An Immunologic Investigation of Canine Eosinophilic Bronchopneumopathy

Hematologic Abnormalities and Diseases Associated with Moderate-to-Marked Basophilia in a Large Cohort of Dogs

Basophilia is a rare hematologic finding in dogs. This research aimed to describe the hematologic and clinical characteristics of dogs with moderate-to-marked basophilia. CBC reports with blood smear examinations from dogs presented to the North Carolina State University Veterinary Teaching Hospital were retrospectively reviewed for basophilia (>193 cells/µL). We classified basophilia as moderate when counts were ≥500 cells/µL and marked when they reached ≥1000 cells/µL. We compared the hematologic and clinical profiles of dogs with moderate-to-marked basophilia (the basophilia group) to those without basophilia, serving as our control group. In addition, we investigated differences between dogs with marked basophilia versus those with moderate basophilia, as well as between dogs in the basophilia group with and without concurrent eosinophilia. Diseases associated with moderate-to-marked basophilia included eosinophilic lung disease (p < 0.0001), leukemia/myeloproliferative neoplasms (p = 0.004), parasitic infection (p = 0.004), mast cell tumor (p = 0.005), and inflammatory bowel disease (p = 0.02). Overall, dogs with marked basophilia had a lower frequency of inflammatory diseases (51% vs. 70%, p = 0.009) and a higher frequency of neoplastic diseases (48% vs. 26%, p = 0.003) compared to those with moderate basophilia. In the basophilia group, concurrent eosinophilia was only seen in 36% of dogs. Dogs with concurrent eosinophilia were more often diagnosed with inflammatory diseases (77% vs. 58%, p = 0.006), with fewer diagnoses of neoplasia (19% vs. 40%, p = 0.001), compared to dogs without concurrent eosinophilia. The findings of this study offer veterinary clinicians valuable guidance in determining diagnostic priorities for dogs with moderate-to-marked basophilia.

Factors influencing the response to therapy in dogs with eosinophilic bronchopneumopathy

OBJECTIVES

Canine eosinophilic bronchopneumopathy (EBP) is a poorly understood disease characterized by chronic inflammation of the lower airways. To date, factors affecting the course of the disease are largely unknown. The objective of this study was to investigate the influence of clinical, laboratory, and environmental factors on therapeutic outcome in dogs with EBP.

MATERIAL AND METHODS

Environmental and housing conditions, course of disease, and response to treatment were evaluated using a standardized questionnaire for owners of 29 dogs diagnosed with EBP from 3 different veterinary referral centers in Germany. Data of diagnostic tests (hematology, radiographs, bronchoalveolar-lavage-fluid-(BALF) cytology) were retrospectively obtained from medical records. The influence of the different factors was assessed using Fisher's-exact-test and Mann-Whitney-U- or Kruskal-Wallis-test.

RESULTS

The proportion of neutrophilic granulocytes in BALF-cytology was significantly higher in dogs with persistent clinical signs compared to dogs that achieved clinical remission (p=0.029). Duration of clinical signs before treatment was significantly longer in dogs with persistent clinical signs (16±12 months) compared to dogs that achieved clinical remission (6±7 months) (p=0.017).

CONCLUSION

Early diagnosis and therapy have a decisive influence on the success of treatment.

CLINICAL RELEVANCE

Dogs with respiratory signs suspicious for EBP should be evaluated in a timely manner to increase the likelihood of clinical remission with an early start of therapy.

Topographical distribution and radiographic pattern of lung lesions in canine eosinophilic bronchopneumopathy

OBJECTIVES

To evaluate the radiographic lung pattern and topographical distribution in canine eosinophilic bronchopneumopathy.

MATERIALS AND METHODS

Medical records were retrospectively reviewed for dogs diagnosed with eosinophilic bronchopneumopathy. Lateral thoracic radiographs were examined for the presence of increased radiopacity, classification of pattern, topography of lung changes (cranioventral, perihilar, caudodorsal, caudoventral) and severity of pulmonary lesions.

RESULTS

Forty-four cases were identified with the Labrador retriever being the most commonly affected breed; there was a mean age of 5 years and an equal gender distribution. Coughing was the most common clinical sign. Circulating eosinophilia was present in 39% of dogs, with a mean peripheral eosinophilia of 5.1×10⁹ cells/L and a mean bronchoalveolar lavage fluid eosinophilia of 40%. Eighty percent of dogs had an abnormal lung pattern in at least one of the four lung fields; the remaining had normal thoracic radiographs. The most common patterns were a bronchial and a bronchointerstitial pattern, with 41 and 89% distribution to the caudodorsal lung field, respectively.

