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Borrás P, Marfil MJ, Tellado M, Hernandez D, Osacar JM, Piras I, Martinez Vivot M, Barandiaran S. Mycobacterium avium in miniature schnauzer from Argentina: a series of cases. Top Companion Anim Med 2022; 51:100698. [PMID: 35985408 DOI: 10.1016/j.tcam.2022.100698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 07/21/2022] [Accepted: 08/11/2022] [Indexed: 10/31/2022]
Abstract
Environmental mycobacteria such as those from the Mycobacterium avium-intacellulare complex may cause disseminated and severe disease in dogs with genetic predisposition. A series of cases of four miniature schnauzers with nonspecific clinical signs and the diagnostic tests are described. Complementary means of diagnosis including complete blood count, biochemical serum analyses and fine needle aspiration cytology staining were performed. The bacteriological culture followed by PCR amplification of 1245 and 901 insertion sequences, allowed the identification of Mycobacterium avium subsp. hominissuis. This environmental Mycobacteria normally do not cause severe disease in dogs or other species, but when CARD-9 gene presents mutations, dogs may become extremely susceptible and disease is fast, disseminated and fatal. Antibiotic therapy can be applied under veterinary consideration in specific situations, as treatment is usually applied for a long period of time. Although zoonotic risk is low as the Mycobacterium is environmental, contamination of the location may be high, and immunosuppressed animals and humans can develop infection as well. This report may aid clinical veterinarians in the diagnosis, treatment, and prognosis in similar cases of this breed and others with the genetic predisposition.
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Affiliation(s)
- Pablo Borrás
- Servicio de Enfermedades Infecciosas y Parasitarias en Animales de Compañía, Clínica Veterinaria Panda. Ciudad Autónoma de Buenos Aires, Argentina
| | - María Jimena Marfil
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Enfermedades Infecciosas. Buenos Aires, Argentina.
| | - Matias Tellado
- VetOncologia Cancer Clinic, Ciudad Autónoma de Buenos Aires, Argentina
| | - Diego Hernandez
- Centro Este Medicina Veterinaria. General Pico, La Pampa, Argentina
| | | | - Indiana Piras
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Enfermedades Infecciosas. Buenos Aires, Argentina
| | - Marcela Martinez Vivot
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Enfermedades Infecciosas. Buenos Aires, Argentina
| | - Soledad Barandiaran
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Cátedra de Enfermedades Infecciosas. Buenos Aires, Argentina; Instituto de Investigaciones en Producción Animal (INPA), Consejo Nacional de Investigaciones Científicas y Técnicas-Universidad de Buenos Aires, Buenos Aires, Argentina
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Häußler TC, Thom N, Prenger-Berninghoff E, Köhler K, Barth SA. Challenging diagnosis and successful treatment of localised Mycobacterium avium subsp. hominissuis glossitis in a dog on long-term immunomodulatory therapy. N Z Vet J 2022; 70:340-348. [PMID: 35968551 DOI: 10.1080/00480169.2022.2113166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
CASE HISTORY A 3-year-old, intact female mixed-breed dog, weighing 7 kg, was presented with generalised swelling of the tongue, leading to impaired deglutition and episodes of dyspnoea. From the age of 2 years the dog had been under immunosuppressive therapy due to atopic dermatitis. CLINICAL FINDINGS AND TREATMENT Multiple nodular lesions at the apex of the tongue were noted as well as mandibular and retropharyngeal lymph node enlargement. Serum biochemistry results showed inflammatory changes. The results of several biopsies taken over 7 months indicated persistent pyogranulomatous and necrotising glossitis despite ongoing antimicrobial treatment with first amoxicillin/clavulanic acid and then pradofloxacin. No foreign material, acid-fast bacteria or fungal hyphae were detected throughout. The final diagnosis of Mycobacterium avium subsp. hominissuis (Mah) was reached after PCR and bacterial culture were carried out on the third biopsy sample. Therapy was initiated with rifampicin, clarithromycin and doxycycline, leading to complete remission of the lesions. DIAGNOSIS Severe chronic pyogranulomatous and necrotising glossitis associated with infection by Mah. CLINICAL RELEVANCE This report describes challenges in the diagnosis and therapy of a localised Mah infection in an iatrogenically immunocompromised dog. Successful treatment was only achieved with a specific combination of antibiotics administered long-term.
