Suspected renal interstitial cell tumor causing polycythemia in two dogs.

Here we report a case series of two dogs diagnosed as renal interstitial cell tumor (RICT) accompanied by elevated serum erythropoietin level and marked polycythemia. RICT is a rare tumor in dogs, originating from renal interstitial cells. While several renal tumors such as renal lymphoma, adenocarcinoma, carcinoma, sarcoma, fibrosarcoma and nephroblastoma may cause polycythemia, polycythemia caused by RICT has never been reported in dogs. The tumors in both dogs were solitary and lied within cortex or cortico-medullary junction. Histopathology revealed spindle-shaped cells suggesting mesenchymal origin, with no mitotic figures suggesting that the tumors in both dogs were benign. Following surgical removal of the affected kidney, serum erythropoietin level and polycythemia normalized in both dogs.

Polycythemia in dogs with chronic hypoxic pulmonary disease.

BACKGROUND: Prolonged tissue hypoxia caused by chronic pulmonary disease is commonly regarded as an important mechanism in the development of secondary polycythemia, but little clinical data are available to support this hypothesis. OBJECTIVE: To study the prevalence and severity of erythrocytosis accompanying chronic hypoxic pulmonary disease in dogs. ANIMALS: Forty-seven dogs with hypoxic chronic pulmonary disease, 27 dogs with nonhypoxic chronic pulmonary disease, and 60 healthy controls. METHODS: Dogs with chronic pulmonary disease and chronic hypoxemia (partial pressure of arterial oxygen [PaO2 ] < 80 mm Hg on at least 2 arterial blood gas measurements a minimum of 1 month apart) were identified retrospectively from patient records. Association between arterial oxygen and red blood cell parameters was analyzed using Pearson's correlation coefficients and multivariable linear regression analysis. RESULTS: Red blood cell parameters measured at the end of the hypoxemia period were within the laboratory reference range in most dogs. In chronically hypoxemic dogs, hematocrit (Hct) was increased in 4/47 (8.5%; 95% confidence interval [CI], 0-17) dogs, erythrocyte count (Erytr) was increased in 12/47 (26%; 95%CI, 13-38) dogs and hemoglobin concentration (Hb) was increased in 3/47 (6.4%; 95%CI, 0-14) dogs. No marked polycythemia (Hct ≥65%) was noted in any of the dogs. Red blood cell parameters were not associated with the severity of hypoxemia (correlation to PaO2 : Erytr, r = -.14; Hb, r = -.21; Hct, r = -.14; P > .05 for all). CONCLUSIONS AND CLINICAL IMPORTANCE: Polycythemia is uncommon, and usually mild if present, in dogs with chronic hypoxia caused by pulmonary disease.

NaHCO3, L-arginine, and vitamin C supplemented vegetable diet ameliorates tachycardia and polycythemia in the broiler chicken.

The study aimed to investigate if vegetable-based high-energy mash diets supplemented with NaHCO3, L-arginine + vitamin C, and vegetable oils were effective against tachycardia and polycythemia in the broiler chicken. A total of 256 Ross-308 day-old male broiler chicks were randomly distributed into eight dietary treatment groups in a three-way ANOVA with 2 × 2 × 2 factorial arrangement (three factors, i.e., NaHCO3, L-arginine + vitamin C, and vegetable oil each with two levels, e.g., 0 and 0.1% of NaHCO3 and L-arginine + vitamin C; 3 and 4% of vegetable oil supplemented with basal diet) for a period of 35 days. Iso-caloric and iso-nitrogenous diets were formulated and supplied ad libitum. The final live weight (FLW), average daily feed intake (ADFI), average daily gain (ADG), feed efficiency (FE), carcass traits, cardio-pulmonary morphometry, total protein (TP), hemoglobin (Hb), triiodothyronine (T3), incidence of tachycardia, and polycythemia were examined. Supplementation of NaHCO3 increased 2.2% ADFI, 5.5% FE, and 23.2% TP. The L-arginine + vitamin C increased 2.4% FLW and decreased 1.9% heart rate. Vegetable oil increased 1.3% ADFI, 4.2% ADG, 8.6% FE, 23.1% Hb, and 15.5% PCV. The NaHCO3, L-arginine + vitamin C, and vegetable oil additively interacted to increase 31.5% T3 at the expense of 21.1% of the weight of the right ventricle (RV). The RV:TV, carcass traits, and hemato-biochemical indices remained within normal range irrespective of the levels of the supplementations of the test ingredients. It was concluded that vegetable-based high-energy mash diets were not susceptible to tachycardia and polycythemia. The addition of NaHCO3 and L-arginine + vitamin C ameliorated the propensity of tachycardia and polycythemia without deteriorating performance, carcass traits, and hemato-biochemical indices of the broiler chicken in a dose-dependent manner.

