Multiple myeloma in a dog with multiple concurrent infectious diseases and persistent polyclonal gammopathy

Vet Clin Pathol. 2013 Mar;42(1):47-54. doi: 10.1111/vcp.12018. Epub 2012 Dec 31.

Abstract

A 12-year-old, spayed female, mixed-breed dog was presented for acute hematuria, stranguria, polyuria, and polydipsia, as well as lameness for 8 days. Previous medical history included treatment for infection with Ehrlichia canis, Anaplasma phagocytophilum, Leishmania infantum, and Dirofilaria immitis 6.5 years prior to presentation. Besides persistently increased antibody titers to E canis and A phagocytophilum, polyclonal gammopathy with a monoclonal spike and moderate hypercalcemia were observed. There was marked hematuria, and Staphylococcus aureus was cultured from urine. Two weeks after successful treatment of the urinary tract infection, radiographs showed an extensive destructive monostotic lesion of the right humerus. Cytologic examination of fine-needle aspirates of this lesion revealed a neoplastic round cell population suggestive of multiple myeloma. The dog was treated with melphalan and prednisolone for suspected multiple myeloma and doxycycline for suspected ehrlichiosis and anaplasmosis. Treatments lead to resolution of the clinical signs, hypercalcemia, and monoclonal gammopathy, and there was radiographic improvement of bone lesions; polyclonal gammopathy persisted. About one year after presentation the dog was still in clinical remission. This is a rare report of a dog with suspected multiple myeloma and a history of multiple chronic infectious diseases, suggesting that chronic infection and uncontrolled long-term stimulation of the immune system could contribute to the pathogenesis of multiple myeloma.

Publication types

  • Case Reports

MeSH terms

  • Anaplasma phagocytophilum
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Diagnosis, Differential
  • Dog Diseases / diagnosis
  • Dog Diseases / drug therapy
  • Dog Diseases / pathology*
  • Dogs
  • Ehrlichia canis
  • Ehrlichiosis / complications
  • Ehrlichiosis / drug therapy
  • Ehrlichiosis / veterinary
  • Female
  • Leishmania infantum
  • Leishmaniasis, Visceral / complications
  • Leishmaniasis, Visceral / veterinary
  • Multiple Myeloma / complications
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / pathology
  • Multiple Myeloma / veterinary*
  • Staphylococcal Infections / complications
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / veterinary
  • Urinary Tract Infections / complications
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / veterinary

Substances

  • Anti-Bacterial Agents
  • Antineoplastic Agents