Comparison of Fine Arts- and Pathology-Based Observational Skills Training for Veterinary Students Learning Cytology.

Keen observational skills are essential for veterinarians; however, the development of these skills is not usually an explicit part of the veterinary curriculum. Fine arts-based (FAB) observation training has been shown to improve medical students' observational skills and might also improve veterinary students' observational skills. We compared FAB and pathology-based (PB) observation training in a veterinary cytology course. Students initially wrote a pre-test in which they described two cytology images and one art image, followed by participation in either FAB or PB observation training. Both groups completed a similar post-test immediately after training and a delayed post-test 4 weeks later following instruction in cytology. Differences between groups were noted only in the immediate post-test cytology descriptions. The PB group used significantly more specific vocabulary terms and significantly more accurate observations than the FAB group, suggesting an immediate benefit to the discipline-specific information gained in the PB observation training. In the delayed post-test, results for both groups were similar. The FAB group significantly increased their use of specific vocabulary terms and maintained but did not increase accurate observations following cytology instruction, while accurate observations decreased significantly for the PB group. The FAB group might have been able to generalize their observation skills to the discipline of cytology and to better retain these skills. Neither type of training resulted in both achievement and maintenance of the highest recorded scores for accurate observations. Both FAB and PB training led to improved observational skills, and explicit observation training may be useful for veterinary students.

Assessment of neutrophil function in canine cancer patients undergoing chemotherapy and correlation with neutrophil numbers.

Decreased neutrophil function following administration of chemotherapy has been reported in dogs with lymphoma. The first objective of our study was to determine if neutrophil oxidative burst and phagocytic activity are affected by chemotherapy 7 to 10 days following initiation of treatment in dogs with lymphoma and non-lymphoma malignancies. The second objective was to determine if there is a correlation between neutrophil numbers and neutrophil function before or after initiation of chemotherapy. Flow cytometric assessment of neutrophil oxidative burst and phagocytosis following stimulation with Escherichia coli was performed in 9 dogs diagnosed with lymphoma and 17 non-lymphoma tumor-bearing dogs pre- and post-chemotherapy, as well as 14 tumor-free control dogs. Spearman rank correlation was performed to determine if blood neutrophil numbers and neutrophil function were significantly correlated. Lymphoma patients showed significantly reduced percentage neutrophil oxidative burst post-chemotherapy compared to healthy controls as well as compared to pre-chemotherapy values (P = 0.0022 and P = 0.0020, respectively). Lymphoma patients also exhibited significantly reduced neutrophil phagocytosis activity post-chemotherapy compared to controls and pre-chemotherapy values (P = 0.0016 and P = 0.014, respectively). Dogs with non-lymphoma malignancies also showed a significant decrease in both percentage oxidative burst and phagocytosis post-chemotherapy compared to pre-chemotherapy values (P = 0.00040 and P = 0.029, respectively). Neutrophil numbers and function were not significantly correlated. The results of the study suggest that chemotherapeutic treatment decreases neutrophil oxidative burst and phagocytic activity 7 to 10 days post-treatment in dogs with various malignancies. Furthermore, neutrophil numbers cannot be used to predict neutrophil function.

