Correlation of cytology to histology in a case of canine granulomatous colitis in a Boxer dog.

A 2-year-old castrated male mixed breed dog presented to the North Carolina State Veterinary Teaching Hospital for chronic diarrhea with hematochezia and weight loss. Cytology performed on a rectal scraping revealed macrophages containing magenta, light pink, and variably blue granular inclusions, and phagocytosed material concerning for infectious organisms. Histopathology was consistent with granulomatous colitis and identified intra-histiocytic bacterial organisms, confirmed by fluorescent in situ hybridization (FISH)-tissue culture-confirmed Escherichia coli. Based on these findings, a diagnosis of granulomatous colitis was made. The patient was successfully treated with oral enrofloxacin, and near-complete remission of signs was achieved within 6 weeks. This report describes a case of granulomatous colitis in a mixed breed dog, and is the first published description of the cytologic features of this uncommon disease, offering a valuable cytologic-histologic correlation. In this case, the cytology was helpful in identifying features consistent with granulomatous colitis and prioritizing the differential diagnoses and diagnostic plan.

Evaluation of Retention of Veterinary Clinical Pathology Knowledge between Second-Year and Fourth-Year Clinical Pathology Courses.

There is a concern over long-term retention of knowledge in professional programs. The goal of this study was to evaluate the retention of veterinary clinical pathology knowledge between the fourth-semester and fourth-year clinical pathology courses. We hypothesize that students will forget a significant amount of content area knowledge between the fourth semester and fourth year in the Doctor of Veterinary Medicine (DVM) program. We further hypothesize that a review of material during the fourth-year clinical pathology rotation will help students rebuild existing knowledge and increase performance on specific test questions, between T2 (rotation pre-test) and T3 (rotation post-test). Initial mastery of course material was assessed via a 94-item multiple-choice final exam (T1) given in the semester 4 clinical pathology course. Retention of course material from semester 4 to year 4 was assessed via a 55-item multiple-choice pre-test, administered at the start of the clinical pathology rotation in year 4 while learning/mastery during the clinical rotation was assessed via a 55-item multiple-choice post-test, administered at the end of each clinical pathology rotation. In this study, evidence of knowledge retention between semester 4 and year 4 was 55.5%. There is a small increase in the measure of knowledge gain from the beginning to the end of the rotation. As an added benefit, we were able to use identified trends for retention of knowledge within specific subject areas as a mechanism to evaluate the effectiveness of our course and reallocate additional instructional time to topics with poorer retention.

Using a Modified Bookmark Procedure to Help Identify Reasonable Consequences for Academic Integrity Violations.

It is recommended that institutions develop academic conduct policies to help preserve academic integrity, enforce compliance, and aid in legal defensibility. These policies should also articulate reasonable consequences for persons found in violation. The problem, however, is that all academic misconduct offenses are not created equal, and determining reasonable consequences for these violations can be particularly challenging due to their subjective nature. Thus, the purpose of this study was to introduce a novel method for more objectively determining reasonable sanctions for several academic misconduct offenses of varying degrees of severity. We utilized a variation of the Bookmark procedure, a popular standard-setting technique used primarily by psychometricians in high-stakes testing environments, to investigate empirical survey data and develop policy recommendations. We encourage others to use this procedure, where appropriate, to identify appropriate cut scores and ranges to aid in policy development across a variety of contexts.

Extreme lymphocytosis with myelomonocytic morphology in a horse with diffuse large B-cell lymphoma.

An 11-year-old, 443-kg Haflinger mare was presented to the North Carolina State University Veterinary Teaching Hospital with a 2-week history of lethargy and a 3-day duration of anorexia, pyrexia, tachycardia, and ventral edema. Severe pitting edema, peripheral lymphadenopathy, and a caudal abdominal mass were noted on physical examination. An extreme leukocytosis (154.3 × 103 /µL) and microscopic hematologic findings suggestive of myelomonocytic leukemia were observed. Serum protein electrophoresis revealed a monoclonal gammopathy and urine protein electrophoresis revealed a monoclonal light chain proteinuria. Necropsy and histopathology confirmed widespread neoplastic infiltration in many organs with a heterogenous population of cells; there was no apparent evidence of bone marrow involvement. Immunohistochemistry confirmed presence of a majority of B cells with a limited antigen expression, admixed with a lower number of T cells. Molecular clonality analysis of IgH2, IgH3, and kappa-deleting element (KDE, B cell) on whole blood and KDE on infiltrated tissues revealed clonal rearrangements, and the KDE intron clones that amplified in blood and in infiltrated tissue were identical. In contrast, the clonality analysis of T-cell receptor γ revealed no clonality on blood cells and infiltrated tissues. In conjunction with the histopathologic changes, the lesion was interpreted to be composed of neoplastic B cells with a reactive T-cell population. Polymerase chain reaction testing for equine herpes virus 5 was negative. The final diagnosis was diffuse large B-cell lymphoma with a marked hematogenous component.

