Sarcina sp. as a presumptive cause of fatal acute gastric dilation and gastric emphysema in rhesus macaques.

A 4-y-old female and 3-y-old male rhesus macaque (Macaca mulatta), both housed in the same facility, died unexpectedly within 2 wk. Postmortem examination revealed severe gastric dilation in both macaques and gastric emphysema in the female macaque. Histologically, bacteria consistent with Sarcina sp. were present in both macaques within the lungs and lumen of the trachea, esophagus, and gastrointestinal (GI) tract without associated inflammation. Additionally, in the female macaque, the bacteria were found in the gastric mucosa and associated with emphysematous spaces in the gastric wall without associated inflammation. PCR and Sanger sequencing of amplicons were subsequently performed on GI contents and non-alimentary tissues from the 2 affected monkeys and on comparative samples from unaffected rhesus monkeys in the same facility and an adjacent primate facility. The cases were compared using the 2-tailed Fisher exact test (p-value at 95% confidence). PCR identified Sarcina in GI contents of both affected and unaffected monkeys (p = 0.6084) and in non-alimentary tissues of affected monkeys only (p = 0.0083). These results suggest that the presence of Sarcina sp. in non-alimentary tissues is associated with gastric distension, gas accumulation, and unexpected death in nonhuman primates.

MULTISYSTEMIC EMPHYSEMA (GAS BUBBLE DISEASE)-ASSOCIATED ACUTE MASS MORTALITY IN A FREE-RANGING POPULATION OF COMMON FROG (RANA TEMPORARIA) IN SWITZERLAND.

In April 2020, nearly 5,000 free-ranging common frogs (Rana temporaria) were found dead on the surface of the water in a retention pond in the Swiss Alps. Macroscopic and microscopic lesions revealed multisystem emphysema, affecting multiple organs. The most severe lesions were seen in the skin, eyes, and blood vessels of internal organs and were secondary to the sudden massive distension of the skin and other affected organs. All frogs had similar lesions consistent with those described associated with gas bubble disease. No obvious pre-existing conditions potentially priming the occurrence of the observed lesions could be detected. All the examined frogs were negative by PCR for Batrachochytrium dendrobatidis, Ranavirus and Ranid Herpesvirus 3 (now Batravirus ranidallo 3). The proposed etiology is considered to be an undetermined physical event, leading to an abrupt change in the molecular or physical characteristics of the water (namely pressure and oxygen or other gas supersaturation), resulting in the occurrence of the observed lesions in the frogs. No obvious pumping system malfunction was recorded in the Mägisalp ponds before the mass mortality, but a sudden and temporary undetected change in the water flow, which then quickly rebalanced, cannot be excluded. Other hypotheses include weather conditions, such as lightning strikes in the water, or a device detonating in the water.

Feline Emphysematous Gastritis in a Cat with Pancreatitis and Secondary Hepatic Lipidosis.

A 7 yr old female neutered domestic shorthair was presented with a 2 mo history of lethargy and hyporexia progressing to anorexia. Initial diagnostics indicated pancreatitis with secondary hepatic lipidosis. Supportive care, including the placement of an esophageal feeding tube, was initiated. The feeding tube was removed traumatically by the cat and thus replaced. The cat acutely deteriorated while hospitalized, developing marked hypersalivation and an obtunded mentation. Radiographs were taken to confirm placement of the feeding tube in case tube dislodgement was contributing to the hypersalivation; results confirmed appropriate positioning and gastric pneumatosis. Despite intensified medical management, the patient suffered cardiopulmonary arrest 7 days after hospital admission. Post-mortem examination confirmed necrotizing gastritis with emphysema alongside segmental mucosal necrosis in the jejunum, focal pancreatic necrosis, and diffuse hepatic lipidosis. Gas in the gastric wall is a rare finding in veterinary medicine and can arise due to gastric pneumatosis or emphysematous gastritis; there are scant reports of either in feline medicine. This report documents a case of emphysematous gastritis in a cat with concurrent pancreatitis and hepatic lipidosis. The cat developed emphysematous gastritis without undergoing gastrointestinal surgery which is currently the only reported feline predis-posing factor for development.

Imaging findings in 14 dogs and 3 cats with lobar emphysema.

