Journal of Feline Medicine and Surgery Open Reports最新文献

Case summary: A 13-year-old male castrated domestic shorthair cat presented with a 2-month history of progressive lameness, poor appetite and constipation. Physical examination revealed palpable lesions in muscles of several extremities. Ultrasound examination confirmed the presence of round lesions with a hypo- or anechoic centre within the muscles. These lesions were characterised by an anechoic, occasionally trabeculated, central area surrounded by a hyperechoic band with heterogeneous echotexture. In total, seven lesions affecting six appendicular muscles were detected in different evolution stages, as suggested by their sizes and ultrasonographic features. Fine-needle aspiration of the muscle lesions revealed nests and isolated pleomorphic large neoplastic cells consistent with a carcinoma (vs sarcoma) and one mass was surgically removed. The histological and immunohistochemical studies confirmed a diagnosis of metastatic urothelial carcinoma. Although this neoplasia typically originates from the urothelium of the urinary bladder or renal pelvis, the primary tumour could not be detected in repeated abdominal ultrasound examinations. The cat was euthanased and further evaluations were declined by the author.

Relevance and novel information: Urothelial carcinoma is a rare and highly aggressive neoplasia in the cat. While metastasis to regional lymph nodes and lungs are common in cats and dogs, to the authors' knowledge, there have been no reports of metastasis to multiple appendicular muscles in cats. This clinical presentation should be considered in the differential diagnoses of multiple nodular or cystic lesions affecting long muscles in cats.

Case series summary: Two cats were initially evaluated for recurrent dysuria and haematuria, which were unresponsive to antibiotic and anti-inflammatory treatments. An abdominal ultrasound revealed focal wall thickening with a severe hypoechoic multicystic parietal lesion at the bladder apex. Surgical excision of the lesion (apical cystectomy) led to complete resolution of the clinical signs in both cases. The histological findings were consistent with large cystic von Brunn's nest hyperplasia, along with foci of small glandular metaplasia. Urine and tissue cultures were negative. Cystitis cystica was diagnosed. No recurrence was reported within 2 years of surgery in both cases.

Relevance and novel information: This case series illustrates the occurrence and ultrasonographic features of a type of cystitis rarely described in animals: cystic cystitis with von Brunn's nest hyperplasia. These lesions result from chronic irritation and can lead to recurrent cystitis if not excised. Cystic cystitis has previously been described histologically in cats. To the authors' knowledge, this is the first report of macroscopic apical cystic cystitis with pre-treatment ultrasound diagnosis. Surgical resection of the hyperplastic von Brunn's nests appeared to be curative in both cases.

Case summary: A 1-year-old spayed female domestic British Shorthair cat was presented for facial trauma; there were multiple mandibular fractures involving the right temporomandibular joint (TMJ) that were managed conservatively. After 2 months, the owner reported a gradual onset of the cat's inability to open its mouth and subsequent inappetence. The maximum mouth opening (MMO) measured 7 mm. CT showed ankylosis of the TMJ, and surgical treatment with caudal segmental mandibulectomy (CSM) was performed. The cat had a rapid postoperative recovery and returned promptly to spontaneous eating, with a nearly normal MMO of 33 mm. A CT scan performed 3 months postoperatively showed a mild rightward deviation of the mandible, and a clearly visible non-ossified ostectomy gap between the body and the ramus of the right mandible. The cat continued to eat spontaneously without dysphagia following surgery and was asymptomatic 1 year postoperatively.

Relevance and novel information: To the authors' knowledge, this is the first report describing the tomographic findings after CSM, as compared with the clinical outcome. Postoperative CT is indicated to confirm the success of the procedure and to assess TMJ ankylosis sequalae or complications of the CSM surgical site at an early stage. This report confirmed the effectiveness of CSM in resolving TMJ stiffness due to articular fractures or ankylosis with a good clinical and tomographic outcome.

Case summary: A 7-year-old castrated male domestic shorthair cat was presented for surgical intervention for obstructive pancreatolithiasis. The patient had a history of chronic weight loss, vomiting and lethargy. Elevation of feline pancreas-specific lipase and a marked decrease in cobalamin were documented on blood biochemistry. Abdominal ultrasound revealed an enlarged right pancreatic limb with a dilated central duct and multiple pancreatoliths visualized within, consistent with partial pancreatic duct obstruction. The patient was successfully treated with a minor duodenal papilla construction using a 2.5 Fr double pigtail ureteral stent.

Relevance and novel information: Pancreatolithiasis is an exceptionally rare condition in veterinary medicine, particularly in cats, with only a few reported cases. Given its low incidence, there is no established consensus regarding the best therapeutic options in clinical practice. This case report outlines the successful application of a locking loop catheter to re-establish the patency of a pancreatic duct. Notably, this is the first documented use of this technique for the surgical management of obstructive pancreatolithiasis.

Case summary: A cat aged 12 years and 7 months was referred to a multidisciplinary hospital for investigation of feline injection site sarcoma (FISS) on the left thoracolumbar region. A CT examination of the mass revealed a multi-lobulated mass affecting the body wall, extending from the level of lumbar vertebrae L2 to L4. The mass was excised with 5 cm lateral margins, including resection of the 13th left rib, the caudal edge of the latissimus dorsi (LD) muscle, full-thickness abdominal wall and sections of the lumbar epaxial muscles. To reconstruct the defect, a combination of muscle flaps was used. This included diaphragmatic advancement and lateralisation, rotation of the LD, and creation of transposition flaps from the internal abdominal oblique and external abdominal oblique muscles, ensuring closure without tension. Skin closure required mobilising an inguinal flank fold flap. The cat was discharged from hospital 3 days postoperatively. Histopathology confirmed a diagnosis of FISS with clean wide margins. A gradual return to normal activity and complete healing of the surgical site was reported on follow-up, with one minor complication related to the skin flap (bruising at the base of the inguinal flank fold flap).

