Artifactually increased serum bicarbonate in a cat with rhabdomyolysis.

A 3-year-old male neutered domestic shorthair cat presented with lethargy, hyporexia, and pyrexia of unknown origin. Biochemical analysis using a Beckman Coulter AU480 demonstrated marked increases in creatine kinase and aspartate aminotransferase, indicative of severe muscle injury, with concurrent presumptive myoglobinuria on urinalysis. A marked, non-physiologic increase in measured bicarbonate and resultant negative anion gap was documented; however, calculated bicarbonate obtained via a point-of-care blood gas analyzer was within normal limits. Laboratory error due to interference by lactate dehydrogenase was suspected and supported by the results of subsequent biochemical testing. Artifactual increases in bicarbonate have been documented in cases of rhabdomyolysis in horses, cows, and a bird. However, to the best of the authors' knowledge, this is the first report to demonstrate this spurious change in a cat.

Macroscopic, cytological and histological diagnosis of proventricular adenocarcinoma in a sulphur-crested cockatoo (Cacatua galerita).

An adult sulphur-crested cockatoo (Cacatua galerita) was unexpectedly found dead and was presented for post-mortem examination. Macroscopically, the proventricular wall was expanded by an infiltrative off-white mass, 10 mm in diameter, with secondary mucosal ulceration. Cytological examination of impression smears revealed a neoplastic epithelial cell population forming occasional well-defined acini with secretory product. Histologically, the neoplastic cells were predominantly arranged in acini and tubules, with fewer in small clusters, supported by a desmoplastic stroma. Neoplastic cells were polygonal, with mostly well-demarcated cell boundaries and a moderate amount of eosinophilic cytoplasm that was multifocally markedly distended by more intensely eosinophilic material. There was an increased nuclear-to-cytoplasmic ratio with moderately sized to large nuclei (approximately 15 µm diameter) with lightly to densely stippled chromatin and single or paired prominent basophilic nucleoli. The mitotic count was 19 in 10 high-power fields (2.37 mm2), with scattered bizarre mitotic figures and atypia including moderate anisocytosis and anisokaryosis and moderate cellular and nuclear pleomorphism. There was frequent intratubular brightly eosinophilic proteinaceous material, which was Alcian blue and periodic acid‒Schiff positive. Proventricular lymphovascular invasion was detected, with metastases within the ventriculus and lungs. The macroscopic, cytological and histological appearance of the neoplasm was consistent with a proventricular adenocarcinoma.

Correlation between cytologic features and histologic grades in cutaneous and subcutaneous soft tissue sarcomas in dogs-A pilot study.

Currently, canine soft tissue sarcoma (STS) grading is based on histopathology. In humans, several studies have demonstrated concordance between cytologic grading systems for STS and histologic grade. The aim of this study was to correlate several cytologic parameters (smear cellularity, anisokaryosis, nucleolar malignancy score, multinucleation, and the number of mitotic figures per 200 cells) that form part of a human STS cytologic grading system, with histologic grades of canine cutaneous and subcutaneous STS. Three observers (blinded) reviewed the cytologic preparations independently from cases with confirmed histologic diagnoses of STS. A cytologic grading score was assigned for each parameter. Correlations between cytologic grading scores (averaged between observers) and histologic grades were assessed using Spearman's correlation coefficient, with statistical significance defined as P < .05. Twenty-one cases were included in the study (10 Grade I STS, nine Grade II STS, and two Grade III STS). The number of mitotic figures (≥3) per 200 cells was the only parameter that showed a significant but weak, positive correlation with histologic grade (rs  = .469; P = .032). No Grade I tumors had ≥3 mitotic figures per 200 cells; however, ≥3 mitotic figures per 200 cells were only observed in 33% of Grade II tumors and 50% (one out of two) of the Grade III tumors. This pilot study suggests that an increased number of mitotic figures seen on cytology might correlate with higher grade STS; however, the sensitivity of this parameter for grading STS appears to be low.

Resting and postprandial serum bile acid concentrations in dogs with liver disease.

