Investigation of hypereosinophilia and potential treatments

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.

A mixed-methods approach to understanding domestic dog health and disease transmission risk in an indigenous reserve in Guyana, South America

Domestic dogs (Canis lupus familiaris) can transmit a variety of pathogens due to their ubiquitousness in urban, rural and natural environments, and their close interactions with wildlife and humans. In this study, we used a mixed-methods approach to assess the role of domestic dogs as potential intermediaries of disease transmission from wildlife to humans among indigenous Waiwai in the Konashen Community Owned Conservation Area, Guyana. To address these objectives we 1) performed physical examinations and collected biological samples to assess Waiwai domestic dog health, and 2) administered questionnaires to characterize the role of dogs in the community and identify potential transmission pathways between wildlife, dogs, and humans. We observed ectoparasites on all dogs (n = 20), including: fleas (100%), ticks (15%), botflies (30%), and jigger flea lesions (Tunga penetrans) (80%). Ten percent of dogs were seropositive for Ehrlichia canis/ewingii, 10% were positive for Dirofilaria immitis, and one dog was seropositive for Leishmania infantum. All dogs (n = 20) were seronegative for: canine distemper virus, Brucella canis, Leptospira serovars, Trypanosoma cruzi, Anaplasma phagocytophilum/platys and Borrelia burgdorferi. Our questionnaire data revealed that the Waiwai remove ectoparasites from their dogs, clean up dog feces, and administer traditional and/or Western medicine to their dogs. White blood cell, strongyle-type ova, and eosinophil counts were lower in dogs that were not frequently used for hunting, dogs that did receive traditional and/or western medicine, and dogs that were frequently kept in elevated dog houses, although differences were not statistically significant. While our results suggest that the Waiwai have developed cultural practices that may promote dog health and/or prevent zoonotic disease transmission, more research is necessary to determine the efficacy of these practices. Our study provides important data on the health of dogs and the potential for disease transmission to humans in a zoonotic hotspot.

Domestic dogs are found throughout the world and interact closely with both wildlife and humans. Dogs can harbor numerous diseases that can be transmitted to other domestic and wildlife species, and human populations. They can serve as bridges, moving diseases between unconnected populations. Additionally, dogs can help in the early detection of wildlife and human diseases. Therefore, understanding what pathogens domestic dogs harbor can inform both wildlife and human health. In this study, we performed physical examinations, collected biological samples, and administered questionnaires to assess dog health and understand the role of dogs as potential bridges of disease transmission from wildlife to humans among indigenous Waiwai in the Konashen Community Owned Conservation Area, Guyana. On physical exam, we observed ectoparasites on all dogs, however, few pathogens were detected with diagnostic screening. Our questionnaire data revealed that the Waiwai engage in husbandry practices that may promote Waiwai dog health.

An unusual case of eosinophilic uveitis in a cat

An 8-year-old female spayed domestic short-haired cat was examined for recurrent unilateral anterior uveitis of 5 month's duration. No underlying cause was found on infectious disease screening. The cat also had a 4-year history of allergic or immune-mediated skin disease that was controlled with corticosteroid injections followed by long-term oral cyclosporine therapy. Medical management with frequent topical anti-inflammatory drugs (prednisolone acetate 1% suspension, diclofenac 0.1% solution) controlled the intraocular inflammation; however, the uveitis would relapse when therapy was discontinued. Eventually, secondary glaucoma developed OD and the eye was enucleated. At the time of surgery, a complete blood count showed a mild eosinophilia. Histopathology revealed a marked panuveitis characterized by an abundant accumulation of mixed inflammatory cells, with a predominantly eosinophilic infiltrate in the anterior chamber, iris, ciliary body, and choroid. No etiologic agents were found on serial sections, and there were no cellular criteria for malignancy noted. Nine months after enucleation, the chronic dermatitis appeared to be in remission despite no further medical management. This is the first known report of a primarily eosinophilic uveitis in a cat with chronic allergic skin disease and may be considered an ocular variant of feline eosinophilic granuloma complex.

