Veterinary Medicine - March 2008 - (Page 147)

A challenging case PEER-REVIEWED 1. An 8-year-old mixed-breed dog with inappetence, weight loss, and alopecia. 2. Erythema, ulcers, and superﬁcial excoriations on the dog’s footpad. 3. Erythema and crusty alopecia on the dog’s dorsal paw, tarsus, hock, and stiﬂe region. 4. A photomicrograph of a footpad biopsy showing parakeratotic hyperkeratosis, acanthosis, and superﬁcial lymphohistiocytic dermatitis. Note the red upper layer of the stratum compactum (short arrow), the white middle layer of ballooning degeneration in the stratum spinosum (arrowhead), and the blue hyperplastic basal cell layer of the epidermis (long arrow) (hematoxylin-eosin stain, 100X). Hepatic enzyme activities and serum preprandial and postprandial bile acid concentrations were normal. Urinalysis of a sample obtained by cystocentesis revealed hematuria and bacteriuria (2+ blood, 1+ bacteria, > 50 RBCs/hpf, and 5 WBCs/hpf), indicating bacterial cystitis. A urine bacterial culture was positive for Escherichia coli, with a wide spectrum of antibacterial sensitivity. Plasma samples analyzed for glucagon concentration by using a human radioimmunoassay at The Ohio State University Medical Center revealed plasma glucagon concentrations greater than 1,700 ng/L (canine reference interval = 35 to 49 ng/L).1 DIFFERENTIAL DIAGNOSIS The physical examination ndings and histopathologic changes were consistent with super cial necrolytic dermatitis, and the plasma glucagon concentration strongly suggested that a glucagonsecreting pancreatic tumor was present. An exploratory laparotomy was scheduled for 18 days after presentation. The dog’s bacterial cystitis was treated. eter multilobular mass was identi ed on the caudal pole of the right lobe of the pancreas. The mass was removed (Figure 5) and submitted for cytologic and histologic evaluation. Postoperative recovery was uneventful. CYTOLOGIC EXAMINATION The cytologic examination revealed that the scrapings of the pancreatic mass were highly cellular. The scrapings consisted primarily of individual and small cohesive groups of neoplastic mononuclear cells mixed with many cell-free nuclei and erythrocytes (Figure 6). The mononuclear cells also had round nuclei with coarsely stippled nuclear chromatin, LAPAROTOMY After routine intravenous anesthetic induction, intubation, and establishment of a surgical plane of anesthesia with iso urane, a ventral midline laparotomy was performed. A 1-cm diam- VETERINARY MEDICINE March 2008 147

Table of Contents Feed for the Digital Edition of Veterinary Medicine - March 2008

Veterinary Medicine - March 2008 Contents Toxicology Brief Idea Exchange A Challenging Case An Update on Diagnosing and Treating Primary Lung Tumors CE Form Product Preview Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - March 2008

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