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Henry PMN, Boag AM, Dandrieux JRS, Rossi R, Woods GA. Diagnostic yield of percutaneous, ultrasound-guided, fine needle aspirates of the gastrointestinal wall: a retrospective analysis of 152 samples. J Small Anim Pract 2024. [PMID: 38958024 DOI: 10.1111/jsap.13759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/24/2024] [Accepted: 05/27/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVES The aim was to assess the technical success of percutaneous ultrasound-guided fine needle aspirates of gastrointestinal wall lesions and evaluate predictors of success. Secondary aims included comparing the cytological diagnosis with histopathology, evaluating the utility of concurrent locoregional lymph node cytology and assessing the procedure's complication rate. MATERIAL AND METHODS Gastrointestinal wall cytology from 75 dogs and 70 cats obtained between 2018 and 2023 were reviewed and categorised as successful (resulting in a diagnostic cytology report) and accurate (resulting in the correct diagnosis when compared to histopathology). Unsuccessful fine needle aspirates, not submitted for cytology, were not recorded. Variables recorded included animal signalment, lesion and lymph node's appearance on ultrasound, size, location, number of smears submitted and experience of the ultrasonographer. RESULTS One hundred and fifty-two reports were analysed. Eighty-eight (58%) were successful: three normal epithelium, 21 inflammatory processes and 64 neoplasms. Variables associated with increased technical success included description of a mass, higher number of slides submitted and thickness of gastrointestinal lesion on ultrasound. Comparison with histopathology, performed for 17 lesions, showed discrepancies in eight, complete agreement in seven and partial in two. Eighty-four loco-regional lymph nodes were sampled, of which, 67 were successful (80%) and 52 brought additional clinical information (supporting GI wall cytology or diagnosing neoplasia not identified on GI wall cytology). No complication strictly attributable to gastrointestinal wall sampling was reported but when possibly related, death of the patient occurred in 2.5% of cases. CLINICAL SIGNIFICANCE Ultrasound-guided fine needle aspirate of gastrointestinal wall had moderate accuracy and was unsuccessful in 42% of cases, but technical success increased when sampling mass lesions, thicker intestinal layers and submitting more slides.
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Affiliation(s)
- P M N Henry
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - A M Boag
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - J R S Dandrieux
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - R Rossi
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, UK
| | - G A Woods
- Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, UK
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Schreeg ME, Cullen JM, Robertson J, Gookin JL. Histologic characterization of the major duodenal papilla and association with concurrent biliary, pancreatic, and intestinal pathology in cats. Vet Pathol 2024; 61:207-220. [PMID: 37560792 DOI: 10.1177/03009858231189450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Conjoining of the major pancreatic duct and common bile duct at the major duodenal papilla (MDP) is suspected to predispose cats to the clinical syndrome of "triaditis." However, microanatomy of the MDP or presence of lesions at the MDP has not been assessed in cats with or without triaditis. The aims of this study were to characterize feline MDP histomorphology and to identify associations between MDP anatomy/disease and the presence of biliary, pancreatic, or intestinal inflammation or neoplasia. Histologic assessment was prospectively performed on the MDP, duodenum, jejunum, ileum, liver, and pancreas from 124 client-owned cats undergoing postmortem examination. The majority of cats (104/124, 84%) had a complex ductular network at the MDP, with no distinction between pancreatic and common bile ducts. Lymphoid aggregates at the MDP were common (63/124, 51%). Inflammation of the MDP (MDPitis) was present in 35 of 124 cats (28%) and was often concurrent with cholangitis, pancreatitis, or enteritis (32/35, 91%), but was only associated with enteritis (19/35, 54%, P < .05). Triaditis was less common (19/124, 15%), but was associated with both conjoined MDP anatomy (19/19, 100%, P < .05) and MDPitis (12/19, 63%, P < .05). Neoplasia was present in 37 of 124 cats (29%), with lymphoma (28/37, 78%) predominating. Enteropathy-associated T-cell lymphoma type 2 (EATL2) was most common (n = 16/37, 43%) and was associated with triaditis and MDPitis (P < .05). These findings suggest that anatomy, immune activation, and/or inflammation of the MDP may play a role in the pathogenesis of triaditis. Further studies are needed to elucidate the relationships between triaditis, MDPitis, and EATL2.
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Affiliation(s)
- Megan E Schreeg
- North Carolina State University, Raleigh, NC
- The Ohio State University, Columbus, OH
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Marsilio S, Freiche V, Johnson E, Leo C, Langerak AW, Peters I, Ackermann MR. ACVIM consensus statement guidelines on diagnosing and distinguishing low-grade neoplastic from inflammatory lymphocytic chronic enteropathies in cats. J Vet Intern Med 2023; 37:794-816. [PMID: 37130034 PMCID: PMC10229359 DOI: 10.1111/jvim.16690] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/10/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Lymphoplasmacytic enteritis (LPE) and low-grade intestinal T cell lymphoma (LGITL) are common diseases in older cats, but their diagnosis and differentiation remain challenging. OBJECTIVES To summarize the current literature on etiopathogenesis and diagnosis of LPE and LGITL in cats and provide guidance on the differentiation between LPE and LGITL in cats. To provide statements established using evidence-based approaches or where such evidence is lacking, statements based on consensus of experts in the field. ANIMALS None. METHODS A panel of 6 experts in the field (2 internists, 1 radiologist, 1 anatomic pathologist, 1 clonality expert, 1 oncologist) with the support of a human medical immunologist, was formed to assess and summarize evidence in the peer-reviewed literature and complement it with consensus recommendations. RESULTS Despite increasing interest on the topic for clinicians and pathologists, few prospective studies were available, and interpretation of the pertinent literature often was challenging because of the heterogeneity of the cases. Most recommendations by the panel were supported by a moderate or low level of evidence. Several understudied areas were identified, including cellular markers using immunohistochemistry, genomics, and transcriptomic studies. CONCLUSIONS AND CLINICAL IMPORTANCE To date, no single diagnostic criterion or known biomarker reliably differentiates inflammatory lesions from neoplastic lymphoproliferations in the intestinal tract of cats and a diagnosis currently is established by integrating all available clinical and diagnostic data. Histopathology remains the mainstay to better differentiate LPE from LGITL in cats with chronic enteropathy.
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Affiliation(s)
- Sina Marsilio
- Department of Veterinary Medicine and EpidemiologyUC Davis School of Veterinary MedicineDavisCaliforniaUSA
| | - Valerie Freiche
- Ecole Nationale Vétérinaire d'AlfortCHUVA, Unité de Médecine InterneMaisons‐AlfortFrance
| | - Eric Johnson
- Department of Surgical & Radiological SciencesUC Davis School of Veterinary MedicineDavisCaliforniaUSA
| | - Chiara Leo
- Anicura Istituto Veterinario NovaraNovaraItaly
| | | | | | - Mark R. Ackermann
- Oregon Veterinary Diagnostic Laboratory, Oregon State UniversityCorvallisOregonUSA
- Present address:
US Department of AgricultureNational Animal Disease CenterAmesIowaUSA
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Ferreira A, Calleja S, Anderson D, Murtagh K, Watson N. Gastrointestinal tract perforation during endoscopy in three cats: A retrospective case series. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Aida Ferreira
- Internal Medicine Anderson Moores Veterinary Specialists Winchester UK
| | - Shaun Calleja
- Internal Medicine Anderson Moores Veterinary Specialists Winchester UK
| | - Davina Anderson
- Small Animal Surgery Anderson Moores Veterinary Specialists Winchester UK
| | - Kevin Murtagh
- Internal Medicine Anderson Moores Veterinary Specialists Winchester UK
| | - Natalie Watson
- Internal Medicine Anderson Moores Veterinary Specialists Winchester UK
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Freiche V, Paulin MV, Cordonnier N, Huet H, Turba M, Macintyre E, Molina T, Hermine O, Couronné L, Bruneau J. Histopathologic, phenotypic, and molecular criteria to discriminate low-grade intestinal T-cell lymphoma in cats from lymphoplasmacytic enteritis. J Vet Intern Med 2021; 35:2673-2684. [PMID: 34374109 PMCID: PMC8692189 DOI: 10.1111/jvim.16231] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Differentiation of low-grade intestinal T-cell lymphoma (LGITL) from lymphoplasmacytic enteritis (LPE) in cats is a diagnostic challenge for pathologists. OBJECTIVE Characterize histologic, immunohistochemical, and molecular features of LGITL and LPE. ANIMALS Forty-four client-owned cats, 22 diagnosed with LGITL and 22 with LPE. METHODS Prospective, cohort study. Clinical suspicion of LGITL or LPE was based on persistent gastrointestinal signs, unresponsive to empirical treatments. All cats underwent a standardized diagnostic evaluation, including biopsy (preferentially full-thickness), and were diagnosed with LGITL or LPE after review of clinical, laboratory, sonographic, histologic, immunohistochemical, and clonality results. RESULTS A monomorphic lymphocytic population (22/22, 100%) and in-depth mucosal infiltration (15/22, 68%) were hallmarks of LGITL. Epithelial patterns (nests and plaques) were significantly more frequent in LGITL (11/22, 50%) than in LPE (1/22, 5%) cases (P = .001). A CD3+ lymphocytic apical-to-basal gradient was observed in 9/22 (41%) of LGITL vs 1/22 (5%) of LPE cases (P = .004). Most LPE cases (17/18, 94%) featured marked fibrosis in the superficial part of the lamina propria. The Ki-67 20%- and 30%-thresholds discriminated between LGITL and LPE within both the epithelium (specificity >95%) and lamina propria (specificity >95%), respectively. All LGITL cases were CD3+ pSTAT3- and pSTAT5+. T-cell receptor gamma chain gene rearrangements indicated monoclonality in 86% of LGITL cases. Surprisingly, 70% of LPE cases featured monoclonality (40%) or monoclonality on a polyclonal background (30%). CONCLUSIONS AND CLINICAL IMPORTANCE We identified new histologic, immunohistochemical, and clonality criteria to distinguish LGITL from LPE.
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Affiliation(s)
- Valérie Freiche
- Ecole Nationale Vétérinaire d'AlfortCHUVA, Unité de Médecine InterneMaisons‐Alfort F‐94700France
| | - Mathieu V. Paulin
- Department of Small Animal Clinical SciencesWestern College of Veterinary Medicine, University of SaskatchewanSaskatoonSKCanada
| | - Nathalie Cordonnier
- Pathology DepartmentEcole Nationale Vétérinaire d'Alfort, BiopôleMaisons‐Alfort F‐94700France
| | - Hélène Huet
- Pathology DepartmentEcole Nationale Vétérinaire d'Alfort, BiopôleMaisons‐Alfort F‐94700France
| | | | - Elizabeth Macintyre
- Laboratory of Onco‐Hematology, Hôpital Necker‐Enfants Malades, Assistance Publique des Hôpitaux de ParisUniversity of ParisParisFrance
- INSERM U1151, Necker‐Enfants Malades InstituteUniversity of ParisParisFrance
- Centre National Expert des Lymphomes Associés à la Maladie CœliaqueUniversity of ParisParisFrance
| | - Thierry‐Jo Molina
- Centre National Expert des Lymphomes Associés à la Maladie CœliaqueUniversity of ParisParisFrance
- Pathology Department, Hôpital Necker‐Enfants Malades, Assistance Publique—Hôpitaux de Paris (APHP)University of ParisParisFrance
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163Imagine Institute, University of ParisParisFrance
| | - Olivier Hermine
- Centre National Expert des Lymphomes Associés à la Maladie CœliaqueUniversity of ParisParisFrance
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163Imagine Institute, University of ParisParisFrance
- Hematology Department, Hôpital Necker‐Enfants Malades, Assistance Publique—Hôpitaux de Paris (APHP)University of ParisParisFrance
| | - Lucile Couronné
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163Imagine Institute, University of ParisParisFrance
- Cytogenetics Department, Hôpital Necker‐Enfants Malades, Assistance Publique—Hôpitaux de Paris (APHP)University of ParisParisFrance
| | - Julie Bruneau
- Centre National Expert des Lymphomes Associés à la Maladie CœliaqueUniversity of ParisParisFrance
- Pathology Department, Hôpital Necker‐Enfants Malades, Assistance Publique—Hôpitaux de Paris (APHP)University of ParisParisFrance
- Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163Imagine Institute, University of ParisParisFrance
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Freiche V, Fages J, Paulin MV, Bruneau J, Couronné L, German AJ, Penninck D, Hermine O. Clinical, laboratory and ultrasonographic findings differentiating low-grade intestinal T-cell lymphoma from lymphoplasmacytic enteritis in cats. J Vet Intern Med 2021; 35:2685-2696. [PMID: 34687072 PMCID: PMC8692195 DOI: 10.1111/jvim.16272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 11/28/2022] Open
Abstract
Background Low‐grade intestinal T‐cell lymphoma (LGITL) is the most common intestinal neoplasm in cats. Differentiating LGITL from lymphoplasmacytic enteritis (LPE) is challenging because clinical signs, laboratory results, diagnostic imaging findings, histology, immunohistochemistry, and clonality features may overlap. Objectives To evaluate possible discriminatory clinical, laboratory and ultrasonographic features to differentiate LGITL from LPE. Animals Twenty‐two cats diagnosed with LGITL and 22 cats with LPE based upon histology, immunohistochemistry, and lymphoid clonality. Methods Prospective, cohort study. Cats presented with clinical signs consistent with LGITL or LPE were enrolled prospectively. All data contributing to the diagnostic evaluation was recorded. Results A 3‐variable model (P < .001) consisting of male sex (P = .01), duration of clinical signs (P = .01), and polyphagia (P = .03) and a 2‐variable model (P < .001) including a rounded jejunal lymph node (P < .001) and ultrasonographic abdominal effusion (P = .04) were both helpful to differentiate LGITL from LPE. Conclusions and Clinical Importance Most clinical signs and laboratory results are similar between cats diagnosed with LGITL and LPE. However, male sex, a longer duration of clinical signs and polyphagia might help clinicians distinguish LGITL from LPE. On ultrasonography, a rounded jejunal lymph node, and the presence of (albeit small volume) abdominal effusion tended to be more prevalent in cats with LGITL. However, a definitive diagnosis requires comprehensive histopathologic and phenotypic assessment.
