Pathology Flashcards
Provide the six pathological processes we need to consider when interpreting a necropsy ?
The six pathological processes
- Malformations and displacements
- Degeneration and necrosis
- Inflammation
- Alterations in vasculature
- Alterations in growth
- Neoplasia
(9) Describe the common post mortem changes often observed ?
9 post mortem changes
- autolysis
- rigor mortis
- algor mortis
- liver mortis (hypostatic congestion)
- post mortem clotting
- haemoglobin imbibition
- bile imbibition
- pseudomelanosis
- bloating, prolapse
- organ displacement
bloody nasal discharge
These changes are non pathological as they occur on or after death.
Describe when and where rigor mortis occurs and why ?
Rigor mortis - contraction of muscles following death
- usually 1-6 hours after death but may persist for 1-2 days
- starts in involuntary muscles, than voluntary muscles
- starts from the head and descends to the trunk and limbs
- muscular animals have a stronger rigor mortis
- high temperature or activity may accelerate the onset of rigor
Note - animals with cachexia / extreme malnutrition may not show signs of rigor mortis
It is caused by a depletion of oxygen and glycogen which subsequently prevents the synthesis of adenosine triphosphate (ATP) after death - no relaxation
Describe this change that occurs post mortem ?
Algor mortis - gradual cooling of the cadaver
- cooling depends upon the body temperature at death eg fever, environmental temp, insulation
- difficult to interpret to establish a time of death
- lens opacity when carcass is cold
Describe this change that occurs post mortem ?
Livor mortis: Hypostatic congestion
Gravitational pull of blood to the down side of the animal
- process begins within an hour of death
- seen externally in skin (best seen white animals)
- seen internally - particularly the lung
Describe this change which occurs post mortem ?
Post mortem clot - clotting in large vessels and heart
Before the blood clots erythrocytes settle to the bottom of a large blood vessel
- dependent on sedimentation rate (ESR)
- faster rate in horses and animals with a systemic inflammatory reaction
Results in two portions
bottoms red mass “red current jelly clot
upper pale yellowish mass “chicken fat clot”
How do we distinguish a a post mortem blood clot from a ante mortem thrombi or emboli ?
How to distinguish a post mortem blood clot
To distinguish carefully remove with forceps
- post-mortem clots are unattached to vessel walls, tend to be shiny, wet and form a perfect cast of the vessel lumen
- anti-mortem arterial thrombi are attached, dry and duller + laminated with a tail extending downstream
- anti-mortem venous thrombi are loosely attached and may resemble post mortem thrombi
Describe this post mortem change, and its cause ?
Autolysis - A breakdown of cells after death
- changes are amplified and accelerated by bacterial decomposition
- bacterial metabolism and dissolution of tissues results in colour and texture changes
- softening
- friable
- gas production and odours are collectively termed putrefaction
What is maceration ?
Maceration - The dissolving of soft tissues eg muscle, leaving behind sclerotized or chitinized portions.
Describe this post mortem change and its cause ?
Haemoglobin imbibition
Refers to the pink red staining of tissue
- haemoglobin from lysed erythrocytes penetrates vessel walls and surrounding tissues
- particularly observed in the heart and large blood vessels (eg aorta), and veins after several hours post mortem
- very obvious in aborted foetuses that have been retained for several hours or days in the uterus
Describe this post mortem change and its cause ?
Bile imbibition = Bile from the gallbladder penetrates its wall and stains adjacent tissue yellowish green
- observed adjacent to the gall bladder
- liver, intestine and to a large extent bile ducts
Describe this post mortem change and its cause ?
Pseudomelanosis
Green - grey - black discolouration of tissues
Post mortem we may observe bloating, organ displacment, livor pallor, mucosal sloughing, bloody nasal discharge and rectal/vaginal prolapse why do these changes occur ?
Post mortem changes
Bloating
- more marked in ruminants and horses
- can be difficult to distinguish from ruminal tympany in ruminants
Organ displacement
- gas held within the gastrointestinal tract
Pale areas in the liver (pallor)
- due to increased abdominal pressure from gas filled intestines or a focal action of post-mortem bacteria
Bloody nasal discharge / often an artefact
- nasal congestion and subsequent rupture of congested vessels
- can be difficult to distinguish from haemorrhage
Rectal or vaginal prolapse
- due to gas distension of abdominal viscera
Describe the three circulatory disorders of the oral cavity pictured below ?
