Journal of Feline Medicine and Surgery Open Reports最新文献

Case series summary: Two cats presenting with chronic sneezing and nasal discharge were diagnosed with sinonasal aspergillosis (SNA) through a combination of CT, rhinoscopy, histopathological analysis and fungal culture of nasal biopsies. Treatment included trephination of the frontal sinuses, followed by a sinonasal flush using a 1% enilconazole solution and the application of 1% clotrimazole cream into the frontal sinuses. In one cat, unilateral treatment resulted in recurrence of SNA 8 months later; however, two bilateral treatments, 1 month apart, proved effective. The second cat underwent a single bilateral treatment. Short-term observations indicate that cats may experience mild to moderate systemic side effects, including anorexia, lethargy and hyperthermia. Clinical cure was achieved in the long term in both cases, although it was not confirmed by follow-up rhinoscopy.

Relevance and novel information: To our knowledge, this paper is the first to describe the technique and outcome of depot therapy in cats presenting with SNA. This treatment approach circumvents the need for systemic antifungal therapy, which is often prolonged, costly and potentially associated with toxicity. However, the success rate and tolerance of this method should be evaluated in a larger cohort of cats.

Case summary: Dynamic intrapelvic urinary bladder displacement (DIUBD) is an uncommon condition where the urinary bladder intermittently displaces caudally into the pelvic canal, resulting in episodic lower urinary tract obstruction. Although this phenomenon is recognized more commonly in canine patients with perineal hernias, documented feline cases remain rare. Trauma or pelvic fractures can compromise the strength and conformation of local musculature and fascia, permitting the bladder to slip caudally under changing pressure gradients. In this case, an 8-year-old spayed female domestic shorthair cat, previously affected by multiple healed pelvic fractures, developed progressive urinary and defecatory straining. Initial imaging, including abdominal radiographs and ultrasonography, confirmed a caudally displaced bladder occasionally reverting to a more cranial position. Blood work and repeated urinalyses indicated post-renal azotemia on re-presentation. Surgical exploration revealed a mobile bladder without a distinct muscular defect, prompting cystopexy to anchor the bladder in a stable cranial position. Postoperative monitoring showed rapid improvement in clinical signs and renal values, and follow-up imaging confirmed that the bladder retained its corrected orientation. This case supports the importance of thorough imaging and an early corrective procedure for cats with recurrent lower urinary obstruction and a history of pelvic fractures.

Relevance and novel information: Although DIUBD is more often recognized in dogs, this case indicates that it can similarly arise in cats with a history of pelvic trauma. Targeted imaging coupled with cystopexy can successfully address the intermittent obstruction.

Case summary: A 7-year-old female spayed domestic shorthair cat was evaluated for a 10-day history of progressive hematuria. Abdominal ultrasound revealed a large non-shadowing echogenic mass in the bladder lumen and multiple small broad-based pedunculated lesions along the luminal urinary bladder wall. The cat was progressively anemic, tachypneic and lethargic, and required a whole blood transfusion. The following morning, peracute bradycardia, bradypnea and unresponsive mentation were noted. A unit of packed red blood cells (pRBCs) was rapidly administered to the patient, resulting in improved cardiorespiratory and mental status. Cystoscopy revealed a blood clot occupying approximately 50% of the bladder lumen, multiple proliferative broad-based masses originating from the bladder wall and two pulsatile bleeding vessels associated with one of the masses. Biopsies of the masses were obtained, followed by electrocautery of the bleeding vessels and sclerotherapy of the entire urinary bladder. Another transfusion with pRBCs was administered the following day, and the patient was discharged 48 h after cystoscopy. The biopsies were consistent with urothelial cell carcinoma, and meloxicam was prescribed. No additional blood transfusions were required, and the cat had resolution of anemia 20 weeks after discharge.

Relevance and novel information: Urothelial cell carcinoma is the most common type of cancer of the bladder wall in cats. However, severe hemorrhage caused by this tumor resulting in hypovolemic shock has been poorly reported in cats. Treatment with electrocautery and sclerotherapy can lead to long-term control of bleeding when definitive treatment is not pursued.

