Externship Experience

Submitted by SAVMA Externship Grant Recipient Alexa Kolakoski, Cornell University

My two week externship was split between Pet Fix, a high quality high volume spay and neuter clinic, and the Humane Society of Greater Savannah. At Pet Fix, I had the opportunity to perform spays and neuters for owned pets, shelter animals, and community cats in the Greater Savannah area. During my time at Pet Fix, I learned high-volume spay and neuter techniques including how to utilize a spay hook, autoligation of cat ovarian pedicles, and the aberdeen knot. I also had the opportunity to observe and assist with spays of different types of patients including: pediatric spays, patients in heat, and rabbits. In the afternoons, I had the opportunity to assist in the “healthy pet” clinic run by Pet Fix where community members can get vaccines and SNAP tests at a low cost. During this clinic, I had the opportunity to refine my vaccination skills (especially on fractious animals) and practice my cephalic and saphenous blood draws. I was also able to perform in-house fecals to diagnose common parasites such as roundworms and hookworms, as well as confirm heartworm disease by finding microfilaria in a blood sample. At Savannah Humane Society, I had the opportunity to observe and assist in the provision of medical care for shelter animals. This involved the completion of intake exams for animals newly arrived at the shelter, veterinary exams for sick animals, as well as daily treatments. After graduation, I plan to pursue a career in shelter medicine with a focus on high quality, high volume spay and neuter. My time at Pet Fix and the Savannah Humane Society was truly invaluable, as I had the opportunity to confirm that this is the right career path for me. I was able to learn techniques to increase my surgical efficiency including the spay hook, aberdeen knot, and pedicle ties- which drastically reduced my surgical times therefore increasing the health and safety of my patients. As a future shelter veterinarian, I know I will often have to rely on low-cost diagnostic tools including in house fecals, ear cytologies, and blood smears. The opportunity to collect, run, and interpret my own fecals, ear cytologies, and blood smears allowed me to improve my confidence in performing these essential skills. At the Savannah Humane Society, I had the opportunity to tour the facility and discuss protocols utilized by the shelter’s technicians to treat various medical conditions. It was extremely beneficial to observe how other shelters are designed (including cage size, isolation wards, group housing, etc) and how certain medical conditions are managed, so I can learn from various sources how to minimize length of stay and manage various diseases in the shelter environment.

Foot In Mouth Disease

Submitted by Rhea Amatya, Colorado State University

Photography

Submitted by Varun Seth, University of Illinois 

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Cases/Abstracts

Snake with a unique parasite-induced malignancy.

Heather Sayles1, Scott D. Fitzgerald, DVM, Dipl ACVP, Dipl ACPV1, and Mayra F. Tsoi, DMV, PhD, Dipl ACVP1

1- Michigan State University College of Veterinary Medicine, East Lansing, MI, 48824, USA

SIGNALMENT:

2-month-old female intact black-headed cat snake (Boiga nigriceps)

HISTORY:

A juvenile black-headed cat snake that was being treated for strongyloides and skin mites was found dead in its enclosure. The animal was kept in quarantine.

GROSS FINDINGS: 

Caudal coelom: Numerous intracoeleomic nematodes along with numerous cysts on the serosa and connective tissue. Large amount of intracoelomic mucus and petechiation in the coelomic fat bodies.

HISTOPATHOLOGIC AND CLINICAL PATHOLOGY FINDINGS: 

Scattered throughout the gastrointestinal tract, oviduct, and kidney were approximately one dozen, 1.5 mm to 2.8mm in diameter, well demarcated nodules consisting of densely cellular, atypical spindle cells forming tight interlacing fascicles. Spindle cells had a small amount of eosinophilic cytoplasm, indistinct cell borders, and ovoid nuclei with finely stippled chromatin and 0-1 prominent nucleoli. Anisokaryosis was mild to moderate and there were no mitoses in 10 high power fields (2.37mm2). Several of these nodules contained encysted nematodes, characterized by a width of 0.25 mm, a pseudocoelom, a digestive tract, lateral chords, and paired lateral alae. Nodules were most often arising from the serosal surface of visceral organs, invading into the muscularis, or arising just below the capsule (kidney). 