Une diminution de la fonction des neutrophiles après l'administration d'une chimiothérapie a été rapportée chez des chiens atteints de lymphome. Le premier objectif de notre étude était de déterminer si la stimulation oxydative des neutrophiles et l'activité phagocytaire sont affectées par la chimiothérapie 7 à 10 jours après le début du traitement chez les chiens atteints de lymphomes et de tumeurs malignes non lymphomateuses. Le deuxième objectif était de déterminer s'il existe une corrélation entre les nombres de neutrophiles et la fonction des neutrophiles avant ou après le début de la chimiothérapie. L'évaluation par cytométrie en flux de la stimulation oxydative des neutrophiles et de la phagocytose après stimulation par Escherichia coli a été réalisée chez neuf chiens diagnostiqués avec un lymphome et 17 chiens avec des tumeurs non lymphomateuses avant et après la chimiothérapie, ainsi que 14 chiens témoins sans tumeur. Une corrélation des rangs de Spearman a été effectuée pour déterminer si les nombres de neutrophiles sanguins et la fonction des neutrophiles étaient significativement corrélés. Les patients atteints de lymphome ont montré un pourcentage significativement réduit de stimulation oxydative des neutrophiles après la chimiothérapie par rapport aux témoins sains ainsi que par rapport aux valeurs pré-chimiothérapie (P = 0,0022 et P = 0,0020, respectivement). Les patients atteints de lymphome ont également présenté une activité de phagocytose par les neutrophiles significativement réduite après la chimiothérapie par rapport aux témoins et aux valeurs pré-chimiothérapie (P = 0,0016 et P = 0,014, respectivement). Les chiens atteints de tumeurs malignes non lymphomateuses ont également montré une diminution significative du pourcentage de stimulation oxydative et de la phagocytose post-chimiothérapie par rapport aux valeurs pré-chimiothérapie (P = 0,00040 et P = 0,029, respectivement). Les nombres et la fonction des neutrophiles n'étaient pas significativement corrélés. Les résultats de l'étude suggèrent que le traitement chimiothérapeutique diminue la poussée oxydative des neutrophiles et l'activité phagocytaire 7 à 10 jours après le traitement chez les chiens atteints de diverses tumeurs malignes. De plus, les nombres de neutrophiles ne peuvent pas être utilisés pour prédire la fonction des neutrophiles.(Traduit par Docteur Serge Messier).

Tolerance of Ambiguity in Veterinary Students at the Beginning and End of a Second-year Clinical Pathology Course.

Tolerance of ambiguity (TOA) is essential for veterinarians because ambiguity and uncertainty are unavoidable aspects of veterinary practice. However, TOA has been little investigated in veterinarians or veterinary students. In this article, the 27-item Tolerance of Ambiguity of Veterinary Students (TAVS) scale, including eight additional clinical pathology-specific items, is used to evaluate TOA in veterinary students at the beginning and end of a clinical pathology course. Clinical pathology is often one of the first subjects in which students encounter ambiguity because real-life cases are used in teaching. The hypotheses are that TOA will increase across the course and that TOA will correlate with the final grade in the course. Analysis of the TAVS scale revealed very good inter-item reliability (α = 0.80) and a positive correlation between the original TAVS items and the new clinical pathology items (ρ = 0.63). Students demonstrated a significant increase in TOA across the course for TAVS items and a similar trend for clinical pathology items. Four items related to affinity for complexity and novice view showed significant increases in TOA. Two items related to discomfort from uncertainty showed significant decreases. There was no correlation between TOA and final grade in the course. Students rated their personal frustration with ambiguity in the course as low and did not think ambiguity in cases was problematic for teaching. The results suggest that the increased TOA at the end of the course might relate to students being taught-and learning how to cope with-ambiguity through the real-life cases used for teaching.

Using Fine Arts-Based Training to Develop Observational Skills in Veterinary Students Learning Cytology: A Pilot Study.

Arts-based training has been shown to improve medical students' observational skills. Veterinarians also need keen observational skills. Student veterinarians are expected to develop their observational skills; however, this training is usually not an explicit part of the veterinary curriculum. The impact of arts-based observation training has not been investigated in veterinary students learning cytology. In this pilot study, we compared student descriptions of art and cytology images before and immediately after receiving arts-based observation training. After 10 hours of cytology instruction, we again tested students' observational skills and asked for feedback via a survey. Pre-tests and post-tests were scored following a rubric based on expert descriptions of the images. Scores for art image descriptions were higher for both the immediate and delayed post-tests compared to the pre-test (p < .05). Scores for cytology image descriptions were higher for the immediate post-test than the pre-test, but this difference was not significant. Despite 10 hours of cytology instruction between post-tests, scores for cytology image descriptions were lower for the delayed post-test than the immediate post-test, but again, this difference was not significant. Student feedback on the arts-based observation training was positive. Overall, our results suggest that arts-based training may improve student observational skills, although context could be important, as the improvement in description was only significant for art images. Further investigation with a larger cohort of students and a control group that does not receive arts-based training would be valuable.

Equine small intestinal angiomatosis.

