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Hepatic abscesses in a neonatal French bulldog

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A one-month-old, intact male, French bulldog was presented to the Cornell University Hospital for Animals’ Small Animal Community Practice for failure to thrive. The presenting neonate was one of five in his litter. Of the five, two others died previously. One had a cleft palate and was believed to have died due to aspiration pneumonia. The other was found dead, suspected to have suffocated. The litter was dewormed at six and eight weeks with fenbendazole at an unknown dose and a second unknown dewormer, both administered by the owner. The puppies were also vaccinated by the owner, although the vaccination details are unknown. The owner reported that the puppy had not been developing in concert with his littermates. The puppy had a one-week history of progressive abdominal distension and developed icterus the night prior to presentation. On presentation, the puppy was obtunded. Vital parameters showed hypothermia (35.1 °C), tachypnea (50 breaths/minute), and a normal heart rate (160 beats/minute). Physical examination revealed severe abdominal distension and generalized icterus with pale mucous membranes. Referred upper airway sounds were noted on auscultation of the lungs. Given the history and presentation, differential diagnoses included a portosystemic vascular anomaly, intussusception, gastrointestinal parasitism, or pneumonia. The owner elected euthanasia; therefore, no treatments or antemortem diagnostics were performed, and the animal was submitted for necropsy and histopathology. Gross examination of the liver revealed hepatomegaly with multifocal serosal and parenchymal abscesses, particularly in the right medial lobe. The lungs were diffusely edematous with a mottled yellow to pink appearance. Histopathology of the liver confirmed the presence of hepatic abscesses with peripheral fibrosis and Splendore-Hoeppli material. The abscesses did not seem to be associated with bile ducts. The hepatic parenchyma had nodular aggregates of lymphocytes, neutrophils, and macrophages surrounding areas of cellular debris and fibrillar eosinophilic material. These aggregates were also surrounded by large foamy macrophages and variable amounts of fibroblasts. Staining with Gram stain showed radiating arrays of gram positive, branching, filamentous bacteria within the inflammatory regions. There was also moderate periodic acid Schiff stain uptake in the cytoplasm of macrophages. The results of staining were most consistent with Actinomyces sp. Anaerobic cultures were not submitted due to a delay between submission and sampling. Aerobic hepatic culture results found low numbers of Streptococcus equi ss zooepidemicus, Enterococcus faecalis, and a gram-negative Pasteurella-like organism.

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2019-09-25

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abscess; icterus; French bulldog; neonate, hepatic; Actinomyces

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case study

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