Cynthia M. Bell

Duodenal endoscopic findings and histopathologic confirmation of intestinal lymphangiectasia in dogs.

BACKGROUND The diagnosis of intestinal lymphangiectasia (IL) has been associated with characteristic duodenal mucosal changes. However, the sensitivity and specificity of the endoscopic duodenal mucosal appearance for the diagnosis of IL are not reported. HYPOTHESIS/OBJECTIVES To evaluate the utility of endoscopic images of the duodenum for diagnosis of IL. Endoscopic appearance of the duodenal mucosal might predict histopathologic diagnosis of IL with a high degree of sensitivity and specificity. ANIMALS 51 dogs that underwent upper gastrointestinal (GI) endoscopy and endoscopic biopsies. METHODS Retrospective review of images acquired during endoscopy. Dogs were included if adequate biopsies were obtained during upper GI endoscopy and digital images were saved during the procedure. Images were assessed for the presence and severity of IL. Using histopathology as the gold standard, the sensitivity and specificity of endoscopy for diagnosing IL were calculated. RESULTS Intestinal lymphangiectasia (IL) was diagnosed in 25/51 dogs. Gross endoscopic appearance of the duodenal mucosa had a sensitivity and specificity (95% confidence interval) of 68% (46%, 84%) and 42% (24%, 63%), respectively for diagnosis of IL. Endoscopic images in cases with lymphopenia, hypocholesterolemia, and hypoalbuminemia had a sensitivity of 80%. CONCLUSIONS AND CLINICAL IMPORTANCE Endoscopic duodenal mucosa appearance alone lacks specificity and has only a moderate sensitivity for diagnosis of IL. Evaluation of biomarkers associated with PLE improved the sensitivity; however, poor specificity for diagnosis of IL supports the need for histopathologic confirmation.

Nomenclature and Classification of Odontogenic Tumors — Part II: Clarification of Specific Nomenclature

Accurate identification of odontogenic tumors is critical for productive communication and an important foundation for useful comparative epidemiologic studies of odontogenic tumors in both domestic animals and humans. This manuscript illuminates the subject of veterinary odontogenic tumor nomenclature and will serve as a foundation for future updates in nomenclature and classification of odontogenic tumors.

H3N2 Canine Influenza Virus Infection in a Dog

In 2015, H3N2 canine influenza emerged in dogs in the greater Chicago area. During this time, a 10-year-old German Shepherd dog presented to the referring veterinarian with lethargy and coughing that quickly progressed to death. This report describes the macroscopic and microscopic lesions and the molecular testing performed to identify the novel North American H3N2 strain of canine influenza. The larynx, pharynx, and trachea were covered by a fibrinonecrotic membrane. Bilaterally, the lungs had multifocal subpleural necrosis of the caudal lung lobes with hemorrhage, congestion, and pulmonary edema. Staphylococcus pseudointermedius was isolated from the lung. Mycoplasma cynos was identified by real-time polymerase chain reaction from nasal passages, oropharynx, larynx, trachea, and cranial lung lobes. The neuraminidase gene sequence from the influenza virus isolated obtained from this dog had ≥98% homology to the strain circulating in the Chicago area.

Mandibular odontoameloblastoma in a rat and a horse

Odontoameloblastoma (OA) is a mixed odontogenic tumor that is an ameloblastoma with concurrent histologic evidence of odontoma differentiation. As a mixed tumor, OA is a tripartite lesion comprised of neoplastic odontogenic epithelium, induced dental ectomesenchyme (dental pulp), and mineralized dental matrix. Although rare, OA represents a diagnostic conundrum, as it is histologically closely related to 2 other mixed odontogenic tumors: odontoma (complex and compound) and ameloblastic fibro-odontoma. Herein we describe an OA arising from the mandible of a 4-mo-old Fischer 344 rat that had been exposed in utero to the mutagen ENU (N-ethyl-N-nitrosourea), and a naturally occurring lesion in a 2-y-old Appaloosa horse. In order to satisfy the diagnostic criteria for this lesion, mineralized dental matrix in relationship to neoplastic odontogenic epithelium must be identifiable within the OA lesion. This group of odontogenic tumors is differentiated by the degree to which the dental matrix is organized and the relative proportions of pulp ectomesenchyme, odontogenic matrix, and odontogenic epithelium.

Histologic, Clinical, and Radiologic Findings of Alveolar Bone Expansion and Osteomyelitis of the Jaws in Cats.

The objective of this study was to characterize clinical, radiologic, and histologic patterns of alveolar bone expansion and osteomyelitis in cats. Based on case materials submitted as surgical biopsy specimens, alveolar bone pathology was diagnosed in 28 cats. These cats had a total of 37 oral lesions with clinical and radiologic changes that involved bone and/or teeth, including periodontitis, bone expansion, tooth resorption, and/or chronic osteomyelitis; 32 lesions were evaluated by histopathology. Canine teeth were affected in 19 cats (27 affected teeth), with bilateral lesions in 5 (26.3%) cats. The caudal premolar and/or molar regions were affected in 10 cats (10 affected sites). All biopsy sites evaluated by a review of clinical images and/or radiographs had evidence of periodontitis. Clinical photographs showed expansion of alveolar bone in 13 of 16 (81%) biopsy sites evaluated. Radiologically, rarifying osseous proliferation of alveolar bone was seen at 26 of 27 (96%) biopsy sites, and tooth resorption occurred at 15 of 18 (83%) sites. Histologically, the tissue samples from canine sites had compressed trabeculae of mature remodeled bone, loose fibrous stroma with paucicellular inflammation, and mild proliferation of woven bone. Tissue samples from the premolar/molar biopsy sites were often highly cellular with mixed lymphoplasmacytic and chronic suppurative inflammation, ulceration with granulation tissue, and robust proliferation of woven bone. Alveolar bone expansion and osteomyelitis in cats occurs in conjunction with periodontal inflammation and frequently with tooth resorption.

