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Catrin Thomas

Webinar Recording: Proactive Pet Care

Watch the recording of our webinar ‘Proactive Pet Care; The Value of Wellness Testing’ which took place on 7th February 2024.

Wellness testing incorporated into pet health plans is becoming a mainstay of general practice. In the presentation Annette Fitzgerald Levey, Director of Pathology at VPG, considers how the evolution of veterinary diagnostics and increased client expectations can be met by a proactive approach to pet health care.

Annette also provides an introduction to the Nu.Q® Vet Test, which measures the circulating nucleosomes in the blood and can aid in the early detection of some underlying cancers in healthy, asymptomatic dogs.

All information was correct at the time of recording.

To access the recording, please enter your details below:


More information on the Nu.Q® Vet Test can be found here or on the Volition website.

For further information on wellness testing please contact our helpful and friendly team at your local lab.

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Case of the Month: Aneurysmal Bone Cyst

Priscilla, an 11 year old female neutered Labrador Retriever.

Clinical history:

Priscilla presented with a two-month history of left thoracic limb lameness and a palpable mass over the left scapula. CT scan showed an osteodestructive lesion, which was suspected to be a primary bone tumour. No metastasis was detected on staging. The entire left thoracic limb was amputated and sent to VPG for histopathological examination.

Histology:

Decalcified histological sections taken through the mass and entire thickness of the scapula revealed a poorly-demarcated mass that was associated with resorption of the bone medulla and cortex, and surrounded by a rim of reactive periosteal bone. The mass itself was formed of numerous large cavernous blood-filled spaces that were separated by a network of internal stromal septa. These septa comprised low numbers of spindle cells within collagenous matrix, with haemosiderophages and small spicules of reactive woven bone surrounded by plump reactive osteoblasts and osteoclasts. The spindle cells did not show atypia or mitotic activity.

Case of the Month - Fig 1

Figure 1. This low power image shows the large central cavernous blood-filled spaces surrounding by a rim of reactive bone (blue arrows).

Figure 2. The peripheral rim of reactive bone is highlighted by the blue arrow. The black arrows indicate islands of reactive bone within the mass.

Figure 3. This high power image shows the spindle cells (red arrows) within collagenous stroma that form the internal septa of the aneurysmal bone cyst. These spindle cells do not show any evidence of atypia. The yellow arrows indicate osteoclasts that are lining and resorbing a spicule of reactive bone.

Histological diagnosis:

Aneurysmal bone cyst

More information on aneurysmal bone cysts:

Although rare, aneurysmal bone cysts (ABCs) are an important entity to be aware of, since they may have a clinical presentation and imaging findings that are similar to a malignant primary bone neoplasm, including osteosarcoma.

The exact pathogenesis of ABCs is uncertain. An aberration of local blood flow is suspected with arteriovenous shunting. An increase in venous pressure may drive the formation and subsequent dilation of the vascular cavities within the bone, resulting in bone lysis and driving proliferation of reactive bone surrounding the lesion. In humans, ABCs are designated as either primary or secondary. Secondary cases are associated with previous trauma or underlying bone tumours. Approximately 70% of human ABCs are associated with a chromosomal abnormality, and these are considered to be primary (1). In dogs, there are rare reported cases of ABCs arising following a history of trauma (2)

ABCs may arise in both the appendicular and axial skeleton of animals, but too few cases have been reported to determine predilection sites. With radiography, ABCs are described as expansile, osteolytic, and are surrounded by a thin layer of reactive bone. The lesion is often arranged eccentrically in the bone. There may be pathological fracture. In contrast to benign unicameral bone cysts, ABCs have multiple cavities separated by internal septa, which leads to a “soap-bubble” type appearance on X-ray. Clinical differentials include osteosarcoma (particularly telangiectatic subtype) and haemangiosarcoma. Fine needle aspirates will likely yield only blood. Histopathology is required to rule out malignancy.

