Performance evaluation of a Test&Treat rapid detection kit for the diagnosis of septic effusions in dogs and cats.

OBJECTIVE: To evaluate the sensitivity and specificity of a veterinary point-of-care (POC) luminometer-based kit for the diagnosis of septic peritoneal or pleural effusion in dogs and cats. DESIGN: Prospective study performed between January 2020 and July 2021. SETTING: University teaching hospital. ANIMALS: Forty-eight animals with naturally occurring peritoneal or pleural effusion collected by aseptic abdominocentesis or thoracocentesis. PROCEDURES: Effusion samples were split into filtered (using a 10-micron filter) and unfiltered aliquots and analyzed by the POC instrument according to the manufacturer's instructions and following variable incubation periods. Samples were also plated aerobically on standard and blood agar plates. Proprietary reagents were added to samples, causing bacterial ATP to generate bioluminescence that is detected by the luminometer. Bioluminescence values (relative light units [RLUs]) were recorded and compared with the presence of bacterial growth on the culture plates. Nucleated cell counts in native and filtered effusion samples were recorded. RESULTS: Twenty-one samples were septic based on positive culture. RLUs were higher in septic effusions for filtered and native effusions compared with sterile effusions. The use of a filter reduced cell counts. In filtered samples incubated for 30 minutes before testing, the sensitivity and specificity of the luminometer for diagnosis of infection in cavitary effusions were 81% and 82%, respectively, using a cutoff of 12,202 RLUs. CONCLUSIONS: The luminometer kit evaluated in this study represents a viable screening tool for diagnosis of septic cavitary effusions and could be used in conjunction with other POC diagnostics to support the rapid diagnosis of infection.

Identification of asinine gamma herpesviruses in a donkey with interstitial pulmonary fibrosis, pleural effusion and thrombocytopenia.

A 23-year-old domestic donkey (Equus asinus) referred for severe respiratory distress due to suspected equine asthma. Ultrasound of the chest revealed bilateral irregular pulmonary consolidation and pleural effusion. Airway endoscopy and tracheal wash cytology showed severe neutrophilic inflammation and bacterial culture was positive for Streptococcus equi subsp. zooepidemicus. Despite aggressive treatment, the donkey died in 48 hours. On post-mortem examination, the lung was whitish, collapsed, and firm, with fibrotic multifocal nodular areas. Pleural effusion and pleuritis were detected. Histologically, the lung architecture was markedly replaced by interstitial fibrosis. The histological features observed were suggestive of a severe chronic fibrosing interstitial pleuropneumonia with type 2 pneumocyte hyperplasia and intralesional syncytial cells. Pulmonary fibrosis was associated with the presence of asinine gammaherpesvirus 2 and 5 infection, confirmed by PCR and sequence analysis. The macroscopic and histological pattern of fibrosis was diffuse and interstitial, and the nodular lesions were consistent with spared lung parenchyma, instead of the canonical nodular distribution of the fibrosis observed in equine multinodular pulmonary fibrosis. Asinine herpesviral pulmonary fibrosis is uncommon, but should be considered by clinicians in the list of differentials in donkeys with chronic respiratory signs.

Silica and barium: Comparison of microscopic appearance and characterization of effects of silica on cytomorphology.

BACKGROUND: Silica from plastic red top sample collection tubes and barium cause recognized artifacts in slide preparations for microscopic examination. OBJECTIVES: The objectives of this study were to evaluate and directly compare the microscopic appearance of silica and barium particles and various slide preparation techniques (e.g., use of coverslips, oil immersion, and different stains). A secondary objective of this study was to evaluate the effects of silica particles on cellular morphology after mechanical trauma with cytocentrifugation. METHODS: Fluid samples (deionized water, pleural effusion, peritoneal effusion, cerebrospinal fluid, and urine) were collected and evaluated in silica- and non-silica-containing tubes. Barium was added to silica and non-silica samples. Direct and cytocentrifuge preparations were compared to evaluate the effect of silica particles on cellular morphology. Preparations were stained with Wright-Giemsa, rhodizonic acid disodium salt, Alizarin Red, Grocott's methenamine silver, and Prussian blue. RESULTS: Silica and barium particles were identifiable via light microscopy with and without polarized light, although silica particles diminished with immersion oil. Barium particles retained their structure and diminished less under oil. Cytoseal mounting medium for coverslip placement resulted in diminished refractility of silica and some barium particles. Silica particles with mechanical interaction during cytocentrifugation resulted in disrupted cellular morphology with many lysed cells. Silica and barium particles were negative for all special stains tested. CONCLUSIONS: Silica from plastic red top tubes adversely affects cell morphology in cytocentrifuge preparations, potentially affecting manual differential cell counts and compromising diagnostic interpretation. Samples intended for microscopic evaluation should not be collected in silica-containing tubes.

