July 2012 Case of the Month

Photomicrographs from a digital swelling in a dog

 

Case information

A 9 year old male castrated miniature schnauzer presented for evaluation of a chronically swollen toe. The patient had been intermittently holding up the left rear paw over a 4 month period. The pad of the left hind fourth digit was historically found to be swollen and slightly erythematous. The swelling was partially responsive to antibiotic treatment, but would return once antibiotics were discontinued.

On physical examination, the patient was overconditioned with a body condition score of 8/9. The patient had an increased body temperature (103.4°F) and was mildly tachycardic (120 bpm) attributed to his excited demeanor. Swelling was evident on the pads of digit III and IV on the left rear paw, but the pads were non-painful on palpation and there was minimal erythema with no ulceration associated with the swelling. A complete blood count and a serum biochemical panel were submitted and the results were unremarkable. Evaluate the representative photomicrograph from fine needle aspiration of the swollen digits (Figure 1) and answer the questions below.

  • How would you characterize the inflammatory cell population? What differential diagnoses would you consider for this type of inflammation?
  • What is the specific cause of the inflammation in this patient?
  • What biochemical abnormality might you expect in a patient with this disease process?

Figure 1: FNA of digital swelling (20x, Wright's stain)
Figure 1: FNA of digital swelling (20x, Wright’s stain)

Answer on next page

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