T‐Cell Lymphoma with Immune‐Mediated Anemia and Thrombocytopenia in a Horse

Abstract

A 13-year-old 480-kg mixed breed gelding was examined because of a 2-day history of anorexia, fever, mild colic, and icterus.Three days before the onset of clinical signs, the horse received vaccinations for rabies, tetanus, West Nile virus, Western equine encephalomyelitis, and Eastern equine encephalomyelitis.On examination the horse was quiet, alert, and responsive. Heart rate was 54 beats/min, respiration rate was 18 breaths/min, and temperature was 37.9°C. Mucous membranes and sclera of the eyes were markedly icteric and capillary refill time was 2 seconds. Heart, lung, and abdominal auscultation were within normal limits. Peripheral lymph nodes were not enlarged and no abnormalities were detected on the remainder of the physical examination.Naso-gastric intubation revealed no net gastric reflux. Abdominal ultrasonography revealed a small area of moderately thickened (0.8 cm) ventral colon. Thoracic ultrasound did not reveal abnormalities. Rectal examination revealed splenomegaly but was otherwise within normal limits. Abdominocentesis was attempted but peritoneal fluid was not obtained.Complete blood count (CBC) revealed anemia (PCV 16%; reference range 33-42%) and thrombocytopenia (26,000/lL [reference range 100,000-600,000/lL]). Total white blood cell count and differential were within normal limits. Cytological evaluation of peripheral blood revealed rare nucleated red blood cells but otherwise abnormalities were not detected. Serum biochemistry abnormalities were limited to hyperglycemia (135 mg/ dL; reference range 60-107 mg/dL) and hyperbilirubinemia (10.9 mg/dL; reference range 0.5-2.5 mg/ dL). Direct and indirect bilirubin values were not measured. Total protein (TP) was 6.1g/dL (reference range 5.5-7.5 g/dL). Hyperfibrinogenemia was detected (275 g/dL; reference range 125-262 g/dL). Venous blood gas analysis a identified hyperlactatemia (7.1 mmol/L; reference range <1 mmol/L) but was otherwise normal. Prothrombin time and partial thromboplastin time were normal. A direct Coombs test was negative.ELISA and agar gel immunodiffusion (Coggins test) for equine infectious anemia and ELISA for Anaplasma phagocytophilum were negative.Volume replacement included lactated Ringer's b (20 mL/kg bolus followed by 2 mL/kg/h IV maintenance). Urine specific gravity (USG) after the initial fluid bolus was 1.025 and dipstick analysis did not reveal any abnormalities. Following the fluid bolus, PCV was 13% and TP 5.6 g/dL. The horse was lethargic and tachycardic (66 beats/min). Commercial fresh frozen plasma c was administered (4 mL/kg IV). Cross matching was performed and 8 L whole blood was administered from a donor horse. Treatment included dexamethasone d (0.2 mg/kg, IV, q24h), trimethoprim sulfamethoxazole e (TMS) (30 mg/kg, PO, q12h), and sucralfate f (20 mg/kg, PO, q6h). Because of the history of colic, feed was withheld for the first 18 hours. No signs of colic or fever were noted. The day after initial examination the horse was brighter and vital parameters were within normal limits. PCV was 17% and blood l...

Suspected case of hypersplenism as a cause of anaemia, thrombocytopenia and leucopenia in a Miniature Horse gelding

“…; Thomas and Livesey ; McGovern et al . ; Teachey and Lambert ). The case presented here is unique in that hypersplenism, which has not been previously reported in horses, was the presumptive cause of destruction in multiple cell lineages.…”

Septic funiculitis caused byStreptococcus equisubspeciesequiinfection with associated immune‐mediated haemolytic anaemia

“…; McGovern et al . ; Taintor and Schleis ; Davis and Rush ). Further diagnostics for neoplasia, including an IgM RID assay, liver biopsy, or bone marrow aspirate (Perkins et al .…”

Multicentric lymphoma in a pony presented as a case of metastatic strangles

“…Reported presentations include acute uveitis, adverse vaccine reaction, rabies, septicaemia in a foal and a range of different presentations of ataxia (Neufeld 1973, Tomlinson and others 1979, Germann and others 2008, McGovern and others 2011, Finding and others 2014). …”