Journal of Feline Medicine and Surgery Open Reports最新文献

Case summary: A 2-year-old female spayed domestic shorthair cat presented with acute left pelvic limb lameness after suspected trauma. Orthopaedic and radiographic findings were consistent with rupture of the medial collateral and caudal cruciate ligaments. Surgical exploration identified complete rupture of the caudal cruciate and medial collateral ligaments, as well as a crushed medial meniscus, necessitating partial medial meniscectomy. Primary repair of the medial collateral ligament was performed and a Mini TightRope (Arthrex) prosthesis was positioned to concurrently aid stifle stability following the rupture of the two ligaments. At 8 weeks postoperatively, the cat demonstrated normal gait and pain-free stifle manipulation, with radiographs confirming implant stability and no complications. No lameness was reported by the owner 2 years postoperatively.

Relevance and novel information: This is the first case report of the use of bone tunnels and a Mini TightRope implant to address complete medial collateral and caudal cruciate ligament rupture and stabilise the stifle in a cat. This novel technique allowed for stabilisation without the need for external coaptation, enabling an early return to function.

Case summary: A 7-year-old spayed female domestic shorthair cat was presented for evaluation of a 4-month history of slowly progressive back pain. Neurological and orthopaedic examinations revealed a low posture of the hindlimbs, reluctance to walk, a wide stance, hind limb ataxia and significant pain at the caudal spine, including the base of the tail. MRI of the brain and spinal cord demonstrated marked segmental dilation of the central canal with diffuse ependymal and parenchymal contrast enhancement, affecting almost the entire spinal cord. Widening of the intracranial ventricular system with a secondary mass effect on the surrounding cerebral parenchyma resulted in a reduction of cerebral cortex thickness as well as of the subarachnoid space, flattening of the cerebellum and a decreased size of the interthalamic adhesion. Histopathological examination of the brain and spinal cord revealed perivascular and parenchymal aggregates of mononuclear cells containing occasional atypical large lymphocytes, often infiltrating into blood vessels and the central canal, and affecting both white and grey matter. The most severe changes were found at the lumbosacral segment, with markedly distorted parenchyma and central canal, and the presence of neuronal and axonal degeneration and loss. Immunohistochemistry showed atypical large mononuclear cells positive to Pax5 (neoplastic B cells) and abundant small round cells positive to CD3 (reactive T cells), confirming the diagnosis of central nervous system T-cell-rich B-cell lymphoma with an angiocentric and angioinvasive distribution pattern.

Relevance and novel information: This article describes imaging characteristics of a rare case of histopathologically confirmed central nervous system T-cell-rich B-cell lymphoma.

Case summary: A 7-month-old Siberian cat was presented for persistent fever and recurrent tachypnoea and dyspnoea. The cat was treated 2 weeks prior by the referring veterinarian for pyothorax. Repeated thoracic radiographs and CT showed severe pleuropneumonia. Although serology was positive for feline coronavirus antibodies, an RT-PCR for feline infectious peritonitis of the thoracic fluid was negative. The feline immunodeficiency virus/feline leukaemia virus SNAP test was negative. Repeated aerobic and anaerobic culture and sensitivity results were unable to detect bacterial growth but did detect Candida albicans. Initial treatment with amphotericin B and long-term treatment with itraconazole resulted in complete and persistent clinical recovery.

Relevance and novel information: Pyothorax by C albicans in a cat has been described once in 1984. To the authors' knowledge, this is only the second case description, confirmed by fungal culture.

Case series summary: A 5-year-old intact female domestic shorthair and a 4-year-old spayed female domestic shorthair were presented for dyspnoea and unproductive vomiting. Thoracic radiographs were suggestive of either diaphragmatic hernia or hiatal hernia. Surgical treatment consisting of reduction and repositioning of the stomach and incisional gastropexy was performed (bilateral in the first case, one-sided in the second case). The second cat died a few hours postoperatively, whereas the other cat was still alive 7 months postoperatively.