Multiple myeloma and primary erythrocytosis in a dog.

A 13-year-old spayed female mixed breed dog was referred for impaired ambulation, limb tremors, back pain, hypergammaglobulinemia on cellulose acetate electrophoresis, and mild proteinuria. Conventional radiology and magnetic resonance imaging (MRI) suggested multifocal neoplastic bone lesions. At the referral examination, lameness and bright red mucous membranes were observed. Severe erythrocytosis, a monoclonal peak in the ß-2 globulin detected by capillary zone electrophoresis, severe proteinuria, bone marrow infiltration of plasma cells, and low serum erythropoietin concentrations were reported. The final diagnosis was multiple myeloma associated with severe primary erythrocytosis. This presentation in a dog is interesting because the combination of both disorders is rare in humans and has not been reported in dogs. Key clinical message: Although rare, multiple myeloma and primary erythrocytosis can occur together in dogs.

Myélome multiple et érythrocytose primaire chez un chien. Une chienne de race mixte stérilisée âgée de 13 ans a été référée pour troubles de la marche, tremblements des membres, maux de dos, hypergammaglobulinémie à l'électrophorèse sur acétate de cellulose et protéinurie légère. La radiologie conventionnelle et l'imagerie par résonance magnétique (IRM) suggéraient des lésions osseuses néoplasiques multifocales. Lors de l'examen de référence, une boiterie et des muqueuses rouge vif ont été observées. Une érythrocytose sévère, un pic monoclonal de la globuline ß-2 détecté par électrophorèse capillaire, une protéinurie sévère, une infiltration de la moëlle osseuse par des plasmocytes et de faibles concentrations sériques d'érythropoïétine ont été rapportés. Le diagnostic final était un myélome multiple associé à une érythrocytose primaire sévère. Cette présentation chez un chien est intéressante car l'association des deux conditions est rare chez l'homme et n'a pas été rapportée chez le chien.Message clinique clé :Bien que rares, le myélome multiple et l'érythrocytose primaire peuvent survenir simultanément chez le chien.(Traduit par Dr Serge Messier).

A novel bone marrow-sparing treatment for primary erythrocytosis in a cat: Onion powder.

Primary erythrocytosis (PE) is a rare myeloproliferative neoplasm in cats resulting in the overproduction of erythrocytes. Current treatment modalities include repeated phlebotomy and chemotherapeutic drugs. These treatments may not be well tolerated by the cat and can present safety and financial challenges to owners. Because of the rarity of PE, prospective studies for new treatment options are difficult to perform. This case report describes the novel use of onion powder in an attempt to produce Heinz body-induced erythrocyte destruction in order to decrease total erythrocyte mass and normalize the hematocrit in a cat with PE. To our knowledge, the use of onion powder in the treatment of PE in cats has never been described before and may have potential as a safe, low-cost, and highly accessible alternative treatment for this rare disease.

A case of canine renal lymphoma of granular lymphocytes with severe polycythemia.

BACKGROUND: Renal lymphoma in dogs is rare and has a poor prognosis. Granular lymphocyte morphology is rarely reported in canine renal lymphoma. Mild to moderate polycythemia is reported in a number of canine renal lymphoma cases. CASE PRESENTATION: A 10-year-old Labrador retriever presented to a university veterinary teaching hospital after a 1-month history of polyuria, polydipsia, and pollakiuria and a 2-week history of abdominal distention, lethargy, and increased respiratory effort. Abdominal ultrasound showed a wedge-shaped to rounded, heterogeneously hypoechoic mass lesion in the left kidney. Cytologic analysis of a percutaneous aspirate of the mass was consistent with lymphoma of granular lymphocytes. Severe polycythemia (hematocrit 0.871) was noted on a complete blood cell count. Clonality analysis identified a clonally rearranged T-cell receptor (TCR) gene and immunohistochemical staining was CD3+, CD79a- and CD11d+, supporting cytotoxic T-cell lymphoma. CONCLUSIONS: To our knowledge, this is the first report of renal cytotoxic T-cell lymphoma with severe polycythemia in a dog. Severe polycythemia and renal cytotoxic T-cell lymphoma are both rare in dogs; this report adds to the body of knowledge on these conditions.