BACKGROUND: Lobar emphysema in dogs and cats is caused by bronchial collapse during expiration and subsequent air trapping. Congenital causes such as bronchial cartilage defects or acquired causes such as compressive neoplastic lesions have been reported. Morbidity results from hyperinflation of the affected lung lobe and compression of adjacent thoracic structures. OBJECTIVE: To describe patient characteristics and imaging findings in dogs and cats with lobar emphysema. ANIMALS: Fourteen dogs and 3 cats with lobar emphysema diagnosed by imaging findings were retrospectively identified from veterinary referral hospital populations over a 10-year period. METHODS: Cases that included thoracic radiography, thoracic computed tomography (CT), or both were included. All images were reviewed by a European College of Veterinary Diagnostic Imaging diplomate. Relevant case information included signalment, clinical findings, treatment, and histopathology where available. RESULTS: Ten of 17 (59%) patients were presented for evaluation of dyspnea and 6 (35%) for coughing. Eleven (65%) patients were <3 years of age. The right middle lung lobe was affected in 12 cases (71%) and multiple lobes were affected in 7 cases (41%). Congenital lobar emphysema was suspected in 14 cases (82%). CONCLUSION AND CLINICAL IMPORTANCE: Lung lobe hyperinflation, atelectasis of nonaffected lung lobes, mediastinal shift, and thoracic wall and diaphragmatic wall deformation were common findings. Lobar or multilobar emphysema should be considered in patients with dyspnea or coughing, particularly younger patients. Although radiography is useful, CT provides better detail. In older patients, acquired causes of bronchial compression should be considered.

Emphysematous Cystitis and Pneumoperitoneum in a Dog with Escherichia coli Urinary Tract Infection and Hyperadrenocorticism.

A 9 yr old male neutered Staffordshire bull terrier with a history of poorly controlled hyperadrenocorticism, urinary tract infections, and emphysematous cystitis (EC) was presented to a veterinary referral teaching hospital for vomiting. Abdominal radiographs revealed EC and a pneumoperitoneum. The urinary bladder was found to be intact based on ultrasound and a pre- and postiohexol contrast computed tomography study with retrograde contrast cystogram. Urine culture confirmed the presence of a recurrent Escherichia coli urinary tract infection. The patient was managed medically, primarily as an outpatient, and had complete resolution of all problems. This case represents an extremely rare form of EC with pneumoperitoneum, without evidence of concurrent urinary bladder rupture. Only six similar cases have been reported in humans, with no previous cases reported in veterinary medicine. This case demonstrated that surgery is not necessarily indicated in all cases of pneumoperitoneum. The patient remained alive at 2 mo follow-up, with no evidence of recurrence of EC.

Spontaneous emphysematous splenitis: Radiographic and ultrasonographic findings in three Golden Retriever dogs.

Spontaneous emphysematous splenitis is a life-threatening condition reported rarely in humans; however, published reports in dogs are currently lacking. The aim of this multicentric, retrospective, case series design study was to describe radiographic and ultrasonographic imaging findings in Golden Retriever dogs diagnosed with spontaneous emphysematous splenitis. A total of three dogs were sampled. All dogs had a history of lethargy, diarrhea, and weight loss. Radiographic findings in all dogs included a mass effect with focal or multifocal coalescing "vesicular-like" gas pattern in the splenic region and focal loss of serosal detail. Ultrasonographic findings in all dogs included focal or multifocal irregularly shaped, hypoechoic areas containing a mixture of hyperechoic fluid and gas within the splenic parenchyma, hyperechoic abdominal free fluid, and generalized hyperechoic mesenteric fat without evidence of splenic torsion. Pneumoperitoneum was detected ultrasonographically and radiographically in two dogs. All three dogs underwent splenectomy and splenic torsion was definitively ruled out at surgery. One dog died three days after surgery, whereas the other two dogs recovered uneventfully. Culture of the splenic tissue and free abdominal fluid was positive for Clostridium spp. in all three cases. Findings supported inclusion of spontaneous emphysematous splenitis and septic peritonitis as differential diagnoses for dogs with this combination of clinical and imaging characteristics.

Self-limiting Orbital Emphysema Following Ocular Evisceration and Demonstration of Nasolacrimal-Oropharyngeal Communication in a South African Ostrich (Struthio camelus australis).