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Affiliation(s)
- Valérie Freiche
- Ecole Nationale Vétérinaire d'Alfort, CHUVA, Unité de Médecine Interne, Maisons-Alfort, France
| | | | - Mathieu Victor Paulin
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine-University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Julie Bruneau
- Pathology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163, Imagine Institute, University of Paris, Paris, France
| | - Lucile Couronné
- Cytogenetics Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP), Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163, Imagine Institute, University of Paris, Paris, France
| | - Alexander J German
- Institute of Life Course and Medical Sciences, University of Liverpool, Merseyside, United Kingdom
| | - Dominique Penninck
- Diagnostic Imaging Section, Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, USA
| | - Olivier Hermine
- Hematology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris (APHP); Laboratory of Cellular and Molecular Mechanisms of Hematological Disorders and Therapeutical Implications, INSERM U1163, Imagine Institute, University of Paris, Paris, France
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Ewald N, Rödler F, Heilmann RM. [Chronic enteropathies in cats - diagnostic and therapeutic approach]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2021; 49:363-376. [PMID: 34670312 DOI: 10.1055/a-1584-9705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Chronic enteropathies are characterized by persistent or recurrent gastrointestinal signs including vomiting, diarrhoea, weight loss, anorexia and lethargy for a minimum duration of 3 weeks. Diagnosis is by excluding other disease processes and includes faecal examinations, blood screenings (e. g., thyroidal, pancreatic, liver dysfunctions, investigation for infectious diseases, vitamin B12 status), diagnostic imaging, histopathological evaluation using biopsies from several different gastrointestinal segments and the response to therapeutic trials. Chronic inflammatory enteropathies are classified as food-responsive enteropathy (FRE), antibiotic-responsive enteropathy (ARE), immunosuppressant-responsive or, similarly -refractory enteropathy (IRE). Small-cell (low-grade) alimentary lymphoma (LGAL), a crucial differential diagnosis, is predominantly seen in older cats. The feline chronic enteropathy activity index (FCEAI), a clinical scoring system, was established to objectively assess the severity of clinical illness and to evaluate the response to treatment. In general, the prognosis depends on the underlying aetiology. Cats diagnosed with FRE typically have a good long-term prognosis with adequate dietary management. The response to treatment varies in cats with IRE, with same cats experiencing frequent relapses of clinical signs and still others being non-responsive to treatment. Prognosis for LGAL, with adequate treatment, is usually fair to good (median survival time 510-704 days).
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Affiliation(s)
- Nicole Ewald
- Kleintierzentrum am Schmelzbach, Fachpraxis für Kleintiermedizin
| | - Frauke Rödler
- Klinik für Kleintiere, Veterinärmedizinische Fakultät, Universität Leipzig
| | - Romy M Heilmann
- Klinik für Kleintiere, Veterinärmedizinische Fakultät, Universität Leipzig
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Concordance of the Histopathologic Diagnosis of Concurrent Duodenal and Ileal Biopsy Specimens in Dogs. Animals (Basel) 2021; 11:ani11102938. [PMID: 34679959 PMCID: PMC8532859 DOI: 10.3390/ani11102938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 12/19/2022] Open
Abstract
Histopathologic discordance between gastrointestinal (GI) locations in canine chronic inflammatory enteropathy (CIE) has prompted recommendations to biopsy both the duodenum and ileum, while further evaluation is required for non-CIE. We aimed to determine the concordance of histopathologic diagnosis between duodenal and ileal endoscopic or full-thickness biopsy specimens for all dogs with CIE and GI neoplasia and to assess the association between histopathologic discordance between GI locations with clinicopathologic variables. Seventy-nine dogs were eligible, with endoscopic (74) or full-thickness (5) biopsy specimens. Clinicopathological data were recorded for all dogs. Concordance of histopathologic diagnosis was retrospectively assessed for concurrent duodenal and ileal biopsy specimens by a single board-certified veterinary pathologist using the modified World Small Animal Veterinary Association (WSAVA) Gastrointestinal Standardization Group guidelines. Sixty-seven dogs were diagnosed with CIE and 5 with enteric-associated T-cell lymphoma-2 (EATL-2). Concordance of histologic diagnosis between duodenal and ileal sites was similar between endoscopic (73.0%) and full-thickness (80.0%) biopsy groups. For the CIE cases, lymphoplasmacytic enteritis had the highest concordance (73.0%) and eosinophilic enteritis the least (16.7%). Of the 5 neoplastic cases, 5/5 (100%) were present at the duodenum but only 3/5 (60%) in the ileum. No clinicopathologic variables demonstrated a statistically significant association with discordance. We conclude that the level of discordance necessitates concurrent biopsy of both duodenum and ileum in all dogs with chronic GI signs. The rate of EATL-2 was lower than rates reported for cats.
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Wang L, Sharif H, Saellström S, Rönnberg H, Eriksson S. Feline thymidine kinase 1: molecular characterization and evaluation of its serum form as a diagnostic biomarker. BMC Vet Res 2021; 17:316. [PMID: 34579716 PMCID: PMC8477555 DOI: 10.1186/s12917-021-03030-5] [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: 04/09/2021] [Accepted: 09/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Thymidine kinase 1 (TK1) catalyzes the initial phosphorylation of thymidine in the salvage pathway synthesis of dTTP, an essential building block of DNA. TK1 is a cytosolic enzyme with its highest level during the S-phase of the cell cycle. In cancer cells TK1 is upregulated and excess TK1 is leaked into the blood. Therefore, serum TK1 has been used as biomarker for cancer diagnosis and prognosis in human medicine. Feline TK1 shows high sequence similarity to TK1 from other species. The aim of this study was to characterize feline TK1 and evaluate if serum TK1 can be used as a diagnostic biomarker. RESULTS Feline TK1 was cloned, expressed and affinity purified. The purified feline TK1 phosphorylated not only pyrimidine deoxyribonucleosides but also pyrimidine ribonucleosides and to some extent purine deoxynucleosides. A number of anticancer and antiviral nucleoside analogs also served as substrates with fairly high efficiency. ATP and dATP were the preferred phosphate donor. Serum TK1 activity in felines with malignant diseases was significantly higher than that in healthy individuals. ROC analysis revealed an area under the curve (AUC) of 0.98 with a sensitivity of 0.83 and a specificity of 0.95 for felines with lymphoma. Serum TK1 activity in felines with IBD or inflammatory disease was within the same range as healthy ones. Furthermore, in felines with lymphoma serum TK1 activity returned to normal levels in response to treatment. CONCLUSION Feline TK1 has high specific activity and a broader substrate specificity in comparison with TK1 from other species. Serum TK1 activity in felines with malignant diseases is significantly higher than that in normal felines and in felines with inflammatory diseases. These results suggest that serum TK1 may be a promising biomarker for the diagnosis and monitoring of malignant diseases and for the differential diagnosis of certain inflammatory disease.
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Affiliation(s)
- Liya Wang
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden.
| | - Hanan Sharif
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Alertix Veterinary Diagnostic AB, SE-392 30, Kalmar, Sweden
| | - Sara Saellström
- University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Henrik Rönnberg
- Department of Clinical Science, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Staffan Eriksson
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
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10
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Sorrell S. Diagnosing and treating chronic vomiting in cats. IN PRACTICE 2021. [DOI: 10.1002/inpr.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Moore C, Stefanovski D, Luethy D. Clinical performance of a commercially available thymidine kinase 1 assay for diagnosis of lymphoma in 42 hospitalized horses (2017-2020). J Vet Intern Med 2021; 35:2495-2499. [PMID: 34359096 PMCID: PMC8478028 DOI: 10.1111/jvim.16239] [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: 02/02/2021] [Revised: 07/12/2021] [Accepted: 07/27/2021] [Indexed: 01/10/2023] Open
Abstract
Background Antemortem definitive diagnosis of lymphoma in horses is often difficult. Thymidine kinase 1 (TK1) assay is a potentially useful biomarker for lymphoma in horses. Hypothesis/objectives To report the clinical performance of a commercially available TK1 assay for diagnosis of lymphoma in horses. We hypothesized that there would be no association between serum TK1 activity and a diagnosis of lymphoma in horses. Animals Forty‐two hospitalized horses, 14 with a definitive diagnosis of lymphoma, 4 with other neoplasia, and 24 with inflammatory disease. Methods Retrospective medical record review, groups were compared via Kruskal‐Wallis and Mann‐Whitney tests, and logistic regression was performed. Results Median (range) TK1 was 3 U/L (0.4‐17.7 U/L) in horses with lymphoma and 3.9 U/L (0.8‐94 U/L) in horses without lymphoma (P = .59). There was no significant difference in total protein between horses with and without lymphoma (6.6 g/dL [5.5‐8.3 g/dL] vs 6.6 g/dL [4.7‐10.4 g/dL]; P = .83). There was no significant difference in fibrinogen between horses with and without lymphoma (447 [100‐1364] mg/dL vs 433 [291‐2004] mg/dL; P = .47). On logistic regression, serum TK1 activity was not associated with a diagnosis of lymphoma (odds ratio, 0.97; 95% confidence interval, 0.9‐1.05, P = .48). Conclusion and Clinical Importance Serum TK1 values were not predictive of lymphoma diagnosis in this cohort of horses.
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Affiliation(s)
- Caitlin Moore
- Department of Clinical Studies, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Darko Stefanovski
- Department of Clinical Studies, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Daniela Luethy
- Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA
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Kim C, Wouda RM, Borrego J, Chon E. Cyclophosphamide rescue therapy for relapsed low-grade alimentary lymphoma after chlorambucil treatment in cats. J Feline Med Surg 2021; 23:976-986. [PMID: 33645321 DOI: 10.1177/1098612x21996498] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aims of this study were to evaluate the response, outcome and prognostic factors in cats with clinically presumed relapsed low-grade alimentary lymphoma (LGAL) receiving cyclophosphamide as a first-line rescue therapy after failing chlorambucil treatment. METHODS The medical records of 20 cats (from three institutions, between 2002 and 2017) treated with cyclophosphamide for relapsed LGAL after initial treatment with chlorambucil were retrospectively reviewed. Progression-free survival (PFS), overall survival time (OST) and the association of select variables with measures of outcome were assessed. Adverse events (AEs) were also described. RESULTS Eighteen cats (90%) achieved a complete clinical response (CR) for a median duration of 239 days. The median PFS was 215 days. The median OST was 1065 days. The only clinical factor associated with a longer PFS was achievement of a CR with cyclophosphamide treatment. Cyclophosphamide was associated with few and reversible constitutional, gastrointestinal and hematologic AEs. CONCLUSIONS AND RELEVANCE Cyclophosphamide appears to be a safe and effective first-rescue therapeutic option for cats with relapsed LGAL.