Relevance and novel information: This report describes the use of the aforementioned combination of muscle flaps to close a major abdominal wall defect in a cat with an excellent outcome. Practitioners can consider this technique when planning tissue reconstruction after FISS resection.

Case summary: This case report describes the clinical and pathological features of telangiectatic osteosarcoma (TOS) with brain invasion in a 4-year-old female domestic shorthair cat. The cat presented with respiratory distress, epistaxis, anorexia and significant nasal obstruction. A rhinoscopy revealed an amorphous white neoformation in the left nasal cavity. Despite treatment, the cat's condition deteriorated and it succumbed to the disease. Necropsy and histopathologic examination revealed an infiltrative malignant neoplasm with osteoid matrix and sarcomatous cells surrounding blood-filled non-vascular spaces. Immunohistochemistry showed positive staining for bone cell markers and vimentin, while endothelial markers were negative, confirming TOS.

Relevance and novel information: Nasal diseases in cats present significant diagnostic challenges due to similar clinical signs, such as respiratory distress and nasal discharge. Nasal osteosarcomas are rare, and TOS is the rarest subtype, characterized by blood-filled spaces within an aggressive osteolytic lesion. This case highlights the diagnostic complexities and poor prognosis associated with TOS in cats, emphasizing the need for advanced imaging and immunohistochemical tests for accurate diagnosis. Given the aggressive nature and rapid progression of TOS, it should be considered in differential diagnoses of feline nasal obstructive lesions.

Case summary: A 13-year-old castrated male American Shorthair cat was referred for evaluation following a 3-week history of poor balance and decreased activity. The MRI findings revealed a well-defined left caudal cerebellar mass with a diameter of 1.2 cm, consistent with a meningioma. CT and MRI scans did not reveal metastasis. After a suboccipital craniotomy, the mass was resected subtotally as a result of parenchymal invasion. A histopathological examination revealed a benign fibrous meningioma with invasion into the cerebellum at the tumour margins. Postoperatively, the cat remained asymptomatic for 25 months, but ataxia recurred, and tumour recurrence was confirmed using MRI and post-mortem examination.

Relevance and novel information: This case demonstrates that even feline meningiomas with benign features can exhibit brain invasion. Since brain invasion is an indicator of malignancy in meningioma, a detailed histopathological evaluation of the tumour margins is essential for accurate grading and prognosis.

Case summary: A female intact domestic shorthair kitten was evaluated at 8 months of age for bilateral mucopurulent nasal discharge, stertor, open-mouth breathing and difficulty eating. Imperforate nasopharynx (INP) was diagnosed on oronasal examination under anesthesia. An extended palatoplasty was performed and resulted in resolution of the clinical signs.

Relevance and novel information: The extended palatoplasty procedure is relatively simple and very similar to the correction of soft palate elongation in brachycephalic dogs. It does not require special equipment and materials; therefore, it represents a viable, more readily available and cost-effective option for the treatment of INP. To the author's knowledge, this is the first case of INP that has been treated with extended palatoplasty.

Case summary: Ectopic thyroid tissue is rarely reported in dogs and cats in its prediaphragmatic location and has never been described in the liver. A 15-year-old spayed female domestic shorthair cat was diagnosed by ultrasound with a heterogeneous hypoechoic nodular area in the liver at the periphery of the quadrate lobe. A generic diagnosis of carcinoma was made after ultrasound-guided fine-needle aspiration and cytological examination. The patient underwent staging by CT scan and subsequently underwent hepatic lobectomy. Histologically, a diagnosis of thyroid adenocarcinoma was made, confirmed immunohistochemically using positive thyroglobulin staining; the tumour was suspected to be of metastatic origin. CT scans excluded primary thyroid involvement; in addition, lesions at other sites were not detected. Therefore, a final diagnosis of thyroid adenocarcinoma arising from ectopic thyroid tissue in the liver was made. The cat recovered uneventfully from surgery.

Relevance and novel information: This report describes an unusual case of an adenocarcinoma originating from presumed thyroid ectopic tissue within the liver of a cat. Ectopic thyroid tissue has been rarely reported in both dogs and cats and, to the authors' knowledge, it has never been described in the liver of a cat.

Case summary: A 16-year-old spayed female domestic shorthair cat with methimazole-treated hyperthyroidism presented with a chronic progressive history of a stiff gait progressing to recumbency. A neurological examination revealed continuous excessive muscle tone with myokymia, which exacerbated with exercise and persisted during general anaesthesia. An electromyographic study revealed myokymic discharges in all tested muscles, as well as complex repetitive discharges, fibrillation potentials and positive sharp waves. Blood tests, urinalysis and abdominal ultrasound did not reveal significant abnormalities. A histological examination of a muscle biopsy showed no specific abnormalities. A clinical diagnosis of acquired neuromyotonia with myokymia was formulated. Phenytoin treatment resulted in temporary improvement, but excessive muscle tone recurred resulting in episodes of dyspnoea. Euthanasia was elected 3 weeks after presentation.

Relevance and novel information: To the best of the authors' knowledge, this is the second report of an acquired neuromyotonia in a cat. In contrast with the previous report, treatment with phenytoin resulted in only partial and temporary improvement of signs. Subsequent progression of the disease, including signs of dyspnoea and dysuria, led to the decision to euthanase the cat. In humans, acquired neuromyotonia (Isaacs syndrome) is usually due to an autoimmune response to proteins associated with voltage-gated potassium channels. More rarely, it has also been described in humans with thyroid disorders. A link with methimazole treatment or hyperthyroidism in the cat reported here could not be excluded.