Fetal ascites & anasarca (hydrops fetalis)

Keywords: bovine, anasarca, ascites, dystocia, heritable, neoplasia, hypoplasia, IVF, clone, cloning

Ascites: < Greek askos; "a bag of wine"
Anasarca: < ana : "throughout" & sarca: "new flesh"
Hydrops fetalis: Abnormal accumulation of fluid in two or more fetal compartments, including ascites, pleural effusion, pericardial effusion, and skin edema.

A complex subject with varying appearances and many different etiologies. Hydrops fetalis (HF) may be due to any factor/s that cause passive venous congestion i.e. intra-peritoneal or intra-thoracic neoplasia (leiomyomas, teratomas hepatoblastomas), liver cirrhosis or other liver anomalies, cardiac anomalies, pulmonic valve stenosis or dysplasia of the lungs themselves. Some of these anomalies are heritable in several breeds of cattle. As is so often the situation with abnormal calves, the calf shown below (photographed 41 years ago!) was discarded without a thorough post mortem examination. Therefore the cause of ascites in this case was unknown.

Because of its enlarged abdomen and resulting dystocia, the calf (weighing 71 kg) was delivered by cesarean. A calf with ascites can often be delivered per vagina after incising its abdomen using a finger knife and allowing the fluid to drain into the cow's uterus. The yellow staining  of the hair coat here was due to meconium discharge from the anus; a common situation during fetal distress precipitated by hypoxia.

Image size: 1330 x 891 px. 

In the fetus below (delivered by cesarean and also discarded without a thorough postmortem examination) there was ascites as well as marked anasarca. The calf showed a multitude of musculo-skeletal deformities too.

Image size: 1500 x 818 px

In fetuses produced by assisted reproductive technology (ART) i.e. cloning through nuclear transfer (NT) and in vitro fertilization (IVF), pregnancy failure is common and many abnormalities have been described in calves, lambs and human babies produced through ART. The most striking of these is the so called "Large offspring syndrome" where newborn babies, calves and lambs can be several times their normal weight at birth. Cardiac, kidney, hepatic and pulmonary abnormalities have been described in these cases. In addition, angiogenesis itself can be abnormal, leading to increased permeability of blood vessels in the fetus and fetal membranes.

In the case shown below, the calf was a product of IVF and abortion occurred at 7 months of gestation. There was severe ascites and anasarca (HF) as well as hydrops amnion and allantois. The case is discussed in more detail in another LORI entry, featuring a video. In that video, the author suggests that genetic alterations may occur in these cases as a result of culture conditions. However, current information shows that the abnormalities manifested in cases of IVF and NT are largely epigenetic in nature.

The calf weight 56Kg; well in excess of the 8 to 18Kg range for a fetus of this gestational age. Meconium staining of the hair coat is obvious in this case as well.

Image size: 1333 x 1076 px

Pitting edema (below) was present over the entire surface of the calf and its fetal membranes.

Image size: 1591 x 988 px

Subcutaneous edema is visible here, in the upper left inset. At lower right, a stream of ascitic fluid  is being released from the abdomen. Readers are encouraged to view the teaching video mentioned above to appreciate the nuances of this case.

 Image size: 1677 x 1190 px

In conclusion, ascites, anasarca, placental edema, hydrops allantois and hydrops amnion are common manifestations of  various conditions that may or may nor be related to one another.

Selected references:

Alberto, M.L.V. et al. 2012. Development of bovine embryos derived from reproductive techniques, Reproduction, Fertility and Development. 25: 907-917

Baraya, Y.S. et al. 2015. Dystocia associated with foetal anasarca (hydrops fetalis) in a Nigerian breed of sheep; Case report. Proceedings: Sixth Pan Commonwealth Vet.Conf.of the CVA and 27th Vet. Assn. Malasia Conf. 519-522

Buchanan, J.W. 2001. Pathogenesis of single right coronary artery and pulmonic stenosis in English Bulldogs. J. Vet. Intern. Med. 15: 101-104