Absolute Erythrocytosis in a Sunda Wrinkled Hornbill (Aceros corrugatus).

A captive, 22-year-old, intact male Sunda wrinkled hornbill (Aceros corrugatus) was presented for an acute onset of open-mouth breathing and bilaterally drooped wings. An external physical examination revealed a moderately thin body condition, marked respiratory effort, and a significant heart murmur. Diagnostic blood testing revealed moderate azotemia and persistent erythrocytosis, initially documented 2 years before this event. Radiographic imaging revealed a subjectively enlarged heart and a right dorsal coelomic cavity mass. Further diagnostic testing included an echocardiogram and ultrasound-guided fine-needle aspirate of the right coelomic cavity mass, with cytology consistent with a carcinoma. The bird was euthanatized because of the poor prognosis. Necropsy and histopathology identified right atrioventricular valve hypertrophy with severe hypertrophic and dilated cardiomyopathy of the right ventricular free wall, atherosclerosis of the great vessels and arteriosclerosis of myocardial vessels, severe hepatic extramedullary hematopoiesis, and pulmonary carcinoma of the right lung. In this case, erythrocytosis was considered a physiologic response to hypoxemia caused by the lung mass.

Inaccurate point-of-care blood glucose measurement in a dog with secondary erythrocytosis.

BACKGROUND: Point-of-care (POC) portable blood glucose meters (PBGMs) are convenient and inexpensive tools for assessing patient blood glucose concentrations. They are often used to quickly diagnose hypoglycemia or collect serial glucose readings in diabetic patients. However, POC meters have been previously identified in human and veterinary literature to be inaccurate when utilized in patients with abnormal HCT. This problem may not be reflected in manufacturer guidelines referenced by practitioners in the POC setting. KEY FINDINGS: A 1.5-year-old dog, previously diagnosed with multiple congenital cardiac malformations, right-to-left cardiac shunting and secondary erythrocytosis, presented to a veterinary emergency center minimally responsive and without detectable pulses. PBGM measurement identified hypoglycemia. Following stabilization of the dog, serial glucose assessments showed discordant results between PBGMs and the reference laboratory biochemistry analyzer. A pathological cause for hypoglycemia was not identified and PBGM readings were determined to be erroneously low due to the dog's abnormally high HCT. SIGNIFICANCE: This case demonstrates the limitations of using PBGMs to assess blood glucose in a dog with secondary erythrocytosis. The report emphasizes the need for judicious use of PBGMs in critically ill patients and that these glucometers may not be reliable in patients with abnormal HCT values.

Inappropriate Secondary Erythrocytosis in a Dog With Renal Sarcoma.

A 7-year-old mixed breed dog was evaluated for erythrocytosis with an initial hematocrit of 82.3%. Abdominal ultrasound revealed a 6 cm mass on the cranial pole of the right kidney. Daily therapeutic phlebotomies were performed, reducing the hematocrit to 54%. The dog underwent a right nephroureterectomy, recovered without complications, and was discharged 3 days after surgery. Histopathologic evaluation revealed a completely excised grade II soft tissue sarcoma. The preoperative erythropoietin level was 7.00 mU/mL (RI 1.90-22.90 mU/mL) and the 3-day postoperative erythropoietin level was 0.99 mU/mL, supporting a diagnosis of inappropriate secondary erythrocytosis due to the renal tumor. Secondary erythrocytosis resulting from renal soft tissue sarcoma is rare. Confirmatory testing with erythropoietin levels can assist in the diagnosis of secondary erythrocytosis. Erythropoietin levels that are normal or increased in the face of erythrocytosis indicate a source of inappropriate erythropoietin production.

Erythrocytosis and fatigue fractures associated with hepatoblastoma in a 3-year-old gelding.

Hepatoblastoma was diagnosed in a 3-year-old Thoroughbred gelding presented with forelimb lameness with bilateral fatigue fractures of the proximal third metacarpal bones. An abdominal mass was detected on ultrasound examination of the abdomen. Absolute erythrocytosis was diagnosed after clinical and haematological evaluation. The fractured metacarpal bones were surgically removed but complications after surgery were fatal. The liver mass was diagnosed as a hepatoblastoma based on histology and immunochemical staining. The combination of hepatoblastoma and fatigue fractures has not been described previously in horses. A potential link between the hepatic and orthopaedic pathologies is hypothesised.

Secondary inappropriate polycythemia with splenic hemangiosarcoma in a young adult cat.