Multiple red, raised nodules multifocally distributed along the serosal surface of the normal and the nonviable jejunum were identified in a 24-year-old neutered male horse undergoing surgery for removal of the strangulating lipoma around the jejunum. Histologically, these nodules consisted of many significantly and variably dilated, blood-filled vascular channels lined by a single layer of flattened, well-differentiated endothelial cells with occasional thrombi within a mildly thickened fibrous stroma. A diagnosis of intestinal angiomatosis was proposed. To the best of the authors' knowledge, this is the second report of small intestinal angiomatosis in a horse.

Angiomatose du petit intestin équin. De multiples nodules rouges surélevés distribués de manière multifocale le long de la surface séreuse du jéjunum viable et non-viable furent identifiés chez un cheval mâle castré âgé de 24 ans soumis à une chirurgie pour le retrait d'un lipome étranglant autour du jéjunum. Histologiquement, ces nodules consistaient en de nombreux canaux vasculaires remplis de sang dilatés de manière significative et variable, et tapissés par une couche unique de cellules endothéliales aplaties et bien différenciées avec à l'occasion des thrombi à l'intérieur d'un stroma fibreux légèrement épaissi. Un diagnostic d'angiomatose intestinale fut proposé. Au meilleur de la connaissance des auteurs, ceci constitue le deuxième rapport d'angiomatose du petit intestin chez un cheval.(Traduit par Dr Serge Messier).

Extraskeletal osteosarcoma associated with a benign hair follicle tumor in a dog.

A rare presentation of an extraskeletal osteosarcoma, suspected to have evolved from chronic inflammation associated with a benign hair follicle tumor in a dog is described. The patient was treated with surgical excision, carboplatin, and toceranib. The patient had an extended disease-free interval and a survival time of 45.4 months.

Ostéosarcome extra-squelettique associé avec une tumeur bénigne d'un follicule pileux chez un chien. On décrit la rare présentation d'un ostéosarcome extra-squelettique, suspecté d'avoir évolué à partir d'une inflammation chronique associée à une tumeur bénigne d'un follicule pileux chez un chien. Le patient fut traité avec excision chirurgicale, carboplatine et toceranib. Le patient eut un intervalle prolongé exempt de maladie et un temps de survie de 45,4 mois.(Traduit par Dr Serge Messier).

Effects of a standardized anesthetic protocol on hematologic variables in healthy cats.

This study evaluated the effects of an anesthetic protocol using intravenous ketamine and midazolam, and intramuscular buprenorphine on hematologic variables in cats. Twelve healthy adult cats had blood collected for a complete blood count before and after the induction of anesthesia. There were significant decreases in red blood cell counts, hemoglobin concentrations and hematocrits after the induction of anesthesia. On average, red blood cell counts and hematocrits decreased by 25%, and hemoglobin concentrations decreased by 24%. Based on hematocrit, 3/12 samples (25%) taken while the cats were anesthetized would have been interpreted as belonging to anemic patients while none of the cats would have been considered anemic before anesthesia. This study suggests that a complete blood count performed on blood taken under anesthesia with this anesthetic protocol should be interpreted cautiously in order to not make a false diagnosis of anemia.

What is your diagnosis? Intracranial mass in a dog.

A 9-year-old, spayed female Chihuahua was presented for evaluation of acute, progressive neurologic disease. On physical examination the dog was depressed and laterally recumbent. The dog had marked neutrophilia with a toxic left shift and monocytosis. Using computed tomography with contrast enhancement a large intracranial mass lesion was identified in the rostral portion of the brain. The mass extended from the central thalamic region rostral to the cribiform plate and obliterated the lateral ventricles. A fine needle aspirate of the mass contained moderately pleomorphic polygonal cells with many intranuclear cytoplasmic pseudoinclusions (ICPs). The primary differential diagnosis was meningioma, based on cell morphology and the presence of ICPs. At necropsy, the mass was well-demarcated, unencapsulated, and densely cellular. Cells were arranged in papillary projections on fibrovascular stalks, and eosinophilic ICPs and nuclear folding were frequently seen. Cavitated areas of necrosis throughout the tumor mass were filled with intact and degenerated neutrophils. The histopathologic diagnosis was malignant papillary meningioma. ICPs are not frequently observed in Wright-stained cytologic preparations but may be found in many types of neoplasms, including meningiomas.