Eosinophilic pericardial effusion in a cat with complex systemic disease and associated peripheral eosinophilia

An 11-year-old domestic shorthair cat was referred for investigation of dry cough of 1-week duration and cardiomegaly. Echocardiography revealed pericardial effusion, and eosinophils were identified as the predominant cell type in fluid collected by pericardiocentesis. Thoracic computed tomography imaging and bronchoscopy were supportive of mild lower airway disease, while bronchoalveolar lavage confirmed eosinophilic inflammation and concurrent Mycoplasma felis infection. A few months after the initial presentation, there was clinical deterioration, and further investigation suggested intestinal lymphoma. It was hypothesized that pericardial effusion and lower airway inflammation were an early manifestation of hypereosinophilic syndrome, possibly as a paraneoplastic consequence of lymphoma.

A case of an intramural, cavitated feline gastrointestinal eosinophilic sclerosing fibroplasia of the cranial abdomen in a domestic longhair cat

Case summary

A 5-year-old neutered male domestic longhair cat was presented for the investigation of a cranial abdominal mass following a 1-month history of inappetence and lethargy. Abdominal ultrasound revealed a large cavitated mass confluent with the mesenteric aspect of the descending duodenum. At surgery, the mass was found to involve the pylorus, proximal duodenum and pancreas, and was non-resectable. Histopathological examination of surgical biopsies revealed a non-neoplastic process involving eosinophils and fibroplasia.

Relevance and novel information

This case report describes an uncommon feline gastrointestinal pathology with an unusual appearance that may provide an additional differential diagnosis other than neoplasia or abdominal abscess when confronted with a cavitated abdominal mass in cats.

Usual or unusual presentations of Dirofilaria repens in two sibling dogs: a case report

This study describes two different manifestations of Dirofilaria repens infection in sibling dogs with microfilaremia. Dog 1, asymptomatic, harbored a gravid female of D. repens on the parietal layer of tunica vaginalis of one testicle and showed a marked circulating eosinophilia (3.3·103/μL). Both testicles were normal in shape and size without any gross lesions. Dog 2 had a pyotraumatic dermatitis. The cases were confirmed by PCR and sequencing. The sequences obtained showed 100% identity with those of D. repens isolated from human scrotum in Croatia. The treatment with moxidectin 2.5% and imidacloprid 10%/kg was effective in eliminating microfilariae after just one application, as demonstrated by negative modified Knott's tests and PCR analyses of blood samples. This status was maintained during the post-treatment observation period. The classical localization of D. repens in dogs is in subcutaneous tissues, within nodules or free; however, it can also occur with some frequency in testicles, as described in humans. The infection can be associated with circulating eosinophilia or pyotraumatic dermatitis, as reported in this study. Thus, in endemic areas, it is advisable to carefully inspect the removed testicles at neutering since parasite localization can take place without any macroscopic changes. Moreover, in the case of circulating eosinophilia or pyotraumatic dermatitis, investigations should include modified Knott's test and PCR to ensure that D. repens is not the cause of these alterations. Rapid and sensitive tests for the early detection of infected animals would help to prevent or limit the spread of this zoonosis.

Comparison of signalment, clinical, laboratory and radiographic parameters in cats with feline asthma and chronic bronchitis

OBJECTIVES

Feline asthma (FA) and feline chronic bronchitis (CB) are common respiratory conditions in cats, frequently referred to as 'feline lower airway disease'. However, the aetiologies of both inflammatory airway diseases are probably different. Little is known about the differences in signalment, clinical signs, laboratory abnormalities and radiographic features between cats with these two airway diseases. The aim of the study was to investigate whether certain parameters can help in differentiating between both diseases, as distinguished by airway cytology.

METHODS

Seventy-three cats with FA and 24 cats with CB were included in the retrospective study. Inclusion criteria were compatible clinical signs and a cytological evaluation of bronchoalveolar lavage fluid indicating either FA (eosinophilic inflammation) or CB (neutrophilic inflammation) without cytological or microbiological evidence of bacterial infection. Parameters of signalment, physical examination, haematology and thoracic radiographs of both disease groups were compared statistically (P <0.05).