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Affiliation(s)
- Changseok Kim
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.,Denney Veterinary Services, Vicksburg, MI, USA
| | - Raelene M Wouda
- Department of Clinical Sciences, Kansas State University, College of Veterinary Medicine, Manhattan, KS, USA
| | - Juan Borrego
- Hospital Aúna Especialidades Veterinarias, Valencia, Spain
| | - Esther Chon
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.,MedVet Indianapolis, Carmel, IN, USA
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Love EK, Leibman NF, Ringold R, Lamb K. Serum haptoglobin concentrations in feline inflammatory bowel disease and small-cell alimentary lymphoma: a potential biomarker for feline chronic enteropathies. J Feline Med Surg 2021; 23:959-964. [PMID: 33541236 DOI: 10.1177/1098612x21991448] [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: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate serum haptoglobin as a biomarker to differentiate between small-cell alimentary lymphoma and inflammatory bowel disease in cats. METHODS Client-owned domestic cats with and without chronic gastrointestinal signs were enrolled in the study. Serum was collected from each patient and serum haptoglobin levels were measured using ELISA. In cats with gastrointestinal signs, histopathologic evaluation of endoscopic biopsies harvested from the intestinal tract was used to separate them into inflammatory bowel disease and small-cell lymphoma cohorts. Serum haptoglobin levels were statistically analyzed and compared among the three groups: healthy cats; cats with inflammatory bowel disease; and cats with small-cell alimentary lymphoma. RESULTS Sixty-two cats were enrolled in the study, including 20 clinically normal cats, 14 cats with small-cell alimentary lymphoma and 28 cats with inflammatory bowel disease. The mean ± SD serum haptoglobin was 73.2 ± 39.1 mg/dl in normal cats, 115.3 ± 72.8 mg/dl in cats with inflammatory bowel disease and 133.1 ± 86.1 mg/dl in cats with small-cell alimentary lymphoma. Cats with inflammatory bowel disease and lymphoma had significantly higher serum haptoglobin than controls, with P values of 0.0382 and 0.0138, respectively. There was no statistical difference between the inflammatory bowel disease and lymphoma cohorts (P = 0.4235). For every one unit increase in serum haptoglobin, the odds of gastrointestinal inflammatory disease (inflammatory bowel disease or small-cell alimentary lymphoma) increased by 1.41% (P = 0.0165). CONCLUSIONS AND RELEVANCE Serum haptoglobin is a useful biomarker for distinguishing between normal cats and those with gastrointestinal inflammatory disease, but it could not significantly differentiate between inflammatory bowel disease and lymphoma. Additional studies may be beneficial in determining the prognostic significance of serum haptoglobin as it may relate to the severity of gastrointestinal inflammation.
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Affiliation(s)
- Edwina K Love
- The Cancer Institute, Animal Medical Center, New York, NY, USA
| | | | | | - Kenneth Lamb
- Lamb Statistical Consulting, West St Paul, MN, USA
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Chow B, Hill SL, Richter KP, Marsilio S, Ackermann MR, Lidbury JA, Suchodolski JS, Cocker S, Steiner JM. Comprehensive comparison of upper and lower endoscopic small intestinal biopsy in cats with chronic enteropathy. J Vet Intern Med 2020; 35:190-198. [PMID: 33345405 PMCID: PMC7848359 DOI: 10.1111/jvim.16000] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/01/2020] [Accepted: 12/03/2020] [Indexed: 01/01/2023] Open
Abstract
Background Integrating immunohistochemistry (IHC) and clonality testing with histopathology may improve the ability to differentiate inflammatory bowel disease (IBD) and alimentary small cell lymphoma (LSA) in cats. Hypothesis/Objectives To evaluate the utility of histopathology, IHC, and clonality testing to differentiate between IBD and LSA and agreement of diagnostic results for endoscopic biopsy (EB) samples from the upper (USI) and lower small intestine (LSI). Animals Fifty‐seven cats with IBD or LSA. Methods All cases were categorized as definitive IBD (DefIBD), possible LSA (PossLSA), probable LSA (ProbLSA), or definitive LSA (DefLSA) based on histopathology alone. Results from IHC and clonality testing were integrated. Results Based on histopathology alone, 24/57 (42.1%), 15/57 (26.3%), and 18/57 (31.6%) cats were diagnosed with DefIBD, PossLSA or ProbLSA, and DefLSA, respectively. After integrating IHC and clonality testing, 11/24 cases (45.8%) and 15/15 cases (100%) previously categorized as DefIBD and PossLSA or ProbLSA, respectively, were reclassified as LSA. A final diagnosis of IBD and LSA was reported in 13/57 (22.8%) and 44/57 (77.2%) cats, respectively. Agreement between USI and LSI samples was moderate based on histopathology alone (κ = 0.66) and after integrating IHC and clonality testing (κ = 0.70). However, only 1/44 (2.3%) of the LSA cases was diagnosed based on LSI biopsy alone. Conclusions and Clinical Importance Integrating IHC and clonality testing increased the number of cases diagnosed with LSA, but the consequence for patient outcome is unclear. There was moderate agreement between USI and LSI samples. Samples from the LSI rarely changed the diagnosis.
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Affiliation(s)
- Betty Chow
- Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA.,VCA Animal Specialty & Emergency Center, Los Angeles, California, USA
| | - Steve L Hill
- Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA.,Flagstaff Veterinary Internal Medicine Consulting, Flagstaff, Arizona, USA
| | - Keith P Richter
- Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA
| | - Sina Marsilio
- Department of Medicine and Epidemiology, University of California, School of Veterinary Medicine, Davis, California, USA.,Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Mark R Ackermann
- Department of Biomedical Sciences and Oregon Veterinary Diagnostic Laboratory, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon, USA
| | - Jonathan A Lidbury
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
| | - Sarah Cocker
- Veterinary Specialty Hospital by Ethos Veterinary Health, San Diego, California, USA
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, Texas, USA
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15
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Corrêa LM, Demetriou JL. Retrospective assessment of the clinical relevance of surgical biopsies of abdominal lymph nodes in cats: 51 cases (2014-2018). J Feline Med Surg 2020; 22:1168-1175. [PMID: 32419573 PMCID: PMC10814371 DOI: 10.1177/1098612x20916387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aims of this study were to assess surgical biopsy of abdominal lymph nodes (LNs) in cats taken at the time of exploratory laparotomy and to evaluate any additional benefit of histopathology compared with LN cytology. METHODS We carried out a retrospective study from a single institution of cats that had abdominal ultrasound and LN biopsies as part of an exploratory laparotomy (2014-2018). Clinical records were reviewed for presenting signs, medical investigations, ultrasound, cytology, surgical findings and histopathology. RESULTS Fifty-one cats were included. In total, 60 LNs were biopsied. Forty-four cats had evident LN enlargement at the time of surgery. Nine of those cases were reported to have normal-sized LNs on ultrasound, including one cat that was subsequently diagnosed with lymphoma. Ultrasound-guided LN aspiration was performed in 19 cases. Five of these cats had a histological diagnosis of neoplasia following biopsy, but only one was correctly identified with cytology. Histopathology results were reactive hyperplasia (n = 41), tumour metastasis (n = 11), lymphadenitis (n = 6), inconclusive (n = 1) and normal (n = 1). The most common final diagnoses were inflammatory bowel disease (n = 17/51) and gastrointestinal lymphoma (n = 10/51). There were 15 cats with neoplastic disease; LN biopsies confirmed metastatic disease in 10 and ruled out nodal involvement in five. CONCLUSIONS AND RELEVANCE Surgical biopsy of grossly enlarged or normal abdominal LNs provides additional information to LN cytology in cats and in the majority of cases is associated with a positive histological diagnosis. There appears to be the potential to underdiagnose neoplasia with cytology alone.
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16
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Černá P, Kilpatrick S, Gunn-Moore DA. Feline comorbidities: What do we really know about feline triaditis? J Feline Med Surg 2020; 22:1047-1067. [PMID: 33100169 PMCID: PMC10814216 DOI: 10.1177/1098612x20965831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PRACTICAL RELEVANCE Feline triaditis describes concurrent pancreatitis, cholangitis and inflammatory bowel disease (IBD). The reported prevalence is 17-39% in ill referral patients. While the aetiology is poorly understood, it is known to include infectious, autoimmune and physical components. What is not known is whether different organs are affected by different diseases, or the same process; indeed, triaditis may be part of a multiorgan inflammatory disease. Feline gastrointestinal tract anatomy plays its role too. Specifically, the short small intestine, high bacterial load and anatomic feature whereby the pancreatic duct joins the common bile duct before entering the duodenal papilla all increase the risk of bacterial reflux and parenchymal inflammation. Inflammation may also be a sequela of bowel bacterial translocation and systemic bacteraemia. DIAGNOSTIC CHALLENGES Cholangitis, pancreatitis and IBD manifest with overlapping, vague and non-specific clinical signs. Cholangitis may be accompanied by increased serum liver enzymes, total bilirubin and bile acid concentrations, and variable ultrasonographic changes. A presumptive diagnosis of pancreatitis is based on increased serum pancreatic lipase immunoreactivity or feline pancreas-specific lipase, and/or abnormal pancreatic changes on ultrasonography, though these tests have low sensitivity. Diagnosis of IBD is challenging without histopathology; ultrasound findings vary from normal to mucosal thickening or loss of layering. Triaditis may cause decreased serum folate or cobalamin (B12) concentrations due to intestinal disease and/or pancreatitis. Triaditis can only be confirmed with histopathology; hence, it remains a presumptive diagnosis in most cases. EVIDENCE BASE The literature on feline triaditis, pancreatitis, cholangitis and IBD is reviewed, focusing on histopathology, clinical significance and diagnostic challenges. Current management recommendations are provided. Further studies are needed to understand the complex pathophysiology, and in turn improve diagnosis and treatment.
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Affiliation(s)
- Petra Černá
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, and Small Animal Clinic, The University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | | | - Danielle A Gunn-Moore
- The Royal (Dick) School of Veterinary Studies, and The Roslin Institute, University of Edinburgh, UK
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17
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Endoscopic Biopsies and Histopathological Findings in Diagnosing Chronic Gastrointestinal Disorders in Dogs and Cats. Vet Med Int 2020; 2020:8827538. [PMID: 33133490 PMCID: PMC7568807 DOI: 10.1155/2020/8827538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/23/2020] [Accepted: 09/29/2020] [Indexed: 01/08/2023] Open
Abstract
Nowadays, endoscopic examination is a diagnostic tool gaining popularity in the management of gastrointestinal disorders in dogs and cats. Direct accessibility of the lumen of gastrointestinal tract combined with the mucosal biopsy provides a great diagnostic potential. Using endoscopy and endoscopically guided biopsy, one can conduct both macro- and microscopic assessment of lesions and perform many specialist adjunct examinations. Histopathological examination of mucosal biopsy specimens collected from the stomach and intestines allows us to distinguish between types of inflammations and to diagnose ulcerative, polypoid, and cancerous lesions.
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18
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Spużak J, Jankowski M, Kubiak K, Glińska-Suchocka K, Ciaputa R. A modified Sydney system for the diagnosis of chronic gastritis in dogs. Acta Vet Scand 2020; 62:44. [PMID: 32787889 PMCID: PMC7425002 DOI: 10.1186/s13028-020-00542-2] [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: 10/30/2019] [Accepted: 08/06/2020] [Indexed: 01/03/2023] Open
Abstract
Background The Sydney system for assessing inflammatory lesions in the gastric mucosa is based on endoscopic and histological examinations. This study aimed to apply the Sydney system to diagnose gastritis in dogs. The study also compared the results of endoscopic and histological examinations conducted on gastric mucosal biopsy specimens. A total of 56 dogs with chronic vomiting were analyzed in the study. The physical appearance of the gastric mucosa was assessed through endoscopic examination, while the severity of the gastric inflammation, inflammation activity, glandular atrophy, and intestinal metaplasia were assessed by histopathological examination. Results The endoscopic examination confirmed the presence of inflammatory lesions affecting the gastric corpus and pylorus in all the dogs, although the severity of these lesions differed between the individuals. Reflux gastritis was the most commonly observed gastric inflammation. In the histopathological examination of the gastric mucosal samples, inflammatory lesions were found in the gastric corpus of 53 dogs, while 55 dogs had lesions in the pylorus. This corresponds to a 96.4% agreement between the methods. Conclusions The Sydney system is a useful tool for macroscopic and microscopic assessment of changes in the gastric mucosa as it enables the determination of inflammation type and severity, which helps the canine gastroenterologists to reliably compare the results of the tests performed in different facilities. Besides, the use of the Sydney system in diagnosing lesions facilitates the selection and effective monitoring of treatment. However, despite a high rate of agreement between the results of endoscopic and histopathological examinations, it is recommended to use both these methods for the assessment of the gastric mucosa in dogs.
