Babesia gibsoni cytochrome b mutations in canine blood samples submitted to a US veterinary diagnostic laboratory.

BACKGROUND: Babesiosis caused by Babesia gibsoni is recognized throughout the world and can be difficult to treat. Resistance to atovaquone is associated with mutations in the B. gibsoni mitochondrial genome, specifically the M128 position of cytochrome b (cytb). The prevalence of cytb mutations in North America has not been reported. HYPOTHESIS/OBJECTIVES: The objective of our study was to describe the prevalence of cytb M128 mutations in B. gibsoni in canine blood samples submitted to a US veterinary diagnostic laboratory. A secondary objective was to determine whether or not some dogs had wild-type cytb in our initial samples then had M128 mutations detected in follow-up samples. ANIMALS: One-Hundred seventy-four dogs that tested positive for the presence of B. gibsoni between 2012 and 2017. METHODS: Case series of consecutive samples submitted to a veterinary diagnostic laboratory. Partial B. gibsoni cytb genes were amplified by polymerase chain reaction and screened for the presence of mutations at the M128 position. RESULTS: The overall prevalence of M128 mutants was 3.5% (6/173 dogs) in the initial samples. The incidence of new cytb mutants in dogs that tested positive for B. gibsoni, which then had follow-up testing, was 12.1% (5/41). Conclusions and Clinic Importance: Our study reaffirms that B. gibsoni infection is widespread and most commonly detected in American Staffordshire Terrier/American Pit Bull Terrier dogs (128/174, 74% of the infected dogs in our study). The prevalence of cytb mutations does not warrant pretreatment genotyping.

Evaluation of information presented within soft tissue sarcoma histopathology reports in the United States: 2012-2015.

Despite the existence of the American College of Veterinary Pathology guidelines for tumour biopsy specimens, anecdotally the authors' have seen inconsistency of reporting of information on the pathology report for canine soft tissue sarcomas (STSs). If crucial aspects are not reported this can result in slower or impeded patient care. This retrospective study evaluated 255 STS histopathology reports submitted from across the United States. Reports were evaluated by a single observer to assess for information contained in 5 main categories: patient history and signalment, gross and microscopic description, grading, histologic margins and the comments section. Inclusion criteria for histopathology reports included a final diagnosis of STS, having a microscopic description and resulting from the initial surgical resection. The majority of the reports stated the patient signalment (91.2%) and clinical history (90.8%). However, only 64.8% of the reports had a gross description of the specimen. Histologic margin description was present in 229 reports (91.6%), however, only 149 reports (59.6%) stated an objective measurement of these margins. Histologic classification was stated in 50.0% of the reports, while grade was given on 97.2% of the reports. Variability in histopathologic reporting including histologic margin description for resected canine STS was identified. Given surgical treatment is the mainstay for STS and histopathological assessment plays an important role in determination of whether additional surgery, radiation or chemotherapy is needed. Standardization or checklists like the American College of Pathology utilize may be helpful to ensure histopathologic characteristics are reported that may guide further treatment recommendations.

Interobserver Agreement Using Histological Scoring of the Canine Liver.

BACKGROUND: Grading schemes for the assessment of hepatic fibrosis and necroinflammatory activity in humans previously have been applied to dogs with chronic hepatitis. Interobserver agreement is a desirable characteristic for any histological scoring scheme. HYPOTHESIS/OBJECTIVES: To assess interobserver agreement associated with pathologists using a previously published histological scoring scheme to assess hepatic fibrosis and necroinflammatory activity in dogs and to compare fibrosis scores assigned to serial sections stained with hematoxylin & eosin (H&E) and picrosirius red. ANIMALS: Histological sections of liver from 50 dogs with variable degrees of hepatic fibrosis and necroinflammatory activity were selected from institutional tissue archives. METHODS: Six board-certified veterinary anatomic pathologists assigned fibrosis and necroinflammatory activity scores to the histological sections. The multiuser kappa statistic was calculated to assess interobserver agreement. Fibrosis stage assigned to serial sections stained with picrosirius red and H&E was compared using the Wilcoxon signed-rank test. RESULTS: Multiuser kappa statistics for assessment of fibrosis and necroinflammatory activity from H&E-stained sections were 0.35 and 0.16, respectively. There was no difference in median fibrosis scores assigned to serial section stained with H&E and picrosirius red (P = .248). CONCLUSIONS AND CLINICAL IMPORTANCE: There was fair interobserver agreement when pathologists assessed fibrosis and poor agreement when they assessed necroinflammatory activity. This suboptimal agreement must be taken into account by clinicians making decisions based on histology reports of the liver and in the design of studies evaluating these findings. To decrease this variability, ideally >1 pathologist should evaluate each section.