Eosinophilic cavitary effusions in cats: 48 cases (2010-2020).

BACKGROUND: Eosinophilic effusions are commonly defined as effusions with ≥10% eosinophils. Eosinophilic cavitary effusions are infrequently observed in cats, with few case reports comprising the majority of the recent literature. OBJECTIVE: The objective was to review disease associations of cats with eosinophilic cavitary effusions and to assess if a lower threshold of eosinophils (5%-9%) may warrant consideration of similar etiologies associated with effusions with ≥10% eosinophils. METHODS: Cytology reports were retrospectively reviewed for all feline cavitary effusions submitted for fluid analysis from 2010 to 2020 at a veterinary teaching hospital. Cases were included if the manual leukocyte differential included ≥5% eosinophils and separated into 5%-9% and ≥10% eosinophils groups. Patient records were reviewed for associated medical conditions. RESULTS: A total of 669 effusions were submitted from 579 cats; 50 effusions from 48 cats had a leukocyte differential with ≥5% eosinophils. The eosinophil proportion was ≥10% in 22 cats; the most common underlying cause was neoplasia (10/22, 45%), followed by inflammatory disease (4/22, 18%), cardiac disease (3/22, 14%), suspect neoplasia (3/22, 14%), and undetermined (2/22, 9%). The underlying causes for the 26 cats with 5%-9% eosinophils were similar; neoplasia (8/26, 31%), cardiac disease (6/26, 23%), inflammatory disease (4/26, 15%), suspect neoplasia (3/26, 12%), undetermined (3/26, 12%), and idiopathic chylothorax (2/26, 8%). Cats with eosinophil proportions ≥10% in the fluid exhibited peripheral eosinophilia more frequently (35%) compared to those with 5%-9% eosinophils (5%). CONCLUSIONS: Consistent with the current literature, neoplasia, particularly lymphoma, remains a primary consideration for cats with eosinophilic effusions. Previously unreported associated diseases included cardiovascular and inflammatory disorders. Our findings suggest an eosinophil differential of 5%-9% is seen with similar etiologies considered for classically defined eosinophilic effusions.

Retrospective evaluation of the etiology and clinical characteristics of peripheral edema in dogs.

BACKGROUND: The prevalence and clinical characteristics of different etiologies of peripheral edema in dogs are unknown. HYPOTHESIS/OBJECTIVES: To determine the prevalence of different etiologies of peripheral edema, describe clinical characteristics that vary among etiologies, and report survival times. ANIMALS: Five hundred twenty-seven dogs with peripheral edema. METHODS: Retrospective medical record review. Differences in clinical variables among etiology groups were assessed by Kruskal-Wallis testing with post hoc pairwise Dunn's testing and Chi-square testing with Monte Carlo simulation. RESULTS: The most common etiologies of peripheral edema in dogs were vasculitis (n = 193, 37%), lymphatic/venous obstruction (LVO; 114, 22%), and hypoalbuminemia (94, 18%). Right-sided congestive heart failure (R-CHF) was uncommon (25, 5%). Edema was localized in 377 (72%) dogs and generalized in 142 (27%) dogs, and hypoalbuminemia was more likely to cause generalized edema compared to LVO or vasculitis (P < .0001). Concurrent abdominal effusion (155, 29%) was more common than pleural (77, 15%) or pericardial (12, 2%) effusion. Abdominal and pleural effusion occurred more commonly in dogs with hypoalbuminemia or R-CHF compared to LVO or vasculitis (P < .0001). CONCLUSIONS AND CLINICAL IMPORTANCE: Distribution of edema, concurrent cavitary effusions, and clinicopathological data can help predict the underlying etiology of peripheral edema in dogs.

Pleural effusion-related Nocardia otitidiscaviarum, Anaplasma platys and Ehrlichia canis coinfection in a dog.