A 25-year-old, male, sanctuary-owned, South African ostrich (Struthio camelus australis) was evaluated for orbital emphysema after evisceration of a nonvisual and chronically irritated eye. On initial ophthalmic examination, the ostrich's left eye displayed severe corneal fibrosis, broad anterior synechia, and a shallow anterior chamber, all suggestive of a previous corneal perforation. Conjunctival hyperemia and eyelid crusts were also present, reportedly associated with chronic rubbing. Evisceration of the left eye was performed by excising the eyelid margins, conjunctiva, nictitans, cornea, and intraocular contents. Four weeks postoperatively, a nonpainful, fluctuant swelling of the surgical site was noted. Trocarization of the surgical site verified orbital emphysema and served to temporarily decompress the orbit. Orbital emphysema reoccurred within 48 hours but gradually regressed without intervention over the subsequent 9 months. A Jones test was performed in the healthy, right eye and demonstrated clear communication to the oropharynx. To our knowledge, this is the first reported case of an evisceration performed on an ostrich and the first reported case of orbital emphysema in any avian species. It is probable that the emphysema noted in this case was secondary to nasolacrimal duct-oropharynx communication.

Concurrent bullous emphysema, bronchointerstitial pneumonia with necrosis, and tension pneumothorax in an 8-week-old puppy.

An 8-week-old, male, mixed breed puppy was presented because of progressive respiratory distress. Thoracic radiographs revealed innumerable coalescing pulmonary bullae throughout the lungs with increased soft tissue opacity of the remaining pulmonary parenchyma and tension pneumothorax. Necropsy and histopathological findings were compatible with bullous emphysema and marked neutrophilic to histiocytic bronchointerstitial pneumonia with necrosis, bronchiectasis, fibrosis, dystrophic mineralization, and vasculitis with thrombosis. Tests for agents of infectious disease did not reveal an underlying etiological agent. This case highlights the radiographic, gross necropsy, and histopathologic features of a puppy with bullous emphysema and severe bronchointerstitial pneumonia with necrosis.

Un chiot mâle croisé âgé de 8 semaines fut présenté à cause de détresse respiratoire progressive. Des radiographies thoraciques ont révélé un nombre incalculable de bulles pulmonaires coalescentes à travers les poumons avec augmentation de l'opacité des tissus mous du parenchyme pulmonaire restant et un pneumothorax de tension. La nécropsie et les trouvailles histopathologiques étaient compatibles avec de l'emphysème bulleux et une pneumonie broncho-interstitielle neutrophilique et histiocytaire marquée avec nécrose, de la bronchiectasie, de la fibrose, une minéralisation dystrophique et une vasculite avec thrombose. Des tests pour agents infectieux de maladie n'ont pas permis de mettre en évidence un agent étiologique sous-jacent. Ce cas met en évidence les trouvailles radiographiques, de nécropsie et histopathologiques chez un chiot avec emphysème bulleux et pneumonie broncho-interstitielle avec nécrose.(Traduit par Dr Serge Messier).

Ultrasonographic differentiation between portal venous and parenchymal gas may be important for the prognosis of canine and feline hepatic emphysema: 37 cases.

The aim of this retrospective, cross-sectional, study was to evaluate clinical findings and outcomes for different ultrasonographic patterns of hepatic emphysema in dogs and cats. Dogs and cats with an ultrasonographic diagnosis of hepatic emphysema and a known outcome, from January 2010 to January 2018, were enrolled. The following data were recorded from medical and ultrasonographic records: ultrasonographic patterns of hepatic emphysema (parenchymal, portal venous, biliary), clinical signs, laboratory findings, and outcomes (favorable, poor). A total of 33 dogs and four cats met the inclusion criteria. Among these, 23 cases were classified as hepatic portal venous gas, 10 as parenchymal emphysema, and four as biliary emphysema. Clinical diagnosis categories were as follows: infection/sepsis (9), gastro-intestinal disease (9), iatrogenic (9), trauma (5), and liver neoplasia (5). An increase in serum liver enzymes was significantly associated with parenchymal emphysema (P = .03). Other clinical and laboratory findings were not associated with the type of hepatic emphysema. Hepatic portal venous gas was mostly transient in patients with ultrasonographic follow-up. The overall mortality was 40.5%. A significant difference was found between mortality by portal venous gas (21.7%) and mortality by parenchymal emphysema (90%) (P = .003). In conclusion, the ultrasonographic differentiation of hepatic emphysema between hepatic portal venous gas and parenchymal emphysema may be important for the prognosis of hepatic emphysema. The presence of parenchymal emphysema may be a poor prognostic indicator, while hepatic portal venous gas may be more benign. However, ultrasound findings should be carefully evaluated in the context of clinical findings.

