Photomicrographs from transtracheal wash fluid from a dog
Case information
A 5 month old intact male Boxer presented with a 2 month history of an intermittent, semi-productive cough. Treatment with amoxicillin-clavulanic acid resulted in some improvement, but the cough never fully resolved. On physical examination, the puppy was in good body condition and vital parameters were within normal limits. No abnormalities were detected on thoracic auscultation and a cough was not elicited with tracheal palpation. Laboratory abnormalities included a mild leukocytosis characterized by a mature neutrophilia and lymphocytosis. The biochemical profile revealed a moderate hyperphosphatemia and mild hypoglobulinemia, but was otherwise unremarkable. Thoracic radiographs showed a mild diffuse airway pattern. A transtracheal wash was performed and direct and sediment smears of the fluid were examined. Evaluate the representative photomicrographs of the sediment smear and consider the following questions.
- What cell types are present? How would you characterize the inflammation?
- What is the likely agent?
- What is the significance of the hyperphosphatemia and hypoglobulinemia in this patient?
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