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Affiliation(s)
- T C Häußler
- Clinic for Small Animals, Surgical Department, Justus Liebig University, Giessen, Germany
| | - N Thom
- Clinic for Small Animals, Department of Dermatology, Justus Liebig University, Giessen, Germany
| | - E Prenger-Berninghoff
- Institute of Hygiene and Infectious Diseases of Animals, Justus Liebig University, Giessen, Germany
| | - K Köhler
- Institute of Veterinary Pathology, Justus Liebig University, Giessen, Germany
| | - S A Barth
- Friedrich-Loeffler-Institute/Federal Research Institute for Animal Health, Institute of Molecular Pathogenesis, Jena, Germany
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Mycobacterium intracellulare induces a Th17 immune response via M1-like macrophage polarization in canine peripheral blood mononuclear cells. Sci Rep 2022; 12:11818. [PMID: 35821058 PMCID: PMC9276657 DOI: 10.1038/s41598-022-16117-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 07/05/2022] [Indexed: 11/11/2022] Open
Abstract
Mycobacterium avium-intracellulare complex (MAC) is one of the most prevalent pathogenic nontuberculous mycobacteria that cause chronic pulmonary disease. The prevalence of MAC infection has been rising globally in a wide range of hosts, including companion animals. MAC infection has been reported in dogs; however, little is known about interaction between MAC and dogs, especially in immune response. In this study, we investigated the host immune response driven by M. intracellulare using the co-culture system of canine T helper cells and autologous monocyte-derived macrophages (MDMs). Transcriptomic analysis revealed that canine MDMs differentiated into M1-like macrophages after M. intracellulare infection and the macrophages secreted molecules that induced Th1/Th17 cell polarization. Furthermore, canine lymphocytes co-cultured with M. intracellulare-infected macrophages induced the adaptive Th17 responses after 5 days. Taken together, our results indicate that M. intracellulare elicits a Th17 response through macrophage activation in this system. Those findings might help the understanding of the canine immune response to MAC infection and diminishing the potential zoonotic risk in One Health aspect.
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Gelendi S, Taylor S, D'Aout C, Pitchford C, Coldrick O, Sanchez-Jimenez C, O'Halloran C. Mycobacterium avium infection associated with sterile polyarthritis in a dog. J Small Anim Pract 2021; 63:154-158. [PMID: 34468983 DOI: 10.1111/jsap.13420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 01/06/2023]
Abstract
A 1-year-old male neutered Portuguese Podengo dog was presented for lameness, inappetence, pyrexia, diarrhoea and abdominal moderate to severe lymphadenomegaly. Cytology of synovial fluid revealed neutrophilic inflammation in multiple joints suggestive of immune-mediated polyarthritis. Cytology of fine-needle-aspiration material obtained from lymph nodes revealed macrophages with intracytoplasmic, rod-like Ziehl-Neelsen positive staining structures, indicative of mycobacteria. Four-month treatment with enrofloxacin, rifampicin and clarithromycin resulted in clinical improvement and resolution of polyarthritis as evidenced on repeat synoviocentesis, but diarrhoea recurred, Ziehl-Neelsen positive organisms were again found on lymph node cytology and analysis of the 16S rRNA-gene using the Basic Local Alignment Search Tool facility resulted in a match to Mycobacterium avium with 100% sequence identity. Treatment was adjusted to include pradofloxacin, doxycycline, rifampicin and ethambutol and 3 months later the dog is clinically normal. Based on the literature search, this is the first time canine Mycobacterium avium infection associated with immune-mediated polyarthritis is reported. Based on scoping searches, this is the first report of canine Mycobacterium avium infection associated with immune-mediated polyarthritis.
