Endogenous lipid pneumonia in a ringed seal (Pusa hispida subsp. ochotensis).

An adult female ringed seal died suddenly and was subsequently examined for diagnostic purposes. The animal's lungs demonstrated mild non-collapsibility and multifocal white to yellow patches. Histopathological examination revealed multifocal pulmonary histiocytosis. Alveoli were filled with numerous foamy macrophages cytoplasm and scattered multinucleated giant cells containing cholesterol clefts. The foamy cytoplasm of the macrophages stained with oil red O stain. Further, lipid droplets within the cytoplasm were detected by electron microscopy. To the author's knowledge, this is the first case report describing the histochemical staining and electron microscopic findings associated with endogenous lipid pneumonia in ringed seal.

Endogenous lipid pneumonia associated with atherosclerosis in a blue-fronted Amazon parrot (Amazona aestiva).

Endogenous lipid pneumonia is a rare inflammatory, non-infectious lung disease characterized by the accumulation of endogenous lipids in alveolar macrophages. It has been associated with bronchial obstruction, chronic lung inflammation, alveolar proteinosis and lipid storage disorders. A 14-year-old female blue-fronted Amazon parrot (Amazona aestiva) presented with intermittent dyspnoea, neurological signs and persistent lipaemia of unknown aetiology. At necropsy, the most relevant gross findings were increased rigidity of the great vessels, lungs with diffuse grey to whitish discolouration of the parenchyma and multifocal small yellowish nodules. Microscopic examination revealed typical lesions of atherosclerosis and severe multifocal accumulation of foamy macrophages filling the parabronchi, which led to a diagnosis of endogenous lipid pneumonia. Although the relationship between dyslipidaemia, atherosclerosis and endogenous lipid pneumonia in birds is not well established, the chronic dyslipidaemia of unknown origin could be involved in the pathogenesis of both the atherosclerosis and the endogenous lipid pneumonia. The present case highlights the need to better understand the relationships between various disorders of lipid metabolism in psittacine birds.

Endogenous lipoid pneumonia associated with pulmonary neoplasia in three dogs.

Endogenous lipoid pneumonia is a poorly characterised condition in veterinary medicine, particularly in dogs, but it is well recognised in association with lung neoplasia in humans. This case series describes three unique cases of endogenous lipoid pneumonia associated with lung neoplasia, including clinical, imaging, cytological findings and outcome. Clinical presentation and imaging lesions can appear non-specific and may be obscured by neoplastic infiltrate and so diagnosis requires cytology or histopathology. Awareness of endogenous lipoid pneumonia in dogs with pulmonary neoplasia has an impact on staging and monitoring, treatment of clinical signs and quality of life and also aids appropriate use of antimicrobials.

Nasogastric Intubation as Health and Safety Risk in Equine Practice-A Questionnaire.

Placing a nasogastric tube can be a life-saving act for a horse but is considered an occupational hazard for veterinarians. An online questionnaire was performed to assess and specify potential risks. 123 equine veterinarians completed the survey, and the majority admitted using the mouth to handle the end of the nasogastric tube (sucking or blowing air) and having accidentally swallowed or aspirated stomach content or medications. This can potentially lead to aspiration pneumonia or pneumonitis. Mineral oil seems to be especially dangerous as aspiration may be asymptomatic at the beginning and lipoid pneumonitis may develop. Furthermore, 60% of responders would also handle the tube with their mouth if the horse was presented with fever and diarrhea or reflux formation, which might be affected by Salmonella sp. or Clostridium difficile producing toxins. The fact that nasogastric tubes are rarely being disinfected increases the risk of infection. 50% of veterinarians would use their mouth to suck or blow air into the tube during nasogastric intubation, even if the patient was presented with suspected poisoning. Rodenticide zinc phosphide is particularly dangerous as its breakdown product is a highly toxic gas. Inhalation leads to serious symptoms in humans, including pulmonary edema and neurological signs. Alternatives to mouth use (lavage, big syringe, or suction pump) when passing a tube should be considered, especially if a patient is presented with duodenitis-proximal jejunitis, diarrhea, or suspected poisoning. Awareness needs to be raised among veterinarians that nasogastric intubation is an extremely hazardous occupational practice.

Lipid-Related Lesions in Quaker Parrots ( Myiopsitta monachus).

