Episodic blindness and ataxia in a horse with cholesterinic granulomas.

An 11-year-old Oldenburg mare presented following three episodes of acute, transient blindness, ataxia, and disorientation within the preceding 7 months. Clinical improvement, including return of vision, occurred within 1 week of initiating corticosteroid therapy for each of the three episodes. However, mild right-sided miosis was a consistent finding on ophthalmic examinations. Routine clinicopathologic testing revealed no significant abnormalities, and testing of cerebral spinal fluid for selected infectious diseases was unrewarding. Computed tomography of the brain demonstrated a hyperattenuating mass with peripheral mineralization in the rostroventral aspect of each lateral ventricle. The mare was euthanized due to a guarded to poor prognosis. On histopathology, the masses consisted of clusters of cholesterol clefts admixed with leukocytes, mineral deposits, and connective tissue. Cholesterinic granulomas of the lateral ventricles and hydrocephaly were diagnosed. Cholesterinic granulomas should be considered a differential diagnosis in horses presenting for intermittent blindness.

Bronchial carcinoma in a red-shouldered hawk (Buteo lineatus).

Respiratory neoplasms are rare in birds. This report describes carcinoma of the bronchial epithelium in a red-shouldered hawk (Buteo lineatus) that presented with weakness and lethargy lasting 4 days that progressed to seizures. Grossly, the caudal air sac and coelomic cavity contained approximately 15 ml of dark brown cloudy fluid that displaced the intestines cranially. Nodular plaques were present on the viscera and air sacs. Microscopic examination of tissues revealed a mass that expanded the bronchial lumen and was composed of papillary proliferations of rows of small cuboidal epithelial cells that were small and uniform in size with a low mitotic index. Metastases were present on the surfaces of caudal air sac, kidney, and multifocal peritoneal surfaces of the coelomic cavity. Clinical signs were most likely the result of West Nile virus infection, which was confirmed by immunohistochemistry of brain tissue.

Spontaneous odontoameloblastoma in a female Sprague Dawley rat.

The present report describes a spontaneously developing, highly infiltrative, and expansile neoplasm in the mandible of a 9-month-old female Sprague Dawley rat. The lesion consisted of abundant odontogenic epithelium with induction of osteodentin in the adjacent mesenchyme and was classified therefore as an odontoameloblastoma. Odontoameloblastomas are reported uncommonly in domestic animals, and the histologic and histochemical features of this neoplasm are reported herein along with a review of the veterinary literature.

Parity is associated with an expanded macrophage population in the mammary gland.

Pregnancy is a well established protective factor against breast cancer. One explanation for protection is the increased differentiation status of the parous epithelium. However, this does not explain the association of parity with increased aggressiveness of breast cancers, particularly cancers that occur soon after pregnancy. Because tumor aggressiveness can be influenced by the cell population that surrounds the mammary epithelium, we examined the potential role of the immune system in establishing a long-term difference between the mammary glands of primiparous and virgin animals. Specific mRNA levels, enzyme activities and antigen expressing cells were quantified in primiparous and virgin mammary glands from Sprague-Dawley rats in diestrous. Our results show that macrophages, but not neutrophils or B-cells, are specifically increased in fully involuted glands compared with age-matched virgin mammary glands. Macrophages play a dual role in tumor progression, both opposing and supporting the process. Our finding of an increased macrophage population in the primiparous mammary gland could explain the dichotomy of the reported association of parity with decreased breast cancer incidence and increased breast cancer aggressiveness.

Extracutaneous neutrophilic inflammation in a dog with lesions resembling Sweet's Syndrome.