Circulatory disorders of the oral cavity
Green = Pallor (pale)
anaemia, haemorrhage, ratsack poisoning
Blue = Icterus (jaundice)
Haemolytic disorders, liver disease
Purple = Cyanosis
oxygen deficiency, methaemoglobinaemia
Describe the two circulatory disorders of the oral cavity pictured below ?
Circulatory disorders of the oral cavity
Blue = Congestion and oedema
Blue tongue virus, buccal mucosa and tongue
Red = Petechia / ecchymosis
septicaemia, DIC and thrombocytopaenia
Oral abnormalities may provide clues of systemic illness.
Identify the development abnormality of the oral cavity depicted below ?
The image demonstrates
Palatoschisis (cleft palate)
- A failure of fusion of the lateral palatine plates
- may involve only the soft palate, or both the hard and soft palate
genetic or toxic origin
Cheiloschisis (cleft lip)
- Failure of fusion of the upper lip along the philtrum (midline)
Define chelitis, gingivitis and glossitis ?
Definitions
Chelitis = chronic inflammation of the lips
Gingivitis = early form of gum disease / inflammation
Glossitis = Tongue becomes inflammed and swollen
When describing lesions we use the words Macule, Papule, Vesicles and Ulcers define these terms ?
Definitions
Macule = raised flat lesion
Papule = raised and round
Vesicles = fluid filled
Erosions = indent top layer only
Ulcer = indent beyond the submucosa
Describe the clinical signs of Vesicular Stomatitides ?
Vesicular Stomatitides
Fluid filled vesicles in the epithelium of the oral cavity, lips, rostral plate and tongue
Lesions enlarge form vessicles, coalesce into bullae rupturing into erosions and ulcers
Lesions and signs
Bullae = large blisters on the skin that are filled with clear fluid
Ptyalism = the animals overproduce saliva
- oral and nasal vesicles and bullae
- oral epithelium detaches leaving a raw ulcerated surface
- Ptyalism - too much saliva
- fever
- anorexia
ulcerations on mammaries and genitalia
Define Bullae and Ptyalism ?
Definitions
Bullae = Large blisters on the skin that are filled with clear fluid
Ptyalism = over production of saliva
What causes Vesicular Stomatitides (inflammation of the mouth) ?
Vesicular Stomatitides
Viral induced vesiculation of the oral epithelium
- Foot and mouth disease ( ruminants, pigs)
- Vesicular stomatitis (cattle, pigs and horses)
- Vesicular Exanthema (pigs)
- Swine vesicular disease (pigs)
These are non fatal but result in great economic loss
- poor weight gain
-possible abortions
-secondary bacterial infections
- exotic to Australia / export barriers
The vesicular viruses are epitheliotrophic causing epithelial lesions
- intracellular oedema leading to swelling of the stratum spongiosum
- cells rupture, virus is released to infect nearby cells
- lesions enlarge, form vesicles, coalesce into bullae
- rupture into erosions and ulcers
What are the potential causes of ulcerative / erosive Stomatitides ?
Identify this type of Stomatitides, and its clinical signs?
Ulcerative / erosive Stomatitides
- erosion / ulceration no vesicles
Identify this type of Stomatitides, and its clinical signs and cause ?
Papular Stomatitides
Two causes
Parapoxvirus - Bovine Papular Stomatitis
- papules and plaques on nares, muzzle, gingiva, buccal cavity, palate and tongue ballooning degeneration
- ballooning degeneration of epithelial cells
- cytoplasmic inclusion bodies
Contagious Ecthyma (Orf, Scabby mouth)
- sheep / goats in young animals
- papules, vesicles, pustules and scabs
Identify this type of Stomatitides, what is its clinical signs ?
Papular Stomatitides
- ballooning degeneration of epithelial cells
- cytoplasmic inclusion bodies
- papules
- vesicles, pustules and scabs
Define Achlasia ?
Achlasia
Is a motility disorder of the oesophagus
- it is a congenital disorder
- causes dysphagia, regurgitation and weight loss
- usually seen post weaning with the initial introduction of food
Define Cricopharyngeal Achlasia ?
