Susceptibility of Well-Differentiated Airway Epithelial Cell Cultures from Domestic and Wild Animals to Severe Acute Respiratory Syndrome Coronavirus 2.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally, and the number of worldwide cases continues to rise. The zoonotic origins of SARS-CoV-2 and its intermediate and potential spillback host reservoirs, besides humans, remain largely unknown. Because of ethical and experimental constraints and more important, to reduce and refine animal experimentation, we used our repository of well-differentiated airway epithelial cell (AEC) cultures from various domesticated and wildlife animal species to assess their susceptibility to SARS-CoV-2. We observed that SARS-CoV-2 replicated efficiently only in monkey and cat AEC culture models. Whole-genome sequencing of progeny viruses revealed no obvious signs of nucleotide transitions required for SARS-CoV-2 to productively infect monkey and cat AEC cultures. Our findings, together with previous reports of human-to-animal spillover events, warrant close surveillance to determine the potential role of cats, monkeys, and closely related species as spillback reservoirs for SARS-CoV-2.

Solitary tracheal B-cell lymphoma in an adult alpaca (Vicugna pacos).

BACKGROUND: This report describes a case of solitary tracheal lymphoma in a 14-year-old alpaca mare. CASE PRESENTATION: The alpaca was referred for dyspnea and inspiratory noise. The clinical examination included complete blood cell count, blood chemistry, endoscopy, ultrasound, radiographs, and computed tomography (CT). A solitary tracheal intraluminal and juxtatracheal lymphoma was diagnosed by fine needle aspiration (FNA). The owner requested euthanasia due to the uncertain prognosis. At postmortem examination, the presence of solitary lymphoma without involvement of other organs was confirmed. Immunohistochemical analysis confirmed a B-cell origin. CONCLUSIONS: Although multicentric lymphoma is the most commonly described neoplasia affecting South American camelids (SAC), solitary forms of the disease may occur.

Bronchioalveolar carcinoma in an adult alpaca (Vicugna pacos).

BACKGROUND: This report describes a case of a bronchiolar adenocarcinoma in a 6-year old alpaca mare. For the first time in an alpaca, neoplasia was classified by histopathology as a lepidic-predominant bronchiolar adenocarcinoma. CASE PRESENTATION: The mare was referred to the Clinic for Ruminants after a 6-week period of forced breathing and weight loss. The clinical examination included complete blood count, blood chemistry, ultrasound, radiographs and a CT-scan of the thorax. A bilateral pneumothorax and several, structures within the lung parenchyma were diagnosed. Differential diagnosis included neoplasia, tuberculosis and fungal granulomas. The owner requested euthanasia due to the mare's ongoing deterioration. At postmortem examination, the granulomatous changes in the lungs were histopathologically classified as lepidic dominant bronchiolar adenocarcinoma. CONCLUSIONS: Neoplastic diseases are more often seen in South American camelids compared to other farm animal species. The use of a CT scan was helpful in classifying the lung lesions and give a clear prognosis.

Polymelia in a chimeric Simmental calf: nociceptive withdrawal reflex, anaesthetic and analgesic management, anatomic and genetic analysis.

BACKGROUND: Polymelia is a congenital defect characterized by one or more supernumerary legs. The genetics and aetiology of this condition in cattle have not yet been thoroughly investigated even though several case reports do exist. The model of the nociceptive withdrawal reflex (NWR) has been characterized in several species to study spinal nociceptive processing. It is a polysynaptic spinal reflex that can be elicited by noxious electrical stimulation and recorded by electromyography. Thorough nociceptive examination and preventive analgesic management has not yet been an aspect in the perioperative management of polymelia cases. CASE PRESENTATION: A 4-month-old female Simmental calf was presented with notomelia. The animal was in good health and showed no neurologic deficiencies. Preoperatively, computed tomography was performed to gain more detailed anatomical information. To evaluate the sensitivity of the accessory limb, NWR testing was performed and revealed a connection of the afferent reflex pathway of the accessory limb to the efferent of the normal limb. The accessory limb was surgically removed under general anaesthesia. Intensive care included multimodal pain therapy adapted to the pain intensity scored during regular pain assessment. A gross anatomical dissection as well as a genetic analysis of the accessory limb were performed postoperatively. The calf was identified as a chimera. CONCLUSION: This calf was successfully relieved of its accessory limb. Chimerism has not been described in the congenital defect polymelia. As the accessory limb was pain sensitive and a common nociceptive reflex pathway was identified, thorough perioperative pain management was performed with the intention to prevent chronic neuropathic pain development.