Chen, Z et al. 2013. Large offspring syndrome. A bovine model for the human loss-of-imprinting overgrowth syndrome Beckwith-Wiedemann. Epigenetics 8:591–601

De Vries, C. et al 2012. Congenital ascites due to hepatoblastoma with extensive peritoneal implantation metastases in a premature equine fetus. J. Comp. Path. 2012, 148: 69-69

Drost, M. 2007. Complications during gestation in the cow. Theriogenology. 68: 487-491

Edwards, J.L. et al. 2003. Cloning adult farm animals: A review of the possibilities and problems associated with somatic cell nuclear transfer. A. J. Reprod. Immunology. 50: 113-123

Golladay, E.S. and Mollit, D.L. 1984. Surgically correctable fetal hydrops. J.Pediatric Surgery.19: 59-62

Pinborg, A. et al. 2014. Large baby syndrome in singletons born after frozen embryo transfer (FET): is it due to maternal factors or the cryotechnique? Hum. Reprod. 9: 618-27

Pushp, M.K. et al. 2016. Dystocia in a non-descript cow due to ascetic fetus- a case report. J. Livestock Sci 7: 62-64

Rheuban, K.S. et al. 1991. Intrapericardial teratoma causing nonimmune hydrops fetalis and pericardial tamponade: A case report. Pediatric Cardiology. 12: 54–56

Roberts, S.J. 1986. Veterinary obstetrics and genital diseases. Diagnosis and treatment of various types of dystocia. pp 333-335. Published by the author, S.J. Roberts.

Sasaki S. et al. 2016. A missense mutation in solute carrier family 12, member 1 (SLC12A1) causes hydrallantois in Japanese Black cattle BMC Genomics 17:724 739

Svara, T. et al. 2016. Pulmonary hypoplasia and anasarca syndrome in Cika cattle. Acta Vet. Scand. 58: 36-40

Testoni, S.et al. 2009. Congenital facial deformities, ascites and hepatic fibrosis in Romagnola calves. Vet.Rec. 164: 693-694

Walker, S.K. et al. 1996. The production of unusually large offspring following embryo manipulation; concepts and challenges. Theriogenology 45: 11l-120 

Whitlock, B.K. et al. 2008. Heritable bovine fetal abnormalities. Theriogenology. 70: 535-549

Windsor, P.A. et al. 2006. Hydrops fetalis associated with pulmonary hypoplasia in Dexter calves.

Australian Vet. J. 84: 278-281

Young, L.E. et al. 1998. Large offspring syndrome in cattle and sheep. Reviews of reproduction. 3: 155-163

Leucosis in the uterus of a pregnant cow

Keywords: leucosis, bovine, neoplasia, BLV, pregnant

Image size: 1000 x 967px

Leucosis seen in the dorsal wall of the body of the uterus in a pregnant cow. This tract was obtained from a slaughter  plant specimen, so no history as available other than the cow being labeled as a "cull cow". It was estimated that this pregnancy was approximately 45 days old. It is not a usual to encounter pregnancies in cattle that are severely affected by leucosis, even when the uterus is involved.

Suspect granulosa cell tumor. Beef cow

Keywords: beef, bovine, ovary, neoplasia, tumor, GCT, granulosa, polycystic

Image size: 1617 x 1096px

A large, firm, polycystic structure replacing the ovary on the tract of a slaughter plant specimen from a beef cow. The bluish appearance of the cysts is probably true, judging by the correct color of the uterus. As for others in this collection, this image from 1980 was labeled as "Ovarian cyst - beef cow". Judging by the size of the tumor and the manner in which it has replaced the ovary, is far more likely that this is a polycystic form of a granulosa cell tumor. Granulosa cell tumors in cattle can be solid, may consist of a single large cyst or can be polycystic or as in this case.

Suspect granulosa cell tumor. Beef cow

Keywords: beef, bovine, ovary, neoplasia, tumor, GCT, granulosa.

