by Elena Martínez de MerloJuly 2019Atlases of cytology are an essential tool in small animal practice. Diagnostic cytology, which is used extensively in routine clinical practice, requires the most comprehensive cell identification possible. This is best achieved with the help of numerous images that reflect the most characteristic and distinguishing featuresof the different cytological patterns, and this book will therefore be of great use to the reader in the diagnostic process of many pathologies.
In detecting malignant tumors, the cytological examination had Se of 96.4% (95% CI: 87.7%, 99.0%), Sp of 55.6% (95% CI: 33.7%, 75.4%), LR+ of 2.2 (95% CI: 1.3, 3.6), and LR- of 0.07 (95% CI: 0.02, 0.27). The cytological diagnosis of tumor behavior was consistent with histopathology in 63 of all 73 cases (86.3%). Fifty three malignant and 10 benign tumors were diagnosed correctly in CP, while in 2 cases false-negative results (considered as benign with cytology instead of malignant tumor) and in 8 cases false-positive results (considered as malignant with cytology instead of benign tumor) were obtained. For all cases, kappa was 58.5% (95% CI: 35.9%, 81.1%), which was indicative of moderate agreement.
In accurate diagnosing of benign vs. malignant mammary tumors, cytological samples should be evaluated at both low and high magnification. Our results demonstrated useful and reliable criteria in differentiating benign from malignant mammary tumors, such as cell dissociation, nuclear size, cell uniformity, nucleoli, nuclear margin, chromatin pattern, cellularity, presence of necrotic debris, inflammation, and RBC. This finding was in line with previous published studies in veterinary and human medicine [8,21,22,25]. In contrast, Yildirim and Gurel  demonstrated that inflammatory cells, including macrophages and necrotic debris, were not distinctive in making a differentiation between benign and malignant CMTs. Only the evaluation of mucosecretory material and ECM was not sufficient to diagnose the behavior of mammary tumors. The results concerning the presence of ECM corroborate the findings of other authors and support the opinion that the cytological diagnosis of complex/mixed tumors is more challenging and difficult [6,21,37]. However, some studies have reported that the mucosecretory material was much more frequent in the malignant compared to the benign mammary tumors [6,22]
Adding cytological grade to cytological diagnosis will provide valuable information about prognosis [15,17,49,53,60]. In the present study, CMTs of grade 2 or 3 in CP were linked with tumor-related cause of death and shorter survival time. Multivariable analysis demonstrated that the cytological grade 2 or 3 and high clinical TNM stage were the only factors that retained statistical significance as independent predictors of shorter survival. Interestingly, cellularity and cytological background features had no prognostic influence on OS. This is a new observation regarding the use of cytological grading of CMTs for prognostic purposes. Further work is required, however, to validate our results. So far only one study  has found the association between cytological diagnosis (benign vs. malignant) and postoperative outcome. According to the previous reports on CMTs, we confirmed that in several cases the clinicopathological factors were also significantly associated with metastases and/or survival time after surgery [14,27,56,61].
Microscopic examination of Wright-stained peritoneal fluid reveals markedly degenerative neutrophils, activated macrophages, and extracellular gold-brown pigment. One neutrophil in this high-powered field contains large bacterial rods (lower right hand side). This cytologic evaluation, together with elevated total bilirubin concentration in the peritoneal fluid relative to the serum concentration, confirms a diagnosis of a septic bile peritonitis.
eClinpath helped 1.2 million visitors last year from 220 countries find important information on animal health. If you enjoy the site, please support our mission and consider a small gift to help us keep pace with its rapid growth. You can donate securely via PayPal or credit card. Thank you!
The evaluation of a pruritic dog requires a step-by-step thought-process and approach that should lead to a definitive diagnosis. The differential diagnoses and role of complicating factors (Table 1) need to be narrowed down using information derived from the history, the findings on physical examination, diagnostic tests (where necessary), and response to treatment. Basic sampling methods and diagnostic tests, which may be required to rule out most of the common differentials are flea combing, skin scraping, hair plucking and cytological examination of skin and ear samples. Depending on the complexity of the case, the following steps may be performed over a series of visits, or all at once.