Relevance and novel information: This case series describes surgical management of type IV hiatal hernia with gastric volvulus in two cats, which is a rare condition in cats. The radiographic challenge presented by this rare presentation is discussed. These cases demonstrate that bilateral gastropexies may be considered in type IV hiatal hernia in cats; however, further research about the aetiology and optimal treatment is necessary.

Case series summary:  An 8.5-month-old female British Shorthair (case 1) and a 2-month-old female domestic shorthair (case 2) were referred for dyspnoea and lethargy. Echocardiography was compatible with unrestrictive patent ductus arteriosus (PDA) with continuous left-to-right shunting and concomitant iso-systemic pulmonary hypertension (PH) (case 1) and restrictive PDA with mild PH (case 2). Radiography showed cardiomegaly, increased pulmonary vascular markings and diffuse interstitial-alveolar pattern consistent with congestive heart failure (CHF) in both cats. After testing for pulmonary vascular reactivity (case 1) and treatment for acute CHF (case 2), surgical ligation of the PDA was attempted. In case 1, PDA ligation led to severe hypotension and asystole, prompting loosening of the ligature because of suspected intolerance to PDA closure. Cardiac massage was initiated and successfully restored the sinus rhythm. The procedure was aborted after partial PDA attenuation. Postoperative echocardiography raised suspicion of pulmonary artery ligation and supra-systemic right ventricle. No surgical revision was performed as the cat remained clinically stable; however, she died 10 days after surgery. In case 2, severe bradycardia developed 20 mins after duct ligation, followed by cardiorespiratory arrest unresponsive to resuscitation. Anatomopathological examination revealed main pulmonary artery and PDA ligation (case 1), and complete left pulmonary artery (LPA) ligation (case 2).

Relevance and novel information:  Inadvertent ligation of the pulmonary artery has been reported in human medicine, and to the best of our knowledge, this is the first report in cats. Prompt recognition and correction of such errors are critical for a favourable immediate perioperative outcome and improved long-term prognosis.

Case summary:  A 15-year-old spayed female domestic shorthair cat presented with a 5-month history of dysphagia that progressed to an inability to open the mouth, resulting in poor prehension of food and subsequent weight loss. Neurological examination revealed an ambulatory vestibular ataxia with reduced postural reactions in all four limbs. There was a head tilt to the right and a positional rotatory nystagmus. The mandibular range of motion was greatly reduced at 20 mm compared with a normal cat (mean 62 ± 8 mm, median 63, range 41-84). MRI of the brain revealed a solitary, large, extra-axial mass at the level of the pons, extending from the level of the caudal colliculi to the level of the cerebellar nuclei. The cat was subsequently euthanased and post-mortem histopathology was declined.

Relevance and novel information:  To our knowledge, this is the first case report of a pontine lesion causing trismus in a cat, and, although rare, should be considered as a differential diagnosis for trismus in the feline population.

Case summary: A 13-year-old spayed female domestic shorthair cat presented with jaundice, showing increased levels of serum liver enzymes and total bilirubin. Abdominal ultrasound revealed a tortuous, dilated common bile duct and a 5-6 mm isoechoic mass near the greater papilla in the duodenum. A CT scan revealed the presence of a duodenal mass that disrupted mucosal continuity and obstructed the common bile and pancreatic ducts. The cat underwent an excisional biopsy of the affected mucosa near the major duodenal papilla. Histopathological examination revealed adenocarcinoma, which was completely removed through duodenal resection. The pancreaticobiliary junction was then anastomosed to the afferent duodenal loop, followed by a gastrojejunostomy procedure. The postoperative total serum bilirubin and pancreatic enzyme levels were within the reference interval. The patient showed no signs of recurrence on postoperative day 408.

Relevance and novel information: This study reports the first case of duodenal peripapillary adenocarcinoma in a cat with long-term postoperative survival. After the complete peripapillary adenocarcinoma resection, a successful surgical digestive system reconstruction was conducted through gastrojejunostomy and pancreaticobiliary junction anastomosis to the duodenum. This approach shows potential as a treatment for duodenal lesions involving the major papilla in cats.