MORPHOLOGICAL/ETIOLOGICAL DIAGNOSIS:

Disseminated sarcomas with encysted nematodes

DISCUSSION:

Nematode-induced tumor formation has been theorized in dogs, cats, ruminants, rodents, pheasants, muskrats and primates1. The nematode with the strongest link to the formation of malignant lesions in veterinary species is Spirocera lupi, the causative agent of spirocercosis2. S. lupi completes its development in the submucosa and the subadventitia of the esophagus, where its presence leads to chronic inflammation and the formation of fibrous nodules or benign granulomas2. In approximately 25% of infected animals, esophageal nodules undergo neoplastic transformation to malignant sarcomas that can metastasize to other organs2. However, this parasite primarily infects dogs and wild carnivores, and no reports have identified spirocercosis in any reptilian species to date. 

Gastrointestinal parasitism is relatively common in snakes. The most common gastrointestinal parasites found in snakes (Ophiotaenia spp., Rhabdias spp., Strongyloides spp., Ophidascaris spp., Eustrongylides spp., Ascaridia spp., and Kalicephalus spp.) are capable of inducing the formation of benign granulomas. In a 2007 case report, multiple granulomatous lesions were found in several organs of a free-ranging adult dice snake likely induced by Eustrongylides larvae3. While there are certainly parallels to be drawn between the dice snake and the juvenile cat snake in this case, the parasite-induced lesions in the juvenile cat snake were not consistent with benign granulomas. The dense cellularity and invasiveness of spindle cells was most consistent with a diagnosis of sarcoma. To the author’s knowledge, there has only been one report suggestive of parasite-induced tumor formation in snakes1. In that report, Ophidascaris spp. was identified inside necrotic areas of a gastric adenocarcinoma in a 7-year-old diamond python4. However, it was unclear as to whether the parasitic infection in that diamond python could have been independent of the adenocarcinoma formation. 

In this case, the presence of multiple cross sections of nematodes surrounded by neoplastic cells forming multifocal nodules is highly suggestive of a link between the nematode and neoplastic transformation of mesenchymal cells. The identification of this nematode was attempted by PCR; unfortunately, there was insufficient DNA in the formalin-fixed, paraffin-embedded sample for identification. 

REFERENCES: 

1. Fonti, N., Parisi, F., Mancianti, F., Freer, G., & Poli, A. (2023, July 26). Cancerogenic parasites in veterinary medicine: A narrative literature review. Infectious agents and cancer. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373346/ 

2. Rojas, A., Dvir, E., & Baneth, G. (2019, November 13). Insights on Spirocerca Lupi, the carcinogenic dog nematode. Insights on Spirocerca lupi, the Carcinogenic Dog Nematode. https://www.sciencedirect.com/science/article/abs/pii/S1471492219302466 

3. Mihalca, A. D., Fictum, P., Škorič, M., Sloboda, M., Kärvemo, S., Ghirra, I., Carlsson, M., & Modrý, D. (2007, January). Severe granulomatous lesions in several organs from eustrongylides larvae in a free-ranging dice snake, Natrix tessellata. Severe Granulomatous Lesions in Several Organs from Eustrongylides Larvae in a Free-ranging Dice Snake, Natrix tessellata. https://pubmed.ncbi.nlm.nih.gov/17197633/ 

4. Baron, H. R., Šlapeta, J., Donahoe, S. L., Doneley, R., & Phalen, D. N. (2018, December). Compensatory gastric stretching following subtotal gastric resection due to gastric adenocarcinoma in a diamond python (Morelia spilota spilota). Australian veterinary journal. https://pubmed.ncbi.nlm.nih.gov/30478847/