Histologically, ABCs are characterised by multiple, cavernous, blood-filled spaces separated by thin septa that are formed of collagenous stroma and spindle cells. There may be scattered haemosiderophages, osteoclast-like giant cells and islands of reactive woven bone or osteoid. Histologically ABCs need to be differentiated from telangiectatic osteosarcoma and haemangiosarcoma. Telangiectatic osteosarcomas typically have atypical neoplastic osteoblasts lining the cavities whilst in haemangiosarcoma, the cavities are lined by atypical neoplastic endothelial cells. In contrast, in ABCs the blood-filled cavities are lined by the stromal septa or occasionally by an attenuated endothelium that does not exhibit atypia. Importantly, this distinction can be difficult to make on small incisional biopsies. In Priscilla’s case, a confident diagnosis of ABC was made on an excisional specimen (amputation) and following examination of multiple additional histological sections to be confident that a neoplasm was not present.

Malignant transformation of ABCs has been documented several times in the human literature following curettage (3, 4), but there is only a single report in a dog. In that case report, a 5 year old Labrador with an ABC in the distal right ulna treated with surgical curettage developed a chondrosarcoma at the surgical site 33 months later (5). However, recurrence following complete surgical excision has not been reported in animals.

How we process limb amputation specimens at VPG:

As with all complex tissue specimens at VPG, amputated limbs are examined grossly by an onsite anatomic pathologist. All parts of the limb are palpated and examined visually. Submitting CT or X-ray images is encouraged since it helps us to focus the gross examination and identify subtle lesions. We will accept a whole limb, but just an area of interest can also be submitted. Any lymph nodes included with the limb (e.g. popliteal, axillary) are sampled. In the case of a bone mass, the adjacent soft tissues and shaved muscle and skin margins are sampled if appropriate. Remaining soft tissues are stripped from the bone. If the bone margin is <1 joint or <5cm from the mass (for example, distal femoral mass amputated mid-shaft), a shaved bone margin is taken. Representative sections, including a full transverse section through the entirety of the bone in the region of the lesion, are taken. Bone sections usually require additional fixation in formalin followed by decalcification in the laboratory, before they can be processed. This adds approximately 7 days onto the standard turnaround time.

References:

  1. Ye Y, Pringle LM, Lau AW, Riquelme DN, Wang H, Jiang T, Lev D, Welman A, Blobel GA, Oliveira AM, Chou MM. TRE17/USP6 oncogene translocated in aneurysmal bone cyst induces matrix metalloproteinase production via activation of NF-kappaB. Oncogene. 2010 Jun 24;29(25):3619-29.
  2. Craig LE, Dittmer KE, Thompson KG. “Bones and Joints”, in Maxie, MG (ed.) Jubb, Kennedy, and Palmer’s Pathology of Domestic Animals. Vol 1, 6th edn. Elsevier, 2016, 17-163.
  3. Kyriakos M, Hardy D. Malignant transformation of aneurysmal bone cyst, with an analysis of the literature. Cancer. 1991 Oct 15;68(8):1770-80.
  4. Brindley GW, Greene JF Jr, Frankel LS. Case reports: malignant transformation of aneurysmal bone cysts. Clin Orthop Relat Res. 2005 Sep;438:282-7.
  5. Barnhart MD. Malignant transformation of an aneurysmal bone cyst in a dog. Vet Surg. 2002 Nov-Dec;31(6):519-24.
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Nu.Q® Vet Test: Answering Your Frequently Asked Questions

We are delighted to have joined forces with Volition Veterinary to provide practices in the UK & Ireland with the Nu.Q® Vet Test.

We understand that as veterinary professionals, you may have some questions about the Nu.Q® Vet Test and how it can benefit your clients.

In this blog, we will address some of the frequently asked questions to help you gain a better understanding of the test that can aid in the early detection of some underlying cancers in healthy, asymptomatic dogs.

 

How do I order the test?

The test can be ordered on PATHPORT, our online test ordering submission platform or by sending a sample directly to our laboratory.

 

What are the sample requirements?

Before sample collection, patients should be fasted for a minimum of 4 hours.

Step 1) Draw 2-5ml of blood from the peripheral or jugular vein

Step 2) Fill EDTA tube. Gently invert 2-3 times

Step 3) Spin the EDTA at 1500-3000rcf (4000rpm) for 10 minutes and separate the EDTA plasma within 1 hour of sampling

Step 4) Decant into a non-clot activator tube (eppendorf) taking care not to disturb the buffy coat and send to the lab chilled but NOT FROZEN within 24 hours. Please label the tube as EDTA plasma

Sampling must be carried out Monday – Wednesday. Please include a clinical history with this test.

Please note that highly haemolysed or lipaemic samples should not be used for this test and will be rejected by the lab.