A 20-month-old castrated male Korean shorthair cat was presented with a 3-week history of intermittent vomiting and anorexia, absolute erythrocytosis, and elevated erythropoietin levels. A diagnosis of splenic hemangiosarcoma was made by histopathology and immunohistochemical identification of factor VIII. Paraneoplastic erythrocytosis caused by a splenic hemangiosarcoma in a cat is described.

Polycythémie secondaire inappropriée et hémangiosarcome splénique chez un jeune chat adulte. Un chat commun coréen mâle castré âgé de 20 mois a été présenté avec une anamnèse de 3 semaines de vomissements intermittents et d'anorexie, d'érythrocytose absolue et des taux élevés d'érythropoïétine. Un diagnostic d'hémangiosarcome splénique a été posé par histopathologie et l'identification immunochimique du facteur VIII. L'érythrocytose paranéoplastique causée par un hémangiosarcorme splénique chez un chat est décrite.(Traduit par Isabelle Vallières).

Tetralogy of Fallot with concurrent patent foramen ovale and tricuspid valve dysplasia in a dog.

The echocardiographic findings of a young Pomeranian-cross dog with tetralogy of Fallot, patent foramen ovale, and tricuspid valve dysplasia are described. Ongoing medical management of hypoxemia and erythrocytosis was carried out and the dog survived to 2 years of age. Treatment options for tetralogy of Fallot are discussed.

Tétralogie de Fallot avec persistance du foramen ovale et dysplasie de la valve tricuspide concomitante chez un chien. Les constatations écho-cardiographiques chez un chien Poméranien de race croisée atteint de la tétralogie de Fallot, de la persistance du foramen ovale et d'une dysplasie de la valve tricuspide sont décrites. Une gestion médicale constante de l'hypoxémie et de l'érythrocytose a été réalisée et le chien a survécu jusqu'à l'âge de 2 ans. Les options de traitement pour la tétralogie de Fallot sont discutées.(Traduit par Isabelle Vallières).

Feline primary erythrocytosis: a multicentre case series of 18 cats.

CASE SERIES SUMMARY: A retrospective multicentre case series of feline primary erythrocytosis (PE) was evaluated. The aim was to gain better understanding of disease presentation and progression to guide management and prognostication. Case records were assessed for evidence of increased packed cell volume (PCV; >48%), sufficient investigation to rule out relative and secondary erythrocytosis, and follow-up data for at least 12 months or until death. Eighteen cats were included in the case series. No significant trends in signalment were noted. Seizures and mentation changes were the most common presenting signs (both n = 10). Median PCV was 70% (median total protein concentration of 76 g/l) with no other consistent haematological changes. Sixteen cats survived to discharge. Phlebotomy was performed initially in 15/16 surviving animals and performed after discharge in 10/16. Hydroxyurea was the most common adjunctive therapy, used in 10/16 cats. Of the 16 patients surviving to discharge, 14 patients were still alive at the conclusion of the study (survival time >17 months post-discharge), with the two non-survivors having lived for 5 years or more after diagnosis. PCV, when stabilised, did not correlate with resolution of clinical signs. RELEVANCE AND NOVEL INFORMATION: In contrast to perceptions, feline PE was generally well managed via a combination of phlebotomy and medical therapy, with evidence of prolonged survival times. The use of hydroxyurea enabled cessation or repeat phlebotomies.

Eritrocitose primária em cão: relato de caso / Primary erythrocytosis in dog: case report

A eritrocitose absoluta primária, também denominada de policitemia vera, é um distúrbio mieloproliferativo crônico de causa desconhecida, caracterizado pela proliferação clonal de células-tronco eritróides neoplásicas. Acomete cães de meia-idade entre seis e sete anos. As manifestações clínicas mais comuns são letargia, fraqueza, poliúria, polidipsia, sangramentos como epistaxe, hematúria, hematoemese, hematoquezia, até mesmo convulsões e ataxia. O diagnóstico é baseado em valores altos de hematócrito, geralmente acima de 70%, excluindo-se as causas de eritrocitose secundária. As concentrações séricas de eritropoietina estão normais ou diminuídas. O tratamento consiste em flebotomia e administração de hidroxiuréia. Relata-se o caso de uma cadela, raça Bichon Frise, 11 anos, que, no início do quadro, apresentou hematócrito de 84%, letargia, ataxia, mucosas congestas, cianose de língua, poliúria e polidipsia. Realizou-se o tratamento com hidroxiuréia durante oito anos, na dose de 15 a 30 mg/kg, a cada 24 horas, sem ocorrência de efeitos colaterais ou recidiva das manifestações clínicas.(AU)

