Clinical Pathology Case Presentation

Brenda Low

Signalment

• DSH

• 10 years old

• FN

• Single cat household

• Indoor cat

History

• Ataxic and inappetant

• Been on metacam for 1 week without improvement

• No weight loss

• Drinking normal

• No vomiting

• Biochemistry

– Albumin slightly low

– Total protein > 120g/l

– Decreased WBC

Further tests

• FIP profile

– For FIP diagnosis in sick cats

– FCoV antibodies

– Haematology/cytology

– A:G ratio

– Alpha 1 AGP

Results

• Haematology smear report

– Platelet numbers adequate but less than reference

– Blood picture poorly regenerative

– Rouleaux formation strongly increased

– Slide agglutination negative

– No evidence of haemoparasites

– Neutrophils show mild toxic change

– Occasional large lymphoblasts

Results

Abnormalities

• WBC 4.46 5.5 – 15.5

• lymphocytes 0.446 1.5 – 7.0

• total protein 154 60 – 85

• albumin 15 26 – 36

• globulin 139 27 – 45

• A:G ratio 0.1

BUT

• FCoV antibodies 0

• Alpha-1 AGP 280 µg/ml

Differentials

• Neoplasia

• Feline immunodeficiency virus (FIV)

Serum protein electrophoresis

• Polyclonal gammopathy

– Non-neoplastic(inflammatory)

• Monoclonal gammopathy

– Neoplastic

Globulinspike

Alb

Alb

Globulin spike

Results

Neoplasia

• Lymphoma

• Multiple myeloma

• Chronic lymphocytic leukaemia

Neoplasia

• Lymphoma

– Alimentary

– Multicentric

– Mediastinal

– Nasal

– Renal

– Spine or CNS

• Multiple myeloma

• Chronic lymphocytic leukaemia

Most common

Further tests

• Lymphoma

– Abdominal ultrasound

– Lymph node excision

– Thoracic radiographs

– FNA of mediastinal mass if present

– Nasal CT

– Spinal radiography / CT / MRI

• Multiple myeloma

– Radiographs – thoracic, abdominal, limbs and spine

FIV

• Older cat

• Neurological signs – ataxia

• Lymphopenia

References

• Jane M. Dobson, B. Duncan, X. Lascelles (2011). BSAVA Manual of Canine and Feline Oncology. 3rd ed. Gloucester: British Small Animal Veterinary Association

• Elizabeth Villiers, Laura Blackwood (2005). BSAVA Manual of Canine and Feline Clinical Pathology. 2nd ed. Gloucester: British Small Animal Veterinary Association

• Ian Ramsey, Bryn Tennant (2001). BSAVA Manual of Canine and Feline Infectious Diseases. 1st ed. Gloucester: British Small Animal Veterinary Association

• http://www.mayomedicallaboratories.com/media/articles/communique/mar2002.pdf

• Companion Animal Studies (CAS) lecture – Oncology 3: Approach to lymphoma and leukaemia. J.S. Morris, BSc, BVSc, PhD, FRCVS

• Companion Animal Studies (CAS) lecture – Feline Infectious Diseases: Panleucopenia, Cat Flu and FIP. Ian Ramsey, BVSc Phd DSAM FHEA MRVCS DipECVIM-CA