RESULTS

The median age of cats with FA was 6 years, and was 7.5 years in cats with CB (P = 0.640). The most commonly reported clinical signs in both groups were a cough (95% FA/96% CB; P = 1.000), pathological pulmonary auscultatory sounds (82% FA/79% CB; P = 0.766) and dyspnoea (73% FA/79% CB; P = 0.601). Abnormal radiographic lung patterns were detected in 94% of cats with FA and 91% with CB (P = 0.629), respectively. Blood eosinophilia was significantly more common in cats with FA (40%) compared with CB (27%) (P = 0.026).

CONCLUSIONS AND RELEVANCE

The study indicates that a differentiation of FA and CB by means of signalment, a single clinical sign, and haematological and radiographic findings is not possible.

First Case of Idiopathic Eosinophilic Meningoencephalitis in a Sheep

A 1.5-year-old ewe was presented with neurological signs that had been observed from about 2 days prior to death. There had been no clinical response to anti-inflammatory and antibiotic treatment. Histopathological examination of the brain revealed a severe and widespread eosinophilic meningoencephalomyelitis of unknown aetiology. Defining histological features included diffuse angiocentric eosinophilic infiltrates in the neuroparenchyma and meninges, neuronal necrosis, astrocytosis, neuropil vacuolation and occasional glial scars. Differential diagnostics for eosinophilic meningoencephalitis were taken into account and investigated by means of special stains, immunohistochemistry, bacteriology and polymerase chain reaction. No pathological changes or ancillary tests were supportive or revealed a specific aetiology for the condition and therefore it was considered idiopathic. Idiopathic meningoencephalitis is a rare disease, mainly described in man and rarely in dogs, with no apparent aetiological cause or potential breed predisposition. To our knowledge this is the first case of idiopathic eosinophilic meningoencephalitis in a sheep and provides a histopathological guideline for prospective comparative pathology studies.

Spinal extradural T-cell lymphoma with paraneoplastic hypereosinophilia in a dog: clinicopathological features, treatment, and outcome

Spinal lymphoma is a rare manifestation of a common canine hematopoietic neoplasia. Description of treatment, outcome, and MRI features are scarce. The latter can be heterogeneous, stressing the importance of lesion excision and analysis. Clinicians should also be aware of hypereosinophilia as accompanying paraneoplastic syndrome and its potential prognostic implications.

A case of an unexplained eosinophilic myocarditis in a dog

An 8-year-old spayed female Munsterlander was evaluated for a chronic low grade fever and a two month history of exercise intolerance. On physical examination, tachycardia and a grade II/VI right systolic heart murmur were detected. Echocardiography revealed marked thickening of the atrial and ventricular walls with mixed echogenicity and concentric hypertrophy of the left and right ventricles and equivocal systolic dysfunction. Serum cardiac troponin I level was markedly elevated. Endomyocardial biopsy was attempted; however, the patient arrested during the procedure and resuscitation was unsuccessful. Post-mortem examination revealed severe, chronic atrial and ventricular eosinophilic myocarditis associated with marked interstitial fibrosis. Serological testing, histopathology and immunohistochemistry staining did not reveal an underlying infectious agent or neoplasm. To our knowledge, this is the first reported case of primary eosinophilic myocarditis in the absence of a peripheral eosinophilia and multi-organ eosinophilic inflammation in a dog.