A Survey of Attitudes of Board-Certified Veterinary Pathologists to Forensic Veterinary Pathology.

An electronic survey was conducted to determine the attitudes of veterinary pathologists toward forensic pathology and the adequacy of their training in the discipline. The survey was sent to 1933 diplomates of the American College of Veterinary Pathologists and 311 completed responses were analyzed. Of respondents, 80% report receiving at least 1 type of medicolegal case, with cases from law enforcement received most frequently. Most (74%) of the respondents indicated that their previous training did not prepare them adequately to handle forensic cases and almost half of the respondents (48%) indicated that they needed more training on serving as an expert witness. Relative risk ratios (RRR) and odds ratios (OR) were generated to determine the strength of a statistically significant association. Responses from a free-text entry question determining additional training needs could be grouped into 3 main categories: (1) veterinary forensic pathology science and procedures, (2) documentation, evidence collection and handling, and (3) knowledge of the medicolegal system. Last, a field for additional comments or suggestions regarding veterinary forensic pathology was completed by 107 respondents and many reinforced the need for training in the categories previously described. The survey highlights that a significant proportion of diplomates of the American College of Veterinary Pathologists are currently engaged in veterinary forensic pathology but feel their training has not adequately prepared them for these cases. Hopefully, the survey results will inform the college and residency training coordinators as they address the training requirements for an important emerging discipline.

How much reproducibility do we need in human and veterinary pathology?

In diagnostic and research reports as well as text-books of human and veterinary pathology repeatability, reproducibility, inter- and intra-observer variation are mentioned rarely as a problem in preparing diagnosis from macroscopic and/or microscopic samples and discussed inconsistently. However, optimal care and restoration of health for a patient are dependent on reliability of diagnosis, therapy, prognosis and prophylaxis. This requires for all tests and procedures a maximal repeatability and reproducibility, a sensitivity and specificity of 85-95% for procedures and methodologies and a comparison of results procedures and methodologies to a gold standard. Looking at the various steps on the road to diagnosis in pathology this is influenced by a series of laboratory steps preparing tissue samples but most importantly reproducibility depends on the handling of visual information in the central nervous system of the individual diagnostician. Thus reproducibility in this context has to be divided into at least three levels: individual (epistemological, organoleptic, inter- and intra-observer variation, and formal/technological- and normative reproducibility). The aim of the present manuscript is to stimulate the reflection among the pathology experts on this most important topic.

Reporting and interpreting red blood cell morphology: is there discordance between clinical pathologists and clinicians?