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Affiliation(s)
- S Gelendi
- Department of Internal Medicine, Lumbry Park Veterinary Specialists, Alton, Hampshire, GU34 3HL, UK
| | - S Taylor
- Department of Internal Medicine, Lumbry Park Veterinary Specialists, Alton, Hampshire, GU34 3HL, UK
| | - C D'Aout
- Department of Internal Medicine, Lumbry Park Veterinary Specialists, Alton, Hampshire, GU34 3HL, UK
| | - C Pitchford
- Department of Clinical Pathology, Synlab VPG, Exeter, Devon, EX5 2FN, UK
| | - O Coldrick
- Department of Clinical Pathology, Synlab VPG, Exeter, Devon, EX5 2FN, UK
| | - C Sanchez-Jimenez
- Department of Internal Medicine, Lumbry Park Veterinary Specialists, Alton, Hampshire, GU34 3HL, UK
| | - C O'Halloran
- Division of Infection and Immunity, The Royal (Dick) School of Veterinary Studies, Edinburgh, Midlothian, EH25 9RG, UK
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Kim S, Park HE, Park WB, Kim SY, Park HT, Yoo HS. Mycobacterium avium Modulates the Protective Immune Response in Canine Peripheral Blood Mononuclear Cells. Front Cell Infect Microbiol 2021; 10:609712. [PMID: 33520738 PMCID: PMC7840563 DOI: 10.3389/fcimb.2020.609712] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/30/2020] [Indexed: 12/31/2022] Open
Abstract
Mycobacterium avium, an opportunistic intracellular pathogen, is a member of the non-tuberculous mycobacteria species. M. avium causes respiratory disease in immunosuppressed individuals and a wide range of animals, including companion dogs and cats. In particular, the number of infected companion dogs has increased, although the underlying mechanism of M. avium pathogenesis in dogs has not been studied. Therefore, in the present study, the host immune response against M. avium in dogs was investigated by transcriptome analysis of canine peripheral blood mononuclear cells. M. avium was shown to induce different immune responses in canine peripheral blood mononuclear cells at different time points after infection. The expression of Th1-associated genes occurred early during M. avium infection, while that of Th17-associated genes increased after 12 h. In addition, the expression of apoptosis-related genes decreased and the abundance of intracellular M. avium increased in monocyte-derived macrophages after infection for 24 h. These results reveal the M. avium induces Th17 immune response and avoids apoptosis in infected canine cells. As the number of M. avium infection cases increases, the results of the present study will contribute to a better understanding of host immune responses to M. avium infection in companion dogs.
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Affiliation(s)
- Suji Kim
- Department of Infectious Diseases, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
- BK21 FOUR Future Veterinary Medicine Leading Education and Research Center, Seoul National University, Seoul, South Korea
| | - Hyun-Eui Park
- Department of Microbiology, College of Medicine, Gyeongsang National University, Jinju, South Korea
| | - Woo Bin Park
- Department of Infectious Diseases, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Seo Yihl Kim
- Department of Veterinary Physiology, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Hong-Tae Park
- Department of Infectious Diseases, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
| | - Han Sang Yoo
- Department of Infectious Diseases, College of Veterinary Medicine, Seoul National University, Seoul, South Korea
- BK21 FOUR Future Veterinary Medicine Leading Education and Research Center, Seoul National University, Seoul, South Korea
- Bio-MAX/N-Bio Institute, Seoul National University, Seoul, South Korea
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Marianelli C, Ape D, Rossi Mori F. Isolation, Molecular Typing, and Antibiotic Susceptibility Testing of Mycobacterium avium Subspecies hominissuis From a Dog With Generalized Mycobacteriosis. Front Vet Sci 2020; 7:569966. [PMID: 33330691 PMCID: PMC7672039 DOI: 10.3389/fvets.2020.569966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/14/2020] [Indexed: 12/02/2022] Open
Abstract
Mycobacterium avium-intracellulare complex infections are becoming an increasing concern in veterinary medicine because they affect livestock, wildlife, and companion animals. Here we describe the isolation, molecular typing, and antibiotic susceptibility testing of the causative agent of a rare case of generalized mycobacteriosis in a crossbred dog. Mycobacterial colonies were isolated from a popliteal lymph node aspirate sample and molecular typed by SNPs typing of the genes gyrB and rpsA, the 3′ region of the hsp65 gene and the internal transcribed spacer (ITS), and MIRU-VNTR analysis. Colonies were also tested in vitro against the macrolide clarithromycin and other drugs, using a resazurin microdilution assay, in order to provide the most appropriate treatment for the dog. Results from SNPs typing of gyrB and ITS, as well as from MIRU-VNTR analysis suggested the isolation of a single strain of M. avium subsp. hominissuis (Mah). On the other hand, SNP typing of rpsA revealed DNA polymorphisms that led colonies to cluster into two groups. The presence of two distinct strains of Mah has been assumed. All colonies, regardless of the nucleotide sequence of rpsA, were found to be sensitive to all of the drugs tested except for ethambutol. Although the therapy administered was adequate, the dog's overall clinical status worsened progressively and the animal died 8 months later. In conclusion, we report on the isolation of Mah from a dog with generalized mycobacteriosis.
