Diagnosis of renal lymphoma by Wright-Giemsa-stained cytocentrifuged urine evaluation in a cat.

Lymphoma represents up to 30% of neoplasms diagnosed in cats. Diagnosis of lymphoma in the urinary system by examination of urine sediment has been described in a dog, but apparently not previously in cats. Concurrent samples of serum, EDTA whole blood, and urine were submitted from a 15-year-old spayed female domestic shorthair cat exhibiting weight loss, polyuria, and polydipsia. Hematology and biochemical abnormalities included a mild normocytic, normochromic, non-regenerative anemia; an inflammatory leukogram; and azotemia. Urinalysis evaluation revealed inadequate urine concentration and marked proteinuria. Wet-mount urine sediment examination revealed moderate numbers of leukocytes and erythrocytes. A uniform population of intermediate-to-large lymphocytes was observed on a fresh, Wright-Giemsa-stained preparation from cytocentrifuged urine. The cat was euthanized and necropsy was completed. Bilateral renomegaly was identified and characterized by multifocal, pale-yellow, coalescing, poorly defined, homogenous nodules. Microscopically, these nodules were composed of dense sheets of CD3-positive round cells, consistent with T-cell renal lymphoma. Key clinical message: Lymphoma is a common neoplasm in cats that can affect many organ systems, including the upper urinary tract. This case represents an uncommon method of identifying neoplastic lymphocytes via evaluation of cytocentrifuged urine, and emphasizes the benefits of examining Romanowsky-stained urine sediment in animals.

Diagnostic du lymphome rénal chez un chat par évaluation d'urine cytocentrifugée avec coloration Wright-Giemsa. Le lymphome représente jusqu'à 30 % des néoplasmes diagnostiqués chez le chat. Le diagnostic d'un lymphome du système urinaire par examen des sédiments urinaires a été décrit chez un chien, mais apparemment pas à ce jour chez le chat. Des échantillons simultanés de sérum, de sang total dans un tube avec EDTA et d'urine ont été soumis provenant d'une chatte domestique à poils courts stérilisée de 15 ans présentant une perte de poids, une polyurie et une polydipsie. Les anomalies hématologiques et biochimiques comprenaient une légère anémie normocytaire, normochrome et non régénérative; une formule leucocytaire inflammatoire; et une azotémie. L'analyse d'urine a révélé une concentration urinaire insuffisante et une protéinurie marquée. L'examen microscopique des sédiments urinaires a révélé un nombre modéré de leucocytes et d'érythrocytes. Une population uniforme de lymphocytes de taille intermédiaire à grande a été observée sur une préparation fraîche colorée au Wright-Giemsa à partir d'urine cytocentrifugée. Le chat a été euthanasié et une autopsie a été réalisée. Une rénomégalie bilatérale a été identifiée et caractérisée par des nodules multifocaux, jaune pâle, coalescents, mal définis et homogènes. Au microscope, ces nodules étaient composés de feuilles denses de cellules rondes CD3-positives, compatibles avec un lymphome rénal à cellules T.Message clinique clé :Le lymphome est une tumeur courante chez le chat qui peut affecter de nombreux systèmes organiques, y compris les voies urinaires supérieures. Ce cas représente une méthode rare d'identification des lymphocytes néoplasiques via l'évaluation de l'urine cytocentrifugée et met l'emphase sur les avantages de l'examen des sédiments urinaires avec coloration de Romanowsky chez les animaux.(Traduit par Dr Serge Messier).

Prevalence of Anaplasma phagocytophilum infection in feral cats in Massachusetts.

OBJECTIVES: The primary objective of this study was to determine the prevalence of Anaplasma phagocytophilum infection and exposure in adult feral cats in Massachusetts, an endemic area for A phagocytophilum and its tick vector Ixodes scapularis. The secondary objective was to determine if there were correlations between A phagocytophilum infection and the presence of anemia and thrombocytopenia. METHODS: Blood samples were collected between June and December 2015 from 175 apparently healthy adult feral cats that were presented to trap and release spay/neuter centers in Massachusetts. Complete blood count, blood smear evaluation, SNAP 4Dx Plus test (IDEXX) and A phagocytophilum PCR were performed on all samples to document acute infection (PCR-positive and/or inclusions observed on blood smear) and exposure to A phagocytophilum (SNAP 4Dx Plus-positive for A phagocytophilum antibodies). RESULTS: The prevalence of exposure to A phagocytophilum in feral cats in Massachusetts was 9.7%, whereas the prevalence of acute infection was 6.9%. All blood smears were negative for Anaplasma species inclusions; therefore, acute infection was defined as testing positive on PCR analysis. No statistically significant correlations were identified for cats that were positive for A phagocytophilum on PCR analysis or SNAP 4Dx Plus test and the presence of anemia or thrombocytopenia. CONCLUSIONS AND RELEVANCE: The prevalence of A phagocytophilum exposure in feral cats approaches 10% and is higher than the previously reported national average prevalence of 4.3% in the USA. A phagocytophilum infection may be an emerging infectious disease in cats. Further research is needed to determine the prevalence of clinical illness associated with A phagocytophilum infection in cats living in endemic areas.