Isolation of Streptococcus agalactiae in a female llama (Lama glama) in South Tyrol (Italy).

BACKGROUND: Streptococcus agalactiae is pathogenic for both animals and humans. In dairy cattle it commonly causes mastitis, with great economic losses, and there is scientific evidence of mastitis, caseous lymphadenitis, contagious skin necrosis and purulent infections associated with S. agalactiae in camels (Camelus dromedarius) as well. In humans, it is a common component of the respiratory and gastrointestinal microflora, but it can also act as a pathogen, especially in elderly people and immunocompromised patients, as well as in pregrant women and newborns. CASE PRESENTATION: A 10-year old non-pregnant female llama (Lama glama) was conferred to the Institute for Animal Health Control, in Bolzano for necropsy after sudden death. The animal had not shown unusual behaviour and had a low to normal nutritional condition (body condition score 2/5). The breeder had reported a chronic suppurative subcutaneous infection in the intermandibular area, resistant to therapy (therapy unknown). After necropsy, several samples were processed for histological, bacteriological and parasitological examinations. CONCLUSIONS: This report describes, to the best of our knowledge, the first isolation of S. agalactiae in llamas (Lama glama). The animal came from a herd that counts approximately 200 South American camelids (llamas, alpacas) along with several horses, chicken, rabbits, cats and dogs; this farm offers services, such as trekking and pet therapy activities.

Dystrophic mineralization of the arterial fibrovascular tissue associated with a vitamin D hypervitaminosis in an 8-year-old female Alpaca (Vicugna pacos).

BACKGROUND: Prophylactic Vitamin D supplementation is a common practice in Alpaca breeding in many regions around the world. An overdosage can lead to dystrophic mineralization of soft tissues. In this paper we illustrate a suspected case of hypervitaminosis D in an 8-year-old female Alpaca. CASE PRESENTATION: In June 2015, the carcass of an 8-year-old female Alpaca (Vicugna pacos) was submitted to the diagnostic laboratory of the Istituto Zooprofilattico Sperimentale delle Venezie (IZSVe) for necropsy. The animal had undergone a spontaneous abortion with uterine prolapse and delivery of the placenta, and had died shortly thereafter. Death occurred due to internal haemorrhage related to dystrophic mineralization of the left renal artery with subsequent rupture and damage of the renal hilum. During the necropsy, histopathological and serum biochemical analyses were performed. After laboratory analyses and the history of mineral and vitamin supplementation reported by the breeder, a hypervitaminosis D was suspected to be the most probable cause of the dystrophic mineralization observed in the left renal artery. CONCLUSIONS: Most of the information regarding Llamas and Alpacas comes from the South American and Australian regions. It is therefore important to provide scientific information about these animals in other regions of the world in order to have a better and wider understanding of the nutritional and environmental conditions necessary for optimal breeding.

Computed tomographic and radiographic examination of dental structures in South American camelid specimen of different ages.

BACKGROUND: Tooth root problems and periodontal diseases are common in South American camelids (SAC). The objective was to evaluate and optimize the imaging technique for dental radiography in SAC and to describe the radiographic and computed tomographic (CT) anatomy of normal teeth at different ages. In this study, the heads of 20 healthy SAC slaughtered for meat production or euthanized for reasons not related to dental problems included 7 female and 10 male llamas and 3 male alpacas. Using a standardized protocol, radiographs and CT scans of the 20 specimen were performed. RESULTS: The most useful radiographic projections for mandibular and maxillary cheek teeth evaluation turned out to be lateral30°ventral-laterodorsal and lateral30°dorsal-lateroventral with slight separation of the dental arcades respectively. Digital radiographic and CT appearance of the mandibular and maxillary teeth were described from the beginning of mineralization till maturity. In addition the normal range of the CT radio density of different cheek teeth and different dental tissues were measured. Hounsfield units of different dental tissues of SAC turned out to be similar to equids. Deviation, shortening and partial destruction of the distal tooth root of mandibular 09's and 10's and of maxillary 09's was observed and the existence of a common pulp chamber in younger teeth was revealed. CONCLUSIONS: The present study provides information about the dental imaging morphology in clinically healthy SAC. This basic information provides fundamental knowledge for evaluating images and planning treatments in clinically affected animals.