A dog with squamous cell carcinoma in the middle ear.

An 8-year-old, castrated male golden retriever was referred for lethargy and inappetance. Severe pain was elicited on palpation of the left temporomandibular joint region. Computed tomography revealed aggressive bone destruction of the left bulla. Squamous cell carcinoma was diagnosed. Malignant tumor in the canine middle ear is rare.

A dog with osteosarcoma which metastasized to the eye months before metastasis to other organs.

A 9-year-old male Shih Tzu with osteosarcoma had a forelimb amputation and underwent chemotherapy. During chemotherapy, the right eye was enucleated due to refractory glaucoma, and was diagnosed as anterior uveal malignant melanoma. The dog lived for 4 months after the enucleation without treatment. After the dog died, the mass in the eye was re-evaluated immunohistochemically, and it was diagnosed as metastasis of appendicular osteosarcoma. Metastasis of appendicular osteosarcoma to the anterior chamber is quite rare, and the clinical course which showed clinically detectable metastases to the eye before systemic multi-organ metastases was quite unique.

Correlation of ultrasonographic appearance of lesions and cytologic and histologic diagnoses in splenic aspirates from dogs and cats: 32 cases (2002-2005).

OBJECTIVE: To determine the accuracy of cytologic diagnosis, compared with histologic diagnosis, in determination of disease in ultrasound-guided fine-needle aspirates of splenic lesions. DESIGN: Retrospective study. SAMPLE POPULATION: Splenic specimens from 29 dogs and 3 cats. PROCEDURES: Records were searched for dogs and cats that had undergone ultrasound-guided splenic aspiration. Criteria for inclusion were ultrasonographic identification of splenic lesions and cytologic and histologic evaluation of tissue from the same lesion. Cytologic samples were obtained by fine-needle aspiration, and histologic specimens were obtained via surgical biopsy, ultrasound-guided biopsy, or necropsy. RESULTS: Cytologic diagnoses corresponded with histologic diagnoses in 19 of 31 (61.3%) cases and differed in 5 of 31(16.1%) cases, and 1 aspirate was inadequate for evaluation. In 7 of 31 (22.6%) cases, histologic evaluation of tissue architecture was required to distinguish between reactive and neoplastic conditions. On the basis of histologic diagnosis in 14 animals with nonneoplastic conditions, the cytologic diagnosis was correct in 11 cases, not definitive in 2 cases, and incorrect in 1 case. In 17 animals with malignant neoplastic diseases, the cytologic diagnosis was correct in 8 cases, not definitive but consistent with possible neoplasia in 5 cases, and incorrect in 4 cases. Multiple similar-appearing nodules were significantly associated with malignancy, whereas single lesions were more often benign. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasound-guided aspiration of splenic lesions is a minimally invasive tool for obtaining specimens for cytologic evaluation. Although cytologic diagnoses often reflect histologic results, if missampling or incomplete sampling occurs or tissue architecture is required to distinguish between reactive and neoplastic conditions, accurate diagnosis with fine-needle aspiration may not be possible.

Cutaneous mass aspirate from a Golden Retriever: "glandular guile".

A 3-year-old, neutered, male Golden Retriever was presented for evaluation of a 10 X 9 X 5 mm, firm, red, raised, cutaneous mass located over the left cranial thorax and noted incidentally by the owner. On cytologic evaluation of a fine-needle aspirate of the mass, the interpretation was a malignant tumor with predominantly mesenchymal features. Differentials included liposarcoma, atypical amelanotic melanoma, anaplastic sarcoma, and anaplastic carcinoma. Following complete excision of the mass, a diagnosis of sebaceous adenocarcinoma was made based on histologic features, positive immunostaining for pancytokeratin, and negative staining for vimentin, Melan-A, and S-100. There was no evidence of metastasis on physical examination or thoracic radiographs, and the prognosis was good. The unique and previously unreported cytologic features of this small, sebaceous adenocarcinoma were the extreme pleomorphism, including marked anisocytosis, anisokaryosis, and multinuclearity, and the paucity of epithelial features.