Case summary: A 16-year-old male castrated domestic shorthair cat was referred for investigation of a 2-week history of lethargy, hyporexia, and intermittent diarrhoea and constipation. CT revealed a colo-colonic intussusception associated with a fat attenuating non-contrast enhancing mass measuring 4.5 × 2.6 cm, arising from the ventral aspect of the intussuscipiens, causing partial obstruction. Surgical intervention involved manual reduction of the intussusception, colectomy with 3 cm margins and end-to-end anastomosis. Histopathological examination identified the mass as a lipoma, composed of well-differentiated adipocytes originating within and expanding into the submucosa of the intestine, with an ulcerated and necrotic luminal surface. The cat was discharged 3 days postoperatively and had fully recovered at the 10-day follow-up. At 9 months postoperatively, the patient continued to do well with no recurrence of clinical signs.

Relevance and novel information: To the best of our knowledge, this is the first reported case of a colonic lipoma and the first reported case of a colonic submucosal lipoma leading to intussusception in a cat. This case highlights the importance of considering colonic lipomas as a differential diagnosis in feline patients presenting with constipation, diarrhoea or an acute abdomen.

Case summary: A 9-year-old neutered male domestic shorthair cat was presented for anorexia and lethargy with a 2-day history of ptyalism and dysorexia. The cat had undergone a cholecystoduodenostomy 8 years before presentation and had suffered from episodes of clinical cholangitis ever since. Abdominal ultrasound revealed duodenal obstruction. Two stones were surgically removed, subjected to spectrophotometric examination and identified as choleliths. Clinical improvement was noted postoperatively, and 12 months after surgery the cat was doing well and had no further digestive problems.

Relevance and novel information: This case report describes an original case of gallstone ileus, a complication which, to our knowledge, has never been described after cholecystoduodenostomy in cats. A parallel can be drawn with Bouveret's syndrome in humans, which is characterised by duodenal or gastric gallstone ileus secondary to an acquired bilioenteric fistula.

Case summary: A 4-year-old castrated male Sphynx presented for evaluation of a heart murmur and was diagnosed with subclinical hypertrophic cardiomyopathy characterized by a primarily apical distribution of left ventricular (LV) wall thickening. Over the course of four sequential follow-ups, progressive LV apical hypertrophy and left atrial dilation developed. Despite medical therapy with clopidogrel and pimobendan, the cat developed congestive heart failure and was euthanized 32 months after echocardiographic diagnosis. No post-mortem examination was performed.

Relevance and novel information: Although feline hypertrophic cardiomyopathy (HCM) is common and the pattern of distribution of LV hypertrophy is heterogeneous, this is the first case report of apical HCM in cats. Data from the human literature are extrapolated to make the diagnosis and discuss potential negative prognostic indicators of this condition in cats.

Case summary: A 12-year-old spayed female Ragdoll cat was treated with chemotherapy for gastric large B-cell lymphoma. Adverse effects included neutropenia and thrombocytopenia (day 132) and transient prednisolone-induced diabetes mellitus (day 209). On day 209, urinalysis revealed yeast, and Candida tropicalis was cultured. Concurrent findings included mild azotaemia, hyperglobulinaemia, right renomegaly and renal pelvic dilation. Chemotherapy was discontinued, and fungal pyelonephritis was treated with oral fluconazole (50 mg q12h). By day 244, progressive right renal pelvic and ureteral dilation with echogenic ureteral material was noted. Management included placement of a subcutaneous ureteral bypass device (SUB), extended oral fluconazole (137 days), fluconazole administration into the renal pelvis via the SUB (10 days) and intravenous caspofungin (10 days). At final follow-up (day 1306), the cat remained clinically well, non-azotaemic, with a patent SUB, reduced kidney size and no recurrence of fungal urinary tract infection, lymphoma or diabetes.