Emphysematous cystitis: Retrospective evaluation of predisposing factors and ultrasound features in 36 dogs and 2 cats.

This retrospective study investigated predisposing factors and ultrasound features in dogs (n = 36) and cats (n = 2) with emphysematous cystitis (EC). Urinary tract infection was present in 25 patients (65.8%), impaired immune system in 10 (26.3%), bladder stones in 9 (23.7%) and neurologic bladder in 7 (18.4%). Diabetes mellitus was present in only 4 patients (10.5%). Most patients had positive urine culture (n = 35; 92.1%), with elevated concentration of Escherichia coli in 25 patients (71.4%). The most common ultrasound features were diffuse thickening of the urinary bladder (n = 15; 39.5%), polyps (n = 9; 23.7%), and focal thickening (n = 4; 10.5%). In 13 patients (34.2%) the bladder wall was not assessable, due to excessive bladder gas. Bladder gas was mostly identified in the lumen (n = 18; 47.4%), followed by the bladder wall (n = 11; 28.9%), and wall and lumen (n = 9; 23.7%).

Cystite emphysémateuse : évaluation rétrospective des facteurs prédisposants et des caractéristiques des échographies chez 36 chiens et 2 chats. Cette étude rétrospective a examiné les facteurs prédisposants et les caractéristiques chez des chiens (n = 36) et des chats (n = 2) atteints d'une cystite emphysémateuse (CE). Une infection des voies urinaires était présente chez 25 patients (65,8 %), un système immunitaire affaibli chez 10 patients (26,3 %), des calculs vésicaux chez 9 patients (23,7 %) et une vessie neurologique chez 7 patients (18,4 %). Le diabète sucré était présent chez seulement 4 patients (10,5 %). La plupart des patients avaient une culture d'urine positive (n = 35; 92,1 %), avec une concentration élevée d'Escherichia coli chez 25 patients (71,4 %). Les caractéristiques les plus courantes à l'échographie étaient un épaississement diffus de la vessie urinaire (n = 15; 39,5 %), des polypes (n = 9; 23,7 %) et l'épaississement concentrique (n = 4; 10,5 %). Chez 13 patients (34,2 %) la vessie n'a pas pu être évaluée en raison de gaz excessifs dans la vessie. Les gaz de la vessie ont surtout été identifiés dans la lumière (n = 18; 47,4 %), suivie de la paroi de la vessie (n = 11; 28,9 %) et de la paroi et la lumière de la vessie (n = 9; 23,7 %).(Traduit par Isabelle Vallières).

Canine and feline emphysematous gastritis may be differentiated from gastric emphysema based on clinical and imaging characteristics: Five cases.

Gastric pneumatosis is an imaging finding defined as the presence of gas foci in the gastric wall. In humans, this imaging feature can result from one of two separate clinical entities: life-threatening emphysematous gastritis or clinically benign gastric emphysema. This retrospective case series study describes the clinical and imaging features in five animals diagnosed with spontaneous gastric pneumatosis without gastric dilatation-volvulus. Three canine and two feline cases of spontaneous gastric pneumatosis were identified on radiographic and ultrasonographic examinations. In addition to gastric pneumatosis, one dog and two cats presented concomitant systemic signs such as lethargy, hematemesis, anemia, or leukocytosis. Two dogs remained asymptomatic or presented mild gastrointestinal signs. Portal gas was described in two dogs and one cat, and pneumoperitoneum in one dog. These features were not considered clinically significant. The dog and two cats with systemic signs were euthanized due to clinical deterioration and diagnosed with emphysematous gastritis. The gastric pneumatosis of both dogs without systemic signs resolved while on medical management without antibiotic therapy. These latter cases were interpreted as consistent with gastric emphysema. Findings from the current study indicated that gastric pneumatosis can occur without gastric dilatation-volvulus in cats and dogs and that a combination of clinical and imaging characteristics may help to differentiate between potentially life-threatening emphysematous gastritis and relatively benign gastric emphysema. More studies are needed to determine the etiology and risk factors associated with these conditions.