Reindeer Husbandry in Switzerland-Management, Feeding, and Endoparasite Infections.

The aim of the present work was to provide an overview of management and feeding practices, and the prevalence of endoparasite infections in captive Swiss reindeer. On two visits to eight farms or zoos, a standardized questionnaire was completed. A total of 67 reindeer were weighed, and fecal samples were collected. The primary management concerns voiced by owners/managers were feeding and successful breeding. All reindeer were fed roughage ad libitum and supplementary feed for reindeer or other browsers, with different compositions in each herd. Males over two years of age weighed from 60 kg up to 127.5 kg, whereas females had a body weight from 53.5 kg to 86.5 kg. The prevalence of gastrointestinal strongyles was 68.6% (46/67), with reindeer in zoos having a lower prevalence (36%; 9/25) than reindeer from private farms (88%; 37/42). Capillaria sp., Strongyloides sp., and Trichuris sp. were detected in lower prevalences (<24%) and were also more frequent in private farms. Intestinal protozoa, as well as fluke and tapeworms, were not detected in any herd. This study provides an overview on husbandry, feeding, and endoparasite prevalence in reindeer in Switzerland and should be of help for breeders and veterinarians dealing with this animal species.

Two Years after Coxiella burnetii Detection: Pathogen Shedding and Phase-Specific Antibody Response in Three Dairy Goat Herds.

The infection dynamics of Coxiella (C.) burnetii were investigated in three dairy goat herds (A, B, and C) 2 years after the first pathogen detection. A total of 28 and 29 goats from herds A and B, and 35 goats from herd C, were examined. Sera were analyzed on three sampling dates using phase-specific serology. Pathogen shedding was assessed using post-partum vaginal swabs and monthly bulk tank milk (BTM) samples. Dust samples from a barn and milking parlor were also collected monthly. These samples were analyzed with PCR (target IS1111). In herd A, individual animals tested seropositive, while vaginal swabs, BTM, and most dust samples tested negative. Herds B and C exhibited high IgG phase I activity, indicating a past infection. In herd B, approximately two-thirds of the goats shed C. burnetii with vaginal mucus, and irregular positive results were obtained from BTM. Herd C had two positive goats based on vaginal swabs, and BTM tested positive once. Dust samples from herds B and C contained C. burnetii DNA, with higher quantities typically found in samples from the milking parlor. This study highlights the different infection dynamics in three unvaccinated dairy goat herds and the potential use of dust samples as a supportive tool to detect C. burnetii at the herd level.

Prevalence and antimicrobial resistance of Salmonella enterica subsp. diarizonae serovar 61:k:1,5,(7) in Swiss sheep flocks.

Salmonella (S.) enterica subspecies diarizonae (IIIb) serovar 61:k:1,5,(7) (S. IIIb 61:k:1,5,(7)) is considered to be sheep-associated, as it can be found in the intestine, tonsils and nose of clinically healthy sheep, but it has also been described in separate clinical disorders in sheep. In particular, S. IIIb 61:k:1,5,(7) is described as the causative agent of chronic proliferative rhinitis (CPR) in sheep. In Switzerland, CPR in sheep due to S. IIIb 61:k:1,5,(7) was first described in 2017 in a flock of Texel sheep. Therefore, we assessed the prevalence of S. IIIb 61:k:1,5,(7) within the Swiss sheep population using a representative sampling strategy. From May 2017 to June 2018 a total of 681 nasal swabs from individual clinically healthy sheep of 141 different flocks throughout Switzerland were taken. Swabs were analysed by selective enrichment for the presence of S. IIIb 61:k:1,5,(7). Additionally, antimicrobial resistance of the isolates was determined by broth microdilution. A total of 146 out of 681 nasal swabs tested positive for S. IIIb 61:k:1,5,(7), which corresponds to a prevalence on animal level of 21% (95%CI 18%-25%). In 73 out of 141 flocks tested, at least one sheep tested positive for S. IIIb 61:k:1.5,(7), resulting in a minimal prevalence on flock level of 52% (95%CI 43%-60%). Positive flocks were found in all cantons except the canton of Jura. Adults were significantly more affected than sheep under one year/lambs and positive sheep were found in several breeds. No microbiologically resistant isolates were detected, except for one isolate showing resistance against ampicillin. Because of its widespread occurrence in the Swiss sheep population, further research should focus on the pathogenic impact of S. IIIb 61:k:1,5,(7) on the health status of sheep.