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19
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Woolhead VL, Whittemore JC, Stewart SA. Multicenter retrospective evaluation of ileocecocolic perforations associated with diagnostic lower gastrointestinal endoscopy in dogs and cats. J Vet Intern Med 2020; 34:684-690. [PMID: 32067277 PMCID: PMC7096662 DOI: 10.1111/jvim.15731] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 02/03/2020] [Indexed: 12/13/2022] Open
Abstract
Background Ileoscopy is increasingly performed in dogs and cats with gastrointestinal signs, but iatrogenic ileocecocolic (ICC) perforations have not been described. Hypothesis/Objectives To characterize endoscopic ICC perforations in dogs and cats. Animals Thirteen dogs and 2 cats. Methods This is a retrospective case series. Signalment, presentation, endoscopic equipment, colonic preparation, endoscopist's experience level, ileal intubation technique, method of diagnosis, perforation location, histopathology, management, and outcome data were collected and reviewed. Results Six ileal, 5 cecal, and 4 colonic perforations were identified between 2012 and 2019. Dogs weighed 2.4‐26 kg (median, 10.3 kg) and cats 4.6‐5.1 kg (median, 4.9 kg). Endoscopy was performed in dogs presented for vomiting (n = 4), as well as large (n = 5), mixed (n = 4), and small (n = 1) bowel diarrhea. Cats had large bowel diarrhea. Endoscopists included 1 supervised intern, 9 supervised internal medicine residents (2 first year, 6 second year, 1 third year), and 5 internal medicine diplomates. Diagnosis was delayed in 5 dogs, occurring 1‐5 days after endoscopy (median, 3 days); dogs were presented again with inappetence (n = 4), lethargy (n = 4), abdominal pain (n = 3), retching (n = 2), and syncope (n = 1). All animals underwent surgical correction. Histopathology did not identify lesions at the perforation site in any animal. Two dogs required a second surgery; 1 died 12 hours after surgery. Survival to discharge was 93%, with 78% surviving ≥8 months. Conclusions and Clinical Importance Iatrogenic endoscopic ICC perforation is not indicative of underlying disease and is associated with a good prognosis. Delayed diagnosis can occur. Therefore, perforation should be considered in the differential diagnosis for animals with clinical deterioration after endoscopy.
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Affiliation(s)
- Vanessa L Woolhead
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, London, UK
| | - Jacqueline C Whittemore
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Sarah A Stewart
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, London, UK
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20
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Cazzini P, Watson MK, Gottdenker N, Mayer J, Reavill D, Fox JG, Parry N, Sakamoto K. Proposed grading scheme for inflammatory bowel disease in ferrets and correlation with clinical signs. J Vet Diagn Invest 2019; 32:17-24. [PMID: 31884894 PMCID: PMC7003233 DOI: 10.1177/1040638719896555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Inflammatory bowel disease (IBD) is an idiopathic, chronic, inflammatory disease of the gastrointestinal tract of companion animals, including ferrets (Mustela putorius furo). Clinical signs of IBD are nonspecific, and intestinal biopsies are necessary for a definitive diagnosis. A grading scheme has not been established for ferrets. Additionally, the association between histologic severity and clinical signs in ferrets is unknown. We evaluated enteric samples from ferrets diagnosed with IBD, compared histologic grading schemes, and correlated the results with the severity of clinical signs. Enteric sections from 23 ferrets with IBD were analyzed using grading schemes for intestinal inflammation in cats and dogs, and a correlation with clinical signs was evaluated. After dividing the histologic samples into groups based on the severity of clinical signs, main histologic differences were identified. Age and sex were also assessed for correlation with clinical signs. No significant correlation was found between the 2 grading schemes and clinical signs (rho = 0.02, p = 0.89; rho = 0.26, p = 0.18, respectively). Degree of villus fusion, hemorrhage and/or fibrin, epithelial damage, inflammation density, and crypt abscess formation were used retrospectively to create a ferret IBD grading scheme, which was significantly correlated with the severity of clinical signs (rho = 0.48, p = 0.01). A positive correlation was observed between age (p = 0.04) and females (p = 0.007) with severity of clinical signs. Our ferret grading scheme may have clinical utility in providing a more objective, consistent evaluation of IBD in ferrets.
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Affiliation(s)
- Paola Cazzini
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - Megan K Watson
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - Nicole Gottdenker
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - Joerg Mayer
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - Drury Reavill
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - James G Fox
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - Nicola Parry
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
| | - Kaori Sakamoto
- Departments of Pathology (Cazzini, Gottdenker, Sakamoto), College of Veterinary Medicine, University of Georgia, Athens, GA.,Small Animal Medicine and Surgery (Mayer), College of Veterinary Medicine, University of Georgia, Athens, GA.,Department of Animal Health and Conservation, Zoo New England, Boston, MA (Watson).,Zoo/Exotic Pathology Service, Carmichael, CA (Reavill).,Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry).,Current address: Easter Bush Pathology, Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, UK (Cazzini)
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Griffin S. Feline abdominal ultrasonography: What's normal? What's abnormal? The diseased gastrointestinal tract. J Feline Med Surg 2019; 21:1047-1060. [PMID: 31648606 PMCID: PMC10814209 DOI: 10.1177/1098612x19880434] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. B-mode ultrasonography is likely the most widely used modality for imaging the gastrointestinal (GI) tract in cats and it can help in the diagnosis of GI masses, foreign bodies and disorders of the ileocaecocolic junction. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variations and pathological changes can be challenging for all but the most experienced. For example, while for inflammatory conditions of the feline GI tract changes are frequently identified on ultrasound, there may occasionally be no changes to the appearance of the intestine; hence a 'normal' ultrasound does not exclude the possibility of inflammatory disease. AIM This review, part of an occasional series on feline abdominal ultrasonography, describes the appearance of a range of conditions that affect the feline GI tract; the normal GI tract is addressed in an accompanying article in this issue of JFMS. Aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
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Affiliation(s)
- Sally Griffin
- Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
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22
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Clonality testing as complementary tool in the assessment of different patient groups with canine chronic enteropathy. Vet Immunol Immunopathol 2019; 214:109893. [PMID: 31378220 DOI: 10.1016/j.vetimm.2019.109893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 07/05/2019] [Accepted: 07/09/2019] [Indexed: 01/02/2023]
Abstract
Differentiation between canine chronic enteropathy (CCE) and intestinal lymphoma is a diagnostic challenge as histopathology might fail to yield unequivocal results. Detection of clonal rearrangements of the T-cell-receptor gamma (TCRG) chain and IG heavy chain (IGH) V-J genes offer a useful solution. In this retrospective study, histopathology samples of 35 CCE patients and 7 healthy Beagle dogs underwent clonality testing. Patients suffered either from inflammatory bowel disease (IBD), food responsive diarrhea (FRD) or protein loosing enteropathy secondary to IBD (PLE/IBD). Healthy Beagles served as controls (CO). Canine IBD activity index (CIBDAI) and histopathological WSAVA-grading differed significantly (p<0.001) between groups. CIBDAI improved significantly after appropriate therapy (p < 0.0001). Intestinal biopsies of all CO showed polyclonal patterns for B- and T-cell primers. All samples from CCE patients showed polyclonal patterns for the B-cell primers. Targeting TCRG, 4 patients showed a monoclonal or oligoclonal pattern of the lymphocytic infiltrates in the duodenum and/or colon. Clinical improvement was observed in all dogs. Although a small cell lymphoma cannot be excluded in view of the short follow up duration, a false positive result, in the sense of a canonical rearrangement or unspecific amplification due to a antigenic stimulation in a non-neoplastic inflammatory process is possible.
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23
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Lyngby JG, Kristensen AT, Fredholm M, Nielsen LN, Cirera S. Evaluation of fecal microRNA stability in healthy cats. Vet Clin Pathol 2019; 48:455-460. [PMID: 31241203 PMCID: PMC6852515 DOI: 10.1111/vcp.12757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/14/2019] [Accepted: 03/03/2019] [Indexed: 12/30/2022]
Abstract
Background Gastrointestinal (GI) cancer accounts for 14% of feline malignancies. There is a great need for reliable noninvasive diagnostic biomarkers to reach a timely diagnosis and initiate treatment. Fecal microRNAs (miRNAs) could be such a biomarker and have shown great potential in colorectal screening in people but have yet to be investigated in cats. Objectives We aimed to evaluate the presence and stability of feline fecal miRNA under different storage conditions (room temperature [RT], 4, and −20°C) and to evaluate the expression levels of specific fecal miRNAs collected on three separate days (days 1, 4, and 7) in healthy cats. Methods Healthy cats were prospectively recruited. Fecal samples were collected, aliquoted, and stored for 24 hours at RT and then transferred to −20°C, stored for 24 hours at 4°C and then transferred to −20°C, or were immediately placed at −20°C on day 1 or at −20°C on days 4 and 7 postcollection. Expression of 22 miRNAs was investigated using quantitative real‐time PCR. Results Ten miRNA assays worked well, and one, let‐7b, was used for normalization. No differences in miRNA expression were seen between the three storage temperatures for the nine miRNAs investigated. Only miR‐26a showed a significant increase in expression between samples of days 1 and 7. The rest of the miRNAs levels were stable over time. Conclusions Fecal miRNA can be isolated from healthy cats. The expression was stable at different temperatures and for most of the miRNAs over time. Prospective studies evaluating fecal miRNA as biomarkers in cats with GI neoplasia are warranted.
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Affiliation(s)
- Janne G Lyngby
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Annemarie T Kristensen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merete Fredholm
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lise N Nielsen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Susanna Cirera
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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24
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Wright KZ, Hohenhaus AE, Verrilli AM, Vaughan-Wasser S. Feline large-cell lymphoma following previous treatment for small-cell gastrointestinal lymphoma: incidence, clinical signs, clinicopathologic data, treatment of a secondary malignancy, response and survival. J Feline Med Surg 2019; 21:353-362. [PMID: 29877752 PMCID: PMC10814630 DOI: 10.1177/1098612x18779870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Lymphoma is a common and clinically important malignancy in cats. Development of a second malignancy has been reported previously in 7-14% of cats with small-cell gastrointestinal (GI) lymphoma. The aim of our study was to describe the incidence, clinical signs, clinicopathologic data, response to therapy and outcomes in cats diagnosed with large-cell lymphoma following treatment for small-cell GI lymphoma. METHODS Medical records from a single referral specialty hospital were reviewed for all cats with lymphoma diagnosed between 2008 and 2017. The cases with a diagnosis of small-cell GI lymphoma followed by a diagnosis of any large-cell lymphoma and complete outcome data were selected for further review. RESULTS Seven hundred and forty cats with a diagnosis of lymphoma were identified. Twelve cats (12/121) treated for small-cell GI lymphoma followed by a diagnosis of any anatomic form of large cell lymphoma were identified. Nine cats met the study inclusion criteria and were used in analyses. Mean event-free survival time from small-cell GI lymphoma diagnosis until diagnosis of large-cell lymphoma was 543 days, with a median survival time of 615 days. Mean event-free survival time from large-cell lymphoma to death was 55 days, with a median survival time of 24.5 days. Hematocrit, albumin and total protein were significantly decreased when cats developed large-cell lymphoma compared with their values at the time of small-cell lymphoma diagnosis. CONCLUSIONS AND RELEVANCE Large-cell lymphoma occurred in 9.9% (12/121) of cats treated for small-cell GI lymphoma. Feline practitioners should include large-cell lymphoma on their list of differential diagnoses in cats diagnosed with small-cell GI lymphoma developing weight loss, anemia, hypoalbuminemia and hypoproteinemia.
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Affiliation(s)
- Katherine Z Wright
- The Cancer Institute, Animal Medical Center, New York, NY, USA
- Oncology Department, BluePearl Veterinary Partners, South Midvale, UT, USA
| | - Ann E Hohenhaus
- The Cancer Institute, Animal Medical Center, New York, NY, USA
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Guttin T, Walsh A, Durham AC, Reetz JA, Brown DC, Rondeau MP. Ability of ultrasonography to predict the presence and location of histologic lesions in the small intestine of cats. J Vet Intern Med 2019; 33:1278-1285. [PMID: 30847975 PMCID: PMC6524111 DOI: 10.1111/jvim.15471] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 02/20/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Diagnosis of infiltrative small intestinal (SI) disease in cats is challenging, and debate continues regarding optimal biopsy techniques. Ultrasonography may facilitate selection of biopsy type and location. HYPOTHESIS/OBJECTIVES Assess ability of ultrasonography to predict histologic lesions by SI segment and tissue layer. ANIMALS One-hundred sixty-nine cats that had abdominal ultrasonography and full-thickness SI biopsies performed. METHODS Ultrasonographic images and full-thickness biopsy samples were retrospectively reviewed, and each SI wall layer evaluated for lesions according to published standards. RESULTS Ultrasonographic SI lesions were present in 132 cats (63 duodenum; 115 jejunum; 71 ileum). Samples were obtained at laparotomy (60) or necropsy (109). Ultrasonographic abnormalities had high positive predictive value (PPV) for histologic lesions (duodenum, 82.0%; 95% confidence interval [CI], 68.6-91.4; jejunum, 91.0%; 95% CI, 81.5-96.6; ileum, 88.1%; 95% CI, 74.4-96.0), but poor negative predictive value (duodenum, 27.1%; 95% CI, 17.2-39.1; jejunum, 27.3%; 95% CI, 10.7-50.2; ileum, 40.4%; 95% CI, 26.4-55.7). The ability of ultrasonography to predict histologic lesions in this population, which had high disease prevalence (SI histologic lesions in 78.1% of cats) was high for mucosal lesions (PPV, 72.7%-100%) but low for submucosal or muscularis lesions (PPV, 18.9%-57.1%). CONCLUSIONS AND CLINICAL IMPORTANCE In a population with high disease prevalence, most cats with SI mucosal ultrasonographic lesions will have mucosal histologic lesions. Small intestinal submucosal and muscularis ultrasonographic lesions are not predictive of histologic disease in those layers, suggesting that full-thickness biopsy may not be essential in these cats. Ultrasonography may help guide decisions about biopsy type in individual cats.