The coinfections by some microorganisms have been related to severe diseases in humans and animals, where immunosuppressive agents favor opportunistic behavior of other pathogens. A 4-month-old, female mixed-breed dog with a two-week history of inappetence, prostration, emaciation, and respiratory distress was admitted at a veterinary hospital in Brazil. Tachycardia, pale mucous membranes, severe respiratory distress, and a large number of ticks (Rhipicephalus sanguineus s.l.) in different body regions were observed at clinical examination. Hematological examination of dog showed leukocytosis, neutrophilia, mild anemia, and thrombocytopenia, whereas unremarkable values in biochemical tests. Thoracic radiography revealed a pleural effusion image. Blood and the pleural fluid (purulent aspect) samples were subjected to qPCR (16S rRNA and dsb genes) and sequencing, which identified Ehrlichia canis and Anaplasma platys coinfection. An aggregate of coccoid-to-branching or long filamentous microorganisms, surrounded by pyogranulomatous inflammatory reaction was seen at the cytology of the pleural fluid. Bacteriological culture of pleural effusion showed colonies compatible with the genus Nocardia, which revealed gram-positive filamentous organisms with a tendency of fragmentation and were identified as Nocardia otitidiscaviarum in mass spectrometry (MALDI-TOF MS). Therapy of N. otitidiscaviarum isolate using levofloxacin (supported by a previous in vitro susceptibility testing) and doxycycline for E. canis and A. platys resulted in complete resolution of the clinical picture. Here, we report for the first time a triple coinfection by Nocardia otitidiscaviarum, A. platys, and E. canis in a dog with pleural effusion, where debilitating or immunosuppressive conditions induced by A. platys and E. canis coinfection probably contributed to the opportunistic behavior of N. otitidiscaviarum.

Chylothorax secondary to subcutaneous cervical lipoma in a dog.

An 8-year-old male neutered American English Coonhound was presented for a 2-day history of increased respiratory effort and rate with an occasional cough. Thoracic radiographs noted pleural effusion, which was chylous based on cytological and chemical evaluation. The dog also had a 2-year history of a slow growing fatty mass in the right cervical region. A CT scan confirmed the large cervical fat attenuating mass extending from the base of the skull to the cranial thorax and right axillary region with compression of vascular structures. Severe bilateral effusion and secondary pulmonary atelectasis was noted within the thoracic cavity. It was elected to surgically remove the cervical mass and place a PleuralPort within the thoracic cavity. The mass was diagnosed as a lipoma and its removal led to rapid and complete resolution of chylothorax. Based on the literature search, this is the first case report of chylothorax secondary to a cervical mass or subcutaneous lipoma.

Etiology and effusion characteristics in 29 cats and 60 dogs with pyothorax (2010-2020).

BACKGROUND: Pyothorax, an accumulation of inflammatory fluid in the pleural space, is often caused by foreign body inhalation in dogs, whereas the etiology in cats can be more difficult to discern. OBJECTIVE: Compare clinical, microbiologic findings, and etiology in cats and dogs with pyothorax. ANIMALS: Twenty-nine cats and 60 dogs. METHODS: Medical records of cats and dogs diagnosed with pyothorax from 2010 to 2020 were reviewed. Clinical findings, fluid analysis, and microbiologic results were retrieved. RESULTS: Antimicrobials had been administered to equal proportions of cats and dogs before fluid sampling (45% and 47%). Groups did not differ in age or total protein concentration or percentage neutrophils in pleural fluid, but effusion cell count was significantly higher in cats than in dogs (P = .01). Neutrophils containing intracellular bacteria were identified in more cats (27/29, 93%) than dogs (44/60, 73%; P = .05). Penetrating damage to the thorax was implicated as the cause of pyothorax in equal percentages of cats (76%) and dogs (75%). Etiology could not be determined in 2 cats and 1 dog. Cats had higher numbers of bacterial isolates per patient (median, 3) than dogs (median, 1; P = .01) and anaerobes were isolated more often in cats (23/29, 73%) than in dogs (27/60, 45%; P = .003). CONCLUSIONS AND CLINICAL IMPORTANCE: Pyothorax had similar etiologies in cats and dogs. Cats had higher fluid cell counts, higher numbers of bacterial isolates identified per patient, and intracellular bacteria detected more commonly than did dogs.

Diagnostic imaging and histopathologic features of rounded atelectasis in four cats and one dog: A descriptive case series study.

