Characterization of clinicopathologic and abdominal ultrasound findings in dogs with glucocorticoid deficient hypoadrenocorticism.

BACKGROUND: Clinical findings of glucocorticoid-deficient hypoadrenocorticism (GDH) can overlap with other diseases, presenting a diagnostic challenge. OBJECTIVES: Describe clinicopathologic and ultrasonographic features of dogs with GDH and those suspected of having GDH that had the disease ruled out. ANIMALS: Six hundred twenty-three dogs. METHODS: Records from dogs with suspected GDH between 2003 and 2018 were reviewed. Dogs with hyperkalemia or hyponatremia were excluded. Dogs were categorized as controls when the resting serum cortisol or post-ACTH cortisol concentration were > 2 µg/dL. Clinicopathologic and ultrasonographic features were compared between groups. The optimal cut-point, area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were calculated for individual features used to detect GDH. RESULTS: Dogs were categorized as GDH (n = 29) or controls (n = 594). Lymphocyte count (>1750 cells/L; sensitivity, 96.6%; 95% confidence interval [CI], 82.8%-99.8%; specificity, 60.3%; 95% CI, 56.3%-64.1%; AUC, 0.828; 95% CI, 0.762-0.894) and albumin/globulin ratio (<1.081; sensitivity, 86.2%; 95% CI, 69.4%-94.5%; specificity, 78.8%; 95% CI, 75.3%-81.9%; AUC, 0.886; 95% CI, 0.827-0.944) had the highest discriminatory power between groups. Left adrenal gland width <0.39 cm was 80% (95% CI, 58.4%-91.9%) sensitive and 82.4% (95% CI, 74.2-88.4) specific for GDH. Serum cobalamin concentrations and ultrasonographic abnormalities of the GI tract were not different between groups. CONCLUSION AND CLINICAL IMPORTANCE: No single variable could be used to confidently rule out GDH and obviate the need for cortisol testing in dogs with a clinical presentation consistent with GDH.

A novel bone marrow-sparing treatment for primary erythrocytosis in a cat: Onion powder.

Primary erythrocytosis (PE) is a rare myeloproliferative neoplasm in cats resulting in the overproduction of erythrocytes. Current treatment modalities include repeated phlebotomy and chemotherapeutic drugs. These treatments may not be well tolerated by the cat and can present safety and financial challenges to owners. Because of the rarity of PE, prospective studies for new treatment options are difficult to perform. This case report describes the novel use of onion powder in an attempt to produce Heinz body-induced erythrocyte destruction in order to decrease total erythrocyte mass and normalize the hematocrit in a cat with PE. To our knowledge, the use of onion powder in the treatment of PE in cats has never been described before and may have potential as a safe, low-cost, and highly accessible alternative treatment for this rare disease.

Urine-Filled Large Prostatic Cystic Structure in Two Unrelated Male Miniature Dachshunds.

A 1 yr old intact male miniature dachshund presented for posturing to urinate without voiding and nocturia. Physical examination revealed congenital reproductive abnormalities and a fluid-filled structure caudal to the urinary bladder. The dog was diagnosed with a prostatic cyst and underwent an exploratory laparotomy with an attempt to remove the cyst. Twelve weeks later, the dog returned with recurring clinical signs, and the cyst was found to have returned back to its original size. A second intact male miniature dachshund presented at 7 mo of age for stranguria. Physical examination revealed congenital reproductive abnormalities and a fluid-filled structure on rectal palpation, much like the first dog. The dog was diagnosed with a prostatic cyst and underwent an exploratory laparotomy. An attempt was made to close communication between the prostate and cyst. The dog re-presented 3 wk later for recurrence of clinical signs, and the prostatic cyst was found to have increased in size. Both dogs were euthanized because of recurrence of clinical signs. This report describes the presence of prostatic cysts in two young dogs with congenital abnormalities of the genital and reproductive tracts and the similarities seen in human boys diagnosed with prostatic utricles.

Pretreatment Histoplasma capsulatum urine enzymatic immunoassay concentrations do not correlate with outcome but may be influenced by renal function in cats with histoplasmosis.

OBJECTIVES: The objective of this study was to determine if urine Histoplasma antigen (HAg) enzyme immunoassay (EIA) concentrations at the time of diagnosis and prior to the administration of antifungal agents are predictive of outcome for cats infected with Histoplasma capsulatum and to determine if compromised renal function affects urine HAg EIA measurements. METHODS: Medical records at four institutions were searched to identify cats diagnosed with histoplasmosis between April 2012 and December 2015. Pretreatment urine Histoplasma EIA values were recorded, along with patient signalment, serum creatinine concentration, urine specific gravity, site(s) of infection and survival data. RESULTS: Pretreatment urine HAg EIA measurements were available for 50 cats, and ranged from 0-19.1 ng/ml (median 6.3 ng/ml). Thirty-five cats were alive at day 180, 12 had died or were euthanized (median survival time 24 days; range 2-124 days) and three were lost to follow-up. The median urine HAg EIA at the time of diagnosis for cats alive at 6 months was 5 ng/ml (range 0-19.1); this was similar to findings for the non-survivors (median 7.29 ng/ml; range 0.78-19.1; P = 0.54). Surviving cats were significantly younger (mean age 6.9 years) than non-survivors (mean age 9.9 years; P = 0.03) but median body weights (3.8 kg vs 3.6 kg) and rates of pulmonary involvement (22/35 vs 9/12) were similar for the two groups. Median urine HAg EIA concentration was lower in cats with evidence of renal compromise than cats with acceptable renal function (0.54 ng/ml vs 7.2 ng/ml; P <0.013). CONCLUSIONS AND RELEVANCE: Urine HAg EIA concentrations at the time of diagnosis are not predictive of outcome in cats with histoplasmosis and should not be used as a prognostic indicator in this species. Renal function may influence urine HAg EIA concentrations in cats; further investigation is needed to see if concurrent kidney disease impacts test sensitivity.