 

When should a dog be tested?

The Nu.Q® Vet Test is ideal for regular wellness checks, particularly in senior dogs aged 7 years and older. For breeds with a higher cancer risk, dogs as young as 4 years can benefit from this test.

Breeds like Labrador Retrievers, French Bulldogs, and Golden Retrievers, to name a few, can greatly benefit from the preventive insights this test provides.

 

What does the Nu.Q Vet Cancer Screening Test Measure?

The Nu.Q® Vet Test quantifies the circulating nucleosome levels in the blood. When cancer is present, these nucleosomes—originating from the cancer cells—enter the bloodstream. Our test captures these using antibodies tailored specifically to detect nucleosomes.

 

Are there any risks to having this test done?

The Nu.Q® Vet Test requires a peripheral blood draw. This means blood can be taken from any peripheral site, including, but not limited to, the jugular vein. The test poses minimal risk to the dog, and no recovery time is necessary afterwards. For further information and scientific research please visit: https://veterinary.volition.com/veterinarians

 

What if I have questions about the results?

Our local friendly and helpful team are available for you to speak to quickly. You can speak directly to the pathologists who reported on your case. They’ll share their opinion on the diagnosis using their experience and insight to help you get the right answer.

Contact us today

 

Still have questions?

The VPG Partnership Team can help to answer any other questions that you have. Book a meeting with a member of our team today.

 

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Case of the Month – Copper Hepatitis

Name, signalment:

Freya, 4 year old female spayed Labrador Retriever

Clinical history:

Freya had an abnormal looking liver observed during laparoscopic spay. Serum biochemistry revealed decreased urea. Multiple biopsies were obtained from the liver and submitted for histology.

Histology:

Depending on the biopsy evaluated, there was significant distortion of the lobular architecture of the liver. Large regions of hepatocytes were lost (parenchymal collapse) and replaced by portal to portal, bridging fibrosis and biliary hyperplasia (ductular reaction). This created a macroscopically irregular contour, as observed during laparoscopy. Significant lymphoplasmacytic, histiocytic, and neutrophilic inflammation was present within the portal tracts and extended into the parenchyma, frequently associated with hepatocyte apoptosis and necrosis (portal to interface hepatitis). Hepatocytes frequently golden to dark brown, finely granular pigment. Randomly within the biopsies, there were small nodular foci of necrotic hepatocytes, macrophages, neutrophils, and pigmented material (pigment granulomas). Bile plugs were present in canaliculi.

Figure 1: Widespread replacement of hepatocytes by bridging fibrosis (outlined in black arrow heads), ductular reaction (green arrow heads), and mixed inflammation (blue circles).

Figure 2: Pigment granulomas (black circles), bile plugs in canaliculi (blue arrow), and random hepatocyte necrosis (green box)

Interpretation:

Chronic hepatitis with intrahepatocellular and intrahistiocytic pigment, parenchymal collapse, bridging fibrosis, and ductular reaction

What is chronic hepatitis?

Chronic hepatitis is defined as an inflammatory condition of the liver which is associated with hepatocyte necrosis (“piecemeal necrosis” or “interface hepatitis”) and varying degrees of fibrosis. The type of inflammation varies, but typically includes a combination of lymphocytic, plasmacytic, histiocytic (macrophagic), and neutrophilic infiltrates. Chronic hepatitis may progress into cirrhosis, which is defined as severe loss of the lobular architecture with bridging fibrosis and nodular regeneration (micronodular or macronodular). This is an end-stage phase of chronic hepatitis and is irreversible. It is very important to note that the degree of fibrosis, nodular regeneration, and inflammation can vary greatly throughout the liver lobes. The periphery of the lobes tend to be the worst affected. Determination of cirrhosis thus requires clinical input and sampling from multiple different lobes. Complications of hepatitis include coagulopathies, portal hypertension, ascites, hepatic encephalopathy, gastroduodenal ulceration, and coagulation.

The underlying cause of chronic hepatitis is often unidentified (idiopathic). Breed predispositions, toxicities (particularly copper accumulation), immune-mediated inflammation, and some infectious organisms (such as atypical Leptospirosis) are observed. Breeds with a suspected hereditary predisposition to chronic hepatitis include English Springer Spaniels, Cocker Spaniels (English and American), West Highland White Terriers, Labrador retrievers, and Dobermans. Female dogs are often overrepresented in these breeds, but not always (Cocker Spaniels).