Emphysematous gastritis in a cat.

OBJECTIVE: To describe the presentation, diagnosis, treatment, and outcome of a case of emphysematous gastritis (EG) in a cat. CASE SERIES SUMMARY: A 15-year-old female neutered domestic short-hair cat presented for a 4-month history of weight loss and intermittent vomiting. Clinicopathologic and imaging findings suggested an underlying primary gastrointestinal (GI) disease, as well as possible hepatobiliary disease. Two days following exploratory laparotomy to obtain GI and liver biopsies, the patient became septic and intracellular bacteria were present on cytology of peritoneal effusion. On radiographs, the stomach was markedly distended with fluid and contained a thin gas opacity surrounding the stomach wall. The patient was taken back to surgery to identify a source of sepsis. At surgery, the patient's stomach was firm and emphysematous on palpation but grossly appeared normal. There were no signs of dehiscence of the previous biopsy sites. Stomach biopsy confirmed the presence of intralesional Gram-positive rods, consistent with microbial EG, and a light growth of a Clostridium sp. was cultured from abdominal fluid, consistent with clostridial peritonitis. During a third surgery for suspected septic peritonitis, a jejunostomy tube was placed for postgastric enteral feeding. The patient ultimately survived to discharge and is clinically stable 10 months later. NEW/UNIQUE INFORMATION PROVIDED: EG is a rare but potentially fatal clinical entity in the human and veterinary literature with only 1 other case reported in cats. Though clostridial organisms have been reported in EG in people, this is the first implication of EG secondary to a Clostridium sp. in the cat. This is also the first report to document the use of a jejunostomy tube for postgastric enteral nutrition to treat EG in the veterinary literature.

Pneumatosis of the intestines, colon and liver in a young cat.

To describe a case of naturally occurring pneumatosis intestinalis, pneumatosis coli and emphysematous hepatitis in a cat. A 9-month-old, indoors-only, female spayed, domestic medium hair cat presented for vomiting, open-mouth breathing and acute collapse. The initial physical examination identified moderate to severe hypothermia [35°C (95°F)], obtunded mentation, weak femoral pulses, tachycardia (heart rate 240 beats per min), pale pink mucous membranes and significant splenomegaly on abdominal palpation. Immediate diagnostics performed [packed cell volume and total solids (PCV, TS), venous blood gas and electrolytes] revealed severe anaemia (PCV 12%), hypoproteinaemia (TS = 2.2 g/dl), and severe metabolic acidosis (pH 6.956). Additional diagnostics performed included Feline Leukaemia Virus and Feline Immunodeficiency Virus testing (FeLV/FIV), complete blood count (CBC) with pathology review, serum biochemistry profile, prothrombin time (PT) and partial thromboplastin time (PTT), urinalysis, and abdominal radiographs. Abdominal radiographs were consistent with gas within hepatic and splenic veins and parenchyma, small intestinal walls and colonic wall. Due to the guarded prognosis, euthanasia was elected. Necropsy was performed and the most significant gross and histopathological findings included intra-luminal and intra-mural intestinal haemorrhage and vascular congestion with mild neutrophilic hepatitis, and marked hepatic periportal emphysema. Clostridium perfrigens and Escherichia coli were cultured from the bowel wall; no bacterial growth from the liver or spleen was identified. This case report describes idiopathic emphysematous hepatitis, with concurrent emphysema of the spleen and intestinal wall and intestinal haemorrhage. To the authors' knowledge, this type of pathology in a feline patient has not been previously described.

Practical Stereology Applications for the Pathologist.

Qualitative histopathology is the gold standard for routine examination of morphological tissue changes in the regulatory or academic environment. The human eye is exceptional for pattern recognition but often cannot detect small changes in quantity. In cases where detection of subtle quantitative changes is critical, more sensitive methods are required. Two-dimensional histomorphometry can provide additional quantitative information and is quite useful in many cases. However, the provided data may not be referent to the entire tissue and, as such, it makes several assumptions, which are sources of bias. In contrast, stereology is design based rather than assumption based and uses stringent sampling methods to obtain accurate and precise 3-dimensional information using geometrical and statistical principles. Recent advances in technology have made stereology more approachable and practical for the pathologist in both regulatory and academic environments. This review introduces pathologists to the basic principles of stereology and walks the reader through some real-world examples for the application of these principles in the workplace.