CLINICAL SIGNIFICANCE

A bronchial and bronchointerstitial pattern are the most common radiographic lung patterns seen in canine eosinophilic bronchopneumopathy with these patterns most frequently topographically distributed to at least the caudodorsal lung field. Furthermore, within the caudodorsal lung field, a bronchointerstitial pattern predominates. This radiographic and topographical finding may allow eosinophilic bronchopneumopathy to take precedence on a differential diagnoses list before confirmatory bronchoalveolar lavage fluid sampling.

Characterization of the Bronchoalveolar Lavage Fluid by Single Cell Gene Expression Analysis in Healthy Dogs: A Promising Technique

Single-cell mRNA-sequencing (scRNA-seq) is a technique which enables unbiased, high throughput and high-resolution transcriptomic analysis of the heterogeneity of cells within a population. This recent technique has been described in humans, mice and other species in various conditions to cluster cells in populations and identify new subpopulations, as well as to study the gene expression of cells in various tissues, conditions and origins. In dogs, a species for which markers of cell populations are often limiting, scRNA-seq presents with elevated yet untested potential for the study of tissue composition. As a proof of principle, we used scRNA-seq to identify cellular populations of the bronchoalveolar lavage fluid (BALF) in healthy dogs (n = 4). A total of 5,710 cells were obtained and analyzed by scRNA-seq. Fourteen distinct clusters of cells were identified, further identified as macrophages/monocytes (4 clusters), T cells (2 clusters) and B cells (1 cluster), neutrophils (1 cluster), mast cells (1 cluster), mature or immature dendritic cells (1 cluster each), ciliated or non-ciliated epithelial cells (1 cluster each) and cycling cells (1 cluster). We used for the first time in dogs the scRNA-seq to investigate cellular subpopulations of the BALF of dog. This study hence expands our knowledge on dog lung immune cell populations, paves the way for the investigation at single-cell level of lower respiratory diseases in dogs, and establishes that scRNA-seq is a powerful tool for the study of dog tissue composition.

Bronchoalveolar lavage fluid lymphocytosis in 104 dogs (2006-2016)

BACKGROUND

Bronchoalveolar lavage (BAL) fluid cytology and culture are used to characterize respiratory diseases in dogs. Little is known about disorders associated with increased numbers of lymphocytes in BAL fluid.

OBJECTIVE

To evaluate duration of clinical signs and detection of specific respiratory diagnoses in dogs with BAL lymphocytosis.

ANIMALS

One-hundred four client-owned dogs evaluated for respiratory signs.

METHODS

Medical records of dogs that had >300 cells/μL and >20% lymphocytes on a differential cell count of BAL fluid between January 1, 2006, and January 1, 2016, were reviewed retrospectively. Cases were evaluated for the duration of clinical signs and respiratory diagnoses, including aspiration injury, infectious or inflammatory respiratory disease, and airway collapse.

RESULTS

Dogs ranged in age from 0.5 to 16 years (median, 7.9 years) and had a median body weight of 11.4 kg (range, 2.0-42.7 kg). Eosinophilic lung disease was documented in 13 of 104 dogs (Group 1) and airway neutrophilia associated with infectious or inflammatory disease was found in 59 of 104 dogs (Group 2). Lymphocytosis alone in BAL fluid was described in 32 dogs (Group 3). Duration of cough did not differ among groups, but airway collapse was significantly more common in dogs with solitary lymphocytosis than in those with other types of inflammation.

CONCLUSIONS AND CLINICAL IMPORTANCE

Lymphocytosis in BAL fluid is common in dogs and, in many cases, likely represents a common response to airway injury, independent of the type or duration of insult. It is unknown whether airway collapse leads to lymphocytosis or if the inflammatory process causes airway collapse.