When chronic hepatitis is identified histologically, further testing for copper should be performed because copper accumulation is one of the few known causes of chronic hepatitis and can potentially be treated. Pathologists typically recommend a combination of special stains for copper (Rubeanic acid or Rhodanine stain) and copper quantification. Assessment of the degree of fibrosis is also crucial and can be achieved by performing stain(s) such as Sirius Red, Trichrome, and/or Reticulin.

If the inflammation is pyogranulomatous, the pathologist will often perform special stains to investigate for microorganisms, such as mycobacterium (Ziehl-Neelsen), fungi (PAS, GMS), and other bacteria (Gram stain). There is an atypical variant of Leptospirosis which is associated with a pyogranulomatous hepatitis. The pathologist may suggest performing FISH (Fluorescence In Situ Hybridization), PCR, +/- Leptospirosis serology to investigate this differential.

What next for Freya?

Copper staining (Rubeanic acid) was recommended and a Sirius Red stain was also performed. Rubeanic acid staining revealed significant copper accumulation within hepatocytes. Additionally, it was frequently observed in the pigment granulomas and in Kupffer cells. Within the Sirius Red, there were large regions of parenchymal collapse and fibrosis.

Figure 3: Rubeanic acid. The dark brown to black colour is copper, which can be seen throughout this entire biopsy. This section was severely affected by parenchymal collapse and fibrosis (see figure 5).

Figure 4: Rubeanic acid. Higher magnification. The central vein is in the upper left corner and the portal tract is in the lower right corner. Centrilobular to periportal hepatocytes contain variable amounts of dark brown to black, finely stippled to coarsely granular copper.

Figure 5: Sirius Red. Same section as the sample in Figure 3. In regions of parenchymal collapse, there is severe replacement of hepatocytes (which are yellow) by fibrillar collagen (bright red).

Toxicology:

Because of the severity of the copper accumulation revealed with the copper staining, copper quantification was recommended. Copper quantification can be performed on liver samples that are stored fresh, frozen, or formalin fixed. It can also be performed after processing for histology.

The amount of copper in Freya’s liver was 2250ppm (dry weight).

The normal amount of copper in the canine liver (dry weight) is 120-400ppm. Copper amounts of greater than 1500ppm are considered toxic.

Final diagnosis:

Chronic hepatitis with toxic copper accumulation and likely cirrhosis

A bit about copper hepatitis:

The causes of pathologic copper accumulation are multifactorial. Heritable defects in copper metabolism are identified (Bedlington Terriers) or suspected (Labrador retrievers, Dalmatian, Doberman Pinscher, and West Highland White Terrier) in many breeds. Excessive dietary copper is also being investigated, as the average dog food contains 2-4 (or more!) times the recommended amount of copper by national nutrition boards. Cholestasis may play a role in copper accumulation, although this is more commonly seen in cats than dogs.

Copper staining allows the pathologist to evaluate the distribution of copper accumulation within the hepatic lobule. Centrilobular accumulation of copper is typically indicative of a pathologic accumulation. Periportal accumulation may indicate a secondary or reactive copper accumulation in dogs with cholestasis. In severe cases, copper may be observed throughout the lobule (centrilobular, midzonal, and periportal). The pathologist will give a semi-quantitative analysis of the severity of copper accumulation through a copper score, from 0-5. Zero indicates no copper accumulation and five indicates copper is present in every hepatocyte at moderate to severe levels.

Copper toxicology provides a numerical amount of copper present in a given liver sample, as parts per million (ppm) per dry weight (dw). Liver tissue may be fresh, frozen, fixed, or processed for histology and embedded in a paraffin block. A minimum of 10mg dry weight (50mg wet tissue) is required as small sample sizes may affect the test accuracy. This corresponds to a pea-sized wedge of liver or 3 x 1cm long 14g needle biopsies.

How should I approach sampling in patients with suspected chronic hepatitis?

A recent consensus statement (Webster et al. ACVIM consensus statement on the diagnosis and treatment of chronic hepatitis in dogs. 2019;33:1173-1200) provides an excellent review of the guidelines for liver sampling in patients with suspected chronic hepatitis.