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Affiliation(s)
- Cinzia Marianelli
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Daniela Ape
- Belli Lisi Studio Veterinario, Monterotondo, Italy
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Roller M, Hansen S, Böhlken-Fascher S, Knauf-Witzens T, Czerny CP, Goethe R, Abd El Wahed A. Molecular and Serological Footprints of Mycobacterium avium Subspecies Infections in Zoo Animals. Vet Sci 2020; 7:vetsci7030117. [PMID: 32842515 PMCID: PMC7558821 DOI: 10.3390/vetsci7030117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Mycobacteria of the Mycobacterium avium complex (MAC) pose a significant risk to zoological collections. Mycobacterium avium subspecies paratuberculosis (MAP) is a member of MAC and the causative agent of Johne’s disease. Despite many reports in animals kept in zoological gardens, systemic surveillance has rarely been reported. Methods: In this study, archived serum samples collected from animal species at the Wilhelma Zoological and Botanical Gardens in Stuttgart, Germany, were screened for the presence of antibodies against MAC and MAP. In addition, molecular investigations were performed on necropsy, fecal, and environmental samples. Results: In total, 30/381 serum samples of various mammalian species were positive for MAC antibodies in ELISA, while one sample of a reticulated giraffe (Giraffa camelopardalis reticulata) was positive in MAP-specific ELISA. Samples from many species were positive in pan-Mycobacterium real-time PCR (40/43 fecal samples, 27/43 environmental samples, and 31/90 necropsy samples). Surprisingly, no sample was positive in the MAP-specific molecular assays. However, two environmental samples from primate enclosures were positive in Mycobacterium avium subspecies hominissuis (MAH)-specific real-time PCR. Conclusions: The results reveal serological indications of MAC infections in the zoological collection. However, the presence of a MAP-contaminated environment by a high-shedding individual animal or MAP-infected population is unlikely.
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Affiliation(s)
- Marco Roller
- Wilhelma Zoological-Botanical Gardens Stuttgart, Wilhelma 13, D-70376 Stuttgart, Germany; (M.R.); (T.K.-W.)
- Department of Animal Sciences, Division of Microbiology and Animal Hygiene, Faculty of Agricultural Science, Georg-August-University, Burckhardtweg 2, D-37077 Göttingen, Germany; (S.H.); (S.B.-F.); (C.-P.C.)
- Institute for Microbiology, University of Veterinary Medicine Hannover, Foundation, Bischofsholer Damm 15, D-30173 Hannover, Germany;
| | - Sören Hansen
- Department of Animal Sciences, Division of Microbiology and Animal Hygiene, Faculty of Agricultural Science, Georg-August-University, Burckhardtweg 2, D-37077 Göttingen, Germany; (S.H.); (S.B.-F.); (C.-P.C.)
| | - Susanne Böhlken-Fascher
- Department of Animal Sciences, Division of Microbiology and Animal Hygiene, Faculty of Agricultural Science, Georg-August-University, Burckhardtweg 2, D-37077 Göttingen, Germany; (S.H.); (S.B.-F.); (C.-P.C.)
| | - Tobias Knauf-Witzens
- Wilhelma Zoological-Botanical Gardens Stuttgart, Wilhelma 13, D-70376 Stuttgart, Germany; (M.R.); (T.K.-W.)
| | - Claus-Peter Czerny
- Department of Animal Sciences, Division of Microbiology and Animal Hygiene, Faculty of Agricultural Science, Georg-August-University, Burckhardtweg 2, D-37077 Göttingen, Germany; (S.H.); (S.B.-F.); (C.-P.C.)
| | - Ralph Goethe
- Institute for Microbiology, University of Veterinary Medicine Hannover, Foundation, Bischofsholer Damm 15, D-30173 Hannover, Germany;
| | - Ahmed Abd El Wahed
- Department of Animal Sciences, Division of Microbiology and Animal Hygiene, Faculty of Agricultural Science, Georg-August-University, Burckhardtweg 2, D-37077 Göttingen, Germany; (S.H.); (S.B.-F.); (C.-P.C.)