Case summary: A 7-month-old intact male Maine Coon cat was presented because of intermittent pyrexia, hyporexia and lethargy. On abdominal palpation, both kidneys appeared to be enlarged with an irregular shape. Haematology and serum biochemistry showed anaemia, hypoalbuminaemia and hyperproteinaemia. Ultrasonographic findings included multiple perirenal cyst-like lesions, heterogenous cortices with cortical striation and a medullary band sign, as well as renomegaly. The cat was euthanased and a limited necropsy of the kidneys revealed pyogranulomatous lesions, which were confirmed to be related to feline infectious peritonitis (FIP) by immunohistochemistry.

Relevance and novel information: To the authors' knowledge, this is the first published report describing perirenal cyst-like lesions of the kidneys related to FIP.

Case summary: A 4.5-year-old male castrated, predominantly indoor-housed domestic shorthair cat presented with lethargy, anorexia and fever, progressing rapidly to severe respiratory distress and neurologic dysfunction. Clinical evaluation and advanced diagnostics revealed widespread systemic disease involving the lower respiratory tract, nervous and hepatic systems. Despite aggressive supportive care, including intravenous fluids, antiemetics and non-steroidal anti-inflammatory drugs, the cat's condition deteriorated, necessitating humane euthanasia. Post-mortem gross findings included consolidated lungs with peribronchiolar pallor, multifocal to coalescing hepatic hemorrhage and multifocal gastrointestinal ulcerations. Histopathologic examination revealed necrotizing and neutrophilic meningoencephalitis and fibrinonecrotizing bronchointerstitial pneumonia alongside necrotizing lesions in the vascular, hepatic, lymphoid, pancreatic and gastrointestinal tissues. Influenza A/H5 subtype (highly pathogenic avian influenza) was confirmed in the brain and pulmonary tissues using real-time RT-PCR. Rabies was excluded via negative indirect fluorescent antibody test performed on brain tissue. Feline calicivirus and feline herpesvirus-1 were not detected in the lung tissues via RT-PCR. No other organisms were observed in tissues by microscopy after histochemical staining.

Relevance and novel information: This case documents highly pathogenic avian influenza infection in a domestic shorthair cat with minimal known outdoor access, confirmed by real-time RT-PCR in both lung and brain tissues. Low cycle threshold values indicated exceptionally high viral loads and pronounced neurotropism. The rapid onset of necrotizing meningoencephalitis and severe bronchointerstitial pneumonia, concurrent with low cycle threshold values, highlights the relationship between high tissue viral burden and fulminant multisystemic pathology. This case expands the current understanding of feline exposure risk by supporting the possibility of indirect environmental contamination or involvement of unrecognized transport hosts.

Case series summary: This case series describes two cases of feline primary pulmonary adenocarcinoma presenting with multiple intracranial metastases. Both cats exhibited acute and severe neurological deterioration characterised by multifocal neurological signs, significant mass effect, herniation and obstructive hydrocephalus identified on MRI. Histopathological analysis confirmed pulmonary adenocarcinoma with extensive intracranial metastatic disease, a rare and poorly documented phenomenon in cats.

Relevance and novel information: Intracranial metastatic disease from pulmonary adenocarcinoma is rare in cats, and detailed descriptions of MRI characteristics of multifocal cerebral metastases are scarce. This report provides novel insights by documenting the MRI appearance of numerous ring-enhancing intracranial lesions, severe perilesional oedema, mass effect and obstructive hydrocephalus secondary to pulmonary adenocarcinoma metastasis in two cats. Such findings highlight the aggressive clinical course and emphasise the importance of including metastatic pulmonary adenocarcinoma in the differential diagnoses for cats presenting with multifocal intracranial lesions, even in the absence of obvious respiratory signs.