Detection of Neospora caninum tachyzoites in cerebrospinal fluid of a dog following prednisone and cyclosporine therapy.

A 9-year-old female spayed Shetland Sheepdog was presented to the Kansas State University Veterinary Medical Teaching Hospital for evaluation following a 3-week history of left rear limb lameness that had progressed to generalized ataxia. Multifocal or diffuse brain lesions were suspected based on physical examination findings. Cerebrospinal fluid (CSF) contained 52 nucleated cells/µL composed of mixed inflammatory cells. Treatment with prednisone and cyclosporine was initiated based on a presumptive diagnosis of granulomatous meningoencephalitis. Thirteen days later the dog was nonambulatory and mentally obtunded. Repeat CSF analysis revealed 298 nucleated cells/µL with 61% eosinophils. Rare protozoal tachyzoites consistent with Neospora caninum, Toxoplasma gondii, or Sarcocystis spp. were found extracellularly and within macrophages and an eosinophil. Despite cessation of prednisone and cyclosporine therapy and provision of supportive care, the dog died 6 days later. Examination of brain tissue sections revealed multifocally extensive, necrotizing, histiocytic, and lymphoplasmacytic meningoencephalitis with numerous protozoal zoites and cysts. Immunohistochemical analysis of brain tissue using a monoclonal antibody specific for N. caninum confirmed the diagnosis of neosporosis. Similar but less severe lesions were noted in the spinal cord, although organisms were not found. This case emphasizes the value of repeated CSF analysis when therapy is ineffective and the importance of excluding infectious causes of meningoencephalitis before commencement of immunosuppressive therapy.

Pelger-Huët anomaly in an Arabian horse.

A 9-year-old Arabian mare was evaluated for a 7-day history of malaise. Results of a CBC included a leukocyte concentration within the reference interval (8.4 x 10(3)/microL, reference interval 6.0-14.0 x 10(3)/microL) with an apparent degenerative left shift (segmented neutrophils 1.2 x 10(3)/microL, reference interval 2.5-7.5 x 10(3)/microL; hyposegmented neutrophils 1.8 x 10(3)/microL, reference interval 0.0-0.2 x 10(3)/microL). Serum clinical chemistry results included increased aspartate transaminase, alkaline phosphatase, and gamma-glutamyltransferase activities. A presumptive diagnosis of hepatitis or cholangiohepatitis was made. The horse was treated with antimicrobials and the malaise quickly resolved. However, in a recheck CBC on day 13, the apparent degenerative left shift remained. Further evaluation of the blood smear revealed many hyposegmented granulocytes with coarse mature chromatin and normal cytoplasmic features. On the basis of the microscopic examination, the horse was diagnosed with Pelger-Huët anomaly. The patient's offspring was subsequently also diagnosed with Pelger-Huët anomaly on the basis of blood film examination. Neutrophil, eosinophil, and basophil mean nuclear scores in both affected horses (mare, range 1.5-2.6; offspring, range 1.6-3.2) were lower than those in 2 unrelated Arabian horses (range, 2.8-5.0) and 5 non-Arabian control horses (range, 2.8-5.0). Results of immunophenotyping and phagocytosis/oxidative burst assays via flow cytometry showed no difference in the expression of myeloid-specific or adhesion molecules or in neutrophil function between affected and control horses. This is the second known report of equine Pelger-Huët anomaly, both of which affected Arabian horses.

Blood smear from a cat: features to "dys"cover.

A 4-year-old, spayed female, domestic shorthair cat was presented for lethargy, nonregenerative anemia, and inappetence. Results of a CBC included macrocytic, normochromic, nonregenerative anemia and a glucocorticoid-associated leukogram. On blood smear examination, neutrophils had abnormal features including hyposegmentation and a diffuse chromatin pattern with nuclear filament formation and nuclear blebbing. Microscopic examination of a roll preparation of bone marrow revealed hypolobulated megakaryocytes with asynchronous maturation of nuclei. The granulocytic to erythrocyte (G:E) ratio was 76. Segmented neutrophils had asynchronous maturation and dysplastic features. The entire erythroid lineage was markedly decreased for the degree of anemia and rare dysplastic features were noted in erythroid precursor cells. The interpretation of bone marrow findings was erythroid hypoplasia, megakaryocytic dysplasia, and granulocytic hyperplasia with dysplasia. Histopathologic examination of a bone marrow core sample also revealed myeloid hyperplasia and erythroid hypoplasia. The result of a direct immunofluorescence assay for FeLV performed on the bone marrow roll preparation was positive. A diagnosis of dysmyelopoiesis associated with FeLV infection was made. This case was unique in that the dysplastic changes occurred in cell lines that did not have associated cytopenias. The dysmyelopoiesis most closely resembled myelodysplastic syndrome with refractory cytopenia (MDS-RC); however, secondary dysmyelopoiesis could not be ruled out.