Case Description—A 4-year-old spayed female mixed-breed dog with a history of allergic skin disease was examined because of regurgitation, coughing, and dysphagia that began 15 days after abdominal surgery for correction of gastric dilatation and volvulus.
Clinical Findings—Severe diffuse esophagitis, esophageal dysmotility, and a benign esophageal stricture at the level of the base of the heart were identified via contrast videofluoroscopy and esophagoscopy. Severe diffuse eosinophilic ulcerative esophagitis was confirmed by histologic examination of esophageal biopsy specimens and cytologic evaluation of specimens obtained by use of a cytology brush. Esophageal eosinophils were evident (14% to 50% of the inflammatory cell population and > 25 eosinophils/hpf).
Treatment and Outcome—No clinical or endoscopic improvement was evident after treatment with antireflux medications, including a proton-pump inhibitor, following an initial esophageal bougienage procedure. An excellent response characterized by resolution of dysphagia and regurgitation with marked improvement of the esophageal mucosa was evident following intralesional and systemic administration of glucocorticoids, 2 additional esophageal bougienage procedures, and feeding of an elimination diet.
Clinical Relevance—To our knowledge, the information reported here is the first description of eosinophilic esophagitis (EE) in a dog. Many similarities exist between the condition in the dog reported here and EE in humans. This clinical report highlights the need to consider EE as a differential diagnosis for esophagitis and esophageal strictures in dogs. When appropriate, esophageal biopsy or cytologic specimens should be obtained and examined to investigate the possibility of EE.
Objective—To determine the frequency of clinically relevant abnormalities missed by failure to perform a blood smear evaluation in a specific subset of dogs receiving chemotherapy and to compare automated and manual neutrophil counts in the same population
Design—Retrospective case series
Animals—50 dogs receiving chemotherapy with a total nucleated cell count > 4,000 nucleated cells/μL.
Procedures—50 blood smears were evaluated for abnormalities that have strong potential to change the medical plan for a patient: presence of blast cells, band neutrophils, nucleated RBCs, toxic change, hemoparasites, schistocytes, and spherocytes. Automated and manual neutrophil counts were compared.
Results—Blood smears from 10 (20%) patients had ≥ 1 abnormalities. Blast cells were identified on 4 (8%) blood smears, increased nucleated RBCs were identified on 5 (10%), and very mild toxic change was identified on 2 (4%). Correlation coefficient of the neutrophil counts was 0.96. Analysis revealed a slight bias between the automated and manual neutrophil counts (mean ± SD difference, −0.43 × 103/μL ± 1.10 × 103/μL)
Conclusions and Clinical Relevance—In this series of patients, neutrophil count correlation was very good. Clinically relevant abnormalities were found on 20% of the blood smears. An automated CBC appears to be accurate for neutrophil counts, but a microscopic examination of the corresponding blood smear is still recommended; further studies are needed to determine whether the detection or frequency of these abnormalities would differ dependent on chemotherapy protocol, neoplastic disease, and decision thresholds used by the oncologist in the ordering of a CBC without a blood smear evaluation.