BACKGROUND: Clinical pathologists (CPs) report RBC morphologic (RBC-M) changes to assist clinicians in prioritizing differential diagnoses. However, reporting is subjective, semiquantitative, and potentially biased. Reporting decisions vary among CPs, and reports may not be interpreted by clinicians as intended. OBJECTIVES: The aims of this study were to survey clinicians and CPs about RBC-M terms and their clinical value, and identify areas of agreement and discordance. METHODS: Online surveys were distributed to small animal clinicians via the Veterinary Information Network and to CPs via the ASVCP listserv. A quiz assessed understanding of RBC-M terms among respondent groups. Descriptive statistics were used to analyze responses to survey questions, and quiz scores were compared among groups. RESULTS: Analyzable responses were obtained from 1662 clinicians and 82 CPs. Both clinicians and CPs considered some terms, e.g., agglutination, useful, whereas only CPs considered other terms, e.g., ghost cells, useful. All groups interpreted certain terms, e.g., Heinz bodies, correctly, whereas some clinicians misinterpreted others, e.g., eccentrocytes. Responses revealed that CPs often do not report RBC-M they consider insignificant, when present in low numbers. Twenty-eight percent of clinicians think CPs review all blood smears while only 19% of CPs report reviewing all smears. CONCLUSIONS: Important differences about the clinical relevance of certain RBC-M terms exist between clinicians and CPs. Inclusion of interpretive comments on CBC reports is the clearest way to ensure that RBC-M changes are interpreted as intended by the CP. Reporting practices should be examined critically to improve communication, transparency, and ultimately medical decisions.

Análisis retrospectivo (2009-2010) de las alteraciones dermatológicas, óticas y oftalmológicas con diagnóstico clínico presuntivo de micosis en caninos y felinos / Análise retrospectiva (2009-2010) das alterações dermatológicas, óticas e oftalmológicas com diagnóstico clínico presuntivo de micose em cães e gatos / A retrospective analysis (2009-2010) of the dermatological, ear and ophtalmological alterations with presumptive clinical diagnosis of mycosis in canines and felines

Objetivo. Determinar la prevalencia de las alteraciones dermatológicas, óticas y oftalmológicas clínicamente presuntivas de ser causadas por hongos y analizar demográficamente su presentación. Materiales y métodos. Se realizó un estudio retrospectivo en una clínica para pequeños animales en Bogotá; se revisaron historias clínicas de pacientes que consultaron por alteraciones dermatológicas, óticas y oftalmológicas durante 2009 y 2010. Resultados. En el período evaluado la prevalencia de las alteraciones dermatológicas en caninos fue de 7,8%, las óticas de 4,2% y las oftalmológicas de 3,3%. Dentro de las alteraciones dermatológicas, la sospecha etiológica principal por diagnóstico clínico fueron los dermatofitos con 86,9%, en las alteraciones óticas fue Malassezia con 86,5% y para las oftalmológicas fue Candida con 83,3%. El análisis estadístico de variables no mostró asociación con los síntomas ni con los agentes etiológicos diagnosticados clínicamente; sin embargo, la evaluación categorizada evidenció asociaciones entre razas y edades con las etiologías por diagnóstico clínico. El diagnóstico de las etiologías micóticas se estableció en la mayoría de los casos por hallazgos clínicos y con menor frecuencia por raspado de piel y citología ótica; en ninguno de los casos se realizó cultivo micológico. La población felina no presentó alteraciones dermatológicas, óticas y oftalmológicas clínicamente compatibles con etiología fúngica. Conclusión. En caninos, la prevalencia de las alteraciones dermatológicas clínicamente compatibles con dermatofitos fue de 86,9%, los procesos óticos asociados con Malassezia de 86,5% y los oftalmológicos sospechosos de Candida con 83,3%. Los diagnósticos definitivos se establecieron por hallazgos clínicos sin la realización de metodologías diagnósticas estándar como el cultivo...