Image size: 1042 x 691px

A large and almost spherical (the image was not re-touched in that regard) tumor replacing the ovary on the tract of a slaughter plant specimen from a beef cow. As for others in this collection, this image from 1980 was labeled as "Ovarian cyst - beef cow". Judging by the size of the tumor and the manner in which it has replaced the ovary, is likely that this was a cystic form of a granulosa cell tumor. Granulosa cell tumors in cattle can be solid, polycystic or as in this case, may consist of a single large cyst. This is a likely diagnosis but of course, is based only on speculation.

Leucosis in a bovine uterus

Keywords: leucosis, bovine, neoplasia, uterus, infertility

Image size: 1600 x 961px

Enzootic bovine leukosis is a result of infection by bovine leukemia virus (BLV). Interestingly, less than 1% of all the cattle infected with this virus actually develop lymphoid sarcomas.  It is characterized by the development of tumors of lymphatic tissues but tumors can be found throughout the body; in this case, the uterus. Although substantial numbers of nodules and diffuse thickening due to leucosis can be found in the uterus, severely affected genital tracts are occasionally found to be pregnant.

Management procedures that transmit blood have the potential to transmit BLV i.e. injections, surgery, tattooing, dehorning etc. It is not clear if biting flies are able to transmit this disease. Although rectal examinations were once incriminated in the spread of BLV, research suggests that under normal conditions this does not occur.

Call-Exner bodies in a bovine granulosa cell tumor

Keywords: granulosa, tumor, neoplasia, Call-Exner, histology

Image size: 1360 x 2048px

Some granulosa cell tumors (GCTs) in cattle can be cystic or polycystic with granulosa cells lining the cysts while others, such as this one, are solid with solid types probably in the majority. As the tumor outgrows its blood supply, areas of necrosis and hemorrhage may occur. Histologically, the neoplastic cells may be in trabecular, diffuse or follicular patterns. As shown in this case, more than one of these patterns may be present in a single tumor (diffuse above and trabecular below). Mitotic figures were not seen (not obvious) in this specimen.

Call-Exner bodies consist of an irregular ring of granulosa cells around a central cavity filled with fluid that stains positively for glycosaminoglycans. They are common in GCTs but they are not pathognomonic for these tumors. They can also be seen in Graafian follicle as well. Two Call-Exner bodies are obvious at lower left in the image below:

Image size: 1360 x 1024px


Note the Call-Exner bodies in the upper image.

A bovine granulosa cell tumor. 

Keywords: bovine, GCT, granulosa, tumor, neoplasia, cow

Image size: 5184 x 3456px

Image size: 5184 x 3456px

A tumor in the ovary of a cull cow. This was a slaughter plant specimen with no other history. Histopathology confirmed that this was a granulosa cell tumor (GCT). That histopathology is shown in another LORI entry

Sex cord tumors of the granulosa-cell type are the most common sex cord-stromal tumors in cattle. They occur in all age groups, even in prenatal and very young calves, and in all breeds.

Steroid production has been reported but is not well characterized. Some studies show that they can produce estradiol 17 beta, progestogens and testosterone. Mammary enlargement in non-gravid affected heifers also suggest that estrogens are produced by some of these tumors.   Those findings are not surprising in terms of the de-differentiated nature of cells that normally produce steroids.

As is the case in other domestic animals  (all farm and companion animals) where granulosa cell tumors have been described, systemic metastasis is not typical but has been described in most species.

Some granulosa cell tumors in cattle can be cystic or polycystic with granulosa cells lining the cysts while others, such as this one, are solid with solid types probably in the majority. As the tumor outgrows its blood supply, areas of necrosis and hemorrhage may occur. Histologically, the neoplastic cells may be in trabecular, diffuse patterns or follicular.

Neoplastic cell types in these tumors have been described as granulosa- like or Sertoli cell- like with cells of either type predominating in separate tumors.

In this case, the tumor weighed approximately 10 kg, somewhat smaller than the largest described at 17.1 kg.

Although granulosa cell tumors such as this one may resemble Theca Cell tumors (also solid and yellow to orange in color)  Theca cell tumors consist of masses of spindle- like cells almost resembling fibromas. They are not nearly as common as granulosa cell tumors.