Detection of specific bacterial agents by quantitative PCR assays in the bronchoalveolar lavage fluid of dogs with eosinophilic bronchopneumopathy vs. dogs with chronic bronchitis and healthy dogs

In humans, Mycoplasma pneumoniae and Bordetella pertussis infections are suggested to trigger or exacerbate asthma. Whether Mycoplasma or Bordetella are associated with chronic inflammatory bronchial diseases in dogs has not been investigated. The aim of this study was to assess detection rates of Mycoplasma canis (M. canis), M. cynos and Bordetella bronchiseptica (Bb), in dogs with eosinophilic bronchopneumopathy (EBP) and chronic bronchitis (CB), compared with healthy dogs. Specific quantitative PCR (qPCR) analysis for M. canis, M. cynos and Bb were retrospectively performed on bronchoalveolar lavage fluid (BALF) collected from 24 dogs with EBP, 21 dogs with CB and 15 healthy dogs. Possible associations between qPCR results and age, BALF cytology or clinical severity scores (CSS) in dogs with EBP were investigated. There was no difference in M. canis, M. cynos and Bb detection rates in dogs with EBP (n=6, n=2 and n=6, respectively) and dogs with CB (n=2, n=2 and n=2, respectively) compared with control dogs (n=4, n=2 and n=2, respectively). In dogs with EBP, the proportion that were qPCR-positive for Bb was higher in dogs with higher CSS (P=0.014) and BALF from Bb-positive dogs had higher percentage of neutrophils (P<0.001). Among dogs that were qPCR-positive for Bb, moderate to high loads were only detected in dogs with EBP. M. canis and M. cynos detection was not associated with EBP or CB; higher Bb loads were only present in dogs with EBP and high CSS. A possible cause and effect relationship between Bb infection or load and EBP remains unclear and requires further investigation.

Comparison of bronchoalveolar lavage cytospins and smears in dogs and cats

Differences in the cytological interpretation of bronchoalveolar lavage fluid (BALF) after cytospin preparation (CP) or manual smearing of pelleted cells preparation (MSP) were investigated in client-owned dogs and cats with inflammatory or infectious lower respiratory disease. Bronchoalveolar lavage fluid from healthy cats was also examined. With MSP, cell lysis was more frequently observed, and cellular distribution was more heterogeneous throughout the slide. When samples from healthy and diseased animals were considered together, a significantly greater percentage of neutrophils was seen on CP than on MSP slides (P<0.002). Cytospin preparations were considered of better quality in all individual comparisons. Cytospin preparation is advised in the evaluation of BALF with low total cell count. When only MSPs are evaluated, clinicians should be aware that differential neutrophil counts may underestimate the counts found on CP slides.

Characterisation of the acute and reversible airway inflammation induced by cadmium chloride inhalation in healthy dogs and evaluation of the effects of salbutamol and prednisolone

The aims of this study were firstly to characterise a model of subclinical and reversible bronchial inflammation induced by cadmium chloride inhalation in healthy dogs and then to examine the effect of prednisolone or salbutamol treatment on the resulting bronchitis. The model characterisation and the effects of treatment were studied using clinical symptoms, haematology, thoracic radiography, bronchoscopy and bronchoalveolar lavage, barometric whole-body plethysmography and histamine broncho-provocation tests. In addition, the activity of matrix metalloproteinases (MMP)-2 and -9 were determined in serum and bronchoalveolar lavage fluid (BALF). Cadmium inhalation induced: (1) a transient bronchial inflammation, dominated by neutrophils; (2) a neutrophilia of the blood that persisted for up to 4 weeks; (3) a transient increased bronchial reactivity, and (4) a significant increase in MMP-9 activity in the BALF. Prednisolone treatment reduced the influx of inflammatory cells into the BALF, but not significantly, had no effect on pulmonary function, and did not reduce of airway hypersensitivity. Salbutamol had almost no effect on any of the parameters investigated.

Canine Eosinophilic Bronchopneumopathy

Eosinophilic bronchopneumopathy (EBP) is a disease characterized by eosinophilic infiltration of the lung and bronchial mucosa, as demonstrated by examination of bronchoalveolar lavage fluid cytologic preparations or histologic examination of the bronchial mucosa. Although the precise cause of EBP is unknown, a hypersensitivity to aeroallergens is suspected. The diagnosis relies on typical history and clinical signs, demonstration of bronchopulmonary eosinophilia by cytology or histopathologic examination, and exclusion of known causes of lower airway eosinophilia. Most dogs display an excellent response to oral corticosteroid therapy; however, side effects of this treatment can be limiting. New therapeutic approaches are being studied, including the use of aerosol therapy, cyclosporine, or drugs interfering with T helper 2 immune response.