Comparison of wet-mount, Wright-Giemsa and Gram-stained urine sediment for predicting bacteriuria in dogs and cats.

This study assessed the standard urinalysis technique and sediment stain techniques as predictors of bacterial culture results for canine and feline urine. Canine (n = 111) and feline (n = 79) urine samples were evaluated using unstained wet-mount and air-dried Gram and Wright-Giemsa stained sediment; results were compared to aerobic bacterial culture. Eleven canine and 7 feline urine samples were culture positive. Unstained wet-mount and stained sediment had sensitivities of 89% and 83% and specificities of 91% and 99%, respectively. The specificity of using either stain was higher (P < 0.01) than wet-mount examination for detecting bacteriuria. There were significant differences among 3 technologists in detecting true positives (P < 0.01). Association of sediment and culture results used 112 canine and 81 feline samples. There was a negative association (P < 0.01) between lipid detection and wet-mount identification of bacteria.

Comparaison de sédiments d'urine à l'état frais, avec la coloration Wright-Giemsa et la coloration de Gram pour la prédiction de la bactériurie chez les chiens et les chats. Cette étude a évalué la technique d'analyse urinaire standard et des techniques de coloration du sédiment d'urine comme prédicteurs des résultats de la culture bactérienne. Les échantillons d'urine canine (n = 111) et féline (n = 79) ont été évalués en utilisant des sédiments à l'état frais et des sédiments séchés à l'air avec coloration de Gram et de Wright-Giemsa; les résultats ont été comparés à une culture bactérienne aérobie. Onze échantillons d'urine canine et 7 échantillons d'urine féline ont obtenu des résultats positifs pour la culture. Le sédiment à l'état frais non coloré et le sédiment coloré présentaient des sensibilités de 89 % et de 83 % et des spécificités de 91 % et de 99 %, respectivement. La spécificité de l'utilisation de l'une ou l'autre de la coloration était supérieure (P < 0,01) à celle de l'examen à l'état frais pour la détection de la bactériurie. Il y avait une différence significative entre les technologues pour la détection des vrais positifs (P < 0,01). L'association des résultats des sédiments et des cultures a utilisé 112 échantillons canins et 81 échantillons félins. Il y avait une association négative (P < 0,01) entre la présence de lipide et l'examen à l'état frais des bactéries.(Traduit par Isabelle Vallières).

Comparison of white and red blood cell estimates in urine sediment with hemocytometer and automated counts in dogs and cats.

BACKGROUND: Therapeutic decisions regarding urinalysis are commonly based on the presence of white and red blood cells. Traditionally, numbers per high-power field are estimated using wet-mount microscopic examination. This technique is not standardized and counts are likely prone to inaccuracy. In addition, differentiation of leukocyte types is not possible. OBJECTIVES: The aims of this study were to (1) compare WBC and RBC estimates using wet-mount examination with counts obtained using a hemocytometer, (2) assess if a hematology automated analyzer (Sysmex ST-2000iV/XT) provides reliable WBC and RBC counts in urine comparable to hemocytometer counts, and (3) evaluate air-dried Wright-Giemsa-stained urine drop sediment preparations for the determination of differential leukocyte counts. METHODS: WBC and RBC counts were obtained by performing wet-mount estimates, manual hemocytometer counts, and Sysmex automated counts on 219 canine and feline urine samples. Results were correlated using Spearman rank correlation. Air-dried Wright-Giemsa stained sediment drop preparations (n = 215) were examined for differential counts of leukocytes. RESULTS: A low but significant association was found between WBC estimates on wet-mount examination and hemocytometer counts (rho = 0.37, P < .01). There was a high and significant association when RBC counts were compared between wet-mount and hemocytometer evaluation (rho = 0.7, P < .01). There was very high and significant interassay correlation between Sysmex data from duplicate samples for what the analyzer classified as WBC (rho = 0.97, P < .01) and RBC (rho = 0.94, P < .01). Low correlations were found between the Sysmex RBC counts and both wet-mount estimates and hemocytometer RBC counts (rho = 0.43, P < .01 and rho = 0.39, P < .01, respectively). Cell preservation in the air-dried sediment preparations was so poor that differential counts could not be performed. CONCLUSION: WBC and RBC estimates on wet-mount examination agreed with hemocytometer counts and are therefore considered adequate. The Sysmex ST-2000iV/XT did not provide reliable cell counts under the conditions used.

Role of nursing students at rural nurse-managed clinics.

With stiff competition for clinical sites, one Midwestern university partners nursing students with faculty who provide primary healthcare to clients in 2 rural nurse-managed clinics. Some students are also assigned to follow select clients during weekly home visit rotations for their public health clinical course. The result has been a successful faculty practice and preceptor model that benefits rural communities, a clinical setting that provides opportunities for students to experience client care needs of the underinsured or uninsured in small communities, and student exposure to the financial burdens and challenges of today's healthcare environment in the United States.