Cricopharyngeal Achlasia
Upper oesophageal sphincter disorder
- this is a congenital disorder frequently seen in small dog breeds such as terriers, cocker spaniels and miniature poodles
Define megaoesophagus ?
Describe the pathology of congenital megaoesophagus ?
Megaoesophagus = a dilation of the oesophagus
Congenital megaoesophagus (Three causes)
1. This is caused by a persistent right aortic arch (vascular ring anomaly)
- aorta, pulmonary artery and ductus arteriosis
- obstruction and dilation cranial to the heart
- Idiopathic denervation, Myasthenia gravis
- dilation cranial to the stomach - Oesophagial ectasia - Megaoesophagus
- dilation due to insufficient or uncoordinated peristalsis
- can be congenital or acquired
How could you acquire megaoesophagus ?
Megaoesophagus
Dilation cranial to the stomach
There are many ways megaoesophagus could be acquired
- idiopathic denervation
- myasthenia gravis (autoimmune muscle disease)
- lead poisoning
- oesophagitis (inflammation)
- polymyositis (muscle inflammation and weakness)
- hypothyroidism
- peripheral neuropathies (nerve damage)
- recurrent gastric dilation (bloat in deep chested dogs)
Breed predilection golden retrievers and Irish setters
Identify four parasites you would find within the oesophagus ?
Identify the pictured disorder ?
Hypertrophy of the distal oesophagus (horse)
Describe primary and secondary ruminal tympany ?
Bloat (ruminal tympany)
Overdistension of the rumen and reticulum by fermentation gasses
Primary Tympany (frothy bloat)
Fermentation gases become trapped within a stable foam; not readily eructed
- rapid digestion and fine dietary particles trap gas in bubbles
- pasture bloat (legumes, alfalfa)
- feedlot bloat (finely ground grain, bacterial slime)
Secondary tympany (free gas bloat)
Animal is unable to eructate free gas in the rumen
- partial obstruction of the oesophagus
- altered ruminoreticula motility (vagal nerve)
- posture recumbancy
Discuss the difference between ulcers and erosions within the oesophagus ?
What processes could lead to oesophagitis ?
Oesophagitis
Erosion is characterised by a partial loss of the epithelium
Ulcer = Segmental or more extensive loss of the epithelium including the basement membrane
Causes of oesophagitis
- acid reflux horse
- bovine viral diarrhoea disease cattle (ulcerative)
- trauma induced oesophageal ulceration horses
- crotalaria plants have a toxin which may cause damage
Identify this disease ?
Diphtheritic oesophagitis
Describe the underlying pathology and clinical signs of ruminal tympany ?
Ruminal tympany
Pathology
- distension is due to a stable foam or free gas
- compression of the diaphragm
- reduced pleural cavity volumes
- increased intra thoracic and intraabdominal pressures
- reduced venous return to the heart
- shock and hypoxia
Clinical signs
- distended left paralumbar fossa
- distended abdomen
- increased respiratory and increased heart rate
- dyspnoea
- sudden death
- bloat line (results from excessive pressure in the thoracic cavity - pushing blood into the oesophagus)
Describe the different types of ruminal foreign bodies ?
Ruminal foreign bodies
Trichobezoars - hair accumulation
Phytobezoars - accumulation of plant matter
Nails
Wire
Describe how carbohydrate overload leads to acidosis and rumenitis ?
Pathology of acidosis
Carbohydrate engorgement
- feedlot cattle
- highly fermentable, CHO rich feed eg grain
Ruminal acidosis
- Streptococcus bovis and Lactobacillus spp
- increased lactic acid production due to an increase in dissociated fatty acids
- rumen = PH < 5
This causes
- metabolic acidosis
- dehydration
- circulatory collapse
The low PH is favourable to the growth of bacteria and fungi
- ruminitis
What findings would you make in a necropsy following a case of ruminal acidosis ?
Ruminal acidosis and necropsy findings
Necropsy finding
- watery acidic ruminal and intestinal contents
- often a large amount of grain in the rumen
- mucosa of ruminal papillae brown friable and sloughs
Histopathology
Ruminal epithelium is damaged
- hydropic change
- coagulative necrosis
- influx of neutrophils
If the animal survives lactic acidosis;
pale stellate scars on ruminal mucosa
Describe the two types of rumenitis and their likely causes ?