Relevance and novel information: This is the second report of feline Candida species pyelonephritis treated with a SUB, and the first of topical antifungal treatment using a nephrostomy tube, resolution of predisposing factors and a successful long-term outcome.

Case summary: Primary portal vein hypoplasia (PVH) is a rare congenital vascular disorder characterised by underdevelopment of the portal veins, leading to hepatic hypoperfusion and hypoplasia of the affected liver lobes. Although PVH is occasionally diagnosed in dogs, its occurrence in cats is exceptionally rare, with only a few cases reported. This case report describes the early detection of PVH in a 1-year-old female Russian Blue cat that exhibited persistently elevated liver enzyme activity without any clinical signs. CT imaging revealed hypoplasia of the left portal branch and a reduction in the volume of specific liver lobes. Histopathology confirmed PVH, revealing hypoplastic portal veins, mild bile duct and arteriolar hyperplasia, and hepatocellular vacuolar degeneration. The cat remained asymptomatic during the 18-month follow-up period.

Relevance and novel information: This case highlights the critical role of advanced imaging modalities, particularly CT, in the early diagnosis of PVH in cats and emphasises the potential for early intervention in asymptomatic cases. These findings contribute to the limited body of knowledge on feline PVH, expanding the understanding and paving the way for further research into its prevalence, pathophysiology and optimal diagnostic approaches in veterinary practice.

Case summary: An 18-month-old castrated domestic shorthair cat was presented to the veterinarian for regurgitation after solid food consumption, 3 days after sedation with xylazine for diagnostic evaluation of chronic upper respiratory disease. Treatment with antibiotics, sucralfate and metoclopramide by the referring veterinarian did not lead to any clinical improvement. Oesophagoscopy 3 weeks after initial sedation with xylazine revealed an oesophageal stricture, which, based on history and after excluding other potential causes, was attributed to oesophagitis resulting from gastro-oesophageal reflux during sedation. The prevalence of gastro-oesophageal reflux in cats under general anaesthesia is in the range of 12-33%; however, the condition has been less studied in this species compared with dogs. The cat in this report underwent several successful balloon dilatation sessions, which corrected the stricture. The cat remains asymptomatic 1 year later.

Relevance and novel information: To our knowledge, this is the first reported case of oesophageal stricture formation after a single xylazine administration in cats. This case highlights the importance of considering gastro-oesophageal reflux and subsequent oesophagitis as a potential complication of sedation and anaesthesia in cats, and the need for prompt diagnosis and management to prevent oesophageal strictures.

Case series summary: This case series describes two cats that developed intra-abdominal infections attributable to clostridial species. Case 1 describes a 3-year-old Oriental Shorthair that presented after acutely vomiting and rapidly declined, culminating in septic shock and death within hours of presentation. Imaging and post mortem revealed severe necrotising inflammation involving the right kidney and septic peritonitis. Histopathology revealed Gram-positive bacilli, consistent with a clostridial infection. Case 2, a 6-year-old Siamese, presented with acute lethargy, anorexia and abdominal pain. An enlarged, cavitated ileocaecal lymph node was identified on ultrasound. Cytology demonstrated abundant bacilli, and anaerobic culture and histopathology confirmed Clostridium septicum. The cat showed rapid clinical recovery after surgical excision of the affected lymph node and surrounding tissue.

Relevance and novel information: These cases highlight the potential for Clostridium species to cause fulminant intra-abdominal disease in previously healthy cats. Case 1 represents an unusual presentation of a septic abdomen due to Clostridium species and subsequent acute decline, while case 2 represents the first reported instance of spontaneous mesenteric lymphadenitis with abscessation due to C septicum in a previously healthy cat. Both cases demonstrate the severity of this bacterium in causing disease and the importance of early recognition. The findings highlight the aggressive nature of clostridial disease and the limitations of aerobic culture alone in diagnosis. This report expands the known host range and clinical manifestations of Clostridium species, supporting its inclusion in the differential diagnosis of necrotising intra-abdominal disease in cats, even in the absence of predisposing factors.