BACKGROUND: Serum bile acids (SBAs) are frequently measured in dogs. However, there is limited data comparing SBAs in different liver diseases diagnosed according to standardized histological criteria. OBJECTIVES: To compare resting and postprandial SBAs, and determine their sensitivity and specificity, for various liver diseases in dogs. ANIMALS: Three hundred and forty-one client-owned dogs with suspected liver disease that had a liver biopsy and SBAs measured. METHODS: Multicenter retrospective study. Cases were classified according to standardized histological criteria. The sensitivity and specificity of resting and postprandial SBAs for the diagnosis of each liver disease, and all liver diseases combined, were calculated. RESULTS: The median resting SBAs were highest in dogs with cirrhosis (98.8 µmol/L; range, 6-135) and congenital circulatory anomalies (CCa; 79.45 µmol/L; 0.3-705). The highest median postprandial concentrations were found in CCa (126 µmol/L; 0-726) and chronic hepatitis (CH; 54.3 µmol/L; 0-260). Using the cut-off value of 10 µmol/L, the highest sensitivities of resting SBAs were recorded in dogs with CCa (87.5%; 95% confidence interval, 76.8-94.4) and CH (81.1%; 71.5-88.6). The sensitivities of postprandial SBAs were the highest in cholangitis (100%; 47.8-100.0) and CCa (91.1%; 78.8-97.5). The specificities of resting and postprandial SBAs for all diseases were 49.3% (37.6-61.1) and 29.7% (15.9-47.0), respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Postprandial SBAs are more sensitive but less specific than resting SBAs for the diagnosis of liver disease. There were dogs in all categories of liver disease with resting SBAs <10 and >90 µmol/L. Therefore, careful interpretation of both normal and elevated values is required.

Preliminary evaluation of a salivary urea test strip method for use in dogs.

BACKGROUND: Salivary urea concentrations correlate with serum urea concentrations in dogs and humans. Salivary urea concentrations can now be determined semi-quantitatively using a salivary urea test strip method that has been validated for use in humans. OBJECTIVES: We aimed to evaluate the repeatability of the salivary urea test strip score, and the correlation between the salivary urea test strip scores and serum urea concentrations in dogs. METHODS: Intra-run and inter-run variabilities were determined (n = 10 in triplicate). Correlations between salivary urea test strip scores and serum urea concentrations in dogs were assessed using the Spearman's correlation coefficient. Receiver operator curve analysis was used to evaluate the diagnostic performance of the salivary urea test strip score to identify dogs with serum urea concentration >7.4 mmol/L (upper limit of laboratory RI). RESULTS: The intra-run repeatability was good (28/30 concordant results) whereas the inter-run repeatability was moderate (23/30 concordant results). Salivary and serum urea concentrations showed a moderately positive correlation (rs  = .63, n = 33; P < .0001). A salivary urea test strip score ≥4 was 57% sensitive and 96% specific for detecting a serum urea concentration >7.4 mmol/L. CONCLUSIONS: Uremia can be detected using salivary urea test strips in dogs. Based on our preliminary data, salivary urea test strip scores of 1 or 2 might exclude clinically relevant uremia in most cases; however, it is recommended that the salivary urea test be repeated in dogs with a test strip score of 3. Dogs with a salivary urea test strip score of ≥4 would likely require additional investigations.

Myoclonus and hypercalcemia in a dog with poorly differentiated lymphoproliferative neoplasia.

A 1-year, 8-month-old Rhodesian Ridgeback was presented with obtundation, ambulatory tetraparesis, and myoclonus. Initial clinical findings included ionized hypercalcemia with an apparent marked increase in parathyroid hormone, thrombocytopenia, and nonregenerative anemia. Low numbers of circulating atypical cells were noted on blood film evaluation. Brain magnetic resonance imaging identified an extra-axial contrast enhancing subtentorial lesion, and cerebrospinal fluid (CSF) analysis documented a marked atypical lymphocytic pleocytosis. Flow cytometry performed on the CSF demonstrated expression of only CD45, CD90, and MHC class II, with Pax5 positivity on subsequent immunohistochemistry. The final diagnosis was of B-cell lymphoblastic lymphoma or acute leukemia, given the distribution of disease and the presence of significant bone marrow infiltration alongside an aggressive clinical course. The unusual immunophenotype of the neoplastic cells and hypercalcemia presented antemortem diagnostic challenges, highlighting the need for a multidisciplinary approach and caution in the interpretation of clinical abnormalities in cases with multiple comorbidities.