A 7-year-old-spayed female standard poodle dog presented to the Iowa State University Veterinary Teaching Hospital with an 8-day history of lethargy, left hind limb lameness, ptyalism and peripheral lymphadenomegaly. On physical examination, the dog was lethargic, febrile (40.5 degrees C) and had multifocal to coalescing erythematous papular to pustular eruptions on the skin of all four limbs, periocularly and on the ventral and lateral thorax and abdomen. Histopathological findings from skin biopsies of the papules revealed a severe diffuse neutrophilic dermatitis with sub- and intra-epithelial pustules. Four days after being admitted the dog died from cardiac and respiratory failure. At necropsy, in addition to the multifocal to coalescing erythematous papules, the skin contained scattered pustules. Additionally, the subcutaneous tissue surrounding the right stifle was diffusely oedematous, and the peripheral and visceral lymph nodes were enlarged. The predominant histologic lesion was neutrophilic inflammation, in the absence of detectable bacteria in the skin, heart, lungs, oesophagus and left tarsus. In the absence of neoplasia or bacteraemia, a syndrome similar to Sweet's Syndrome should be considered as a differential diagnosis in dogs with cutaneous and extracutaneous neutrophilic infiltrates.

Peer assessment of a final-year capstone experience for formative evaluation of a pathology curriculum.

In spring of 2005, the authors implemented and evaluated a process at the Iowa State University College of Veterinary Medicine in which third-year students evaluated fourth-year students' performances on an advanced case-analysis assignment. This assignment, called the case correlation assignment, required a thorough integration and explanation of all ante- and post-mortem data for a specific hospital patient. Using a 21-point rubric, the necropsy course instructor and third-year students rated these assignments. Fourth-year students' performances on this assignment were used as an indicator of the success of the pathology curriculum. The authors evaluated the assessment process for feasibility, reliability, and validity. Many-facet Rasch analysis was used to determine item, case, and rater agreement. The assessment process produced good agreement among items and cases (VM4 student competence). Furthermore, most third-year students were able to reliably rate the case correlation assignments with no special training. The evaluation process was cost effective and occurred in the context of regular course assignments, thereby making it feasible. A case can be made that the overall process provides a valid measure of the pathology program's success in preparing students in the area of veterinary pathology.

Multinodular pulmonary fibrosis in five horses.

CASE DESCRIPTION: 5 horses were evaluated because of decreased appetite, weight loss, fever, cough, tachypnea, and respiratory distress. CLINICAL FINDINGS: Tachycardia, tachypnea, increased respiratory effort, lethargy, fever, poor body condition, and nasal discharge were detected in various combinations on initial physical examination. Evaluation of the lower portion of the respiratory tract via radiography and ultrasonography revealed a severe nodular interstitial pattern. Histologic examination of lung tissue revealed interstitial expansion of alveolar parenchyma with collagen, intraluminal accumulation of neutrophils and macrophages within the alveoli, and occasional intranuclear inclusion bodies within alveolar macrophages. Equine herpesvirus type 5 was detected in samples of lung tissue, bronchoalveolar lavage fluid, or both via polymerase chain reaction assay in all cases. A diagnosis of equine multinodular pulmonary fibrosis (EMPF) was established. TREATMENT AND OUTCOME: Horses were provided supportive treatment and were administered a variety of medications including corticosteroids and acyclovir. Two horses survived and returned to their previous level of activity. Three horses were euthanized because of either deterioration of clinical condition (n=2) or failure to improve within 4 weeks of initiation of treatment (1). CLINICAL RELEVANCE: EMPF should be considered as a differential diagnosis for adult horses with interstitial pneumonia and should be suspected on the basis of characteristic radiographic, ultrasonographic, and histopathologic findings. Equine herpesvirus type 5 is found in association with EMPF; although the exact pathogenic role this virus plays in EMPF is unknown, equine herpesvirus type 5 may be an etiologic agent or cofactor in the development of EMPF.

Use of posaconazole in the management of invasive orbital aspergillosis in a cat.