ADITIVOS ANTIBIÓTICO, PROBIÓTICO E PREBIÓTICO EM RAÇÕES PARA LEITÕES DESMAMADOS PRECOCEMENTE

Resumo Objetivou-se avaliar a adição do prebiótico mananoligossacarídeo (MOS 0,2%), probiótico (Bacillus subtilis 30g/tonelada) e antibiótico (bacitracina de zinco 125g/tonelada) em rações para leitões na fase de creche. Utilizaram-se 80 leitões (Danbread x Agroceres), sendo 40 machos e 40 fêmeas, com peso inicial de 7,1±0,0175kg, distribuídos em delineamento de blocos ao acaso, com quatro tratamentos e cinco repetições: 1 - controle; 2 - prebiótico; 3 - probióticos; e 4 - antibiótico. As variáveis avaliadas foram ganho de peso diário (GPD), consumo de ração diário (CRD), conversão alimentar (CA), consistência fecal e leucometria global. Aos 43 dias de idade, os animais apresentaram o mesmo ganho de peso (P>0,05), porém, a dieta contendo prebiótico aumentou o consumo (P>0,05); a conversão alimentar foi melhor na dieta controle (P<0,05). No período de 54 dias de idade dos animais, não houve diferença para ganho de peso diário (P>0,05), consumo de ração diário (P>0,05) e conversão alimentar (P>0,05). Não houve diferença para consistência fecal (P>0,05). O número de leucócitos aumentou aos 32 dias de idade, quando as dietas contendo prebióticos e probióticos foram utilizadas (P>0,05). A ração contendo prebiótico aumentou o número de monócitos (P<0,05) e a dieta contendo antibiótico proporcionou maior número de basófilos (P<0,05), aos 36 dias de idade dos animais; o número de linfócitos não foi alterado pelas dietas experimentais (P>0,05). As dietas não promoveram alterações nas imunoglobulinas IgA, IgM e IgG (P>0,05). Conclui-se que o uso de prebióticos, probióticos e antibióticos não influenciou o desempenho dos animais dos 22 aos 54 dias de idade.

Feline gastrointestinal eosinophilic sclerosing fibroplasia: 13 cases and review of an emerging clinical entity

OBJECTIVE

Feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF) is a recently described inflammatory disease of cats affecting stomach or intestines and draining regional lymph nodes. This study presents clinical and laboratory data on 13 newly described cases from Australia (11) and the UK (two).

OBSERVATIONS

The disease was most often observed in middle-aged cats (median 7 years of age; interquartile range 5-9 years). Ragdolls (7/13) and males (9/13) were overrepresented. Cats generally had a long history of vomiting and/or diarrhoea. Lesions were typically large, hard, non-painful, easily palpable and most commonly situated near the pylorus or ileocaecocolic junction. Lesions were heterogeneous ultrasonographically and on sectioning at celiotomy or necropsy. Masses were hard and 'gritty' on fine-needle aspiration due to internal trabeculae made up of mature collagen bundles. Bacteria were commonly detected within masses (9/13 cases) using either culture or conventional light microscopy and a panel of special stains, and/or fluorescence in situ hybridisation (FISH), although detection often required a diligent search of multiple tissue sections. A consistent bacterial morphology could not be appreciated among the different cases.

OUTCOME

Patients were treated with a variable combination of cytoreduction (debulking and biopsy, to complete surgical resection), immunosuppressive therapy and antimicrobial agents. Many cats had a poor outcome, which was attributable to late diagnosis combined with suboptimal management. It is hoped that suggestions outlined in the discussion may improve clinical outcomes and long-term survival in future cases.

Loeffler's endocarditis and bicavity eosinophilic effusions in a dog with visceral mast cell tumour and hypereosinophilia

A 9-year-old crossbred dog was presented with a 2-week history of diarrhoea and tachypnoea. Marked circulating eosinophilia was identified. Pleural and abdominal effusions were detected by radiography and ultrasonography and cytological examination of these fluids revealed a predominance of eosinophils. Splenic and hepatic cytology revealed mast cell neoplasia, which was confirmed as visceral mast cell tumour on post-mortem examination. Histological changes of myocardial inflammation, necrosis and fibrosis were found. These findings are consistent with Loeffler's endocarditis.

Canine reference intervals for the Sysmex XT-2000iV hematology analyzer

BACKGROUND

The laser-based Sysmex XT-2000iV hematology analyzer is increasingly used in veterinary clinical pathology laboratories, and instrument-specific reference intervals for dogs are not available.

OBJECTIVE

The purpose of this study was to establish canine hematologic reference intervals according to International Federation of Clinical Chemistry and Clinical and Laboratory Standards Institute guidelines using the Sysmex XT-2000iV hematology analyzer.