In humans, rounded atelectasis is defined as focal lung collapse that radiologically appears as a round mass-like lesion in the periphery of the lung. In general, human patients with rounded atelectasis have a history of pleural effusion and abnormal pleura and characteristic CT findings help to distinguish rounded atelectasis from pulmonary neoplasia without the need for invasive surgical biopsy. This retrospective multi-center case series describes rounded atelectasis in four cats and one dog. Chylothorax was seen in four patients and an eosinophilic and lymphoplasmacytic effusion was seen in one patient. All patients had solitary or multifocal subpleural pulmonary masses (26 masses total in 5 patients) with diffuse, multifocal, or focal visceral and parietal pleural thickening. All the masses but one were broad-based towards the visceral pleura. Masses were most common in the ventral or lateral aspect of the lungs. Indistinctness at the hilar aspect of the lesion was seen in all masses; a "comet tail" sign was seen in 14 of 26 masses. On postcontrast images, the lesions were homogeneously enhanced in 24 of 26 masses and heterogeneous in two of 26 masses. Other findings include ground glass opacities (n = 5), parenchymal bands (n = 4), mild to moderate lymphadenopathy (n = 4), and compensatory hyperinflation of the lung lobes not affected by atelectasis (n = 2). Histopathology of four cases revealed atelectasis with fixed pleural folds, chronic pleuritis, and mild to moderate pleural fibrosis. Awareness of rounded atelectasis in veterinary species will enable inclusion of a benign etiology into the differential diagnosis for subpleural masses in cases with pleural abnormalities.

Lung lobe torsion in association with a pulmonary papillary carcinoma in a dog.

Lung lobe torsion (LLT) is an uncommon condition in dogs reported to be most commonly idiopathic or secondary to trauma, pleural effusion, lung lobectomy or thoracic neoplasia. Carcinomas are the most common primary lung tumours in dogs, but only a few cases have been reported in association with LLT in veterinary medicine. This case describes an adult male neutered Labrador, which presented with lethargy, weight loss and pleural effusion. Computed tomography (CT), cytology of the lung, thoracocentesis and fluid analysis were performed. CT revealed pleural effusion and torsion of the left cranial lung lobe with no evidence of a pulmonary mass or metastatic disease. Thoracotomy and left cranial lung lobectomy were performed. Intraoperatively there was no macroscopic evidence of pulmonary neoplasia. Histopathology of the lobar tissue confirmed grade 2 pulmonary papillary carcinoma. It is possible that early detection and surgical management might help to prevent the morbidity and mortality associated with LLT. However, as in this case, the underlying cause for the LLT will ultimately determine the patient's prognosis. The final diagnosis of papillary carcinoma in this case, was only made via histopathological assessment of the pulmonary tissue as it was unclear on the advanced imaging and macroscopic intraoperative evaluation of the lungs. This case highlights the importance of considering pulmonary neoplasia as a differential for LLT even in the absence of a macroscopic mass, and therefore the value of performing histopathology on the excised lung tissue.

Prospective evaluation of lymphatic embolization as part of the treatment in dogs with presumptive idiopathic chylothorax.

OBJECTIVE: To describe the embolization technique and short-term clinical outcome in dogs undergoing lymphatic embolization (LE) as part of treatment for presumptive idiopathic chylothorax (IC). Additionally, to document findings in computed tomography lymphangiography (CTLa) following embolization. STUDY DESIGN: Prospective case series. ANIMALS: Eight client-owned dogs. METHODS: Dogs underwent CTLa followed by thoracic duct ligation (TDL), pericardiectomy (PC) and LE. A mixture of 3:1 lipiodol: n-butyl cyanoacrylate embolic solution was injected through a catheterized mesenteric lymphatic vessel via limited abdominal approach using intraoperative fluoroscopy. CTLa was scheduled for 12 weeks postoperatively, and long-term follow-up was obtained via telephone contact. RESULTS: LE was technically successful in six of the eight dogs; and clinically successful in five of the six dogs. In the unsuccessful dog, a diagnosis of lymphangiosarcoma was determined, and the owners elected for euthanasia. Five dogs who underwent successful LE underwent CTLa at 12 weeks. Complete resolution of pleural effusion occurred in three dogs and scant pleural effusion in two dogs. A robust lymphatic embolus preventing antegrade continuation of radiocontrast was documented in all five dogs. Five of the six dogs that underwent LE, were alive and clinically normal at 358-960 days postoperatively. CONCLUSIONS: LE is a feasible part of treatment for dogs with IC. Additionally, a robust lymphatic embolus and lack of radiocontrast flow past the embolus was documented at 12 weeks following surgery. CLINICAL SIGNIFICANCE: LE has the potential to reduce surgical failure by reducing efferent lymphatic chyle flow, occluding missed lymphatic branches and preventing the development of collateral branches.