Toxoplasma gondii and Neospora caninum infections in sheep and goats in Switzerland: Seroprevalence and occurrence in aborted foetuses.

Toxoplasma gondii and Neospora caninum infections are important causes of abortion in ruminants. Besides, meat from T. gondii infected animals represent a major infection source for humans. The occurrence of these protozoan parasites in Switzerland was investigated both, in a nationwide cross-sectional serological survey, and by molecular methods in aborted sheep and goat foetuses. A total of 653 sheep from 143 farms and 748 goats from 164 farms were tested by commercial ELISAs and inconclusive results were defined by immunoblot. Besides, a risk factor analysis for seropositivity was performed. The observed seroprevalences for T. gondii in sheep and goats were 66.3% and 50.5% at the animal level, and 90.9% and 81.1% at the farm level, respectively. For N. caninum, the detected seroprevalences in sheep and goats were 0.8% and 0.9% at the animal level, and 2.8% and 1.8% at the farm level, respectively. Older small ruminants, and sheep (vs. goats) had a higher risk of being seropositive to T. gondii. Alpine grazing in summer was identified as a protective factor for seropositivity to T. gondii in both animal species. Toxoplasma gondii and N. caninum DNA were detected in 6.1% and 2.4% (n = 82), and in 6.8% and 1.4% (n = 73) of the tested ovine and caprine foetuses, respectively. These results suggest the involvement of these parasites in abortions and reveal a high prevalence of T. gondii and lower prevalence of N. caninum infections in small ruminants in Switzerland. They also suggest that consumption of undercooked meat from T. gondii infected sheep and goats may represent a risk for public health.

Switzerland-wide Neospora caninum seroprevalence in female cattle and identification of risk factors for infection.

Introduction: Neospora caninum is an important cause of abortion in cattle worldwide. Infection in cattle occurs horizontally by ingestion of oocysts shed by canids or vertically, from an infected dam to the fetus, and may result in abortion, stillbirth, or birth of seropositive offspring. The control of bovine neosporosis is difficult and costly. The objectives of this study were to estimate the current nationwide seroprevalence of N. caninum infections in Swiss cattle and to assess risk factors for infection with this parasite. Methods: We conducted a cross-sectional study with cattle farms randomly selected and stratified according to population size, resulting in a sample of 780 female cattle. The cattle originated from 161 farms distributed over all Switzerland. The serum samples were tested for antibodies against N. caninum using a commercial ELISA and if inconclusive, retested using an in-house immunoblot technique. To collect farm parameters relevant to N. caninum transmission and prevention, farm owners were mailed a questionnaire which addressed topics putatively related to N. caninum infection such as husbandry, history of abortion, and presence of dogs on farm. Univariate analysis by generalized linear mixed model (with animal seropositivity as outcome variable) and logistic regression modeling (with farm seropositivity as outcome variable) was conducted on farm parameters investigated in the questionnaire. Results: By ELISA and immunoblot, 4.2% (33/780) of cattle sera yielded positive results. At the farm level, 16.2% (26/161) of the sampled farms had at least one seropositive animal. The return rate of the valid questionnaires was 54.0%. At the animal level, odds for farm seropositivity were 3.8 times higher when rodents had been recorded by the farmer as a problem on the farm. At the farm-level, two protective factors were identified: rearing of replacement heifers and feeding of concentrated feed. Conclusion: We recorded a low seroprevalence of N. caninum in a random sample of Swiss cattle representative for the years 2017-2018. Based on a questionnaire survey, we could identify risk and protective factors for infection with N. caninum, however their biological relevance needs to be confirmed in further studies.

Establishment of well-differentiated camelid airway cultures to study Middle East respiratory syndrome coronavirus.

In 2012, Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in Saudi Arabia and was mostly associated with severe respiratory illness in humans. Dromedary camels are the zoonotic reservoir for MERS-CoV. To investigate the biology of MERS-CoV in camelids, we developed a well-differentiated airway epithelial cell (AEC) culture model for Llama glama and Camelus bactrianus. Histological characterization revealed progressive epithelial cellular differentiation with well-resemblance to autologous ex vivo tissues. We demonstrate that MERS-CoV displays a divergent cell tropism and replication kinetics profile in both AEC models. Furthermore, we observed that in the camelid AEC models MERS-CoV replication can be inhibited by both type I and III interferons (IFNs). In conclusion, we successfully established camelid AEC cultures that recapitulate the in vivo airway epithelium and reflect MERS-CoV infection in vivo. In combination with human AEC cultures, this system allows detailed characterization of the molecular basis of MERS-CoV cross-species transmission in respiratory epithelium.