METHODS

Blood samples from 132 healthy purebred dogs from France, selected to represent the most prevalent canine breeds in France, were analyzed. Blood smears were scored for platelet (PLT) aggregates. Reference intervals were established using the nonparametric method. PLT and RBC counts obtained by impedance and optical methods were compared. Effects of sex and age on reference intervals were determined.

RESULTS

The correlation between impedance (I) and optical (O) measurements of RBC and PLT counts was excellent (Pearson r=.99 and .98, respectively); however, there were significant differences between the 2 methods (Student's paired t-test, P<.0001). Differences between sexes were not significant except for HCT, PLT-I, and PLT-O. WBC, lymphocyte, and neutrophil counts decreased significantly with age (ANOVA, P<.05). Median eosinophil counts were higher in Brittany Spaniels (1.87 × 10(9) /L), Rottweilers (1.41 × 10(9) /L), and German Shepherd dogs (1.38 × 10(9) /L) than in the overall population (0.9 × 10(9) /L). PLT aggregates were responsible for lower PLT counts by the impedance, but not the optical, method.

CONCLUSION

Reference intervals for hematologic analytes and indices were determined under controlled preanalytical and analytical conditions for a well-characterized population of dogs according to international recommendations.

X-Chromosome Inactivation Pattern Analysis for the Assessment of Cell Clonality in Cats

X-chromosome inactivation pattern (XCIP) analysis has been widely used to assess cell clonality in various types of neoplasms in humans. In the present study, a polymerase chain reaction–based feline XCIP analysis using the feline androgen receptor gene was developed. To construct the system of the analysis, polymorphism in CAG tandem repeats within the feline androgen receptor gene was explored using somatic DNAs from 50 male and 103 female cats. CAG tandem repeats in exon 1 of the feline androgen receptor gene were found to be polymorphic, containing 15 to 22 CAG repeats. Of the 103 female cats, 70 (68%) were heterozygous for the number of CAG repeats, indicating the possible usefulness of XCIP analysis in cats. Application of the feline XCIP analysis to 3 feline mammary gland adenocarcinoma cell lines revealed distinctly skewed XCIPs in these cell lines, indicating their clonal origins. Twelve (80%) of the 15 primary tissue/cell samples obtained from cats with various neoplastic diseases showed skewed XCIPs. Moreover, bone marrow samples from 3 cats with myelodysplastic syndrome were also found to have skewed XCIPs. The polymerase chain reaction–based XCIP analysis developed in this study can provide information on cell clonality in female cats, potentially facilitating the differential diagnosis of various disorders in cats.

Idiopathic Eosinophilic Meningoencephalomyelitis in a Rottweiler Dog

A 6-month-old, female, intact Rottweiler dog was presented to the Iowa State University Veterinary Teaching Hospital for a progressive history of abnormal behavior and generalized ataxia. At necropsy, there was eosinophilic infiltration of the brain and spinal cord, most severe in the medulla oblongata, cerebellum, and cervical spinal cord. Infiltrates of eosinophils were also present in the liver and small intestines. The dog was diagnosed with idiopathic eosinophilic meningoencephalomyelitis based on cerebrospinal fluid analysis, histopathology, and special stains to exclude etiologic agents.

Eosinophilia and eosinophilic infiltration into splenic B-cell high-grade lymphoma in a dog

A 13-year-old mixed-breed dog showing ascites, anorexia and anemia was found to have leukocytosis with marked eosinophilia, splenomegaly and hepatomegaly. The dog died 4 days after initial presentation and was diagnosed with splenic high-grade B-cell lymphoma at necropsy. Remarkable infiltrations of eosinophils were observed in spleen and liver tissues. The eosinophilia and infiltration of eosinophils into the lesions could have been associated with B-cell lymphoma because causes other than lymphoma were excluded. This is the first report of eosinophilia and eosinophilic infiltrations into neoplastic lesions in a dog with high-grade B-cell lymphoma.