Reduced risk of arterial thromboembolism in cats with pleural effusion due to congestive heart failure.

OBJECTIVES: The aim of the study was to determine whether cardiogenic pleural effusion in cats is associated with a lower risk of arterial thromboembolism (ATE) compared with cats with cardiac disease without evidence of pleural effusion. METHODS: A cross-sectional study was conducted on owned cats with natural occurring cardiac diseases. Cats included were classified in three groups: those with cardiac disease but no evidence of congestive heart failure (CHF); those with evidence of cardiogenic pulmonary oedema; and those with evidence of cardiogenic pleural effusion. Prevalence of ATE was calculated and the variables analysed for an association with this outcome were the presence and type of CHF, sex and neuter status, age, breed, type of cardiac diseases and left atrial (LA) dimension. A multivariable logistic regression model was used to fit the association between ATE and these variables. RESULTS: A total of 366 cats with cardiac disease met the inclusion criteria: 179 were included in the group with cardiac disease but no evidence of CHF, 66 in the group with evidence of cardiogenic pulmonary oedema and 121 in the group with evidence of cardiogenic pleural effusion. Prevalence of ATE (58/366 [15.8%]) was significantly different among groups (with no evidence of CHF, 28/179 [15.6%]; with evidence of cardiogenic pulmonary oedema, 22/66 [33.3%]; with evidence of cardiogenic pleural effusion, 8/121 [6.6%]; P <0.001). Cats with ATE had a significantly higher LA to aortic root ratio (2.30 ± 0.46) than those without ATE (2.04 ± 0.46; P <0.001). Multivariable logistic regression analysis indicated that the group with evidence of cardiogenic pleural effusion was associated with a lower risk of developing ATE compared with groups with cardiac disease but no evidence of CHF and with evidence of cardiogenic pulmonary oedema (P = 0.005 and P <0.001, respectively). CONCLUSIONS AND RELEVANCE: Presence of cardiogenic pleural effusion is associated with a lower risk of developing ATE, while LA enlargement is a risk factor for ATE.

Total protein concentration as a predictor of neoplastic peritoneal and pleural effusions of dogs.

BACKGROUND: The diagnosis of neoplastic cavitary effusions requires the identification of neoplastic cells in effusions, yet the cytologic appearance of neoplastic effusions can be highly variable due to the varied mechanisms of formation. Additional parameters might aid in the interpretation of equivocal cytologic results. OBJECTIVES: Our goal was to evaluate whether total protein concentrations can be used to support the diagnosis of neoplasia in the peritoneal and pleural effusions of dogs with lower cellularities (≤5000 nucleated cells/µL). METHODS: Pleural and peritoneal fluid analyses from dogs presented to the University of Illinois Veterinary Teaching Hospital between 2014 and 2019 were evaluated retrospectively. Effusions were categorized as neoplastic or non-neoplastic based on histology or cytology. Non-neoplastic effusions were subcategorized according to mechanism: decreased oncotic pressure, increased hydrostatic pressure, increased vascular permeability, leakage of urine, and leakage of lymph. The TP and blood albumin to fluid TP ratio (Albblood :TPfluid ) were compared among groups. RESULTS: Twenty-seven neoplastic and 65 non-neoplastic cases were evaluated. TP was higher in the neoplastic group (P = .001) than in the non-neoplastic group. Neoplastic effusions had a lower Albblood :TPfluid than non-neoplastic (P = .001), and effusions with Albblood :TPfluid of ≤0.6 were 5.6 times more likely to be neoplastic (95% CI 1.69-17.36; P = .003). CONCLUSIONS: Fluid TP concentrations were significantly greater in neoplastic than non-neoplastic effusions; however, given the considerable overlap between groups, the diagnostic utility of this difference is low. A neoplastic etiology might be more likely in cases with an Albblood :TPfluid ≤0.6.

Accuracy of artificial intelligence software for the detection of confirmed pleural effusion in thoracic radiographs in dogs.

