What is your diagnosis? Splenic aspirate from a dog

Abstract

| CASE PRESENTATIONAn 8-year-old spayed female Nova Scotia Duck Tolling Retriever was presented to NC State Veterinary Hospital with a severalmonth history of polyuria/polydipsia, hyporexia, elevated liver values, hypercalcemia, hyperglobulinemia, and multifocal pyogranulomatous inflammation of unknown etiology. Physical examination revealed the patient to be dull with moderate dental calculus, mild muscle wasting, and few petechial hemorrhages on the medial aspect of the left fundus. The CBC revealed mild thrombocytopenia (177 × 10 3 /μL, RI 190-468), a mild left shift (0.174 × 10 3 /μL), and some rouleaux formation. Abnormal biochemistry findings included hypercalcemia (12.8 mg/dL, RI 9.4-11.4), hypoalbuminemia (2.4 g/dL, RI 3.0-3.9), hyperglobulinemia (5.5 g/dL, RI 1.7-3.8), hyperbilirubinemia (1.0 mg/dL, RI 0-0.2), elevated alkaline phosphatase (3665 IU/L, RI 16-140), increased alanine transferase (442 IU/L, RI 12-54), and increased creatine kinase (779 IU/L, RI 43-234). Urinalysis revealed a specific gravity of 1.024, 2+ bilirubin, and 2+ protein. Ionized hypercalcemia (1.43 mmol/L, RI 0.90-1.32) and hyperammonemia (47 μmol/L, RI 10-30) were also