Journal of Feline Medicine and Surgery Open Reports最新文献

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 13-year-old castrated male domestic shorthair cat was diagnosed with diabetes mellitus based on hyperglycaemia, glucosuria and an elevated plasma fructosamine concentration. The diagnosis followed a 1-month history of lethargy and weight loss, along with a 1-week history of polyuria and polydipsia, which developed after the patient received a long-acting methylprednisolone injection from the referring veterinarian for pruritus. Treatment with velagliflozin was initiated, resulting in excellent glucose control, weight gain and resolution of clinical signs. However, the owner reported diarrhoea that did not improve with dietary modifications, symptomatic treatments or dose reduction of velagliflozin. Consequently, velagliflozin was discontinued after 64 days. Despite discontinuation, the cat remained euglycemic, with plasma fructosamine levels within the reference interval throughout a 175-day follow-up period. According to the Agreeing Language in Veterinary Endocrinology consensus definition, diabetes mellitus remission was confirmed.

Relevance and novel information: This case report highlights that diabetic remission is achievable in cats treated with SGLT2 inhibitors, as described in human patients with type 2 diabetes mellitus.

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.

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.