A minimum of 12-15 portal tracts is required for assessment of chronic hepatitis. This is best achieved with guillotine wedge or laparoscopic liver biopsies. However, these sampling methods are more invasive than Tru-cut (needle) biopsies. Determination of the biopsy type (Tru-cut, laparoscopic, guillotine wedge) requires assessment of the patient’s coagulation parameters, index of clinical suspicion for chronic hepatitis, distribution of the liver lesions on ultrasound, and the veterinarian’s tools. For Tru-cut needle biopsies, diagnostic accuracy is increased with a larger gauge needle (14 or 16) and by obtaining biopsies from multiple sites.

At least 2 different lobes should be sampled, with a minimum of 5 laparoscopic, surgical, or Tru-cut biopsies. At least 3 samples should be placed in formalin for histology, 1 sample in transport media for culture (aerobic and anaerobic), and 1 in an empty glass tube for copper quantification. Note that samples placed in formalin cannot be cultured.

At VPG Histology, we will routinely perform haematoxylin and eosin (H&E) staining on all liver biopsies. Collagen staining is performed at the pathologist’s discretion. Copper staining is performed at an additional charge, usually following the recommendation of the pathologist. We also offer a specific liver evaluation test (HISL), which includes the copper and collagen staining. Because pathologic copper accumulation is a common and potentially treatable cause of chronic hepatitis, if chronic hepatitis is suspected, copper analysis should be performed.

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VPG’s Digital Transformation

2023 was a year for digital transformation at VPG! We successfully transitioned to digital histology, allowing us to streamline our workflow, achieve unbeatable turnaround times and maintain the exceptional service offered by our histopathology lab.

We are now delighted to announce the roll-out of digital cytology in our reference labs, with Pannoramic 3D Histech scanners installed at our Leeds, Hitchin and Cork labs. These state-of-the-art digital scanners have been selected for VPG, following extensive trialling of products available on the market.

Simon Baker-Moore, Pathology Operations Manager at VPG, played a pivotal role in the selection process and expressed his satisfaction with the choice of 3DHistech scanners:

“During our digital cytology transformation, we found that the 3DHistech scanners offered us the image quality, throughput, and software integration capabilities that we required for a successful deployment of digital cytology.”

The Pannoramic 3D Histech P1000 in VPG Hitchin

With up to 80X magnification, excellent colour quality and resolution and integration into our cloud-based network, we can provide our Clinical Pathologists with the high-quality images needed to support our world-leading cytology service.

Annette Fitzgerald Levey, Director of Pathology, expressed her enthusiasm about the digital transformation:

“VPG’s transition to digital histology and cytology offers an incredible opportunity both to ourselves as a company and to our valued customers. We have taken great effort to comprehensively trial and select digital scanners that offer exceptional quality of images and scanning capacity, allowing us to continue setting the standard for veterinary pathology services across the industry. Our teams can continue to provide the personalised service that our clients expect, offering expert opinions and specialist advice, even for the most challenging of cases”.

Alex Penrose, Head of Pathology and Board Certified Clinical Pathologist shared insights from a cytologist’s perspective:

“From a cytologist’s perspective, the use of digital cytology at the VPG has been transformative. It enables collaboration across the group, ensuring expertise can be shared on complex cases, so that our clients get the very best advice from our team. It has also helped us to reduce turnaround times so that patients get their diagnosis sooner, helping clinicians work up cases more efficiently. The quality of the images obtained by the scanner is exceptional and enables us to produce reports that continue to be of the highest standard.”

The excellent image quality of the Pannoramic 3D Histech

Sean Haugland, Head of Pathology and Board Certified Anatomic Pathologist, emphasised the positive impact of VPG Histology’s digital platform on operations:

“VPG Histology’s digital platform has positively transformed the way we operate and has provided a fantastic opportunity for us to innovate and remain at the forefront of veterinary diagnostic service provision. The platform allows real-time case sharing with pathologist colleagues and the ability to share cases and collaborate geographically, for instance with specialists in a particular field of pathology. Rapid access to second opinions and case discussions ensures that our pathologists feel equipped and supported to provide the clinically relevant and accurate reports that our clients expect.”

High-quality Histology Imagery

The digitalisation of our cytology and histology services is just the beginning of our digital transformation journey. More internal changes are on the horizon, promising further streamlining of services and the continuation of our commitment to providing high-quality veterinary pathology services, so that VPG continues to deliver Excellence Everywhere.

For further information on our digital cytology service, please contact your local laboratory.