The use of artificial intelligence (AI) algorithms in diagnostic radiology is a developing area in veterinary medicine and may provide substantial benefit in many clinical settings. These range from timely image interpretation in the emergency setting when no boarded radiologist is available to allowing boarded radiologists to focus on more challenging cases that require complex medical decision making. Testing the performance of artificial intelligence (AI) software in veterinary medicine is at its early stages, and only a scant number of reports of validation of AI software have been published. The purpose of this study was to investigate the performance of an AI algorithm (Vetology AI® ) in the detection of pleural effusion in thoracic radiographs of dogs. In this retrospective, diagnostic case-controlled study, 62 canine patients were recruited. A control group of 21 dogs with normal thoracic radiographs and a sample group of 41 dogs with confirmed pleural effusion were selected from the electronic medical records at the Cummings School of Veterinary Medicine. The images were cropped to include only the area of interest (i.e., thorax). The software then classified images into those with pleural effusion and those without. The AI algorithm was able to determine the presence of pleural effusion with 88.7% accuracy (P < 0.05). The sensitivity and specificity were 90.2% and 81.8%, respectively (positive predictive value, 92.5%; negative predictive value, 81.8%). The application of this technology in the diagnostic interpretation of thoracic radiographs in veterinary medicine appears to be of value and warrants further investigation and testing.

Retrospective analysis of radiographic signs in feline pleural effusions to predict disease aetiology.

BACKGROUND: The objectives of the study were to determine the prevalence of underlying conditions causing pleural effusion in cats and to calculate the positive predictive values, negative predictive values, sensitivity and specificity of radiographic signs to predict aetiology of the pleural fluid. METHODS: Data from 148 cats with pleural effusion and diagnosed with known aetiologies were retrospectively analysed. Sixty one cats had thoracic radiographs evaluated by consensus through pre-defined radiographic signs by two radiologists blinded to the diagnoses. RESULTS: Congestive heart failure (53.4%) was the most common diagnosis, followed by neoplasia (20.3%), pyothorax (10.8%), idiopathic chylous effusion (5.4%), feline infectious peritonitis (1.4%) and "other" or cats with multiple diagnoses (total 8.8%). Cats with an enlarged cardiac silhouette had a high positive predictive value of congestive heart failure (90%). Mediastinal masses (100%)and pulmonary masses (100%) were highly predictive of neoplastic disease. Pulmonary nodules (50%) were poorly predictive of neoplastic disease. The remainder of the radiographic variables were not informative predictors of underlying disease. CONCLUSIONS: In our sample of cats, congestive heart failure was the most common cause of pleural effusion. Radiographically enlarged cardiac silhouette and presence of a mediastinal mass may be useful predictors of aetiology, however there are limitations to the use of radiography alone as a diagnostic tool.

Chronic nonchylous lymphatic pleural effusion in a bottlenose dolphin (Tursiops truncatus).

CASE DESCRIPTION: A 19-year-old male bottlenose dolphin (Tursiops truncatus) presented with inappetence and avoidant behavior. CLINICAL FINDINGS: Ultrasound revealed a large-volume left-sided pleural effusion, which was consistent with chronic nonchylous lymphatic effusion and mild chronic hemorrhage by cytology. Computed tomography identified ipsilateral rib fractures, atelectasis, nodular pleuritis, marginal lymph node enlargement, and suspected dilation of the thoracic duct and internal thoracic veins. Fifteen lipids were significantly higher in serum of the dolphin as compared with controls (n = 3) using nontargeted lipidomics. TREATMENT AND OUTCOME: A series of thoracentesis procedures were performed. Follow-up CT demonstrated marked reduction in pleural effusion with persistence of thoracic duct dilation and mass-like areas of pleural thickening. Ultrasonographic resolution of pleural effusion occurred 14 months after presentation; however, recrudescence was noted 5 months later. Over a total of 24 months, 21.52 L of pleural effusion was removed. Despite the presence of pleural effusion, the patient was clinically stable during this time and quality of life was considered good on the basis of continuous animal welfare evaluations. Humane euthanasia was elected following acute clinical decline 27 months after initial diagnosis. Necropsy confirmed severe pleural effusion, chronic severe pleural fibrosis with chronic hemorrhage, and mediastinal fibrosis with entrapped lymph nodes and thymic tissue. CLINICAL RELEVANCE: Pleuritis and effusion were suspected sequelae of previous rib fractures. To our knowledge, this is the first report of nonchylous lymphatic pleural effusion with repeated pleural drainage and diagnostic imaging for clinical management in a bottlenose dolphin.

Laboratory diagnosis of canine uroperitoneum based on cellular and biochemical characteristics of serum and abdominal fluid.