- Institute of Animal Hygiene and Veterinary Public Health, University of Leipzig, An den Tierkliniken 43, D-04103 Leipzig, Germany
- Correspondence: ; Tel.: +49-176-6136-0325
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Ghielmetti G, Giger U. Mycobacterium avium: an Emerging Pathogen for Dog Breeds with Hereditary Immunodeficiencies. CURRENT CLINICAL MICROBIOLOGY REPORTS 2020; 7:67-80. [PMID: 33842195 DOI: 10.1007/s40588-020-00145-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Purpose of Review Among the nontuberculous mycobacteria (NTM), Mycobacterium avium complex (MAC) is the leading cause of pulmonary disease in humans. Innate and acquired immunodeficiencies have been associated with an increased host susceptibility to NTM infections. The underlying mechanisms predisposing humans and dogs to MAC infections is being elucidated. Recent Findings Although MAC infection is infrequently diagnosed in dogs, a strong breed predisposition particularly for Miniature Schnauzer and Basset Hound dogs is evident. A recessively inherited defect of the adaptor protein CARD9 has recently been documented to be responsible for the increased susceptibility to MAC in the Miniature Schnauzer breed. Summary Given the zoonotic potential of a MAC infected dog particularly to immunocompromised human patients, diseased dogs pose a public health risk. While not a reportable disease, treatment of systemic mycobacteriosis is generally not effective and discouraged in dogs. The collaborative efforts by microbiologists, veterinary clinicians, dog breeders, primary care physicians, and infectious disease specialists applying the One Health approach is therefore crucial for the best management and prevention of MAC infection.
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Affiliation(s)
- Giovanni Ghielmetti
- Institute for Food Safety and Hygiene, Section of Veterinary Bacteriology, University of Zurich, Winterthurerstrasse 270, 8057 Zurich, Switzerland
| | - Urs Giger
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zürich, Switzerland
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Rampacci E, Stefanetti V, Passamonti F, Henao-Tamayo M. Preclinical Models of Nontuberculous Mycobacteria Infection for Early Drug Discovery and Vaccine Research. Pathogens 2020; 9:E641. [PMID: 32781698 PMCID: PMC7459799 DOI: 10.3390/pathogens9080641] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 12/11/2022] Open
Abstract
Nontuberculous mycobacteria (NTM) represent an increasingly prevalent etiology of soft tissue infections in animals and humans. NTM are widely distributed in the environment and while, for the most part, they behave as saprophytic organisms, in certain situations, they can be pathogenic, so much so that the incidence of NTM infections has surpassed that of Mycobacterium tuberculosis in developed countries. As a result, a growing body of the literature has focused attention on the critical role that drug susceptibility tests and infection models play in the design of appropriate therapeutic strategies against NTM diseases. This paper is an overview of the in vitro and in vivo models of NTM infection employed in the preclinical phase for early drug discovery and vaccine development. It summarizes alternative methods, not fully explored, for the characterization of anti-mycobacterial compounds.
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Affiliation(s)
- Elisa Rampacci
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (E.R.); (V.S.)
| | - Valentina Stefanetti
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (E.R.); (V.S.)
| | - Fabrizio Passamonti
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (E.R.); (V.S.)
| | - Marcela Henao-Tamayo
- Mycobacteria Research Laboratories, Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, CO 80523, USA;
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Sharp E, Taylor S, O'Halloran C. Unusual presentation of canine Mycobacterium avium infection. Vet Rec 2019; 184:800. [PMID: 31164481 DOI: 10.1136/vr.105311] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/09/2019] [Accepted: 05/03/2019] [Indexed: 01/15/2023]
Abstract
This short communication describes the clinical and morphological findings, diagnosis and treatment of a case of Mycobacterium avium infection in a golden retriever that presented with a progressive nasal swelling and lymphadenopathy. Although well documented in cats, where cutaneous lesions are frequently recognised, canine M avium infection is less commonly reported, and cutaneous lesions are rare. To the authors' knowledge this is the first documented case of canine M avium infection that presented with a cutaneous lesion but no systemic clinical signs. It occurred in a dog with no previously reported breed predisposition and highlights that in cases of cutaneous histiocytic infiltrate in dogs mycobacterial infection should remain a differential diagnosis, even in the absence of suggestive organisms on histopathological examination.
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Affiliation(s)
- Emily Sharp
- Lumbry Park Veterinary Specialists, Alton, UK
| | | | - Conor O'Halloran
- Royal Dick School of Veterinary Studies, University of Edinburgh, Easter Bush, UK.,Roslin Institute, University of Edinburgh, Roslin, UK
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