Hypertrophic osteopathy associated with a bronchial foreign body (grass awn) in a dog: a case report

Abstract

ABSTRACT:A five-year-old dog was referred with a five-month history of lethargy, decreased appetite, cough and intermittent forelimb lameness. Radiographs revealed an intra-thoracic lesion and a marked periosteal bone apposition of the second digit on the left forelimb. As it was palisading and circumferential, the latter appeared typical of hypertrophic osteopathy (HO). A grass awn in a sub-lobar ramification of the right caudal bronchus was identified and removed by bronchoscopy. At three months follow-up, the digit appeared clinically normal. On radiographs the periosteal bone reaction had decreased, indicative of resolving hypertrophic osteopathy. Thoracic radiographs showed no abnormalities five months after foreign body removal and the bone lesion on the digit had disappeared. Successful treatment of the pulmonary foreign body abscess led to spontaneous regression of HO and eventually to complete resolution of clinical signs. To the authors' knowledge, this is the first reported case of HO secondary to a bronchial-pulmonary grass an abscess.Keywords: hypertrophic osteopathy; grass awn; foreign body; dog Hypertrophic osteopathy (HO) is an uncommon disorder characterised by a painful periosteal reaction and oedematous soft tissue swelling of the limbs usually associated with intrathoracic disease (Dunn et al. 2007). Radiographically, HO is characterised by new periosteal bone formation starting in the digits and extending toward the axial skeleton (Caywood et al. 1985;Dunn et al. 2007).Broncho-pulmonary inflammatory diseases such as abscesses rarely cause HO (Caywood et al. 1985). On the other hand, pyogranulomatous inflammation or abscessation in various body sites due to migration of grass awns, also referred to as "grass awn disease" is a rather common occurrence in Italy (Brennan and Ihrke 1983; Lotti and Niebauer 1992). The characteristic barbed shape of Hordeum spp. explains their tendency toward tissue migration. The most commonly affected sites include the external ear canal, the interdigital area, the nasal cavity and the third eyelid. There is also a relatively high incidence of intra-thoracic abscessation caused by awn inhalation followed by long-lasting broncho-pleural migration. Despite the fact that such chronic intra-thoracic foreign body abscesses may be seen relatively often in endemic areas an association with HO has not been described (Lotti and Niebauer 1992).We hereby report a case of HO secondary to bronchial grass awn inhalation, its successful treatment by bronchoscopic extraction and the ensuing spontaneous regression of HO. Case descriptionA five-year-old, male, German Shepherd dog, weighing 41 kg was referred with a five-month history of lethargy, decreased appetite, cough and intermittent forelimb lameness. A progressively increasing firm swelling of the distal thoracic extremities had developed over the course of the last five months. For one week before presentation the dog was treated with antibiotics and corticosteroids (enrofloxacine 5 mg/kg orally once a day and prednisone 0...

Hypertrophic osteopathy in a dog associated with chronic lung lobe torsion

“…33,47 The authors suspect that pleural effusion was likely initially present in this patient, but resolved given The time for development of secondary HO is unknown, although previous literature supports the notion that chronicity of the underlying disease is required. 24,48,49 In this case, chronicity of the LLT was confirmed during surgery and with histopathology findings of marked interstitial and pleural mature fibrous adhesions. The authors suspect that bacterial pneumonia and associated inflammation in this dog may have contributed to, or exacerbated, the progression of HO.…”

Hypertrophic osteopathy and suspected subsequent disseminated intravascular coagulation in a dog with an abdominal gossypiboma

“…Other theories include periosteal irritation by circulating toxins, rapid increases in distal extremity blood flow and platelet clumps deposited in the distal vasculature release platelet‐derived growth factor and vascular endothelial growth factor leading to fibroblast proliferation, angiogenesis and osteoblastic differentiation and periosteal reaction formation 7,50,51 . HO has been previously reported in association with infections that have induced granulomatous inflammation and chronic foreign bodies 20,52–55 . The chronic granulomatous inflammation in a gossypiboma has previously caused osseous lesions and lead to malignant transformation and osteomyelitis 2,3,56 …”

“…7,50,51 HO has been previously reported in association with infections that have induced granulomatous inflammation and chronic foreign bodies. 20,[52][53][54][55] The chronic granulomatous inflammation in a gossypiboma has previously caused osseous lesions and lead to malignant transformation and osteomyelitis. 2,3,56 The treatment of HO and DIC is removal of the precipitating cause.…”

Foreign body cystitis in a male guinea pig due to a sedge (Carexspecies) leaf

“…Migrating foreign bodies are a common clinical condition in small animal practice. While the ear canal is the most common localisation of migrating vegetal matters, they can also be found subcutaneously in the respiratory tract,9 in body cavities10 or even the CNS 11 12…”

“…8 Migrating foreign bodies are a common clinical condition in small animal practice. While the ear canal is the most common localisation of migrating vegetal matters, they can also be found subcutaneously in the respiratory tract, 9 in body cavities 10 or even the CNS. 11 12 The urinary bladder is a localisation of minor importance in pet animals but has nevertheless been described in dogs, 13 14 cats 13 and horses.…”