What is your diagnosis? Peritoneal effusion from a dog

Abstract

A 5-year-old, female Italian hound dog was presented with progressive weight loss, anorexia, and lethargy. Physical examination abnormalities included poor body condition, abdominal distension, splenomegaly, and areas of crusty alopecia on the head and limbs. Clinicopathologic abnormalities included mild normocytic normochromic anemia, moderate hyperproteinemia and hyperglobulinemia, mild hypoalbuminemia, and hyponatremia, a mild increase in serum alkaline phosphatase activity, and a moderate to marked increase in beta- and gamma-globulins on serum protein electrophoresis. Abdominal ultrasonography revealed peritoneal effusion. Abdominocentesis yielded approximately 200 mL of serosanguinous, slightly turbid fluid with 2.6 x 10(9) nucleated cells/L, and a protein concentration of 32 g/L. Cytologic specimens of the fluid contained a mixed population of inflammatory cells. Intracytoplasmic inclusions identified as Leishmania sp. amastigotes were observed in numerous macrophages and also free in the background. An ELISA for canine Leishmania sp. antibody was positive. The abdominal effusion resolved within a few days of beginning treatment with meglumine antimoniate and allopurinol. Finding Leishmania amastigotes in peritoneal fluid is rare in canine leishmaniasias and allows an easy, quick diagnosis of the disease.

Antibodies to Leishmania infantum in peritoneal effusion from a dog with atypical signs of leishmaniosis: treatment and follow‐up

“…The presence of Leishmania amastigotes can be observed in peritoneal fluid with sick dogs 20 26. In the authors’ research, the cytological examination of the abdominal fluid did not reveal the presence of the parasites, showing a negative result and leading to the need for other confirmation tests with higher sensitivity, such as molecular techniques.…”

“…Hepatobiliary failure due to L. infantum has been experimentally documented and in naturally infected dogs, observing laboratory alterations associated with liver injury and histopathological changes in the liver characterised by the presence of a mononuclear inflammatory cell infiltration 16–19. Peritoneal effusion is a very unusual clinical finding in canine leishmaniosis, classifying the effusion as exudate, modified transudate or transudate, as in this report 11 20–22. The pathogenesis of peritoneal effusion as a consequence of leishmaniosis is not clearly described, and different mechanisms have been proposed, such as liver failure and/or increased vascular permeability in hepatic veins 11 21.…”