Aortic tear and dissection related to connective tissues abnormalities resembling Marfan syndrome in a Great Dane.

Aortic tears and acute aortic dissection are rarely reported in dogs. This report describes a case of aortic dissection and probable sinus of Valsalva rupture in a young Great Dane with associated histopathologic findings suggestive of a connective tissue abnormality.

Clinicopathologic characterization of oral pyogenic granuloma in 8 cats.

This case series characterizes the clinicopathologic features and treatment of oral pyogenic granuloma in 8 cats. The cats reported here were patients originating from collaborative efforts at an academic clinical teaching hospital and a specialty dentistry/oral surgery referral practice. Although the initial biopsy results were variable, in all cases the diagnosis reflected an inflammatory process. A second clinicopathologic evaluation of these cases determined that all lesions were consistent with oral pyogenic granuloma. The location of the lesion was consistent among all cats within the present study. Lesions developed at the vestibular mucogingival tissues of the mandibular first molar teeth. We propose that malocclusion and secondary traumatic contact of the ipsilateral maxillary fourth premolar tooth with the mandibular soft tissues is a possible contributing factor in the etiopathogenic mechanism.

Nomenclature and Classification of Odontogenic Tumors — Part I: Historical Review

Odontogenic tumor nomenclature and classification is frustrating for both physicians and veterinarians. There has been and continues to be an evolution of the terms and taxonomy used in veterinary and human literature. In this historical review, we aim to provide veterinarians a fundamental basis for understanding how the etymology for odontogenic tumors has evolved over the past two centuries.

Idiopathic Hemorrhagic Pericardial Effusion as a Precursor to Epicardial Lymphosarcoma in Three Cows

A 2-year-old female Holstein heifer was referred for evaluation of acute onset brisket edema and jugular venous distension. The heifer was 223 days in milk and 139 days pregnant and had been producing milk at expected levels until the day before presentation. Physical examination at admission to the University of Wisconsin Veterinary Medical Teaching Hospital revealed a bright and alert individual with a rectal temperature of 100.6 F, and pulse and respiratory rates of 76 beats and 34 breaths per minute, respectively. Muffled heart sounds were present and both jugular veins were turgid, visibly distended, and displayed retrograde fill. An echocardiogram at admission using a 2.5–3.5 MHz phased array transducer from a right parasternal approach identified an approximately 8-cm distension of the pericardial sac by anechoic fluid that was evident during all phases of the cardiac cycle. Some thickening of the epicardial surface was noted with strands of more hyperechoic tissue floating on the epicardial surface with the ultrasonographic appearance of fibrin. Cardiac contractility appeared subjectively poor although functional cardiac measurements were not obtained because of the depth of pericardial fluid. A serum sample obtained at admission tested positive by both ELISA and AGID techniques for antibodies to the bovine leukosis virus (BLV). Pericardiocentesis yielded bloody fluid with a PCV of 14%, total protein concentration of 5.2 g/dL, and total nucleated cell count (TNCC) of 5.75 9 10/lL. The nucleated cells were comprised of 14% neutrophils, 64% small lymphocytes, and 22% macrophages. The lymphocytes were cytologically normal. Approximately 5.5 L of hemorrhagic pericardial fluid was removed through a 24 French chest tube placed in the left 5th intercostal space, decreasing the visible depth of pericardial fluid to approximately 2 cm. The heifer was given 0.1 mg/kg dexamethasone IV q24h for 3 days and underwent daily ultrasonographic assessment of pericardial fluid volume and subjective evaluation of cardiac function. By day 3 of hospitalization, minimal pericardial fluid remained (<10 mm) but focal areas of epicardial fibrin still could be seen. Jugular venous distension had resolved and the heifer’s heart rate was normal. It had normal appetite and milk production had improved. The heifer was returned to its farm of origin and continued to do well, producing 68 lb of milk at a subsequent test date approximately 50 days post discharge. Unfortunately, it was found dead approximately 100 days after discharge. Necropsy showed thickening of the epicardial surface of the heart with multiple fibrous attachments connecting the epicardial surface to the pericardium. The epicardial surface was matted with extensive areas of fibrosis admixed with fibrin and hemorrhage. Multiple thoracic lymph nodes were enlarged with similar multifocal white to tan infiltrates. Histologically, the epicardium was expanded with fibrosis and highly vascular papillary projections in which there were many atypical neoplastic lymphocytes alongside a mononuclear inflammatory infiltrate of small lymphocytes and plasma cells. The myocardium had areas of fibrosis but no neoplastic infiltrate. Histologically, lymphosarcoma was confirmed in the thoracic lymph nodes.

Suspected Lateral Periodontal Cyst Presenting Concurrently with Canine Acanthomatous Ameloblastoma in a 2-Year-Old Standard Poodle

Lateral periodontal cysts (LPCs) are odontogenic epithelial cysts composed of nonkeratinized epithelial cells that are in the category of developmental cysts, rather than inflammatory cysts. Lateral periodontal cysts are rare both in people and domestic animals; they are associated with vital teeth and located lateral to a tooth root. Lateral periodontal cysts are typically asymptomatic lesions that are characterized radiographically as a unilocular lucency with well-defined corticated borders. Canine acanthomatous ameloblastoma (CAA) is the most common odontogenic neoplasm in dogs and rarely presents as a cystic lesion. This case report describes the diagnosis and treatment of a cyst that occurred as a swelling apical to a gingival mass that was diagnosed histologically as CAA. Surgical management by conservative gingivectomy, cyst enucleation, and bone grafting was an effective treatment in this patient.