Primary absolute erythrocytosis, also termed polycythemia vera, is a chronic myeloproliferative disorder of unknown cause. It is characterized by clonal proliferation of neoplastic erythroid stem cells. It affects middle-aged dogs between 6-7 years. The most common clinical manifestations are lethargy, weakness, polyuria, polydipsia, and bleeding such as epistaxis, hematuria, hematoemese, and hematochezia. Seizures and ataxia are also common. Diagnosis is based on high hematocrit values, generally above 70% excluding the causes of secondary erythrocytosis. Serum concentrations of erythropoietin are at a normal level or decreased level. Treatments consists of hydroxyurea and phlebotomy management. It is reported that case of female Bichon Frise, 11 years old who onset of the disease had a hematocrit of 84%, lethargy, ataxia, congested mucous membranes, tongue cyanosis, polyuria and polydipsia. The treatment with hydroxyurea was performed for 8 years, at a dose of 15 to 20mg/kg, every 24 hours, without occurrence of side effects or recurrence of clinical manifestations.(AU)

Extreme Tetralogy of Fallot With Polycythemia in a Ferret (Mustela putorius furo).

A 5-month-old, intact male ferret (Mustela putorius furo) was presented with apathy, tachypnea and exercise intolerance. On initial physical examination, tachypnea and cyanosis were the two primary clinical signs detected. The complete blood count also revealed a severe polycythemia, with lymphopenia, neutrophilia and eosinophilia. Further diagnostic imaging tests were performed. The thoracic radiographs revealed cardiomegaly and a diffuse alveolar pulmonary pattern. Consequently, an echocardiography was performed and showed an interventricular septal defect, pulmonic artery occlusion, overriding of the aorta and right ventricle hypertrophy. All abnormalities were compatible with a tetralogy of Fallot (TOF). As a treatment plan, a phlebotomy was performed and the ferret was posteriorly maintained with oxygen and fluid therapy. The following day, the hematocrit decreased 11% and the respiratory distress improved. Four days later, the ferret got clinically worse and was euthanized. A necropsy was performed and confirmed the presence of an extreme TOF with a diffused interstitial pneumonia secondary to Pneumocystis carinii. To the author's knowledge, this is the first report of an extreme tetralogy of Fallot with polycythemia in a ferret.

Bilateral renal T-cell lymphoma with hepatic infiltration and secondary polycythemia in a dog: Utility of cytology slides.

This is a case of bilateral renal T-cell lymphoma associated with secondary erythrocytosis in a dog. This case is distinctive in using clonality combined with immunocytochemistry to support the diagnosis, thus emphasizing the utility of cytology slides when histology is unavailable. This combination may be a unique canine lymphoma entity.

Lymphome à cellules T rénal bilatéral avec infiltration hépatique et polycythémie secondaire chez un chien : utilité des lames de cytologie. Nous présentons un cas de lymphome à cellules T rénal bilatéral associé à une érythrocytose secondaire chez un chien. Ce cas est distinct parce qu'il fait appel à la clonalité combinée à l'immunocytochimie pour appuyer le diagnostic, ce qui souligne l'utilité des lames de cytologie lorsqu'une histologie n'est pas disponible. Cette combinaison pourrait être une entité unique de lymphome canin.(Traduit par Isabelle Vallières).

Absolute polycythemia in a bald eagle (Haliaeetus leucocephalus).

An approximately 6-mo-old female bald eagle (Haliaeetus leucocephalus) was presented for an inability to fly and bilateral drooped wings. Pectoral muscle atrophy with a moderate polycythemia was present. Over the course of 3 wk, there were no improvements in flight capacity, although the bird gained substantial weight. Further investigation revealed a prominent cyanosis that was responsive to oxygen therapy, a chronic respiratory acidosis with hypoxia, a cardiac murmur, and a persistent polycythemia. No obvious antemortem etiology for the clinical findings was discovered on computerized tomography, angiography, or echocardiography. The bird was euthanatized as a result of the poor prognosis. Necropsy and histopathology revealed no significant cardiovascular or pulmonary pathology. No myopathy was evident on electron microscopy of formalin-fixed tissues. Based on these diagnostics, a neuromuscular disorder is suspected as the cause for the blood gas abnormalities, with a resulting polycythemia from the hypoxia.