Journal of Feline Medicine and Surgery Open Reports最新文献

Case summary: An 8-year-old castrated male cat presented with a 7-year history of urinary incontinence (UI) and severe urinary scalding (US) caused by continuous urine leakage after prepubic urethrostomy (PPU) performed at 5 months of age for urinary trauma. The patient experienced significant pain and discomfort associated with US. Despite attempts at medical management, the patient's condition did not improve. Consequently, a hepatic occluder (HO) device was implanted around the shortened urethra after the PPU. Gradual occluder inflation was conducted over approximately 13 weeks to facilitate sphincter function recovery. The HO device effectively improved and controlled the UI, significantly enhancing the patient's quality of life and satisfying the owners.

Relevance and novel information: This case report describes the successful use of an HO to manage UI in a cat with a structurally irregular and shortened urethra resulting from traumatic injury and multiple prior surgeries. Urethral sphincter occluders, including HO, may represent a viable salvage option for managing UI in cats with complex urethral anatomy.

Case summary: Lymphoma is a prevalent malignancy in cats, commonly involving lymphatic or gastrointestinal tissues; however, primary muscular lymphoma is an exceedingly rare condition in veterinary medicine. This report describes a 7-year-old spayed female domestic shorthair cat that was presented for a 3-day history of progressive change in iris colour in the right eye. After rapid deterioration, the affected eye was enucleated and the cat was diagnosed with large T-cell lymphoma based on ocular histopathology and immunohistochemistry. The initial clinical signs were ocular; however, subsequent diagnostic evaluation revealed muscular involvement. Lymphoma was suspected to have originated in the quadriceps femoris muscle and subsequently metastasised to the eye.

Relevance and novel information: This case underscores the diagnostic complexity of lymphoma and highlights the importance of considering systemic disease in cases of unexplained uveitis. It was not possible to determine whether the muscle or the eye was the primary site; clinical signs were first ocular, but this does not confirm the eye as the origin. The association between primary muscular lymphoma and ocular presentation has not been previously reported. Early detection of lymphoma can improve clinical management, but diagnostic challenges often arise because of atypical presentations and the absence of detectable masses.

Case summary: A 4-year-old, indoor-only male castrated domestic shorthair cat was referred after identification of cardiomegaly and pleural effusion by the primary veterinarian. Echocardiography revealed generalised left ventricular hypertrophy with left atrial enlargement, pleural effusion and a small amount of pericardial effusion. Therefore, congestive heart failure was suspected, and the patient was treated with furosemide (2 mg/kg PO q12h). Subsequent investigations included pleural fluid analysis, plasma cardiac troponin I and serum alpha-1 acid glycoprotein (AGP) measurements. Plasma cardiac troponin concentration raised suspicion of myocarditis at 1.31 ng/ml (reference interval [RI] <0.05), while pleural fluid analysis revealed it to be a highly proteinaceous (84.3 g/l) exudate with mixed neutrophilic and macrophagic inflammation. A quantitative RT-PCR for feline coronavirus performed on the same fluid was positive in conjunction with markedly elevated serum AGP levels (2709 µg/ml; RI <500); therefore, a diagnosis of effusive feline infectious peritonitis (FIP) was made. The patient was treated with GS-441524 (10 mg/kg PO q12h) for 12 weeks, which resulted in resolution of the clinical signs, normalisation of AGP and fully reversed cardiac remodelling.

Relevance and novel information: This case report summarises an unusual case of FIP as the putative cause of myocarditis in a cat. Although acute myocarditis has been well described in people as a cardiovascular complication of systemic coronavirus disease (COVID-19), this is the first suspected ante-mortem diagnosis in a cat with FIP. Furthermore, once the FIP was successfully treated, the cardiac abnormalities entirely resolved. This case also highlights the importance of pleural fluid analysis in cats with effusion, even when heart failure is suspected as the cause.

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.