Ovine footrot: A review of current knowledge.

Footrot is a contagious foot disease mainly affecting sheep. It is caused by the Gram-negative anaerobic bacterium Dichelobacter nodosus. Warm, wet environmental conditions favour development of footrot, and under perfect conditions, it takes just 2-3 weeks from infection to manifestation of clinical signs. Affected sheep show lameness of various degrees and often graze while resting on their carpi. Local clinical signs vary in severity and extent from interdigital inflammation (benign footrot) to underrunning of the complete horn shoe in advanced stages of virulent footrot. Laboratory diagnosis ideally involves collection of four-foot interdigital swab samples followed by competitive real time PCR, allowing for detection of the presence of D. nodosus and differentiation between benign and virulent strains. Laboratory-based diagnostics at the flock level based on risk-based sampling and pooling of interdigital swab samples are recommended. The list of treatment options of individual sheep includes careful removal of the loose undermined horn, local or systemic administration of antimicrobials, systemic administration of non-steroidal anti-inflammatories (NSAIDs) and disinfectant footbathing. Strategies for control at the flock level are manifold and depend on the environmental conditions and the procedures traditionally implemented by the respective country. Generally, measures consist of treatment/culling of infected sheep, vaccination and prevention of reinfection of disease-free flocks. Gaining deeper insight into the beneficial effects of NSAIDs, screening for eco-friendly footbath solutions, developing better vaccines, including the development of a robust, reproducible infection model and elucidation of protective immune responses, as well as the elaboration of effective awareness training programs for sheep farmers, are relevant research gaps.

Influence of Housing and Management on Claw Health in Swiss Dairy Goats.

Due to a rising demand for goat milk and goat milk products worldwide, it is likely that dairy goat production will be intensified in the future, with larger herds per farm. In Switzerland, as in many other countries with intensive farming systems, dairy goats are typically housed on deep litter, with little access to hard abrasive surfaces. Such housing conditions will result in wall horn overgrowth. The aim of this study was to gain profound knowledge on the occurrence of overgrown wall horn, its impact on claw health and locomotor behavior, and possible adverse effects on animal welfare. Additionally, housing and management factors that may contribute to non-physiological claw conditions were evaluated. To compare claw conditions after the summer grazing period and the winter indoor housing period, data were collected on 28 Swiss dairy goat farms in autumn and spring (621 goats in total). Claw lesions were recorded with the help of a "claw card" documenting each claw. Furthermore, pictures were taken of each claw to determine the severity of wall horn overgrowth. Locomotion behavior (activity, lying time and lying bouts) was recorded with three-dimensional accelerometers fixed to the goats' hind legs. In autumn, 66.7% of the examined claws showed moderate overgrowth, 32.4% severe overgrowth and 0.9% no overgrowth. In spring, 47.4% of the examined claws were affected with moderate overgrowth, 52.6% with severe overgrowth and 0.0% with no overgrowth. Horn separation (48.1% of examined claws) and sole hemorrhages (16.0% of examined claws) were the most frequent lesions. In goats with severely overgrown claws, the risk of developing sole hemorrhages was doubled compared with moderate overgrowth. The occurrence rate of horn separation was lower if the trimmer had attended a special skills training course (p < 0.001). Furthermore, locomotor activity (p < 0.01) and the number of lying bouts per day (p < 0.01) were higher in spring than autumn. Neither the goats' activity nor the number of lying bouts per day differed before and after claw trimming. Finally, season and trimming were not associated with the goats' total lying time. A certain extent of wall horn overgrowth in dairy goat claws cannot be avoided under the housing conditions typical for Swiss farms. Severe wall horn overgrowth is associated with an increase in the proportion of claws with sole hemorrhages. Therefore, regular and careful functional claw trimming, taking the housing situation (deep bedding, access to pasture, grazing on alpine pasture) into account, should be promoted.

Causes of Abortions in South American Camelids in Switzerland-Cases and Questionnaire.