Two types of ruminitis
Bacterial ruminitis
- usually secondary to acidosis or mechanical rumen trauma
- cause Fusobacterium necrophorum (necrobacillosis) or Truperella pyogenes
- bacteria often migrate through the portal vein and cause hepatic abscesses
Mycotic fungal ruminitis
- can develop several days following ruminal acidosis or injury
- can also be secondary to antibiotics
- Mucor, Rhizopus, Absidia and Aspergillus sp
- can spread to the placenta
What are the four types of Vagus indigestion ?
Define a simple gastric dilation and a GDV ?
Definitions
Simple gastric dilation
- occurs in many species
- common and non life threatening
- eg pups overeating
Acute GDV = Gastric dilation and volvulus
LIFE THREATENING DISEASE
- predilection in deep chested dog breeds (German sheppard)
GDV is thought to be associated with
- large amounts of food
- dry dog biscuits with a high fat content
- post prandial exercise/ excitement
- aerophagia (air swallowing and belching)
What is Parakerotosis ?
Parakerotosis
Parakerotosis of the reticulo rumen is characterised by hardening and enlargement of the papillae of the reticulo rumen.
- most common in animals feed a high concentrate diet during the finishing period
What is this image of ?
Ruminal papillomas
Name a potential parasite which could invade the rumen ?
Identify this condition and why is it of significant concern for the animal ?
Traumatic reticulitis (Hardware disease)
Reticuloperitonitis
Concern - can lead to pericarditis
Questions 1-4 ?
Questions
1. Dilation of the oesophagus
- Megaoesophagus
- congenital
- persistent right aortic arch (vascular ring anomaly)
- obstruction and dilation of the oesophagus cranial to the - Clinical signs = difficulty swallowing, regurgitation and weight loss
- X ray
heart
black = heart blue = oesophagus
purple = aorta green = ligamentum arteriosum pink = pulmonary artery
2.
Question
1. Primary tympany = fermentation gases become trapped within a stable foam and the cow is unable to eructate.
Rapid digestion and fine dietary particles trap the gas in bubbles
- excessive production of gas
- entrapment
- compression of the diaphragm puts a strain on breathing
- increased thoracic and intrabdominal pressures
- reduced venous return to the heart = shock and hypoxia
- Two other ways bloat may develop
- altered ruminoreticula motility (vagal nerve)
- posture recumbency
- partial obstruction of the oesophagus
Describe the pathology and clinical signs of GDV ?
GDV Gastric dilation and volvulus
Pathology
- gastric dilation through the accumulation of food and water
-Gastric volvulus - the stomach rotates along its mesenteric axis causing obstruction of the gastro-oesophageal and pyloric outflow
- high intra gastric pressures and twisting causes outflow obstruction to gastric veins
- more fluid and gas build up in the stomach
- decreased cardiac venous return leads to cardiac failure or cardiogenic shock
Clinical signs
- tachycardia (rapid heart rate)
- tachypnoea (rapid breathing)
- pale mucous membranes
- reduced cardiac out put
weakness collapse and death
- gastric ischaemia and necrosis
Describe an abomasal displacement and volvulus ?
What factors would predispose an animal to abomasal displacement ?
Abomasal displacement and volvulus
The majority of abomasal displacements occur to the left side
- this is a result of abomasal atony, or gaseous distension
- stops tuning over its contents and gases build up causing the abomasum to move up the abdomen
- hypocalcaemic atony
- non pregnant cows following strenuous activity
- 15% of abomasal displacements occur to the right, but these are more prone to volvulus
This mostly affects high performing dairy cows 6 weeks post calving
Right sided (RDA) occur in only 15-20% of cases
What are the clinical signs of Abomasal displacement and volvulus ?
Abomasal displacement and volvulus
Clinical signs
- anorexia
- cachexia (muscle mass loss)
- dehydration
- lack faeces
High pitched “ping” upon percussion
Describe the pathology and clinical signs of Abomasal dilation and tympany (bloat) ?