A retrospective analysis (2009-2010) of the dermatological, ear and ophtalmological alterations with presumptive clinical diagnosis of mycosis in canines and felines. Objective. To determine the prevalence of dermatological, ear and ophthalmological alterations clinically presumptive to be caused by fungi and to analyze their occurrence demographically. Materials and methods. We carried out a retrospective study in a clinic in Bogota for small animals. We reviewed the medical histories of patients who requested medical appointments due to dermatological, ear and ophtalmological alterations in 2009 and 2010. Results. In the assessed period, the prevalence of dermatological alterations in dogs was of 7.8%, 4.2% of ear alterations and of 3.3% of ophtalmological alterations. The main etiological suspects through clinical diagnosis were: dermatophytes with an incidence of 86.9% among dermatological alterations, Malassezia with an 86.5% of incidence in ear alterations, and Candida with 83.3% of incidence in ophtalmological alterations. Statistical analysis of variables showed no association with symptoms or clinically diagnosed etiological agents, but the categorized evaluation showed associations of races and ages with the etiologies through clinical diagnosis. The diagnosis of fungal etiologies was accomplished in most cases by clinical findings and less frequently by skin scrapings and ear cytology; in none of the cases a mycological culture was done. The feline population showed no dermatological, ear or ophtalmological alterations compatible with a fungal etiology. Conclusion. In canines, the prevalence of dermatological alterations clinically compatible with dermatophytes was of 86.9%; ear alterations associated with Malassezia were of 86.5%; and ophtalmological alterations Candida-suspected were 83.3%. Final diagnoses were accomplished with the help of clinical findings without following standard diagnostic methodologies such as cultivation...

Análise retrospectiva (2009-2010) das alterações dermatológicas, óticas e oftalmológicas com diagnóstico clínico presuntivo de micose em cães e gatos. Objetivo. Determinar a prevalência das alterações dérmicas, óticas e oftálmicas clinicamente presuntivo de serem causadas por fungos e analisar demograficamente sua apresentação. Materiais e métodos. Foi realizado um estudo retrospectivo numa clínica para pequenos animais em Bogotá; foram revisadas as histórias clínicas de pacientes com alterações dérmicas, óticas e oftalmicas em 2009 e 2010. Resultados. Durante o período de avaliação a prevalência das alterações dérmicas em cães foi de 7,8%, as óticas de 4,2% e as oftálmicas de 3,3%. Dentro das alterações dérmicas, a principal suspeita etiológica por diagnóstico clínico foram os dermatófitos com 86,9%, nas alterações óticas foi Malassezia com 86,5% e para as oftálmicas foi Candida com 83,3%. A análise estatística das variáveis não apresentou associação com os sintomas ou com os agentes etiológicos diagnosticados clínicamente; embora, a avaliação categorizada evidenciou associações entre raças e idades com as etiologias por diagnóstico clínico. O diagnóstico das etiologias micóticas foi estabelecido na maioria dos casos pelos achados clínicos e, menos freqüentemente por raspados de pele e citologia ótica, em nenhum dos casos foi realizada uma cultura micótica. A população felina não apresentou alterações dérmicas, óticas e oftálmicas clinicamente compatíveis com etiologia fúngica. Conclusão. Em cães, a prevalência das alterações dérmicas clinicamente compatíveis com dermatófitos foi de 86,9%, os processos óticos associados com Malassezia foi de 86,5% e os oftálmicos suspeitos de Candida foi de 83,3%. Os diagnósticos definitivos foram estabelecidos pelos achados clínicos sem a realização de métodos diagnósticos padroes, como o cultivo...

An impending crisis in the provision of histopathology expertise for mouse functional genomics.

The generation of new mouse models of human disease is accelerating rapidly, due to the completion of whole-genome sequencing efforts and technological advances in the manipulation of the mouse genome. We sought to investigate manpower issues in the provision of histopathology expertise for mouse functional genomics and compared this to the perceived demand from principal investigators (PIs). Through the European Commission (EC)-funded PRIME pathology training initiative, two questionnaires were devised to collect information from pathologists and EC-funded PIs on the current provision of mouse histopathology expertise in Europe and the demands for this service. We find that pathological analysis is being performed almost exclusively by professionally qualified pathologists, generally employed in clinical diagnostic posts, where the work is undertaken as collaboration outside of their contractual commitments but without previous training in veterinary or comparative pathology. The results indicate that there is a lack of both trainees and provision of specialist training in this field. Unsurprisingly, the availability of diagnostic expertise and advice falls far short of the number of genetically engineered mice (GEM) being generated for analysis. We analyse these results with reference to previous studies and discuss solutions for the future recruitment, training and funding for pathologists in mouse functional genomics in Europe.