Over the last decade, South American camelids (SAC) have gained increasing popularity in Switzerland. They are used for several purposes such as fiber and meat production, as companion or guard animals and for trekking activities. The purpose of this study was to investigate the frequency and reasons for pregnancy loss and perinatal death in SAC herds. Within the scope of this study, early embryonic losses could not be identified, as pregnancy examinations by ultrasonography are not performed routinely. Aborted and stillborn fetuses were collected, necropsied and analyzed for infectious abortifacients. A nationwide survey among breeders was carried out. During a 1.5-year period, only eight cases of aborted or stillborn alpaca and llama (out of a population of 6550 animals) were reported by the breeders, and their causes were subsequently analyzed. In half of the cases, Coxiella burnetii was identified in the fetoplacental material. Abortions and stillbirths were reported to be rare in Swiss herds. As a conclusion, recording of embryonic losses through ultrasound training of veterinarians should be impaired and breeders motivated to have abortions and perinatal mortality examined. Special focus should be laid on C. burnetii due to its zoonotic risk.

Animal-Based Indicators for On-Farm Welfare Assessment in Sheep.

The value society assigns to animal welfare in agricultural productions is increasing, resulting in ever-enhancing methods to assess the well-being of farm animals. The aim of this study was to review the scientific literature to obtain an overview of the current knowledge on welfare assessments for sheep and to extract animal-based welfare indicators as well as welfare protocols with animal-based indicators. By title and abstract screening, we identified five protocols and 53 potential indicators from 55 references. Three out of the five protocols include animal-based as well as resource-based indicators. All of them were assessed as being practicable on-farm but lacking reliability. Some of the single indicators are endorsed by the literature and widely used in the field like assessment of behaviour, lameness or body condition score. Others (e.g., Faffa Malan Chart FAMACHA©, dag score or pain assessment) are regularly mentioned in the literature, but their reliability and usefulness are still subject of discussion. Several indicators, such as pruritic behaviour, eye condition, lying time or tooth loss are relatively new in the literature and still lack evidence for their validity and usefulness. This literature review serves as a starting point for the development of valid and practicable welfare protocols for sheep.

Animal-Based Indicators for On-Farm Welfare Assessment in Goats.

This review describes the current state of knowledge relating to scientific literature on welfare indicators for goats. Our aim was to provide an overview of animal-based indicators for on-farm welfare assessments. We performed a literature search and extracted 96 relevant articles by title, abstract, and full-text screening. Out of these articles, similar indicators were aggregated to result in a total of 32 welfare indicators, some of which were covered in multiple articles, others in only a single one. We discuss a set of three established assessment protocols containing these indicators, as well as all individual indicators which were covered in more than one article. As single indicators, we identified lameness, body condition score (BCS), qualitative behaviour assessment (QBA), and human-animal relationship (HAR) tests with substantial evidence for sufficient validity to assess welfare in goats. A multitude of indicators (e.g., hair coat condition) was studied less intensively but was successfully used for welfare assessments. For some indicators (e.g., oblivion, lying behaviour), we highlight the need for future research to further validate them or to optimise their use in on-farm welfare assessments. Moreover, further investigations need to include kids, bucks, and meat and fibre goats, as well as extensively kept goats as the literature predominantly focuses on dairy goats in intensive production systems.

Clinicopathological and Genomic Characterization of a Simmental Calf with Generalized Bovine Juvenile Angiomatosis.

Bovine juvenile angiomatosis (BJA) comprises a group of single or multiple proliferative vascular anomalies in the skin and viscera of affected calves. The purpose of this study was to characterize the clinicopathological phenotype of a 1.5-month-old Simmental calf with multiple cutaneous, subcutaneous, and visceral vascular hamartomas, which were compatible with a generalized form of BJA, and to identify genetic cause for this phenotype by whole-genome sequencing (WGS). The calf was referred to the clinics as a result of its failure to thrive and the presence of multiple cutaneous and subcutaneous nodules, some of which bled abundantly following spontaneous rupture. Gross pathology revealed similar lesions at the inner thoracic wall, diaphragm, mediastinum, pericardium, inner abdominal wall, and mesentery. Histologically, variably sized cavities lined by a single layer of plump cells and supported by a loose stroma with occasional acute hemorrhage were observed. Determined by immunochemistry, the plump cells lining the cavities displayed a strong cytoplasmic signal for PECAM-1, von Willebrand factor, and vimentin. WGS revealed six private protein-changing variants affecting different genes present in the calf and absent in more than 4500 control genomes. Assuming a spontaneous de novo mutation event, one of the identified variants found in the PREX1, UBE3B, PCDHGA2, and ZSWIM6 genes may represent a possible candidate pathogenic variant for this rare form of vascular malformation.