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Affiliation(s)
- Talia Guttin
- Department of Small Animal Medicine and Surgery, St. George's University School of Veterinary Medicine, Grenada, West Indies
| | - Audra Walsh
- VetPath Laboratories, Perth, Western Australia, Australia
| | - Amy C Durham
- Department of Pathobiology, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania
| | - Jennifer A Reetz
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania
| | | | - Mark P Rondeau
- Department of Clinical Sciences and Advanced Medicine, University of Pennsylvania School of Veterinary Medicine, Philadelphia, Pennsylvania
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Paulin MV, Couronné L, Beguin J, Le Poder S, Delverdier M, Semin MO, Bruneau J, Cerf-Bensussan N, Malamut G, Cellier C, Benchekroun G, Tiret L, German AJ, Hermine O, Freiche V. Feline low-grade alimentary lymphoma: an emerging entity and a potential animal model for human disease. BMC Vet Res 2018; 14:306. [PMID: 30305106 PMCID: PMC6180644 DOI: 10.1186/s12917-018-1635-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 09/28/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Low-grade alimentary lymphoma (LGAL) is characterised by the infiltration of neoplastic T-lymphocytes, typically in the small intestine. The incidence of LGAL has increased over the last ten years and it is now the most frequent digestive neoplasia in cats and comprises 60 to 75% of gastrointestinal lymphoma cases. Given that LGAL shares common clinical, paraclinical and ultrasonographic features with inflammatory bowel diseases, establishing a diagnosis is challenging. A review was designed to summarise current knowledge of the pathogenesis, diagnosis, prognosis and treatment of feline LGAL. Electronic searches of PubMed and Science Direct were carried out without date or language restrictions. RESULTS A total of 176 peer-reviewed documents were identified and most of which were published in the last twenty years. 130 studies were found from the veterinary literature and 46 from the human medicine literature. Heterogeneity of study designs and outcome measures made meta-analysis inappropriate. The pathophysiology of feline LGAL still needs to be elucidated, not least the putative roles of infectious agents, environmental factors as well as genetic events. The most common therapeutic strategy is combination treatment with prednisolone and chlorambucil, and prolonged remission can often be achieved. Developments in immunohistochemical analysis and clonality testing have improved the confidence of clinicians in obtaining a correct diagnosis between LGAL and IBD. The condition shares similarities with some diseases in humans, especially human indolent T-cell lymphoproliferative disorder of the gastrointestinal tract. CONCLUSIONS The pathophysiology of feline LGAL still needs to be elucidated and prospective studies as well as standardisation of therapeutic strategies are needed. A combination of conventional histopathology and immunohistochemistry remains the current gold-standard test, but clinicians should be cautious about reclassifying cats previously diagnosed with IBD to lymphoma on the basis of clonality testing. Importantly, feline LGAL could be considered to be a potential animal model for indolent digestive T-cell lymphoproliferative disorder, a rare condition in human medicine.
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Affiliation(s)
- Mathieu V Paulin
- Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - Lucile Couronné
- Hematology Department, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1163, CNRS ERL 8254, Institut Imagine, Paris, France
| | - Jérémy Beguin
- Internal Medicine Department, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - Sophie Le Poder
- UMR 1161 Virologie, INRA-ENVA-ANSES, Université Paris-Est, École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Maxence Delverdier
- Anatomical Pathology Department, Université de Toulouse, École Nationale Vétérinaire de Toulouse, 23 Chemin des Capelles, 31076, Toulouse Cedex, France
| | - Marie-Odile Semin
- Anatomical Pathology Department, Université de Toulouse, École Nationale Vétérinaire de Toulouse, 23 Chemin des Capelles, 31076, Toulouse Cedex, France
| | - Julie Bruneau
- Pathology Department, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM 1163, Institut Imagine, Site Hôpital Universitaire Necker - Enfants Malades, Paris, France
| | - Nadine Cerf-Bensussan
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,UMR 1163, Laboratory of Intestinal Immunity, INSERM, Paris, France
| | - Georgia Malamut
- Gastroenterology Department, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris (APHP), Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1163, Institut Imagine, Paris, France
| | - Christophe Cellier
- Gastroenterology Department, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris (APHP), Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1163, Institut Imagine, Paris, France
| | - Ghita Benchekroun
- Internal Medicine Department, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France
| | - Laurent Tiret
- Inserm U955-E10 BNMS, IMRB, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 94000, Maisons-Alfort, France
| | - Alexander J German
- Institute of Ageing and Chronic Disease, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK
| | - Olivier Hermine
- Hematology Department, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,INSERM UMR 1163, CNRS ERL 8254, Institut Imagine, Paris, France
| | - Valérie Freiche
- Internal Medicine Department, Université Paris-Est, École Nationale Vétérinaire d'Alfort, 7 Avenue du Général de Gaulle, 94700, Maisons-Alfort, France.
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Mitze S, Moser K, Teske E, V Bomhard W, Stockhaus C. Correlation between the FCEAI and diagnostic parameters in chronic enteropathies in 147 cats (2006-2012). TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2017; 45:170089. [PMID: 29099902 DOI: 10.15654/tpk-170089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 08/01/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The Feline Chronic Enteropathy Activity Index (FCEAI) has been established as a quantitative index for disease activity in chronic enteropathies in cats. A definite diagnosis is aimed at histology with initial exclusion of extraintestinal causes by laboratory examinations, diagnostic imaging and endoscopy. The study aimed to examine diagnostic parameters and FCEAI in chronic gastroenteropathies. MATERIALS AND METHODS A retrospective case review of 147 cats with chronic enteropathies was performed. In all patients, the FCEAI was established and endoscopy performed including biopsies and duodenal cytology. Histopathologic reports were reviewed for the diagnosis of lymphoma and architectural changes (epithelial integrity, villi/gland atrophy, intestinal crypt atrophy, lymphangiectasia, epitheliotropism/infiltration of intraepithelial lymphocytes). A cytopathologic score (CS) and histopathologic score (HS) regarding lymphocytic intestinal infiltration were assigned. Statistical dependency analysis was used to determine correlations between the FCEAI, lymphoma, architectural changes, CS, HS, serum concentrations of cobalamin, folate and albumin. RESULTS The 147 cats consisted of predominately European Shorthair cats (n = 126), were mostly castrated (n = 127) and had a mean age of 9.8 (1-17) years. For the proven lymphoma group (12.2%; n = 18) and the non-lymphoma group a mean FCEAI of 7.3 (4-17) and 6.6 (2-13), respectively, was established. The FCEAI showed a low correlation with the CS (p = 0.010; R = 0.22) and intestinal villous atrophy (n = 121; p = 0.035; R = 0.19). Cats with a CS of 0 had a significant lower FCEAI score (p = 0.015) than cats with all other CSs. The histo- and cytopathologic scores were highly related (p < 0.001; R = 0.43). The gastric intraepithelial lymphocytic infiltration (n = 131) was significantly correlated to serum folate (p = 0.014; R = -0.56) and albumin (p = 0,048; R = -0.20). CONCLUSION The FCEAI showed only a few correlations. Not only the grade of inflammation, but also the histologic architectural changes are of importance.
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Affiliation(s)
- Stefanie Mitze
- Dr. Stefanie Mitze, Tierklinik Haar, Keferloher Strasse 25, 85540 Haar,
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Baron J, Giuffrida M, Mayhew PD, Singh A, Case JB, Culp WTN, Holt DE, Mayhew KN, Runge JJ. Minimally invasive small intestinal exploration and targeted abdominal organ biopsy with a wound retraction device in 42 cats (2005-2015). Vet Surg 2017; 46:925-932. [DOI: 10.1111/vsu.12693] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 03/07/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Jessica Baron
- Department of Surgery, Cummings School of Veterinary Medicine; Tufts University; North Grafton Massachusetts
| | - Michelle Giuffrida
- Department of Surgical and Radiological Sciences; University of California-Davis; Davis California
| | - Philipp D. Mayhew
- Department of Surgical and Radiological Sciences; University of California-Davis; Davis California
| | - Ameet Singh
- Department of Clinical Studies, Ontario Veterinary College; University of Guelph; Guelph, Ontario Canada
| | - J. Brad Case
- Department of Small Animal Clinical Sciences; Small Animal Hospital at the University of Florida; Gainesville Florida
| | - William T. N. Culp
- Department of Surgical and Radiological Sciences; University of California-Davis; Davis California
| | - David E. Holt
- Department of Clinical Studies, Section of Surgery Veterinary Hospital; University of Pennsylvania; Philadelphia Pennsylvania
| | | | - Jeffrey J. Runge
- Department of Clinical Studies, Section of Surgery Veterinary Hospital; University of Pennsylvania; Philadelphia Pennsylvania
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30
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Swinbourne F, Jeffery N, Tivers M, Artingstall R, Bird F, Charlesworth T, Doran I, Freeman A, Hall J, Hattersley R, Henken J, Hughes J, de la Puerta B, Rutherford L, Ryan T, Williams H, Woods S, Nicholson I. The incidence of surgical site dehiscence following full-thickness gastrointestinal biopsy in dogs and cats and associated risk factors. J Small Anim Pract 2017; 58:495-503. [DOI: 10.1111/jsap.12696] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 11/28/2022]
Affiliation(s)
- F. Swinbourne
- Willows Referral Service; Shirley Solihull B90 4NH UK
| | - N. Jeffery
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences; Texas A&M University; College Station Texas 77843 USA
| | - M.S. Tivers
- School of Veterinary Sciences; University of Bristol; Langford Bristol BS40 5DU UK
| | - R. Artingstall
- Vale Referrals; The Animal Hospital; Stinchcombe Dursley GL11 6AJ UK
| | - F. Bird
- Pride Veterinary Hospital; Derby DE24 8HY UK
| | | | - I. Doran
- School of Veterinary Sciences; University of Bristol; Langford Bristol BS40 5DU UK
| | - A. Freeman
- Small Animal Teaching Hospital, Institute of Veterinary Science; University of Liverpool; Neston Wirral CH64 7TE UK
| | - J. Hall
- Northwest Surgeons; Sutton Weaver Cheshire WA7 3FW UK
| | | | - J. Henken
- Village Vet Highgate; London NW51BX UK
| | - J. Hughes
- North Downs Specialist Referrals; Bletchingley Surrey RH1 4QP UK
| | - B. de la Puerta
- Department of Clinical Services, Royal Veterinary College; Queen Mother Hospital for Animals; North Mymms Hatfield AL9 7TA UK
| | - L. Rutherford
- Southern Counties Veterinary Specialists; Ringwood Hampshire BH24 3JW UK
| | - T. Ryan
- Easter Bush Veterinary Centre, Royal (Dick) School of Veterinary Studies; University of Edinburgh; Roslin Midlothian EH25 9RG UK
| | - H. Williams
- School of Veterinary Sciences; University of Bristol; Langford Bristol BS40 5DU UK
| | - S. Woods
- Northwest Surgeons; Sutton Weaver Cheshire WA7 3FW UK
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McClaran JK, Skerrett SC, Currao RL, Pavia PR, Tarvin KM. Comparison of laparoscopic-assisted technique and open laparotomy for gastrointestinal biopsy in cats*. Vet Surg 2017; 46:821-828. [DOI: 10.1111/vsu.12667] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 01/31/2017] [Accepted: 02/14/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Janet Kovak McClaran
- Department of Surgery; Bobst Hospital of the Animal Medical Center; New York New York
| | - Suzanne C. Skerrett
- Department of Surgery; Bobst Hospital of the Animal Medical Center; New York New York
| | - Rachael L. Currao
- Department of Surgery; Bobst Hospital of the Animal Medical Center; New York New York
| | - Philippa R. Pavia
- Department of Surgery; Bobst Hospital of the Animal Medical Center; New York New York
| | - Kiki M. Tarvin
- Department of Surgery; Bobst Hospital of the Animal Medical Center; New York New York
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Hahn H, Pey P, Baril A, Charpentier J, Desquilbet L, Le Poder S, Château-Joubert S, Laloy E, Freiche V. Ultrasonographic, endoscopic and histological appearances of the caecum in cats presenting with chronic clinical signs of caecocolic disease. J Feline Med Surg 2017; 19:94-104. [PMID: 27613492 PMCID: PMC10816573 DOI: 10.1177/1098612x16663594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Objectives This study aimed to describe the ultrasonographic, endoscopic and histological characteristics of the caecum and ileocaecocolic junction in cats suffering from chronic clinical signs compatible with caecocolic disease. Methods Cats presenting with clinical signs suggestive of a caecocolic disease were prospectively recruited. All cats underwent an ultrasonographic examination of the caecum, ileum, colon, ileocolic lymph nodes and local mesenteric fat, in addition to comprehensive abdominal ultrasonography. This was followed by a colonoscopy with a macroscopic assessment of the caecocolic mucosa; caecocolic tissue samples were systematically collected for histologic analysis. Results Eighteen cats were included. Eleven of 18 cats had ultrasonographic abnormalities adjacent to the ileocaecocolic junction (lymphadenopathy, local steatitis) and 13/18 cats had abnormalities directly related to the junction (wall thickening, loss of wall layering). Seventeen of 18 cats had at least one ultrasonographic abnormality. Endoscopically, hyperaemia, oedema, discoloration and/or erosions were found in all cats. Each cat was classified as having mild or moderate-to-severe lesions according to endoscopic results; no classification could be established statistically for ultrasonographic results. The accentuation of the dimpled pattern tended to be inversely related to the severity of endoscopic lesion scoring. Histologically, a large proportion of cats showed typhlitis (13/16), one had lymphoma and two were normal. All cats with typhlitis also had colitis. There was only slight agreement between endoscopic and histological caecal results regarding the severity of lesions. Loss of caecal wall layering on ultrasound was found in 7/18 cats and, surprisingly, did not appear as a reliable predictor of the severity of inflammation or of malignancy; neither did local steatitis nor lymph node size. Conclusions and relevance Ultrasonography and endoscopy should not be used as the sole methods to investigate the ileocaecocolic region in cats with clinical signs suggestive of caecocolic disease. The presence of chronic clinical signs should routinely prompt histological biopsy.