Orbital infection with Aspergillus fumigatus was diagnosed in a Persian cat that was presented with chronic third eyelid protrusion and exophthalmos. Evidence of nasal, sinus, or disseminated aspergillosis was not detected in this cat. Complete surgical excision of diseased tissues was not possible during orbital exenteration, and infection subsequently extended into the tissues of the oral cavity. Oral therapy with itraconazole and parenteral therapy with amphotericin B were ineffective in resolving the infection. Oral therapy with a novel triazole, posaconazole, was curative.

Unilateral uveitis in a dog with uveodermatologic syndrome.

CASE DESCRIPTION: A 7-year-old Siberian Husky-type dog with heterochromia irides was evaluated because of signs of pain associated with the right eye. CLINICAL FINDINGS: Unilateral panuveitis, iris bombé, and secondary glaucoma were detected in the right eye. Tear production was low bilaterally. Facial and truncal poliosis and vitiligo were also evident; skin biopsy specimens were obtained from the nasal planum. Uveodermatologic syndrome was diagnosed on the basis of histopathologic findings of a lichenoid interface dermatitis and pigmentary incontinence within the dermis. Immunohistochemical analysis was performed on skin samples retrospectively, and findings were inconclusive. TREATMENT AND OUTCOME: Treatment involved topical (ocular) and oral administration of corticosteroids, oral administration of azathioprine, and topical (ocular) administration of a carbonic anhydrase inhibitor and a lacrimostimulant. The secondary glaucoma was refractory to treatment, and the right eye was enucleated. Uveodermatologic syndrome was confirmed via histologic examination of ocular tissues. The left eye remained free of inflammation 16 months after the initial diagnosis. The periocular skin and skin of the nose partially regained pigment, but the hair did not. CLINICAL RELEVANCE: Some breeds in which uveodermatologic syndrome has been reported (eg, Siberian Huskies, Old English Sheepdogs, Australian Shepherds, and Shetland Sheepdogs) often have heterochromia irides. This case highlights the fact that dogs with asymmetric uveal pigmentation may have unilateral ocular changes; therefore, uveodermatologic syndrome should not be excluded as a differential diagnosis on the basis of unilateral clinical signs.

Comparative histologic effects of daily topical application of creams containing all-trans-retinoic acid or all-trans-retinoyl beta-glucuronide on pig skin.

The efficacy of all-trans-retinoic acid (tRA) and all-trans-retinoyl beta-glucuronide (RAG), a water-soluble metabolite of vitamin A, in the topical treatment of acne is comparable. However, whereas 3.3 mM tRA shows side effects, 3.3 mM RAG does not. To assess the relative toxic and histologic effects (dermal and epidermal changes) of long-term (24-week) daily applications of tRA and RAG on the skin, separate skin patches were measured and marked dorsally on the skin of six 21-day-old, castrated male pigs. Each skin patch area was treated daily with a cream formulation containing either 3.3 mM RAG, 16.5 mM RAG, 33 mM RAG, 3.3 mM tRA, 16.5 mM tRA or blank cream. To serve as controls, one patch received no treatment, one patch received blank cream only and for 5.3 weeks one 'washed' patch was given daily application of 33 mM RAG with routine cleansing using a mild soap typical of skin care. The amount of cream used per square centimeter remained the same during the course of the study. Biopsy tissue was collected at -1, 0, 2, 4, 8, 12 and 24 weeks from 7 test patches. The 'washed' patch was biopsied once at the 5.3-week mark. Topically applied RAG cream (3.3 mM) resulted in significantly lower histologic scores when compared with scores from tissue treated with an equimolar concentration of tRA. The highest concentration of RAG tested (33.3 mM) resulted in a response comparable to that observed in the lowest tRA (3.3 mM) treated patch area. Daily cleansing of the test area receiving 33.3 mM RAG completely eliminated any clinical signs or negative histologic changes. In conclusion, long-term topical tRA treatment in young pigs, as in humans, showed dose-dependent adverse effects on the skin, whereas RAG treatment had significantly lower histologic changes and less irritation and/or inflammation.