Department of Comparative, Diagnostic, and Population Medicine, University of Florida, Gainesville, Florida, USA.
Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
Vet Clin Pathol. 2024 Jun;53(2):242-249. doi: 10.1111/vcp.13354. Epub 2024 Apr 29.
A 9-month-old female intact toy poodle and a 1-year-old female intact Labrador retriever mix presented to separate teaching hospitals for chronic histories of malaise and clinicopathologic evidence of hepatic dysfunction. The signalment and clinical histories of these dogs prompted consideration of a congenital portosystemic shunt as a primary differential. However, microscopic evaluation of peritoneal effusion, pleural effusion, and peripheral blood samples from the dogs revealed round to ovoid yeast organisms morphologically most compatible with Histoplasma capsulatum. Additional testing confirmed histoplasmosis in each case. The poodle underwent a computed tomography (CT) study, which showed hepatomegaly with a spleno-gonadal shunt, pancreatic and gastric wall edema, and marked peritoneal effusion, findings compatible with portal hypertension and secondary acquired shunt formation. The dog was later humanely euthanized due to clinical deterioration, and on necropsy hepatic histoplasmosis was verified, with additional affected tissues comprising lungs and spleen. The Labrador Retriever mix responded clinically and clinicopathologically to antifungal therapy, though no abdominal imaging was performed to definitively exclude the possibility of a congenital portosystemic shunt. In retrospect, several features were more compatible with histoplasmosis than portosystemic shunt in these cases, including hyperbilirubinemia, effusion, and hepatomegaly. These findings serve as a reminder of the need to interpret serum biochemical findings in the context of the totality of the clinicopathologic data and imaging findings, as well as the diagnostic value of microscopy in the evaluation of hematologic and body cavity fluid samples.
一只 9 月龄雌性未绝育玩具贵宾犬和一只 1 岁雌性未绝育拉布拉多犬混合品种因慢性不适和临床病理证据表明肝功能障碍而分别被送到两所教学医院就诊。这两只狗的特征和临床病史提示先天性门体分流作为主要鉴别诊断。然而，对狗的腹腔积液、胸腔积液和外周血样本进行的显微镜评估显示出形态上最符合荚膜组织胞浆菌的圆形到卵圆形酵母样生物体。进一步的检测证实了这两种情况均为组织胞浆菌病。贵宾犬接受了计算机断层扫描（CT）检查，显示肝肿大伴脾-性腺分流、胰腺和胃壁水肿以及明显的腹腔积液，这些发现与门静脉高压和继发性获得性分流形成相符。由于临床恶化，该犬后来被人道地安乐死，尸检时肝组织胞浆菌病得到证实，其他受影响的组织包括肺和脾。拉布拉多犬混合品种对抗真菌治疗有临床和临床病理反应，尽管没有进行腹部成像来明确排除先天性门体分流的可能性。回顾这些病例，有几个特征更符合组织胞浆菌病而不是门体分流，包括高胆红素血症、积液和肝肿大。这些发现提醒我们需要根据临床病理数据和影像学发现的整体情况以及血液学和体腔液样本的显微镜检查的诊断价值来解释血清生化结果。