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Affiliation(s)
- Harriet Hahn
- Department of Medical Imaging, University Paris-Est Créteil, National Veterinary School of Alfort, Maisons-Alfort, France
- Current address: CHV Frégis, France
| | - Pascaline Pey
- Department of Medical Imaging, University Paris-Est Créteil, National Veterinary School of Alfort, Maisons-Alfort, France
- Current address: Antech Imaging Services, 17672-B Cowan Avenue, Irvine, CA 92614, USA
| | - Aurélie Baril
- Department of Internal Medicine, University Paris-Est Créteil, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Julie Charpentier
- Department of Embryology and Histopathology, University Paris-Est Créteil, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Loic Desquilbet
- Department of Biostatistics and Clinical Epidemiology, University Paris-Est Créteil, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Sophie Le Poder
- Research Unit of Virology UMR 1161 INRA-ENVA-ANSES, University Paris-Est Créteil, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Sophie Château-Joubert
- Department of Embryology and Histopathology, University Paris-Est Créteil, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Eve Laloy
- Department of Embryology and Histopathology, University Paris-Est Créteil, National Veterinary School of Alfort, Maisons-Alfort, France
| | - Valerie Freiche
- Department of Internal Medicine, University Paris-Est Créteil, National Veterinary School of Alfort, Maisons-Alfort, France
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Abstract
CASE SERIES SUMMARY Fanconi syndrome (FS) is well described in humans and dogs, but has not been reported in cats. This case series describes four cats with acquired FS. On the basis of clinical signs and intestinal biopsies, all cats were initially diagnosed with alimentary lymphoma or inflammatory bowel disease. Treatment with chlorambucil and corticosteroids was started at standard doses, based on published protocols. Within 2-26 months of the start of treatment, glucosuria, despite normoglycemia, was identified incidentally on routine biochemical screening; FS was diagnosed with urine metabolic assays, confirming aminoaciduria and glucosuria in all four cases. Neither polyuria nor polydipsia were noted in any case, and only 1/4 cats had any clinical signs at the time of diagnosis. Partial or complete resolution of FS was seen in 3/4 cases within 3 months of discontinuing chlorambucil therapy. RELEVANCE AND NOVEL INFORMATION This is the first case series to document acquired FS in the cat, and the first to suggest a possible association between chlorambucil and acquired FS. Cats treated with chlorambucil should be monitored for the development of glucosuria, and discontinuation of chlorambucil should be considered if FS is identified. Further study into the association between chlorambucil and acquired FS in cats is warranted.
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Affiliation(s)
| | - David G Feldman
- VCA Los Angeles Veterinary Specialists, West Hollywood, CA, USA
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Awaysheh A, Wilcke J, Elvinger F, Rees L, Fan W, Zimmerman KL. Evaluation of supervised machine-learning algorithms to distinguish between inflammatory bowel disease and alimentary lymphoma in cats. J Vet Diagn Invest 2016; 28:679-687. [DOI: 10.1177/1040638716657377] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Inflammatory bowel disease (IBD) and alimentary lymphoma (ALA) are common gastrointestinal diseases in cats. The very similar clinical signs and histopathologic features of these diseases make the distinction between them diagnostically challenging. We tested the use of supervised machine-learning algorithms to differentiate between the 2 diseases using data generated from noninvasive diagnostic tests. Three prediction models were developed using 3 machine-learning algorithms: naive Bayes, decision trees, and artificial neural networks. The models were trained and tested on data from complete blood count (CBC) and serum chemistry (SC) results for the following 3 groups of client-owned cats: normal, inflammatory bowel disease (IBD), or alimentary lymphoma (ALA). Naive Bayes and artificial neural networks achieved higher classification accuracy (sensitivities of 70.8% and 69.2%, respectively) than the decision tree algorithm (63%, p < 0.0001). The areas under the receiver-operating characteristic curve for classifying cases into the 3 categories was 83% by naive Bayes, 79% by decision tree, and 82% by artificial neural networks. Prediction models using machine learning provided a method for distinguishing between ALA–IBD, ALA–normal, and IBD–normal. The naive Bayes and artificial neural networks classifiers used 10 and 4 of the CBC and SC variables, respectively, to outperform the C4.5 decision tree, which used 5 CBC and SC variables in classifying cats into the 3 classes. These models can provide another noninvasive diagnostic tool to assist clinicians with differentiating between IBD and ALA, and between diseased and nondiseased cats.
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Affiliation(s)
- Abdullah Awaysheh
- Departments of Biomedical Sciences and Pathobiology (Awaysheh, Wilcke, Zimmerman), Virginia Tech, Blacksburg, VA
- Population Health Sciences (Elvinger), Virginia Tech, Blacksburg, VA
- Business Information Technology (Rees), Virginia Tech, Blacksburg, VA
- Accounting and Information Systems (Fan), Virginia Tech, Blacksburg, VA
| | - Jeffrey Wilcke
- Departments of Biomedical Sciences and Pathobiology (Awaysheh, Wilcke, Zimmerman), Virginia Tech, Blacksburg, VA
- Population Health Sciences (Elvinger), Virginia Tech, Blacksburg, VA
- Business Information Technology (Rees), Virginia Tech, Blacksburg, VA
- Accounting and Information Systems (Fan), Virginia Tech, Blacksburg, VA
| | - François Elvinger
- Departments of Biomedical Sciences and Pathobiology (Awaysheh, Wilcke, Zimmerman), Virginia Tech, Blacksburg, VA
- Population Health Sciences (Elvinger), Virginia Tech, Blacksburg, VA
- Business Information Technology (Rees), Virginia Tech, Blacksburg, VA
- Accounting and Information Systems (Fan), Virginia Tech, Blacksburg, VA
| | - Loren Rees
- Departments of Biomedical Sciences and Pathobiology (Awaysheh, Wilcke, Zimmerman), Virginia Tech, Blacksburg, VA
- Population Health Sciences (Elvinger), Virginia Tech, Blacksburg, VA
- Business Information Technology (Rees), Virginia Tech, Blacksburg, VA
- Accounting and Information Systems (Fan), Virginia Tech, Blacksburg, VA
| | - Weiguo Fan
- Departments of Biomedical Sciences and Pathobiology (Awaysheh, Wilcke, Zimmerman), Virginia Tech, Blacksburg, VA
- Population Health Sciences (Elvinger), Virginia Tech, Blacksburg, VA
- Business Information Technology (Rees), Virginia Tech, Blacksburg, VA
- Accounting and Information Systems (Fan), Virginia Tech, Blacksburg, VA
| | - Kurt L. Zimmerman
- Departments of Biomedical Sciences and Pathobiology (Awaysheh, Wilcke, Zimmerman), Virginia Tech, Blacksburg, VA
- Population Health Sciences (Elvinger), Virginia Tech, Blacksburg, VA
- Business Information Technology (Rees), Virginia Tech, Blacksburg, VA
- Accounting and Information Systems (Fan), Virginia Tech, Blacksburg, VA
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Hauck SR, Gisselman K, Cordner A, Nicholson AG. Chronic Vomiting in Cats: Etiology and Diagnostic Testing. J Am Anim Hosp Assoc 2016; 52:269-76. [PMID: 27487349 DOI: 10.5326/jaaha-ms-6290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chronic vomiting in cats is a common presenting problem seen in veterinary practice today. The initial step when presented with a vomiting patient is to differentiate between vomiting and regurgitation or dysphagia. There are numerous causes for chronic vomiting in cats, and therefore a detailed and comprehensive patient history and a systematic diagnostic approach are key steps in determining the cause for vomiting and the most appropriate treatment plan. Common causes for chronic vomiting in cats may include inflammatory bowel disease, food allergy, gastrointestinal motility disorders, neoplasia, and extra-gastrointestinal diseases, such as renal disease, hepatobiliary disease, and hyperthyroidism.
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Affiliation(s)
- Shannon Ryan Hauck
- From The Hope Center for Advanced Veterinary Medicine, Vienna, VA (S.R.H., K.G., A.C., A.G.N.)
| | - Kelly Gisselman
- From The Hope Center for Advanced Veterinary Medicine, Vienna, VA (S.R.H., K.G., A.C., A.G.N.)
| | - Amy Cordner
- From The Hope Center for Advanced Veterinary Medicine, Vienna, VA (S.R.H., K.G., A.C., A.G.N.)
| | - Angela Gasser Nicholson
- From The Hope Center for Advanced Veterinary Medicine, Vienna, VA (S.R.H., K.G., A.C., A.G.N.)
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Maximizing the diagnostic utility of endoscopic biopsy in dogs and cats with gastrointestinal disease. Vet J 2016; 214:50-60. [DOI: 10.1016/j.tvjl.2016.04.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 03/26/2016] [Accepted: 04/14/2016] [Indexed: 02/06/2023]
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Fragkou FC, Adamama-Moraitou KK, Poutahidis T, Prassinos NN, Kritsepi-Konstantinou M, Xenoulis PG, Steiner JM, Lidbury JA, Suchodolski JS, Rallis TS. Prevalence and Clinicopathological Features of Triaditis in a Prospective Case Series of Symptomatic and Asymptomatic Cats. J Vet Intern Med 2016; 30:1031-45. [PMID: 27296565 PMCID: PMC5089651 DOI: 10.1111/jvim.14356] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 04/26/2016] [Accepted: 05/16/2016] [Indexed: 12/25/2022] Open
Abstract
Background The term triaditis designates the concurrent presence of idiopathic inflammatory bowel disease (IBD), cholangitis, and pancreatitis in cats. Hypothesis/Objectives The histopathology of concurrent, but often subclinical, inflammatory processes in the small intestine, liver, and pancreas of cats is poorly described. We aimed to investigate the frequency of enteritis, cholangitis, pancreatitis, or some combination of these in symptomatic and asymptomatic cats, compare clinicopathological features, and correlate histopathological with laboratory findings. Animals Domestic cats (27 symptomatic, 20 asymptomatic, and 8 normal). Methods Prospective study. Physical examination, laboratory variables (CBC, serum biochemistry profile, serum thyroxine concentration, serum feline trypsin‐like immunoreactivity [fTLI], feline lipase immunoreactivity [fPLI, as measured by Spec fPL®], urinalysis, and fecal analysis), imaging, and histopathological examinations were conducted. Feline liver, pancreas, and small intestine were biopsied during laparotomy. Results Inflammatory lesions were detected in 47 cats (27 symptomatic, 20 asymptomatic). In total, 20 cats had histopathologic lesions of IBD (13/47, 27.7%), cholangitis (6/47, 12.8%), or pancreatitis (1/47, 2.1%) alone, or inflammation involving >1 organ (27/47, 57.4%). More specifically, 16/47 cats (34.0%) had concurrent lesions of IBD and cholangitis, 3/47 (6.4%) of IBD and pancreatitis, and 8/47 cats (17%) of triaditis. Triaditis was identified only in symptomatic cats (8/27, 29.6%). A mild, positive correlation was detected between the severity (score) of IBD lesions and the number of comorbidities (rho = +0.367, P = .022). Conclusions and Clinical Importance Histopathological evidence of IBD or IBD with comorbidities was detected in both symptomatic and asymptomatic cats. The possibility of triaditis should be considered in symptomatic cats with severe IBD.