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Case of the Month: Trunk Predominant Pemphigus foliaceus

Sukie, a 12 year old female intact cross breed dog

Clinical history

Sukie presented with multiple highly pruritic lesions on the dorsum between the thoracic and lumbar spine and some smaller lesions distributed across the back over the last 2 months. Some lesions resolved with antibiotic treatment, while others remained. She had a bout of similar lesions in the previous year. The submitting vet suspected furunculosis.

Histology

Multiple large pustules filled with eosinophils and degenerate and non-degenerate neutrophils were found predominantly in the infundibula of hair follicles, but also in the epidermis. The pustules contained numerous acantholytic keratinocytes and occasionally rafts of detaching keratinocytes. This was associated with a predominantly eosinophilic and neutrophilic mural folliculitis and peri folliculitis, as well as reactive epidermal hyperplasia.

 Figure 1: Hair follicle; note extensive intrainfundibular pustule.

Figure 2: Intrainfundibular pustule filled with numerous eosinophils (examples: green arrow head) and acantholytic keratinocytes (examples: blue arrow heads); also note raft of detaching keratinocytes (red arrow head).

Figure 3: Higher magnification of follicular wall; note numerous eosinophils (green arrow head) and neutrophils (blue arrow head) in the perifollicular dermis and eosinophils (yellow arrow head) in the follicular wall.

Figure 4: Large intracorneal pustule in the epidermis.

Figure 5: Higher magnification of epidermal pustule; note numerous acantholytic keratinocytes (yellow arrow heads).

Interpretation

Trunk-predominant pemphigus foliaceus

Note that due to the observation of numerous eosinophils in the inflammatory infiltrate and the follicle-centric inflammation, eosinophilic furunculosis was considered, which can sometimes be observed in skin areas other than the face. However, the very obvious acantholysis and lack of follicular destruction observed in this case suggested this is unlikely.

Some information on Pemphigus foliaceus and trunk-predominant Pemphigus foliaceus

Pemphigus foliaceus (PF) is an autoimmune skin disease that is characterized by the production of autoantibodies against a component of the adhesion molecules on keratinocytes causing the cells to detach from each other within the superficial epidermal layers (acantholysis). PF is the most common autoimmune skin disease in dogs and cats. There is no proven age, sex, or breed predisposition, but among dogs, Akitas and Chow Chows may be predisposed. PF is usually idiopathic, but some cases may be drug induced, or may occur as a sequel to a chronic inflammatory skin disease.

The primary lesions are superficial pustules. Intact pustules can be difficult to find because they are fragile and rupture easily. Secondary lesions include superficial erosions, crusts, scales, epidermal collarettes and alopecia. The disease often begins on the bridge of the nose, around the eyes, and on the ear pinnae, before it becomes generalized. Nasal depigmentation frequently accompanies facial lesions. Skin lesions are variably pruritic and may wax and wane. Footpad hyperkeratosis is common and in some dogs and cats, this is the only symptom. Mucocutaneous involvement is usually minimal in dogs. In cats, lesions around the nail beds and nipples are a unique and common feature of pemphigus.

In this particular case, the distribution of the lesions was restricted to the trunk, consistent with the recently described trunk-predominant PF. This is a variant of PF that presents without muzzle/ nasal planum involvement and sometimes without footpad involvement. This variant is thus more difficult to differentiate from superficial bacterial pyoderma. The histopathological features in trunk-predominant PF are generally similar to those in ‘conventional’ PF. Involvement of hair follicles is described in both trunk-predominant and ‘conventional’ PF and may be prominent in facial PF. A predominance of follicular lesions has not been described for trunk-predominant PF so far and may be a unique feature in this case.

Possible differential diagnoses based on clinical picture

Differentials include demodicosis, superficial pyoderma, dermatophytosis, other autoimmune skin diseases, subcorneal pustular dermatosis, eosinophilic pustulosis, drug eruption, dermatomyositis, zinc-responsive dermatosis, cutaneous epitheliotropic lymphoma, superficial necrolytic migratory erythema, and mosquito bite hypersensitivity (in cats).