Prohibiting Students from Asking Questions during Exams: A Guideline for Promoting Fairness and Preserving Score Validity.

Many medical and professional programs implement policies that prohibit students from asking questions during examinations. The reasoning behind these policies remains unclear to some, as there is a lack of literature addressing this topic. The purpose of this article is to present the rationale behind such policies and to discuss why these policies may help promote fairness and preserve score validity.

Proceedings of the 2015 National Toxicology Program Satellite Symposium.

The 2015 Annual National Toxicology Program Satellite Symposium, entitled "Pathology Potpourri" was held in Minneapolis, Minnesota, at the American College of Veterinary Pathologists/American Society for Veterinary Clinical Pathology/Society of Toxicologic Pathology combined meeting. The goal of this symposium is to present and discuss diagnostic pathology challenges or nomenclature issues. Because of the combined meeting, both laboratory and domestic animal cases were presented. This article presents summaries of the speakers' talks, including challenging diagnostic cases or nomenclature issues that were presented, along with select images that were used for audience voting and discussion. Some lesions and topics covered during the symposium included hepatocellular lesions, a proposed harmonized diagnostic approach to rat cardiomyopathy, crop milk in a bird, avian feeding accoutrement, heat exchanger in a tuna, metastasis of a tobacco carcinogen-induced pulmonary carcinoma, neurocytoma in a rat, pituicytoma in a rat, rodent mammary gland whole mounts, dog and rat alveolar macrophage ultrastructure, dog and rat pulmonary phospholipidosis, alveolar macrophage aggregation in a dog, degenerating yeast in a cat liver aspirate, myeloid leukemia in lymph node aspirates from a dog, Trypanosoma cruzi in a dog, solanum toxicity in a cow, bovine astrovirus, malignant microglial tumor, and nomenclature challenges from the Special Senses International Harmonization of Nomenclature and Diagnostic Criteria Organ Working Group.

Scanning technology selection impacts acceptability and usefulness of image-rich content.

OBJECTIVE: Clinical and research usefulness of articles can depend on image quality. This study addressed whether scans of figures in black and white (B&W), grayscale, or color, or portable document format (PDF) to tagged image file format (TIFF) conversions as provided by interlibrary loan or document delivery were viewed as acceptable or useful by radiologists or pathologists. METHODS: Residency coordinators selected eighteen figures from studies from radiology, clinical pathology, and anatomic pathology journals. With original PDF controls, each figure was prepared in three or four experimental conditions: PDF conversion to TIFF, and scans from print in B&W, grayscale, and color. Twelve independent observers indicated whether they could identify the features and whether the image quality was acceptable. They also ranked all the experimental conditions of each figure in terms of usefulness. RESULTS: Of 982 assessments of 87 anatomic pathology, 83 clinical pathology, and 77 radiology images, 471 (48%) were unidentifiable. Unidentifiability of originals (4%) and conversions (10%) was low. For scans, unidentifiability ranged from 53% for color, to 74% for grayscale, to 97% for B&W. Of 987 responses about acceptability (n=405), 41% were said to be unacceptable, 97% of B&W, 66% of grayscale, 41% of color, and 1% of conversions. Hypothesized order (original, conversion, color, grayscale, B&W) matched 67% of rankings (n=215). CONCLUSIONS: PDF to TIFF conversion provided acceptable content. Color images are rarely useful in grayscale (12%) or B&W (less than 1%). Acceptability of grayscale scans of noncolor originals was 52%. Digital originals are needed for most images. Print images in color or grayscale should be scanned using those modalities.

Cyniclomyces guttulatus Infection in Dogs: 19 Cases (2006-2013).