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Affiliation(s)
- F C Fragkou
- Medicine Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K K Adamama-Moraitou
- Medicine Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - T Poutahidis
- Laboratory of Pathology, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - N N Prassinos
- Surgery and Obstetrics Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Kritsepi-Konstantinou
- Diagnostic Laboratory, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - P G Xenoulis
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - J M Steiner
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - J A Lidbury
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - J S Suchodolski
- Gastrointestinal Laboratory, Texas A&M University, College Station, TX, USA
| | - T S Rallis
- Medicine Unit, Companion Animal Clinic, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Watson MK, Cazzini P, Mayer J, Gottdenker N, Reavill D, Parry N, Fox JG, Sakamoto K. Histology and immunohistochemistry of severe inflammatory bowel disease versus lymphoma in the ferret (Mustela putorius furo). J Vet Diagn Invest 2016; 28:198-206. [DOI: 10.1177/1040638716641156] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Inflammatory bowel disease (IBD) is a common disorder of ferrets ( Mustela putorius furo) that may progress to lymphoma. Although routine histology is used to distinguish between these diseases, misclassifications may occur. Immunohistochemistry (IHC) is commonly used to distinguish between IBD and lymphoma in small animals. The objective of our study was to determine the agreement in the diagnosis reached solely using hematoxylin and eosin (HE)-stained, full-thickness sections versus using a combination of HE and IHC. Enteric sections from 44 ferrets previously diagnosed with IBD or intestinal lymphoma and 3 control ferrets were analyzed by pathologists with expertise in ferrets. A pathologist blinded to the original diagnosis assessed the same HE-stained sections. Analysis was then repeated using HE sections in parallel with sections stained using antibodies against CD3 and CD79a. No significant difference was found between the original HE diagnosis and the HE diagnosis reached by the blinded pathologist ( p = 0.91) or between the blinded pathologist’s HE versus HE with IHC diagnosis ( p = 0.16). In the 2 cases where disagreement was present, IHC was pivotal in reaching a final diagnosis. There was no significant age ( p = 0.29) difference between diagnoses; however, significantly more male ferrets were affected with IBD than females ( p = 0.004). Immunophenotype of the lymphoma was not correlated with predilection for location in the intestinal wall ( p = 0.44). Results suggest that although IHC is not necessary to distinguish IBD from intestinal lymphoma in ferrets, it can be useful a definitive diagnosis in cases of severe IBD.
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Affiliation(s)
- Megan K. Watson
- College of Veterinary Medicine, University of Illinois, Urbana, IL (Watson)
- Royal (Dick) School of Veterinary Studies, Easter Bush Pathology, University of Edinburgh, Edinburgh, United Kingdom (Cazzini)
- College of Veterinary Medicine, University of Georgia, Athens, GA (Sakamoto, Gottdenker, Mayer)
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry)
- Zoo/Exotic Pathology Service, West Sacramento, CA (Reavill)
| | - Paola Cazzini
- College of Veterinary Medicine, University of Illinois, Urbana, IL (Watson)
- Royal (Dick) School of Veterinary Studies, Easter Bush Pathology, University of Edinburgh, Edinburgh, United Kingdom (Cazzini)
- College of Veterinary Medicine, University of Georgia, Athens, GA (Sakamoto, Gottdenker, Mayer)
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry)
- Zoo/Exotic Pathology Service, West Sacramento, CA (Reavill)
| | - Joerg Mayer
- College of Veterinary Medicine, University of Illinois, Urbana, IL (Watson)
- Royal (Dick) School of Veterinary Studies, Easter Bush Pathology, University of Edinburgh, Edinburgh, United Kingdom (Cazzini)
- College of Veterinary Medicine, University of Georgia, Athens, GA (Sakamoto, Gottdenker, Mayer)
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry)
- Zoo/Exotic Pathology Service, West Sacramento, CA (Reavill)
| | - Nicole Gottdenker
- College of Veterinary Medicine, University of Illinois, Urbana, IL (Watson)
- Royal (Dick) School of Veterinary Studies, Easter Bush Pathology, University of Edinburgh, Edinburgh, United Kingdom (Cazzini)
- College of Veterinary Medicine, University of Georgia, Athens, GA (Sakamoto, Gottdenker, Mayer)
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry)
- Zoo/Exotic Pathology Service, West Sacramento, CA (Reavill)
| | - Drury Reavill
- College of Veterinary Medicine, University of Illinois, Urbana, IL (Watson)
- Royal (Dick) School of Veterinary Studies, Easter Bush Pathology, University of Edinburgh, Edinburgh, United Kingdom (Cazzini)
- College of Veterinary Medicine, University of Georgia, Athens, GA (Sakamoto, Gottdenker, Mayer)
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry)
- Zoo/Exotic Pathology Service, West Sacramento, CA (Reavill)
| | - Nicola Parry
- College of Veterinary Medicine, University of Illinois, Urbana, IL (Watson)
- Royal (Dick) School of Veterinary Studies, Easter Bush Pathology, University of Edinburgh, Edinburgh, United Kingdom (Cazzini)
- College of Veterinary Medicine, University of Georgia, Athens, GA (Sakamoto, Gottdenker, Mayer)
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry)
- Zoo/Exotic Pathology Service, West Sacramento, CA (Reavill)
| | - James G. Fox
- College of Veterinary Medicine, University of Illinois, Urbana, IL (Watson)
- Royal (Dick) School of Veterinary Studies, Easter Bush Pathology, University of Edinburgh, Edinburgh, United Kingdom (Cazzini)
- College of Veterinary Medicine, University of Georgia, Athens, GA (Sakamoto, Gottdenker, Mayer)
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry)
- Zoo/Exotic Pathology Service, West Sacramento, CA (Reavill)
| | - Kaori Sakamoto
- College of Veterinary Medicine, University of Illinois, Urbana, IL (Watson)
- Royal (Dick) School of Veterinary Studies, Easter Bush Pathology, University of Edinburgh, Edinburgh, United Kingdom (Cazzini)
- College of Veterinary Medicine, University of Georgia, Athens, GA (Sakamoto, Gottdenker, Mayer)
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA (Fox, Parry)
- Zoo/Exotic Pathology Service, West Sacramento, CA (Reavill)
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Norsworthy GD, Estep JS, Hollinger C, Steiner JM, Lavallee JO, Gassler LN, Restine LM, Kiupel M. Prevalence and underlying causes of histologic abnormalities in cats suspected to have chronic small bowel disease: 300 cases (2008–2013). J Am Vet Med Assoc 2015; 247:629-35. [DOI: 10.2460/javma.247.6.629] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Pignon C, Huynh M, Husnik R, Jekl V. Flexible Gastrointestinal Endoscopy in Ferrets (Mustela putorius furo). Vet Clin North Am Exot Anim Pract 2015; 18:369-400. [PMID: 26335999 DOI: 10.1016/j.cvex.2015.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Gastrointestinal disease is a common complaint in ferrets (Mustela putorius furo). Their relatively simple and short gastrointestinal tract makes them good candidates for flexible endoscopy. However, apart from a few references in biomedical research articles, there is little information on the use of flexible endoscopy in ferrets. This review describes patient preparation, equipment, and select gastrointestinal endoscopy techniques in ferrets, including esophagoscopy, gastroscopy, duodenoscopy, percutaneous endoscopic gastrostomy, jejunoileoscopy, colonoscopy, and biopsy.
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Affiliation(s)
- Charly Pignon
- Exotics Medicine Service, Alfort National Veterinary School, 7 Avenue du Général de Gaulle, Maisons-Alfort 94700, France.
| | - Minh Huynh
- Exotics Medicine Service, Centre Hospitalier Vétérinaire Frégis, Rue Aristide Briand, Arcueil 94110, France
| | - Roman Husnik
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Skip Bertman Drive, Baton Rouge, LA 70803, USA; International Clinical Research Center (ICRC), St. Anne's University Hospital Brno, Pekarska 53, Brno 656 91, Czech Republic
| | - Vladimir Jekl
- Avian and Exotic Animal Clinic, University of Veterinary and Pharmaceutical Sciences Brno, Brno 65691, Czech Republic
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41
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Ohmura S, Leipig M, Schöpper I, Hergt F, Weber K, Rütgen BC, Tsujimoto H, Hermanns W, Hirschberger J. Detection of monoclonality in intestinal lymphoma with polymerase chain reaction for antigen receptor gene rearrangement analysis to differentiate from enteritis in dogs. Vet Comp Oncol 2015; 15:194-207. [PMID: 25988583 DOI: 10.1111/vco.12151] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 03/27/2015] [Accepted: 04/04/2015] [Indexed: 11/29/2022]
Abstract
The diagnosis of canine intestinal lymphoma by morphological examination is challenging, especially when endoscopic tissue specimens are used. The utility of detection of antigen receptor gene rearrangement by polymerase chain reaction (PARR) in canine lymphoma has been well established, but its usefulness to distinguish enteritis and intestinal lymphoma remains unclear. In this retrospective study we assessed clonality of 29 primary canine intestinal lymphoma, 14 enteritis and 15 healthy control cases by PARR analysis, using formalin-fixed, paraffin-embedded full-thickness tissue specimens. We could detect monoclonal rearrangements in 22 of 29 canine intestinal lymphomas [76%; 95% confidence interval (CI) 56-90%] and polyclonal rearrangements in all of the enteritis and healthy control cases (100%; CI 88-100%). We revealed a predominance of T-cell phenotype compared to B-cell phenotype (85%; CI 65-96% and 15%; CI 4-35%, respectively). We showed that PARR analysis contributes to differentiation of canine intestinal lymphoma from enteritis and to phenotyping of lymphomas.
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Affiliation(s)
- S Ohmura
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - M Leipig
- Institute of Veterinary Pathology, Ludwig Maximilian University, Munich, Germany
| | - I Schöpper
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - F Hergt
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - K Weber
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
| | - B C Rütgen
- Department of Pathobiology, Clinical Pathology Platform, University of Veterinary Medicine, Vienna, Austria
| | - H Tsujimoto
- Department of Veterinary, Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - W Hermanns
- Institute of Veterinary Pathology, Ludwig Maximilian University, Munich, Germany
| | - J Hirschberger
- Clinic of Small Animal Medicine, Center for Clinical Veterinary Medicine, Ludwig Maximilian University, Munich, Germany
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42
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Association between lymphocyte antigen receptor gene rearrangements and histopathological evaluation in canine chronic enteropathy. Vet Immunol Immunopathol 2015; 165:138-44. [PMID: 25912485 DOI: 10.1016/j.vetimm.2015.03.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/13/2015] [Accepted: 03/30/2015] [Indexed: 11/23/2022]
Abstract
Although definitive diagnosis of chronic enteropathy (CE) and gastrointestinal (GI) lymphoma requires histopathological evaluation of the GI tract, these conditions are often still difficult to differentiate from each other. Polymerase chain reaction (PCR) for antigen receptor gene rearrangements (PARR) has been applied recently as an adjunctive for diagnosis of lymphoid tumors; however, its clinical value in canine CE and GI lymphoma remains unclear. The purpose of this study was to investigate the relationship between PARR and histopathological diagnosis, degree of enteritis or lymphoma, and long-term prognosis in dogs, in order to evaluate the clinical significance of PARR. Endoscopic biopsy specimens obtained from 96 dogs with chronic enteritis (mild, n=14; moderate, n=20; marked, n=62) and 21 dogs with GI lymphoma were used. Clonality was observed in 51% of the animals with chronic enteritis; interestingly, it was found in 29% of those with only mild enteritis. In dogs with marked enteritis, the rate of PARR was higher in those with lymphocyte epitheliotropism than in those without epitheliotropism. The sensitivity of PARR in animals with GI lymphoma was 76%. There was no significant prognostic difference between chronic enteritis with or without clonal rearrangements. In contrast, dogs histopathologically diagnosed with marked enteritis had a significantly shorter survival time than did those with mild or moderate enteritis. While the significance of PARR in the diagnosis of GI lymphoma remains uncertain, the pathological roles of clonally expanding lymphocytes in canine CE should be investigated further.
