toracolombar grau V foi a alteração mais encontrada, além de hiperpatia e progressão cranial da diminuição do reflexo cutâneo do tronco. Em sete cães a causa da MHP foi a doença do disco intervertebral toracolombar, em um cão a causa foi o trauma medular, em dois cães a MHP foi decorrente de linfoma e em quatro cães a causa provável foi doença de disco intervertebral. Alterações na análise do líquido cerebroespinhal, na mielografia e na evolução dos sinais clínicos e neurológicos foram extremamente importantes para diagnosticar a MHP. Seis animais progrediram para tetraplegia e quatro cães já apresentavam tetraplegia flácida no atendimento inicial. Em outros quatro pacientes, a identificação de sinais sugestivos de MHP antes desta progressão levou à indicação de eutanásia. Como o prognóstico é ruim e ocasiona sofrimento ao animal, o clínico deve estar atento ao histórico de paraplegia com posterior mudança da síndrome de neurônio motor superior para neurônio motor inferior, diminuição do reflexo cutâneo do tronco cranialmente e presença de respiração abdominal, sendo que algumas alterações em exames complementares encontradas neste trabalho também podem auxiliar no diagnóstico precoce da MHP, como o líquido cerebroespinhal xantocrômico com aumento de proteínas, hemácias e pleocitose. Na mielografia o edema medular e a presença de contraste no interior do tecido nervoso, frente às alterações clínicas e liquóricas, são sugestivas de MHP.

Yolk embolism associated with trauma in vitellogenic sea turtles in Florida (USA): a review of 11 cases.

Case information and postmortem examination findings are presented for 11 adult female sea turtles in reproductive form that died in Florida, USA. All had abundant, large vitellogenic follicles, and most were either gravid or had recently nested. Species included six loggerheads (Caretta caretta) and five green turtles (Chelonia mydas). Identified proximate causes of death included falls or entrapment by obstructions on nesting beaches, burial under collapsed dunes, and other traumatic injuries of different causes. Evidence of yolk embolization was found in 10 cases and suspected in an 11th turtle. Ten turtles also had various amounts of free intracoelomic yolk. Although the effects of yolk embolization are uncertain at this time, precedence of pathologic importance in other species suggests that embolism may complicate traumatic injuries, including seemingly minor events.

Antemortem diagnosis and successful management of noncompressive segmental myelopathy in a Siberian-Bengal mixed breed tiger.

A 10-yr-old female spayed mixed breed tiger presented for a 9-day history of acute and nonprogressive paralysis of the pelvic limbs. Magnetic resonance imaging revealed a lesion suggestive of fibrocartilaginous embolic myelopathy with regional spinal cord edema, decreased disk signal intensity at L2-L3, and mild intervertebral disk protrusion at L1-L2 and L2-L3. Cerebral spinal fluid analysis showed no overt evidence of infection or neoplasia. Medical therapy was instituted, including corticosteroids and gastroprotectants as well as nursing care and physical therapy. The tiger began showing clinical improvement 2 wk after initiating treatment, progressing to the point where the animal was standing and intermittently walking. Three months after diagnosis, the tiger had regained muscle strength of its hind limbs and walked regularly with improving coordination. This case is the first report of antemortem diagnosis and successful medical management of suspected fibrocartilaginous embolic myelopathy in a large exotic felid.

Embolised mesothelial cells in a tracheobronchial lymph node associated with idiopathic chylopericardium in a dog.

A 5·5-year-old male castrated Bernese mountain dog presented with respiratory difficulties and was diagnosed with haemorrhagic pericardial effusion which transformed into chylopericardium. Thoracic duct ligation and subtotal pericardiectomy in combination with biopsy of an enlarged tracheobronchial lymph node were performed. Multiple clusters of mesothelial cell emboli were observed in the subcapsular sinus of the lymph node. No causative agent for the pericardial effusion could be identified, suggesting that this is a case of mesothelial cell embolisation associated with idiopathic -chylopericardium in a dog.