The Quaker parrot has been used as a psittacine model to study clinical lipidology and lipid-related disorders. However, while Quaker parrots appear to be anecdotally susceptible to a variety of spontaneous dyslipidemic disorders and lesions caused by excess lipid accumulation, epidemiologic data are lacking. A multicenter retrospective study on 652 pathology submissions (411 necropsies and 243 biopsies) from Quaker parrots was performed by recording the final pathological diagnoses, age, and sex for each bird. The prevalence of lesions associated with lipid metabolism, such as hepatic lipidosis, atherosclerosis, xanthomas, adipose tumors, coelomic steatitis/steatonecrosis, endogenous lipid pneumonia, and acute pancreatic necrosis/pancreatitis, was reported. Multiple logistic regression models were used to characterize the effects of sex and age on these lesions, and the prevalence of hepatic lipidosis and atherosclerosis was compared to those in a random sample of control psittacine birds. The raw prevalence of atherosclerosis and hepatic lipidosis was 5.6% (95% confidence interval [CI], 3.4%-7.8%) and 21.2% (95% CI, 17.2%-25.1%), respectively. While the prevalence of atherosclerosis was similar to other psittacine species, hepatic lipidosis was more common in Quaker parrots. Quaker parrots also showed a unique susceptibility to acute pancreatic necrosis with a prevalence of 12.9% (95% CI, 9.7%-16.1%). Male parrots were found to be more susceptible than females to lipid accumulation lesions ( P = .0024), including atherosclerosis ( P = .018) and hepatic lipidosis ( P < .001). This retrospective study confirms the high susceptibility of Quaker parrots to lipid-related disorders and presents epidemiological data that may be useful to avian clinicians, pathologists, and researchers using Quaker parrots.

Lipoid pneumonia in an orangutan (Pongo abelii) with chronic respiratory problems.

An orangutan (Pongo abelii) presented with chronic respiratory problems. Cytological evaluation of the bronchoalveolar lavage fluids revealed macrophages with well-circumscribed intracytoplasmic clear vacuoles and lipid droplets in the background, confirmed by Oil Red O staining. The findings were indicative of lipoid pneumonia. This is the first report of lipoid pneumonia in an orangutan.

Morbillivirus-associated lipid pneumonia in Arctic foxes.

We describe lipid pneumonia in 5 of 24 Arctic foxes ( Vulpes lagopus) in association with morbillivirus infection, and lymphoid depletion in 3 of these 5 foxes. Canine distemper virus (CDV) immunohistochemistry yielded positive staining in lung, lymph nodes, spleen, adipose tissue, and renal pelvic urothelial cells in 5 cases. Liver and bone marrow samples collected from these cases tested positive for morbillivirus by reverse-transcription PCR assay. Strains belonged to the CDV Arctic lineage based on sequencing of the hemagglutinin gene followed by phylogenetic analysis. Phylogenetic analysis of the phosphoprotein gene showed that the identified CDV strains were not closely related to any previously documented strains responsible for outbreaks in different animals in other parts of the world.

Mycobacterium fortuitum lipoid pneumonia in a dog.

A 1-year old female spayed German Shepherd dog was evaluated for acute onset of dyspnea. Pyogranulomatous inflammation and green globoid structures were present on aspirates of the affected lung. Impression smears and histopathology confirmed pyogranulomatous pneumonia, with large amounts of lipid corresponding to the green structures noted cytologically, and identified poorly staining bacterial rods within lipid vacuoles. Special stains confirmed the presence of acid-fast bacterial rods, and polymerase chain reaction and DNA sequencing identified the organism as Mycobacterium fortuitum. M. fortuitum pneumonia is well described in humans and has previously been reported in 4 dogs and 1 cat. Lipid was a prominent cytologic and histologic feature, as is often described in humans and in the single feline case report. Additionally, this case highlights the variable cytologic appearance of lipid, as well as Mycobacterium spp, which are classically nonstaining with Wright-Giemsa.

Endogenous lipid pneumonia in an African grey parrot (Psittacus erithacus erithacus).

Lipid pneumonia is an unusual, non-infectious, inflammatory lung disease characterized by patchy pneumonic consolidation secondary to accumulation of lipid in macrophages. It can be classified as exogenous or endogenous, depending on whether it is associated with the aspiration of foreign material. Endogenous lipid pneumonia (EnLP) has been reported in many mammal species. In pet birds, EnLP is an incidental and uncommon lesion of unknown pathogenesis. A 35-year-old African grey parrot (Psittacus erithacus erithacus) was presented for depression lasting several months, with marked worsening over the 2 days prior to presentation. The animal died shortly after admission. Necropsy examination showed that the lungs were firm with diffuse grey discolouration. Microscopically, there was EnLP, anthracosis, severe atherosclerosis and hepatic amyloidosis. Although the pathogenesis of EnLP in birds is not clear, it has been associated with concurrent atherosclerosis, hepatic diseases and other lesions of the respiratory tract. This is the first description of EnLP in a bird associated with severe respiratory distress.

Endogenous lipid (cholesterol) pneumonia in three captive Siberian tigers (Panthera tigris altaica).

During the years 2009-2011, 7 Siberian tigers (Panthera tigris altaica), aged between 2 and 14 years, from the Safaripark of Pombia were referred for necropsy to the Department of Animal Pathology of the University of Turin (Italy). Three tigers, aged 10 (2 animals) and 14 years, had multifocal, irregularly distributed, white, soft, subpleural, 3-mm nodules scattered throughout the lungs. Histologically, there was a marked infiltration of macrophages, with foamy cytoplasm, and multinucleate giant cells interspersed with numerous clusters of cholesterol clefts. A mild lymphocytic infiltration was localized around the lesion. The findings were consistent with endogenous lipid pneumonia, which was considered an incidental finding of no clinical significance.