Analytical, physiologic, and clinical validation of a radioimmunoassay for measurement of procollagen type III amino terminal propeptide in serum and bronchoalveolar lavage fluid obtained from dogs

OBJECTIVE

To validate a radioimmunoassay for measurement of procollagen type III amino terminal propeptide (PIIINP) concentrations in canine serum and bronchoalveolar lavage fluid (BALF) and investigate the effects of physiologic and pathologic conditions on PIIINP concentrations.

SAMPLE POPULATION

Sera from healthy adult (n = 70) and growing dogs (20) and dogs with chronic renal failure (CRF; 10), cardiomyopathy (CMP; 12), or degenerative valve disease (DVD; 26); and sera and BALF from dogs with chronic bronchopneumopathy (CBP; 15) and healthy control dogs (10 growing and 9 adult dogs).

PROCEDURE

A radioimmunoassay was validated, and a reference range for serum PIIINP (S-PIIINP) concentration was established. Effects of growth, age, sex, weight, CRF, and heart failure on S-PIIINP concentration were analyzed. In CBP-affected dogs, S-PIIINP and BALF-PIIINP concentrations were evaluated.

RESULTS

The radioimmunoassay had good sensitivity, linearity, precision, and reproducibility and reasonable accuracy for measurement of S-PIIINP and BALF-PIIINP concentrations. The S-PIIINP concentration reference range in adult dogs was 8.86 to 11.48 mug/L. Serum PIIINP concentration correlated with weight and age. Growing dogs had significantly higher S-PIIINP concentrations than adults, but concentrations in CRF-, CMP-, DVD-, or CBP-affected dogs were not significantly different from control values. Mean BALF-PIIINP concentration was significantly higher in CBP-affected dogs than in healthy adults.

CONCLUSIONS AND CLINICAL RELEVANCE

In dogs, renal or cardiac disease or CBP did not significantly affect S-PIIINP concentration; dogs with CBP had high BALF-PIIINP concentrations. Data suggest that the use of PIIINP as a marker of pathologic fibrosis might be limited in growing dogs.

Real-time RT-PCR quantification of mRNA encoding cytokines, CC chemokines and CCR3 in bronchial biopsies from dogs with eosinophilic bronchopneumopathy

Idiopathic canine eosinophilic bronchopneumopathy (EBP) is a disease characterized by eosinophilic infiltration of the pulmonary interstitium and bronchial mucosa, a cause for which has not yet been discovered. A recent study, examining the relative proportion of various lymphocyte cell subsets within bronchoalveolar lavage fluid from dogs with EBP, has shown a selective increase in CD4(+) T-cells and a selective decrease in CD8(+) T-cells, suggesting that a similar Th2 immune response might occur in EBP. The aim of the present study was to determine the profile of cytokine, chemokine and CC chemokine receptor 3 (CCR3) messenger RNA (mRNA) expression in bronchial tissue from dogs with EBP. Real-time RT-PCR assays were used for the quantification of mRNA encoding for a panel of cytokines, CC chemokines and CCR3 in perendoscopic bronchial biopsies from eight dogs with EBP and seven age-matched control dogs. Messenger RNA transcribed from the housekeeping gene glyceraldehyde-3-phosphate dehydrogenase was used for normalisation of the threshold cycle in order to determine the relative copy numbers of the transcripts. No significant difference in the expression of any cytokine, MCP-1, -2, -4 and CCR3 was found between control and EBP dogs. The expression of transcript for MCP-3, eotaxin-2 and -3 was significantly greater in bronchial biopsies from dogs with EBP than in samples from control dogs while there was significantly less mRNA encoding RANTES in the mucosa of dogs with EBP. In conclusion, the cytokine mRNA expression profile in perendoscopic bronchial biopsies is similar in dogs with EBP and dogs without respiratory disease. Further studies on the quantification of mRNA encoding cytokines in isolated T lymphocytes from bronchoalveolar lavage fluid or bronchial biopsies are needed before any conclusion on the cytokine profile in canine EBP can be drawn. Eotaxin-2, -3 and MCP-3 appear to be implicated in the pathogenesis of the disease.