BACKGROUND: Literature on the laboratory diagnosis of uroperitoneum is scarce, and it is mostly based on the biochemical findings of cavitary fluid and serum. Cell count and protein concentrations measurements are rarely used and available studies on this subject are based on a relatively small cohort of individuals. OBJECTIVES: We aimed to use a large sample pool of dogs to establish cutoff points for biochemical analytes in cavitary fluids and serum for the diagnosis of uroperitoneum. We also sought to evaluate the general classification of these cavitary fluids. METHODS: In a retrospective and prospective study, 180 canine abdominal effusion cases were evaluated, 30 of which were uroperitoneum (uroperitoneum group, UG) and 150 with other etiologies (non-uroperitoneum group, NUG). RESULTS: The results showed that 83.3% of UG and 12.7% of NUG abdominal fluid cases were not classified as transudates or exudates. The use of specific cutoffs for fluid creatinine concentrations (≥2.1 mg/dL) and fluid:serum creatinine ratios (Cf: Cs ≥ 1.25) in these unclassified effusions resulted in an accuracy of 99.0% for the laboratory diagnosis of uroperitoneum. CONCLUSIONS: The adoption of a new set of criteria and cutoffs based on the combination of parameters such as TP, TNCC, fluid creatinine and Cf: Cs improves the diagnosis of uroperitoneum in dogs.

Lipoprotein profile of pleural and peritoneal transudates in dogs and cats.

BACKGROUND: Current diagnostic evaluation of transudative effusions rarely aids in identifying an underlying etiology. Lipoproteins in the fluid might reflect the site or nature of vessel involvement. OBJECTIVES: Improve the classification and diagnostic utility of pleural and peritoneal transudates in dogs and cats by investigating lipoprotein patterns in effusions. Compare these patterns with other peritonaeal and pleural fluid variables and underlying diseases. ANIMALS: Samples of transudates and serum from 18 cats and 37 dogs with transudative effusion (total nucleated cell count [TNCC] <5000 cells/µL) were analyzed. METHODS: Lipoprotein fractions, triglyceride, and cholesterol (CHO) concentrations were prospectively determined in paired fluid and serum samples. Standard fluid measurements were retrospectively collected. RESULTS: Two distinct fluid lipoprotein patterns were noted. Fluids rich in VLDL+IDL were associated with chronic kidney disease, acquired portosystemic shunts or protein-losing enteropathy (group I). Fluids rich in denser lipoproteins were associated with underlying heart disease, caudal vena cava syndrome or intracavitary neoplasia (group II). Group I and group II also had significant differences between fluid concentrations of CHO (x̄ = 8 vs 110 mg/dL) and TP (x̄ = 0.6 vs 3.8 g/dL), respectively. Five peritoneal transudates were triglyceride-rich (>100 mg/dL) and associated with pancreatitis. CONCLUSIONS AND CLINICAL IMPORTANCE: Protein-poor (TP <1.5 g/dL) and protein-rich (TP >2.5 g/dL) transudates were associated with distinct lipoprotein patterns and specific groups of disease. Effusions secondary to pancreatitis might be transudative and rich in triglycerides.

Unusual case of pleural effusion caused by amlodipine in a dog with systemic hypertension.

OBJECTIVE: The aim of this report is to document the case of a dog that developed pleural effusion as a potential side-effect to the administration of a high-dose of amlodipine. CASE SUMMARY: A Yorkshire terrier dog (13-year-old, castrated male, 4.5 kg) presented with severe systemic hypertension (>200 mmHg), hyperkalaemia, and acute pancreatitis. The dog had hyperadrenocorticism, chronic valvular heart disease, chronic kidney disease, and cerebellar infarction as underlying diseases. Additionally, the dog had laboured breathing and tachypnoea during hospitalization. Screening examinations revealed a pleural effusion (pure transudate) for which hypoalbuminemia and thromboembolism were ruled out as the causes. Therefore, the adverse drug event of an anti-hypertensive drug (amlodipine) was tentatively diagnosed. CONCLUSIONS: Pleural effusion resolved within 24 h of reducing the dosage of amlodipine. Hence, the dog was diagnosed with amlodipine-induced pleural effusion. Rarely, amlodipine can cause pleural effusion after high-dose administrations in humans, but only two cases of peripheral edema have been reported in animals. If pleural effusion occurs in hypertensive patients administered amlodipine, it should be considered as the potential cause.