Neutrophil cytoplasmic toxicity is manifested as an abnormality in cell size or the cytoplasmic content upon examination of Romanowsky-stained blood smears, and is traditionally associated with infection and inflammation. The purpose of this retrospective study was to investigate the association of such changes with clinical and clinicopathologic characteristics, diseases, and prognoses in dogs. Dogs with neutrophil toxicity (n ϭ 248) were compared with negative controls (n ϭ 248). Statistical analyses included chi-square tests, independent t-tests, nonparametric Mann-Whitney tests, the chi-square trend test, and survival analysis. Dogs with neutrophil toxicity had a significantly higher prevalence of pale mucous membranes, tachycardia, fever, abdominal organomegaly, icterus, melena, and hematuria. Most mean hematologic variables were significantly different between groups. Dogs with neutrophil toxicity had a significantly (P Ͻ .05) higher prevalence of leukocytosis, leukopenia, neutrophilia, neutropenia, anemia, hyponatremia, hypokalemia, hypoproteinemia, hypoalbuminemia, and hypocalcemia. The prevalence of pyometra, parvovirus infection, acute renal failure, peritonitis, immune-mediated hemolytic anemia, disseminated intravascular coagulation, pancreatitis, septicemia, and neoplastic disorders was significantly higher among these dogs. Case fatality, hospitalization length, and treatment cost were significantly (P Ͻ .001) higher in dogs with neutrophil toxicity. Neutrophil toxicity severity was significantly (P Ͻ .0035) and positively associated with neutropenia, and negatively associated with leukocytosis and neutrophilia. A significant trend (P ϭ .05) toward increasing case fatality with an increase of neutrophil toxicity was observed. In the neutrophil toxicity group, dogs with leukopenia (Ͻ5.0 ϫ 10 3 /mm 3 ) had a significantly (P Ͻ .0001) higher case fatality compared to dogs with normal or high leukocyte counts. We conclude that evaluation of blood smears for neutrophil cytoplasmic toxicity provides useful clinical information and can serve as a good prognostic predictor.Key words: Canine; Döhle bodies; Hematology; Leukocytes; Toxic changes; Toxic neutrophils.T oxic neutrophils have abnormalities in cell size, nuclear shape and consistency, and cytoplasmic content, which are evident upon examination of Romanowskystained blood smears.1,2 Toxic changes occur in neutrophils during their development in the bone marrow, and are divided into 3 categories: nuclear, cytoplasmic, and giant neutrophils.1,2 The most commonly noted and important changes are the cytoplasmic ones, which include diffuse basophilia, granulation, foamy vacuolation, and the presence of Döhle bodies.1,2 Cytoplasmic basophilia appears as a bluish gray to dark-blue cytoplasm as opposed to the normal neutral cytoplasm of the cell, and results from RNA and ribosome retention in the neutrophil's cytoplasm during the maturation process.1,2 Toxic granulation refers to the presence of azurophilic granules in the neutrophil's cytoplasm, and is pres...

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Case Description—A 15-kg (33-lb) pregnant female mixed-breed dog of unknown age was referred because of a 10-day history of difficulty breathing. Clinical Findings—Physical examination findings were dyspnea, tachypnea, decreased bronchovesicular sounds (bilateral), muffled heart sounds, and abdominal distention with palpable fetuses. Hematologic abnormalities included anemia, leukocytosis, and thrombocytosis. Abnormalities detected during serum biochemical analysis included decreases in concentrations of albumin, sodium, triglycerides, and total calcium and increases in activities of alkaline phosphatase, alanine aminotransferase, γ-glutamyltransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine kinase. Thoracic radiography revealed a diaphragmatic hernia with fetuses and a soft tissue or fluid opacity within the thoracic cavity. Treatment and Outcome—Exploratory celiotomy, ovariohysterectomy, partial sternotomy, placement of a right-sided thoracostomy tube, and herniorrhaphy were performed. After surgery, pneumothorax developed, and the thoracostomy tube was used to remove pleural effusion and free air. The pneumothorax did not resolve after continuous drainage of the thoracic cavity for 4 days. Autologous blood pleurodesis was performed by infusion of 80 mL (6 mL/kg [2.73 mL/lb]) of whole blood. The pneumothorax resolved immediately after injection of the blood. Conclusions and Clinical Relevance—Blood pleurodesis was used for resolution of pneumothorax in a dog after correction of a diaphragmatic hernia. Blood pleurodesis may provide a simple, safe, and inexpensive medical treatment for resolution of persistent (duration > 5 days) pneumothorax when surgery is not an option.

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SummaryReasons for performing study: There is a consensus in the veterinary literature that Parascaris equorum (ascarid) impaction carries a poor prognosis. Hence surgery is often delayed and foals are often subjected to euthanasia after diagnosis of ascarid impaction is established. Our clinical impression was that ascarid impaction carries a better prognosis than previously reported. Objectives: Our expectation was that manually evacuating the impaction into the caecum, thus refraining from opening the small intestine, would improve the prognosis for survival of horses with ascarid impaction. The aim of this study was to examine medical records of horses treated surgically for ascarid impaction, record their clinical findings and evaluate the association of outcome with the method of relieving the impaction. Methods: The medical records of all horses presented to our hospital between October 2002 and December 2011 that underwent exploratory celiotomy for ascarid impaction were reviewed. Information retrieved from the medical record included surgical findings, surgical technique, complications, shortand long-term survival. The association between categorical variables was assessed using the Fisher's exact test. A P value <0.05 was considered statistically significant. Results: Fifteen horses fulfilled the inclusion criteria. Eighty percent of horses (12/15) survived to discharge and 60% (6/10) survived for at least one year. Five horses are doing well but are still in convalescence. Horses that underwent small intestinal enterotomy or resection and anastomosis (n = 5) were less likely to survive to discharge (P = 0.022). Conclusions: In our study, manual evacuation of ascarid impaction into the caecum, while refraining from opening the small intestine resulted in significantly improved survival in horses with ascarid impaction. Potential relevance: Refraining from opening the small intestine may be the key to improving surgical outcome in horses with ascarid impaction.