Treatment of a giant pulmonary emphysematous cyst with primary bronchoalveolar papillary carcinoma in a Shih Tzu dog.

OBJECTIVE: To report the surgical treatment of a pulmonary emphysematous cyst concurrent with primary pulmonary bronchoalveolar papillary carcinoma in a dog. STUDY DESIGN: Clinical case report. ANIMALS: 12-year-old 6.4 kg spayed female Shih Tzu dog. METHODS: The dog presented for surgical treatment of pulmonary emphysema. Radiography revealed that more than half of the left caudal lung lobe was enlarged and hyperlucent and computed tomography (CT) confirmed the presence of an emphysematous space. Thoracoscopic lung lobectomy was attempted but was converted to an intercostal thoracotomy due to poor visualization and pleural adhesions. A left caudal total lung lobectomy was performed using a self-cutting endoscopic stapler. RESULTS: The dog recovered uneventfully and a postoperative histopathologic diagnosis of pulmonary cystic bronchoalveolar papillary carcinoma was made. Re-evaluation using a CT scan with contrast study on postoperative days 27 and 177 revealed no evidence of residual, metastatic, or recurrent lesions. The dog has been doing well since surgery during the 11 month follow-up period. CONCLUSION: This case report suggests a potential relationship between pulmonary emphysematous diseases and primary lung tumors in dogs.

Stridor and emphysema due to cystic echinococcosis in cattle and buffalo intermediate hosts in Punjab, India.

The clinical symptoms associated with hydatid disease in the bovine populations remain largely unknown and the disease is usually considered asymptomatic in these intermediate hosts. We report occurrence of symptoms such as sudden onset of continuous stridor, coughing and wheezing due to hydatid cysts present in the lungs of infected cattle and buffalo. Two cattle and one buffalo presented to the Teaching Veterinary Hospital, Guru Angad Dev Veterinary & Animal Sciences University with the complaint of continuous stridor, coughing and wheezing with normal feed and water intake were followed up. The comprehensive clinical examination followed by haematology, radiography of upper and lower respiratory tract, ultrasonography of lungs, liver and reticulum revealed presence of multiple hydatid cysts in the lung parenchyma. There was presence of subcutaneous emphysema in one of the infected animal. Radiography revealed cysts occupying up to 60% of alveolar space in the lungs. Endoscopy up to hilus was carried out to rule out the presence of any other mass/lesion in the respiratory tract. Per cutaneous aspiration (Ultrasound guided) of cystic fluid confirmed the diagnosis and fertile nature of hydatid cysts. The current study reports association of stridor and emphysema with hydatid disease in bovine hosts and it is important that veterinary practitioners in endemic areas consider hydatid disease for differential diagnosis when investigating the etiology of stridor and emphysema in bovine intermediate hosts.

Emphysematous pyelitis and cystitis associated with vesicoureteral reflux in a diabetic dog.

A 12-year-old female dog with a 3-month history of poor response to diabetes treatment had an acute worsening of symptoms, including weakness and blindness. The dog had elevated blood glucose, alkaline phosphatase and urea concentration, hyposthenuria, glycosuria, hematuria, and pyuria. Escherichia coli was isolated from the urine. Radiographs and ultrasound examination showed that the dog had unilateral emphysematous pyelitis and concurrent cystitis associated with vesicoureteral reflux.

Pyélite emphysémateuse et cystite associées au reflux vésico-urétéral chez une chienne diabétique. Une chienne âgée de 12 ans avec une anamnèse de 3 mois de mauvaise réponse au traitement du diabète a présenté un aggravement aigu des symptômes, y compris de la faiblesse et de la cécité. La chienne avait une glycémie élevée, ainsi que des concentrations sériques élevées de la phosphatase alcaline et d'urée, de l'hyposthénurie, de la glycosurie, de l'hématurie et de la pyurie. Escherichia coli a été isolé de l'urine. Des radiographies et des échographies ont montré que la chienne était atteinte de pyélite emphysémateuse unilatérale et de cystite concomitante associées au reflux vésico-urétéral.(Traduit par Isabelle Vallières).