Bromide-associated lower airway disease: a retrospective study of seven cats.

Seven cats were presented for mild-to-moderate cough and/or dyspnoea after starting bromide (Br) therapy for neurological diseases. The thoracic auscultation was abnormal in three cats showing increased respiratory sounds and wheezes. Haematology revealed mild eosinophilia in one cat. The thoracic radiographs showed bronchial patterns with peribronchial cuffing in most of them. Bronchoalveolar lavage performed in two cats revealed neutrophilic and eosinophilic inflammation. Histopathology conducted in one cat showed endogenous lipid pneumonia (EnLP). All cats improved with steroid therapy after Br discontinuation. Five cats were completely weaned off steroids, with no recurrence of clinical signs. In one cat, the treatment was discontinued despite persistent clinical signs. The cat presenting with EnLP developed secondary pneumothorax and did not recover. Br-associated lower airway disease can appear in cats after months of treatment and clinical improvement occurs only after discontinuing Br therapy.

Imaging of exogenous lipoid pneumonia simulating lung malignancy in a dog.

This report presents peculiar radiographic and computed tomographic features of a lung mass in a dog, later diagnosed by histology as exogenous lipoid pneumonia. Although lipoid pneumonia is a well-known pathological entity in pets, this is the first imaging description of a single infiltrative lesion mimicking a neoplasm.

Endogenous lipid pneumonia in a dog.

Endogenous lipid pneumonia has previously been diagnosed in dogs only once. This report describes a case in a dog with a persistent cough, in which the histological diagnosis was based on the presence of numerous foamy macrophages that filled the alveoli and contained small sudanophilic vacuoles. The appearance of endogenous lipid pneumonia in this animal was accompanied by Dirofilaria immitis infection and chronic bronchitis.

Canine distemper in a genet (Gennetta gennetta), associated with endogenous lipid pneumonia.

This report describes the histological and immunohistochemical findings in an adult male genet (Gennetta gennetta) which died a few hours after being found lying in a forest in Lugo (north-western Spain). Subpleural, yellowish, firm foci were found in the lung. Histopathological examination confirmed a diagnosis of endogenous lipid pneumonia. Microscopical lesions that gave rise to a suspicion of canine distemper virus (CDV) infection included lymphoid depletion, non-suppurative encephalitis and demyelination in the central nervous system, and the presence of inclusion bodies in renal tubules. Immunohistochemical examination was performed with the streptavidin-biotin-complex method and a monoclonal antibody against the nucleocapsid protein (NP) of CDV. Antigen was detected in epithelial, nervous and lymphoid cells in several organs. This would appear to be the first report of distemper-like infection in a genet.

Lymphosarcoma in a brown bear (Ursus arctos).

An example of lymphoblastic lymphosarcoma was found in a 7-year-old male brown bear (Ursus arctos) that died after having a 7-month history of depression, anorexia and watery diarrhea. Grossly the mesenteric lymph nodes were enlarged to approximately 4 to 6 times their normal size and histologically diagnosed as lymphoblastic lymphosarcoma. The small intestinal mucosa was corrugated and had severe mural thickening due to infiltrated neoplastic cells. Hepatic metastasis was also noted. This is the first reported case of lymphosarcoma in Ursidae in Korea. As an incidental finding, endogenous lipid pneumonia was noted in the lung.

Endogenous lipid pneumonia in cats: 24 cases (1985-1998).

OBJECTIVE: To determine clinical signs, radiographic and histologic abnormalities, and concurrent diseases in cats with endogenous lipid pneumonia (EnLP) and to determine the pathologic importance of EnLP in cats. DESIGN: Retrospective study. ANIMALS: 24 cats. PROCEDURE: Medical records of cats in which EnLP was confirmed by histologic examination of necropsy specimens were reviewed. Information collected from the medical records included signalment, body weight, clinical signs, and results of clinicopathologic tests. Thoracic radiographs were reviewed by a radiologist; histologic specimens were reviewed by a pathologist. RESULTS: All cats had nonspecific clinical abnormalities, such as lethargy, anorexia, or weight loss; 16 had signs of respiratory tract disease. All cats had concurrent systemic diseases, and clinicopathologic abnormalities were reflective of these conditions. Nonspecific abnormalities were detected on thoracic radiographs from 9 of 11 cats. Most cats had macroscopic, multifocal, subpleural lesions; inflammatory infiltrates, cholesterol clefts, and multinucleated giant cells were common. Ten cats had an underlying obstructive pulmonary disease that was the likely cause of EnLP. Lesions of EnLP were not considered to be severe enough or extensive enough to be the cause of death in any of these cats. CONCLUSIONS AND CLINICAL RELEVANCE: EnLP is an uncommon respiratory tract disorder of cats with no pathognomonic clinical, laboratory, or radiographic findings. Although EnLP was not the cause of death in any of these cats, results of the present study do suggest that EnLP may be a marker for potentially severe underlying obstructive pulmonary disease.