Bacterial skin infections caused by Staphylococcus pseudintermedius (SP) are common in dogs with AD. The typical lesions of superficial pyoderma, such as papulo-pustular eruption and epidermal collarettes, are often distinctive enough to make a clinical diagnosis on gross appearance alone. However, the initial diagnosis should be confirmed by examining cytological samples, stained with Diff-Quik, taken from the skin by impression smears or acetate tape impressions [12, 24]. Samples from pricked pustules will most likely yield definitive results, while samples from papules and epidermal collarettes may be less rewarding. Aerobic bacterial culture and sensitivity testing is not indicated in every case, but if particular conditions are fulfilled (e.g., previous history of antibiotic treatment, initial appropriate antibacterial treatment has not been effective, high prevalence of meticillin-resistant SP in the area, etc.), a bacterial culture with antibiogram should be performed . Bacterial cultures can be performed while the dog is currently being treated with systemic antibiotics .
Atlases of cytology are an essential tool in small animal practice. Diagnostic cytology, which is used extensively in routine clinical practice, requires the most comprehensive cell identification possible. This is best achieved with the help of numerous images that reflect the most characteristic and distinguishing featuresof the different cytological patterns, and this book will therefore be of great use to the reader in the diagnostic process of many pathologies.
There is insufficient evidence to recommend use of either pulse (intermittent) or chronic low-dose therapy for prevention of UTIs. The effect of these practices on emergence of resistance should be considered. There is anecdotal evidence that a small percentage of animals with severe clinical signs may require such an approach, but only after thorough evaluation for underlying causes, ideally by a specialist in small animal internal medicine. Although there may be some theoretical benefit for the administration of urinary antiseptics such as methenamine (methenamine hippurate), there is currently insufficient evidence available to assess the effectiveness of these treatments in animals.
UTI should be suspected in catheterized animals exhibiting clinical signs of infection. However, such patients may not be easily identified. As such, infection should be suspected in all cases of fever of unknown origin or bacteremia with an unknown focus. Infection should also be suspected when there are gross or cytological (i.e., hematuria, pyuria) abnormalities.
Addressing the globally increasing issue of antimicrobial resistance is complex and difficult. Because of the high incidence of antimicrobial use in UTIs of dogs and cats, veterinarians must be cognizant of the role of inappropriate treatment in the emergence and dissemination of multidrug-resistant pathogens. At the same time, the Working Group believes that prudent (and therefore rare) use of certain drugs in the treatment of canine and feline UTIs would constitute a miniscule fraction of overall use of these critical drugs. As such, use of critically important antimicrobials in companion animals can be justified as long as their use is prudent and proper, based on culture and susceptibility data as well as patient care and welfare reasons In particular, the use of drugs such as vancomycin, carbapenems, and linezolid is not justified unless the following criteria are met.(i)Infection must be documented based on clinical, culture, and cytological abnormalities. The use of these drugs for the treatment of subclinical infection is not supported.(ii)Resistance to all other reasonable options and susceptibility to the chosen antimicrobial must be documented.(iii)The infection must be potentially treatable. The use of critical drugs in situations where there is little realistic chance of elimination of infection (e.g., failure to remove the underlying cause) is not supported. (iv)Consultation with someone with expertise in infectious diseases and antimicrobial therapy must be obtained to determine whether there are any other viable options and whether treatment is reasonable.
A diverse faculty consisting of 5 ACVP board certified clinical pathologists with predominantly clinical to predominantly research appointments supports residency training. There is a high quality, high volume clinical caseload with an emphasis on small animal cytology/hematology stemming from internal medicine, primary care, and oncology. Graduate research opportunities, if desired, include but are not limited to NIH funded research projects in musculoskeletal disease, stem cell biology, infectious disease, comparative oncology, and radiation research. Additional clinical and applied research opportunities are also available, including the diagnosis of lymphoproliferative disease, scholarship of teaching and learning, diagnostic flow cytometry, and companion animal cytology, hematology, clinical chemistry, and coagulation. 153554b96e