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Marolf AJ, Bachand AM, Sharber J, Twedt DC. Comparison of endoscopy and sonography findings in dogs and cats with histologically confirmed gastric neoplasia. J Small Anim Pract 2015; 56:339-44. [DOI: 10.1111/jsap.12324] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/24/2014] [Accepted: 12/01/2014] [Indexed: 11/29/2022]
Affiliation(s)
- A. J. Marolf
- Department of Environmental and Radiological Health Sciences; Colorado State University; Fort Collins CO 80523 USA
| | - A. M. Bachand
- Department of Environmental and Radiological Health Sciences; Colorado State University; Fort Collins CO 80523 USA
| | - J. Sharber
- Department of Clinical Sciences; Colorado State University; Fort Collins CO 80523 USA
| | - D. C. Twedt
- Department of Clinical Sciences; Colorado State University; Fort Collins CO 80523 USA
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44
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Distinguishing Intestinal Lymphoma From Inflammatory Bowel Disease in Canine Duodenal Endoscopic Biopsy Samples. Vet Pathol 2014; 52:668-75. [DOI: 10.1177/0300985814559398] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Inflammatory bowel disease (IBD) and intestinal lymphoma are intestinal disorders in dogs, both causing similar chronic digestive signs, although with a different prognosis and different treatment requirements. Differentiation between these 2 conditions is based on histopathologic evaluation of intestinal biopsies. However, an accurate diagnosis is often difficult based on histology alone, especially when only endoscopic biopsies are available to differentiate IBD from enteropathy-associated T-cell lymphoma (EATL) type 2, a small cell lymphoma. The purpose of this study was to evaluate the utility of histopathology; immunohistochemistry (IHC) for CD3, CD20, and Ki-67; and polymerase chain reaction (PCR) for antigen receptor rearrangement (T-cell clonality) in the differential diagnosis of severe IBD vs intestinal lymphoma. Endoscopic biopsies from 32 dogs with severe IBD or intestinal lymphoma were evaluated. The original diagnosis was based on microscopic examination of hematoxylin and eosin (HE)–stained sections alone followed by a second evaluation using morphology in association with IHC for CD3 and CD20 and a third evaluation using PCR for clonality. Our results show that, in contrast to feline intestinal lymphomas, 6 of 8 canine small intestinal lymphomas were EATL type 1 (large cell) lymphomas. EATL type 2 was uncommon. Regardless, in dogs, intraepithelial lymphocytes were not an important diagnostic feature to differentiate IBD from EATL as confirmed by PCR. EATL type 1 had a significantly higher Ki-67 index than did EATL type 2 or IBD cases. Based on the results of this study, a stepwise diagnostic approach using histology as the first step, followed by immunophenotyping and determining the Ki67 index and finally PCR for clonality, improves the accuracy of distinguishing intestinal lymphoma from IBD in dogs.
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45
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Mayhew PD, Mayhew KN, Shilo-Benjamini Y, Kass PH, Pascoe PJ. Prospective evaluation of access incision position for minimally invasive surgical organ exposure in cats. J Am Vet Med Assoc 2014; 245:1129-34. [PMID: 25356713 DOI: 10.2460/javma.245.10.1129] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the exposure obtained for minimally invasive abdominal organ biopsy (MIOB) from 3 access incisions in cats. DESIGN Prospective experimental study and clinical case series. ANIMALS 6 purpose-bred research cats and 6 feline clinical patients with indications for abdominal organ biopsy. PROCEDURES Three 3-cm incisions into the peritoneal cavity were created at different locations along the linea alba in research cats in randomized order. A wound retraction device was inserted in each incision. Ability to exteriorize various abdominal organs to the extent required to reasonably perform a surgical biopsy was recorded, and results were compared among incision sites. On the basis of results obtained, the access incision that provided exposure of the most frequently biopsied abdominal organs was used to perform MIOB in 6 feline clinical patients with various underlying pathological conditions. RESULTS On the basis of experiments with research cats, a 3-cm access incision centered midway between the caudal margin of the xiphoid cartilage and the umbilicus was found to provide access for MIOB for most organs. In 5 of 6 clinical patients, all of the organs of interest were biopsied successfully via this incision location, although access to all hepatic lobes and all parts of the pancreas was inconsistent. In 1 cat, conversion to an open approach was performed because a palpable mass was detected in the area of the duodenocolic ligament. CONCLUSIONS AND CLINICAL RELEVANCE Optimization of access incision location for MIOB allowed biopsy specimen collection from organs of interest to be performed in a minimally invasive manner in cats.
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Affiliation(s)
- Philipp D Mayhew
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616
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46
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Robertson E, Twedt D, Webb C. Diagnostic laparoscopy in the cat: 1. Rationale and equipment. J Feline Med Surg 2014; 16:5-16. [PMID: 24361945 DOI: 10.1177/1098612x13516567] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PRACTICAL RELEVANCE The integration of minimally invasive techniques into feline practice seems to be an intuitive step forward, especially for those cases where the owner may be reluctant to subject their cat to major surgery 'just for a biopsy'. Although ultrasound is frequently employed as a diagnostic tool in similar cases, this modality can only provide information on gross abnormalities in organ size and shape, echogenicity and internal architecture; even with ultrasound-guided fine-needle aspiration a definitive diagnosis is rarely achieved. So the clinician and owner are left with unanswered questions that are central to the diagnosis, the most appropriate treatment to pursue and the prognosis for the cat. Laparoscopy does require anesthesia and is more expensive than ultrasound; however, when performed correctly, it is only marginally more invasive and vastly more informative, with a proven track record of minimal morbidity. AUDIENCE This article is aimed at all feline practitioners, from first opinion through to the referral setting. It is intended to encourage practitioners untrained in minimally invasive procedures to seek formalized training, especially those who want to expand their diagnostic capabilities. For those already performing minimally invasive surgery, it describes how laparoscopic techniques can be applied to many feline gastrointestinal cases. EVIDENCE BASE Information provided in this article is based on published literature, comprising original studies, case review series and textbook chapters, and the authors' own clinical experience.
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Affiliation(s)
- Elise Robertson
- Feline Vet Referrals/Endoscopy Vet Referrals, Brighton, East Sussex BN41 1DQ, UK
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47
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Sharman M, Bacci B, Whittem T, Mansfield C. In vivo histologically equivalent evaluation of gastric mucosal topologic morphology in dogs by using confocal endomicroscopy. J Vet Intern Med 2014; 28:799-808. [PMID: 24597616 PMCID: PMC4895453 DOI: 10.1111/jvim.12332] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 01/06/2014] [Accepted: 01/21/2014] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Confocal endomicroscopy (CEM) is an endoscopic technology permitting in vivo cellular and subcellular imaging. CEM aids real-time clinical assessment and diagnosis of various gastrointestinal diseases in people. CEM allows in vivo characterization of small intestinal mucosal morphology in dogs. OBJECTIVE To determine the feasibility of CEM to evaluate gastric mucosal morphology in dogs and to characterize the appearance in healthy dogs. ANIMALS Fourteen clinically healthy research colony dogs. METHODS Experimental study. Under general anesthesia, dogs underwent standard endoscopic evaluation and CEM of the gastric mucosa. In the initial 6 dogs, fluorescent contrast was provided with the fluorophore acriflavine (0.05% solution), applied topically. Subsequently, 8 dogs were assessed using a combination of fluorescein (10% solution, 15 mg/kg IV), followed by acriflavine administered topically. For each fluorophore, a minimum of 5 sites were assessed. RESULTS Confocal endomicroscopy provided high quality in vivo histologically equivalent images of the gastric mucosa, but reduced flexibility of the endoscope tip limited imaging of the cranial stomach in some dogs. Intravenous administration of fluorescein allowed assessment of cellular cytoplasmic and microvasculature features. Topical application of acriflavine preferentially stained cellular nucleic acids, allowing additional evaluation of nuclear morphology. Identification of Helicobacter-like organisms was possible in 13 dogs. CONCLUSION AND CLINICAL IMPORTANCE Confocal endomicroscopy provides in vivo images allowing assessment of gastric mucosal morphology during endoscopy, potentially permitting real-time diagnosis of gastrointestinal disease.
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Affiliation(s)
- M.J. Sharman
- Translational Research and Animal Clinical Trial Study (TRACTS) Group, the Faculty of Veterinary ScienceThe University of MelbourneMelbourneVic.Australia
| | - B. Bacci
- Translational Research and Animal Clinical Trial Study (TRACTS) Group, the Faculty of Veterinary ScienceThe University of MelbourneMelbourneVic.Australia
| | - T. Whittem
- Translational Research and Animal Clinical Trial Study (TRACTS) Group, the Faculty of Veterinary ScienceThe University of MelbourneMelbourneVic.Australia
| | - C.S. Mansfield
- Translational Research and Animal Clinical Trial Study (TRACTS) Group, the Faculty of Veterinary ScienceThe University of MelbourneMelbourneVic.Australia
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48
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Tucker S, Penninck DG, Keating JH, Webster CRL. Clinicopathological and ultrasonographic features of cats with eosinophilic enteritis. J Feline Med Surg 2014; 16:950-6. [PMID: 24591305 DOI: 10.1177/1098612x14525385] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Eosinophilic enteritis (EE) in cats is poorly characterized. The aim of the current study was to retrospectively evaluate the clinical and ultrasonographic findings in cats with histologic evidence of eosinophilic inflammation on gastrointestinal biopsy. Twenty-five cats with tissue eosinophilia on surgical (10) or endoscopic (15) biopsy of the gastrointestinal tract, having an abdominal ultrasound performed within 48 h of biopsy acquisition, were enrolled. History, clinical presentation, clinical pathology and abdominal ultrasound findings were reviewed. Intestinal biopsies were evaluated by a single pathologist and separated into two groups based on the degree of eosinophilic infiltrate: mild (<10 eosinophils/high-power field [HPF], 11/25 cats), or moderate/marked (>10 eosinophils/HPF, 14/25 cats). The former were considered primary lymphoplasmacytic or lymphocytic inflammatory bowel disease (LPE) with subtle eosinophilic infiltrates, and the latter to have EE. Signalment, history and clinical signs were similar in all cats. Only cats with EE (6/14) had palpably thickened intestines. The only distinguishing clinicopathological feature of cats with EE was the presence of peripheral eosinophilia (6/14). On ultrasound, when compared with cats with LPE, cats with EE had a greater mean jejunal wall thickness (3.34 mm ± 0.72 mm vs 4.07 mm ± 0.58 mm, respectively) and an increased incidence of thickening of the muscularis layer (1/11 and 11/14, respectively). In conclusion, ultrasonographic evidence of a prominent intestinal muscularis layer, palpably thickened intestines and peripheral eosinophilia can serve as biomarkers for the presence of EE in cats with chronic intestinal signs.
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Affiliation(s)
- Samuel Tucker
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - Dominique G Penninck
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - John H Keating
- Department of Biomedical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, USA
| | - Cynthia R L Webster
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA, USA
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49
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Williams J. Feline gastrointestinal surgery: principles and essential techniques. J Feline Med Surg 2014; 16:231-9. [PMID: 24563494 DOI: 10.1177/1098612x14523185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE Gastrointestinal (GI) surgical procedures are performed commonly in cats in general practice for both diagnostic and treatment purposes. It is essential that the surgeon understands and adheres to the principles of GI surgery in order that postoperative morbidity and mortality are kept to a minimum. AUDIENCE This review is aimed at feline and general practitioners wanting to update their core skills in GI surgery. It discusses anatomical considerations and surgical principles, and aims to familiarise the surgeon with techniques (some well established, others newer) that will help to promote surgical success. EQUIPMENT Standard general surgical equipment is required, together with the facilities to provide adequate pre-, intra- and postoperative patient care. EVIDENCE BASE The author draws on clinical experience and evidence from the literature, where appropriate, in reviewing the guidance and techniques under discussion.
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Affiliation(s)
- John Williams
- Northwest Surgeons, Delamere House, Ashville Point, Sutton Weaver, Cheshire WA7 3FW, UK
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Lalor S, Schwartz AM, Titmarsh H, Reed N, Tasker S, Boland L, Berry J, Gunn-Moore D, Mellanby RJ. Cats with inflammatory bowel disease and intestinal small cell lymphoma have low serum concentrations of 25-hydroxyvitamin D. J Vet Intern Med 2014; 28:351-5. [PMID: 24433362 PMCID: PMC4858012 DOI: 10.1111/jvim.12294] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 11/08/2013] [Accepted: 12/02/2013] [Indexed: 12/24/2022] Open
Abstract
Background Inflammatory bowel disease (IBD) and intestinal small cell lymphoma (ISCL) are common diseases in cats. The prevalence of alterations in the serum concentrations of fat soluble vitamins, such as vitamin D, in cats with IBD and ISCL is unknown. Hypothesis/Objectives The objective of this study was to measure serum 25 hydroxyvitamin D (25[OH]D) concentrations in cats with IBD or ISCL. Serum 25(OH)D also was measured in healthy cats, and in hospitalized ill cats with nongastrointestinal diseases. Animals Eighty‐four cats were included in the study: 23 in the healthy group, 41 in the hospitalized ill group, and 20 in the IBD/ISCL group. Methods Retrospective study. Serum samples for vitamin D analysis were frozen at −20°C until serum 25(OH)D was measured by high‐performance liquid chromatography (HPLC). Results Although there was overlap in serum 25(OH)D concentrations among the 3 groups, serum 25(OH)D concentrations were significantly lower in the cats with IBD or ISCL compared to healthy cats (P < .0001) and hospitalized ill cats (P = .014). In the IBD/ISCL group, there was a significant moderate positive correlation between serum albumin and 25(OH)D concentrations (r = 0.58, P = .018). Conclusion and Clinical Importance The median serum concentration of 25(OH)D was significantly lower in cats with IBD/ISCL than in healthy cats and in hospitalized ill cats. Additional studies are required to elucidate the mechanism of hypovitaminosis D in cats with gastrointestinal diseases, to define the best management strategy to treat this complication, and to investigate its potential prognostic implications.
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Affiliation(s)
- S Lalor
- The Royal (Dick) School of Veterinary Studies, Division of Clinical Veterinary Sciences, University of Edinburgh, Edinburgh, UK
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