Abomasal dilation and tympany (bloat)
Syndrome of young cattle - mainly dairy breeds
Pathology
- This results from the fermentation of high energy ingesta and gas producing bacteria in the abomasum
Clinical signs
- Hypercalcaemia (high calcium level in blood)
- glycosuria (glucose in urine)
Necropsy
- haemorrhage, oedema, necrosis, emphysema of the abomasum, and other compartments of the forestomachs
- clostridium and Sarcina ventriculi
What factors would predispose a calf to abomasal dilation and tympany ?
abomasal dilation and tympany
Predisposing factors
- bucket feed calves
- single milk feed per day
- cold milk / milk replacer
- lack of free choice water
- inconsistency of feeding time
- dosing with a high energy electrolyte solutions
- failure of passive transfer
What factors could result in gastric or abomasal impaction ?
Factors leading to impaction
Vagal nerve damage
- thoracic lesions eg pneumonia, pleuritis and lymphosarcoma
Physical obstruction
- foreign material
- roughage feed
- Trichobezoars
- Phytobezoars
What is going on in this picture of a horse ?
Horse gastric rupture
Gastric dilation and rupture in a horse may occur secondarily to grain overload
- Clostridium type A toxins grass disease
- idiopathic
- difficult to tell if rupture occurred prior to or after death
Describe the pathology of gastritis ?
What are the clinical signs of gastritis ?
Clinical signs of gastritis
- haemorrhage
- oedema
- increase in mucous production
- inflammatory leucocytes
- abcesses, granulomas, necrosis, erosions and ulcers
Describe the different types of Abomasal inflammation or abomasitis ?
Abomasitis
Mycotic abomasitis
- Aspergillius, Mucor, Rhizopus, Absidia and Mortierella sp
- often secondary to lactic acidosis
- fungi are often angioinvasive (infiltrate blood vessels)
- cause vasculitis, thrombosis, infarcts and necrosis
Parasitic abomasitis
- haemonchs, ostertagia and T.axei
Viral abomasitis
- IBR, mucosal disease, rinderpest, MCF and bluetongue
Haemorrhagic abomasitis (Braxy in sheep and cattle)
- Clostridium septicum exotoxemia
- gelatinous oedema of the submuscosa
Describe two conditions of hypertrophy/hyperplasia in the stomach ?
Hyperplasia = increase cell number
Hypertrophy = enlargement
Hypertrophic Gastritis
- dogs, pigs, horses, and monkeys
- thickened rugae due to hyperplasia of the gastric glands
-it is thought to result from retained gastric fluid and bile reflux
- parasitic nodules eg Draschia, Habronema sp
Chronic giant hypertrophic gastropathy
- Dog breeds affected besenji, beagle, boxer and bull terriers
- weight loss vomiting and diarrhoea
- protein losing gastropathy, hypoproteinemia
- increased mucosal permeability to proteins
- hypertrophy, hyperplasia and inflammation
Describe the factors which could lead to gastric ulcers and erosions ?
Gastric ulcers and erosions
Caused by an imbalance between acid secretion and mucosal protection
- injury (trauma, chemicals)
- high acidity (islet cell tumours produce histamine)
- Ischaemia
- Reduced protective PGs (steroids, NSAIDS)
Pathology - allows pepsin and HCL into the submucosa
Describe the most important gastric parasites ?
What is the difference between an erosion and an ulcer ?
Erosion = Partial loss of the epithelial layer
Ulcer = Complete loss of the epithelial layer exposing the submucosa
Describe the anatomy of the pancreas ?
Pancreas anatomy
Exocrine 85% of organ mass
- composed of acini cells (dark purple area)
- secretes digestive enzymes trpsin, lipase, amylase (which activate other enzymes)
- secretes bicarbonate
- most enzymes secreted as proenzymes to be activated in the duodenum (eg trypsinogen - trypsin)
Endocrin
Islets of Langerhans (lighter coloured areas)
- secretes insulin and glucagon hormones.
What mechanisms would the pancreas utilise for defence (5) ?
Pancreas defence
- Proenzymes - activation to enzymes within the duodenum
- Protective enzymes - eg trypsin inhibitors inactivate trypsin
- Resident immune cells - monocyte macrophage system
- Innate and adaptive immune responses
- Location - protected by the skin, ribcage and omentum
Identify the four portals of entry into the pancreas ?
Portal of entry into the pancreas
- Penetration / extension - direct trauma (from GIT or externally)
- Haematogenous
- Ascending - retrograde up the pancreatic duct
- Autodigestion