Distribution of leucocyte subsets in bronchial mucosa from dogs with eosinophilic bronchopneumopathy

Immunohistochemistry was used to characterize the distribution of leucocyte subsets in the bronchial mucosa of 11 dogs with idiopathic eosinophilic bronchopneumopathy (EBP). Formalin-fixed tissues from all dogs were included in the study, but frozen tissue from only one dog was available. MHC class II(+) cells were found in moderate numbers in the lamina propria (LP). These cells were morphologically either dendritic-like cells or macrophages, but many macrophages did not express MHC class II. Such molecules were expressed by occasional fibroblasts. L1(+) cells, which formed a relatively small component of the LP inflammatory infiltrate, were morphologically either macrophages or polymorphonuclear cells (probably eosinophils). IgA(+) plasma cells were found in varying numbers in the LP, mostly in association with glandular tissue. IgG(+) plasma cells were less common, and IgM(+) plasma cells were present in low numbers. Many CD3(+) cells were present in the LP. In the single case from which frozen tissue was available, most of the lymphocytes were labelled with CD4 marker, while smaller numbers were CD8(+) T cells. Most of the lymphocytes in this case were positively labelled with T-cell receptor (TCR)-alphabeta marker. TCR-gammadelta(+) cells, although less common, were present in significant numbers throughout the LP. CDlc(+) dendritic cells were numerous in the epithelium and in the LP, immediately beneath the basement membrane. These findings, which were similar to those described in human asthma, are suggestive of a Th2 dominant immune response in canine EBP. As in human asthma, this provides a possible basis for new forms of treatment in canine EBP.

Real-time RT-PCR quantification of mRNA encoding cytokines and chemokines in histologically normal canine nasal, bronchial and pulmonary tissue

Cytokines and chemokines are likely to be involved in the pathogenesis of inflammatory diseases of the canine respiratory tract. The roles and relative amounts of these molecules have not yet been defined in the respiratory mucosa of normal dogs or dogs with naturally acquired respiratory inflammation. In the present study, real-time reverse transcriptase polymerase chain reaction (RT-PCR) assays were employed to quantify messenger RNA (mRNA) encoding the chemokines monocyte chemotactic protein (MCP)-2, eotaxin-2 and eotaxin-3, and the cytokines interleukin-4 (IL-4), IL-5, IL-6, IL-10, IL-12p40, IL-18, interferon-gamma (IFN-gamma), tumour necrosis factor-alpha (TNF-alpha) and transforming growth factor-beta (TGF-beta) in normal nasal, bronchial and pulmonary tissues from puppies (n = 4) and from adult dogs (n = 7). There was no significant difference in the expression of any transcript between puppies and adult dogs at any of the anatomical sites examined. The expression of mRNA encoding eotaxin-2 and eotaxin-3 increased significantly with progression from the nasal mucosa to pulmonary parenchyma but expression of MCP-2 mRNA did not show this trend. At all levels of the respiratory mucosa, the most abundant transcripts were those encoding IL-18 and TGF-beta. Transcripts encoding IL-6, IL-10, IL-12 and TNF-alpha were approximately ten-fold less abundant, and IL-4, IL-5 and IFN-gamma were the least abundant templates. There was significantly different amount of mRNA encoding IL-5, IL-18 and TNF-alpha between particular anatomical levels of the respiratory mucosa while the mRNA expression of the other cytokines was similar at all anatomical sites. The results of the present study will enable comparisons to be made with results obtained from similar samples obtained from dogs with nasal, bronchial or pulmonary diseases.