Cyniclomyces guttulatus, a gastrointestinal yeast of rabbits, is considered an uncommon, nonpathogenic, "pass through" organism and possible opportunistic pathogen in dogs that consume rabbit feces. This retrospective study aimed to characterize the presenting complaint, clinical findings, location of organisms, and final diagnosis of dogs in which yeast morphologically consistent with C. guttulatus were identified at a veterinary teaching hospital from 2006-2013. The prevalence of C. guttulatus infection in a general population of dogs from a regional animal shelter was also determined. Nineteen dogs were retrospectively identified as diagnosed with C. guttulatus infection. Among these, 79% presented with a chief complaint and/or clinical signs consistent with gastrointestinal tract disease. The most common clinical sign was chronic diarrhea. The majority of dogs had C. guttulatus identified cytologically within samples obtained from the gastrointestinal tract; however, four dogs had C. guttulatus identified in non-gastrointestinal tract samples, including a nasal biopsy (one dog) and urine (three dogs). C. guttulatus was not identified in any of 105 shelter dogs evaluated, suggesting low prevalence of C. guttulatus in our region. These findings suggest that additional studies to determine if C. guttulatus is a potential cause or consequence of gastrointestinal illness in dogs may be warranted.

Comparison of automated versus manual neutrophil counts for the detection of cellular abnormalities in dogs receiving chemotherapy: 50 cases (May to June 2008).

OBJECTIVE: To determine the frequency of clinically relevant abnormalities missed by failure to perform a blood smear evaluation in a specific subset of dogs receiving chemotherapy and to compare automated and manual neutrophil counts in the same population. DESIGN: Retrospective case series. ANIMALS: 50 dogs receiving chemotherapy with a total nucleated cell count > 4,000 nucleated cells/µL. PROCEDURES: 50 blood smears were evaluated for abnormalities that have strong potential to change the medical plan for a patient: presence of blast cells, band neutrophils, nucleated RBCs, toxic change, hemoparasites, schistocytes, and spherocytes. Automated and manual neutrophil counts were compared. RESULTS: Blood smears from 10 (20%) patients had ≥ 1 abnormalities. Blast cells were identified on 4 (8%) blood smears, increased nucleated RBCs were identified on 5 (10%), and very mild toxic change was identified on 2 (4%). Correlation coefficient of the neutrophil counts was 0.96. Analysis revealed a slight bias between the automated and manual neutrophil counts (mean ± SD difference, -0.43 × 10(3)/µL ± 1.10 × 10(3)/µL). CONCLUSIONS AND CLINICAL RELEVANCE: In this series of patients, neutrophil count correlation was very good. Clinically relevant abnormalities were found on 20% of the blood smears. An automated CBC appears to be accurate for neutrophil counts, but a microscopic examination of the corresponding blood smear is still recommended; further studies are needed to determine whether the detection or frequency of these abnormalities would differ dependent on chemotherapy protocol, neoplastic disease, and decision thresholds used by the oncologist in the ordering of a CBC without a blood smear evaluation.

Comparison of manual polychromatophilic cell and automated reticulocyte quantification in evaluating regenerative response in anemic dogs.

BACKGROUND: Degree of polychromasia and reticulocyte counts are commonly used in veterinary medicine to evaluate response to anemia. The quantitative association between these 2 measurements has not been evaluated. OBJECTIVE: The aim of this retrospective study was to compare automated reticulocyte percents and counts with those of polychromatophilic cells on blood films from dogs. METHODS: Blood films and medical records from 30 clinically healthy dogs and 60 anemic dogs were evaluated. Manual percentage of polychromatophilic cells (MPP) was determined by counting cells in 10 1000× fields, and automated reticulocyte percentage (ARP) was measured using an ADVIA 120 hematology analyzer; absolute polychromatophilic cell and reticulocyte counts were then calculated. Degree of polychromasia, estimated as slight, mild, moderate, marked was documented. Percentages and absolute counts of polychromatophilic cells and reticulocytes were compared using least squares regression and Pearson's correlation coefficients. RESULTS: The reference interval for MPP in healthy dogs was 0.21-0.26%. Correlation between MPP and ARP was highest when all levels were considered (n = 60, r = .98, P < .0001), strong when ARP was > 5% (n = 20, r = .91, P < .0001), and poor when ARP was 1-2% (n = 20, r = .35, P < .0001). Results were similar for comparisons of absolute reticulocyte and polychromatophilic cell counts, with the best correlation found when all levels of counts were analyzed together (r = .96) and for automated reticulocyte counts > 150,000/µL (r = .94). Correlation of estimates of polychromasia with ARP was good (r = .83). CONCLUSION: In anemic dogs MPP can be used for assessment of regeneration, especially in dogs with higher levels of ARP. Standard quantification of reticulocytes is more accurate in dogs with lesser degrees of regeneration.