 Diagnosis

  • Rule out other differentials.
  • Cytology (pustule): neutrophils and acantholytic cells are seen. Eosinophils may also be present.
  • Antinuclear antibodies (ANA): negative, but false positives are common.
  • Histopathology: intra-/ subcorneal pustules containing neutrophils and acantholytic cells, with variable numbers of eosinophils
  • Immunofluorescence (skin biopsy specimens): detection of intercellular antibody deposition is suggestive, but false-positive and false-negative results are common. Positive results should be confirmed histologically
  • Bacterial culture (pustule): usually sterile, but occasionally bacteria are isolated if secondary infections are present

Histology sampling with suspected PF

Make sure that intact pustules are collected, otherwise the diagnostic features of the disease will be obscured by erosion and ulceration of the epidermis. Choose a punch biopsy instrument that is wide enough to capture the pustule in its entirety, otherwise the roof of the pustule will float off. If this is not possible, take an ellipse/ wedge biopsy.

References

Gedon et al.: Histopathological characterisation of trunk-dominant canine pemphigus foliaceus, and comparison with classic facial and insecticide-triggered forms. Vet Derm (2023). DOI: 10.1111/vde.13174

Medlau and Hnilica: Small animal Dermatology. A Color Atlas and  Therapeutic guide. 2nd edition (2006).

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VPG Unveils Exciting Rebrand

13th November 2023, Exeter, UK – Veterinary Pathology Group (VPG), a high-quality leading diagnostic laboratory, is thrilled to launch its updated brand identity. The transformation is a significant milestone in the company’s history, reflecting its ongoing commitment to delivering excellence everywhere.

For over twenty years VPG has been at the forefront of providing high quality insights, guidance and test results to the veterinary industry. As vets themselves, the company has continuously evolved to meet the changing needs of the veterinary community by developing the right services in the right way. By vets, for vets.

The rebrand encompasses a new visual identity, a redesigned website, and a renewed dedication to using scientific excellence, innovation and personalised support to help veterinary practices. This reimagined image aims to better represent the company’s mission and values while ensuring a more modern and consistent experience for clients.

What won’t change is the company’s ability to intelligently question, reason and inform – always in the pursuit of higher quality and greater excellence, to ensure they stay at the forefront.

Fiona Gosling, CEO of VPG, commented “Our rebranding is an exciting step forward in our journey and commitment to better serve the veterinary community. We remain dedicated to providing top-tier diagnostic services, and this new identity will help us communicate our vision, to always do the right thing, more effectively.”

“We are looking forward to showcasing our new brand at the London Vet Show on stand K11”

Feedback from our clients has been very positive, with one long-term partner stating “VPG is back”.

For more information about VPG and to explore the revamped website, please visit thevpg.co.uk. The company invites all clients, partners, and stakeholders to explore its new brand identity and experience the improvements first-hand.

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VPG & Volition launch Nu.Q® Test in UK & Ireland

Exeter, UK, 6th November 2023 – Veterinary Pathology Group (VPG), a high quality leading diagnostic laboratory, and VolitionRx Limited (Volition), a multi-national epigenetics company, have joined forces to launch the Nu.Q® Test to veterinary practices in the UK and Ireland.

VPG is the first-to-market diagnostic laboratory in the UK and Ireland to offer the Nu.Q® Test, a groundbreaking tool for the early detection and monitoring of cancer in dogs.

Volition’s Nu.Q® Test is an accessible and affordable screening tool for dogs with increased risk of developing cancer, such as older dogs, certain breeds with higher cancer prevalence rates and those dogs with familial history.

Dr Tom Butera, Chief Executive Officer, Volition Veterinary Diagnostics Development LLP said “Working with VPG, we are thrilled to be rolling out the Nu.Q® Test to veterinary practices across the UK and Ireland, two renowned pet-loving nations. It is a non-invasive blood test that can easily integrate into preventive care plans. Veterinarians can run the test alongside routine blood work and imaging, to help provide earlier cancer detection, improve a dog’s quality of life and give a better chance of effective treatment.”

Fiona Gosling, Chief Executive Officer at VPG, said “Our collaboration with Volition highlights the commitment of both organisations to improving the quality of life for pets and supporting veterinary professionals in their mission to provide the best possible care.

“By integrating the revolutionary Nu.Q® Test into our diagnostic portfolio, we are expanding our wellness testing offering and empowering veterinarians with an accessible, cutting edge tool to detect cancer in its early stages, ultimately leading to better outcomes and improved patient care.

“Veterinary practices interested in offering the Nu.Q® Test to their clients can find out more here”.

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