Distribution of leucocyte subsets in the canine respiratory tract

Histochemistry and immunohistochemistry were used to characterize leucocyte subsets in the respiratory tract of 15 outbred dogs (five aged <6 months and 10 aged >1 year) that had no evidence of respiratory disease. No organized nose- or bronchus-associated lymphoid tissue was observed in any of the sections examined. IgA(+) plasma cells predominated in nasal mucosa and in all parts of the bronchial tree, with fewer IgG(+) and IgM(+) plasma cells. The numbers of IgA(+) and IgM(+) cells were significantly greater in the nasal mucosa than in any other part of the respiratory mucosa. There were significantly fewer IgA(+), IgG(+) and IgM(+) cells in all parts of the respiratory tract in the puppies than in the adults. The number and distribution of mast cells and cells expressing MHC class II, L1 or CD1c were recorded. Mast cells were mainly found in the subepithelial lamina propria of nasal and bronchial mucosa and in the alveolar interstitium, and cells expressing IgE had a similar distribution. Mast cells were also present within muscle layers of the bronchial tree. The numbers of mast cells and MHC class II(+) cells were significantly greater in the nasal mucosa than in any other part of the respiratory mucosa. In the nose, carina and primary and secondary bronchus, there were significantly more mast cells and MHC class II(+) cells in puppies than in adult dogs, whereas the numbers of L1(+) cells and CD1c(+) cells in most sites were significantly greater in older dogs. There were significantly more CD3(+) and CD8(+) cells in the nasal mucosa than in any part of the bronchial mucosa. In most parts of the respiratory mucosa, CD4(+), CD8(+) and TCR alphabeta(+) cells were present in significantly greater numbers in adults than in puppies. All parts of the respiratory tract had similar numbers of mucosal CD4(+) and CD8(+) T lymphocytes. TCR gammadelta(+) cells were absent or sparse in all samples. These data, obtained from dogs without respiratory disease, will enable comparisons to be made with dogs suffering from infectious or inflammatory nasal, bronchial and pulmonary diseases.

Investigation of hypereosinophilia and potential treatments

Hypereosinophilia is excessive eosinophilia and has been defined in dogs and cats as eosinophils greater than 5 x 10(9)/L (> 5000/microL). Canine breeds with a predisposition to higher eosinophil counts or certain eosinophilic diseases include the Rottweiler, German Shepard, Siberian Husky, Alaskan Malamute, and Cavalier King Charles Spaniel. Two of the more common causes of canine hypereosinophilia are pulmonary infiltrates with eosinophils (PIE) and gastrointestinal disease. The highest eosinophil counts are expected in dogs with pneumonia or PIE. The most common cause of eosinophilia in cats is flea allergy. The greatest eosinophilia occurs in cats with flea allergy, feline asthma, and eosinophilic granuloma. Innovative recent treatments for human patients with asthma have been successful in reducing eosinophil numbers but have had a confusing and disappointing lack of reducing symptoms. The role of eosinophils in many eosinophilic diseases remains a mystery.

Rhinitis/Bronchopneumonia Syndrome in Irish Wolfhounds

This study describes the clinical, immunologic, genetic, and pathologic features of Irish Wolfhounds with rhinitis/bronchopneumonia syndrome. The dogs examined were from Belgium, The Netherlands, UK, Canada, Germany, and Switzerland. Signs included transient to persistent mucoid or mucopurulent rhinorrhea, cough, and respiratory dyspnea. Radiographic, rhinoscopic, and bronchoscopic findings were variable. Analysis of ciliary ultrastructure was performed in 5 affected dogs, but no characteristic primary ciliary defects (primary ciliary dyskinesia) were detected. Serum and bronchoalveolar lavage fluid (BALF) concentrations of IgA, IgG, and IgM were determined in some affected dogs and clinically normal Irish Wolfhounds. Serum IgA concentration was below the reference range in 5 of 8 affected dogs tested, whereas BALF IgA concentration was above the normal range in 2 affected adult dogs. The CD4 to CD8 lymphocyte subset ratio (CD4:CD8) in peripheral blood was tested in 3 affected dogs and was within the normal range. BALF CD4:CD8 was tested in 1 affected dog and was higher than the normal range. Decreased neutrophil phagocytosis was observed in 1 of the 4 dogs tested. Analysis of pedigrees of the Belgian, Canadian, German, and Swiss dogs revealed common ancestry, suggesting a heritable syndrome.

Eosinophilic diseases in two Cavalier King Charles spaniels

This report describes the clinical presentation of two Cavalier King Charles spaniels with different eosinophilic diseases. The first case presented with dyspnoea and a non-productive cough, and investigations demonstrated eosinophilic bronchopneumonopathy. The second dog was referred for the investigation of haemorrhagic vomiting and diarrhoea and was eventually diagnosed with eosinophilic enteritis. Both dogs had concurrent eosinophilic stomatitis, and both responded completely to immunosuppressive glucocorticoid therapy. This report is the first to describe the concurrence of eosinophilic stomatitis and systemic eosinophilic disease in Cavalier King Charles spaniels, and suggest that this breed may be predisposed to eosinophilic syndromes.