Journal of Feline Medicine and Surgery Open Reports最新文献

Case summary: A 6-month-old male entire domestic shorthair cat presented for presumptive Toxoplasma myopathy that was non-responsive to antiprotozoal therapy. Clinical features included marked macroglossia, dysphagia, regurgitation, truncal muscle hypertrophy, pelvic limb gait abnormalities and megaoesophagus. Relevant diagnostics included serial creatine kinase activity, cardiac troponin I, fluoroscopic swallow study and routine muscle histopathology. Ultimately, post-mortem histopathology with immunostaining demonstrated markedly decreased or absent staining for the rod and carboxy terminus of dystrophin, confirming a dystrophin-deficient muscular dystrophy (MD). The misdiagnosis of toxoplasmosis was based on an increased IgG titre and muscle histopathology submitted to a local laboratory. Treatment for megaoesophagus included vertical feeding of wet food only, sildenafil and omeprazole. Dysphagia and regurgitation improved moderately. Presumptive hyperaesthesia and muscle pain were managed with anti-inflammatory doses of prednisolone. The patient was ultimately euthanased as a result of progressive MD signs and uraemia at 2 years of age.

Relevance and novel information: This case report highlights the collective clinical features of MD, as they could be considered pathognomonic for this rare condition and must be differentiated from other myopathies via specific immunostaining of muscle biopsies. This is crucial to obtain a correct and early diagnosis, allowing instigation of potentially valuable treatments. Megaoesophagus is an inconsistent feature in feline MD in addition to the more commonly observed oropharyngeal dysphagia. Management with a canned diet, sildenafil, omeprazole and upright feeding was beneficial with moderate improvement in the frequency of regurgitation. Prednisolone was thought to minimise the presumptive myalgia.

Case summary: A 9-year-old male castrated domestic shorthair cat was presented with a 2-week history of acute, progressive left pelvic limb lameness. Gait evaluation revealed a grade 3/5 left pelvic limb lameness with no apparent orthopedic cause for the lameness based on orthopedic examination or radiographs. The neurological examination was otherwise normal. MRI revealed a left-sided L6-7 far lateral intervertebral disc extrusion with possible secondary neuritis of the L6 spinal nerve. A left-sided L6-7 foraminotomy was performed to remove the extruded disc material and provide additional space for the significantly enlarged nerve root. An L6-7 fenestration was also performed. The patient made an excellent recovery with near-complete resolution of lameness at 26 days postoperatively.

Relevance and novel information: This case report contributes to the growing body of literature on lateral intervertebral disc extrusion as an etiological factor in pelvic limb lameness in cats, particularly when neurological deficits are absent. Furthermore, the case report highlights the diagnostic utility of cross-sectional advanced imaging for cats with lameness for which an orthopedic or radiographic cause cannot be identified. Finally, this case underscores the efficacy of surgical intervention as a treatment option for cats with lumbar far lateral intervertebral disc extrusions that do not improve with medical management alone. This finding could have implications for future surgical approaches in cats with similar findings.

Case summary: An 11-year-old male neutered cat was referred to The Ohio State University's Veterinary Teaching Hospital after being diagnosed with pleural effusion by a referral veterinarian. After thoracocentesis, analysis of the effusion was consistent with chyle. Echocardiography, radiographs and bloodwork were used to diagnose hypertrophic cardiomyopathy phenotype and left-sided congestive heart failure, suspected to be secondary to uncontrolled hyperthyroidism. While initiating medical therapy, repeated thoracocenteses were required. A severe pneumothorax developed, necessitating placement of bilateral thoracostomy tubes. A thoracic CT scan did not reveal a cause for the pneumothorax; therefore, it was suspected to have occurred secondarily to an iatrogenic laceration of the parenchyma during thoracocentesis. An autologous blood patch pleurodesis was considered contraindicated so instead the cat was administered a blood patch using blood from a canine blood donor. The cat's respiratory status remained stable without additional intervention. At 30 h after blood patch pleurodesis, the thoracostomy tubes were removed and thoracic radiographs revealed near resolution of the pleural effusion and pneumothorax. The cat remained subclinical and was discharged from the hospital 48 h after the blood patch pleurodesis. Upon follow-up at 4 and 8 weeks after discharge, the cat was alive and had no complications or adverse reactions from the blood patch pleurodesis.

Relevance and novel information: This case documents the first report of a xeno-blood patch pleurodesis performed in a cat using blood from a canine donor. The cat had a successful discharge from the hospital with no adverse reactions from the xeno-blood patch pleurodesis.

Case series summary: Two cats, aged 13.5 and 14 years, presented with duodenal masses ultimately diagnosed as Brunner's gland (BG) adenomas. In the first cat, the lesion was a firm, pale tan, proximal duodenal polyp adjacent to the major duodenal papilla that was composed histologically of a well demarcated, expansile mass of well-differentiated BGs separated by fibrovascular septa and few adipocytes. This patient was euthanized for otitis-related vestibular signs, and the clinical significance of the duodenal polyp is unknown. The second cat presented with a 6-month history of vomiting. This cat had a mural duodenal mass in the region of the major duodenal papilla of approximately 2 cm, which was histologically composed of a dense population of variably ectatic BGs expanding the submucosa and lamina propria. This patient's mass was non-resectable, but the vomiting resolved after palliative gastroenterostomy loop surgery to allow ingesta to flow past the mass. The patient survived 35 months after the procedure.

Relevance and novel information: BG adenoma is a rare, typically benign tumor in humans with non-specific clinical manifestations and no clear etiopathogenesis. This lesion, and the related condition BG hyperplasia, has been documented rarely in animals (one dog, two horses, and in mice and rats). This is the first description of the lesion in the cat. The comparative pathology, differential diagnoses and possible significance of these lesions are discussed.

Case summary: A 10-year-old neutered female domestic shorthair cat was presented to our hospital with a 2-day history of anorexia, vomiting and lethargy. The biochemistry panel revealed increased hepatic enzyme activity and serum amyloid A concentration. Haematological values were within reference intervals. An abdominal ultrasound identified a hyperechoic spindle-shaped structure within the common bile duct and a suspected secondary subobstruction, associated with signs of intra- and extrahepatic biliary tract inflammation. During hospitalisation, the cat developed severe and sustained ionised hypercalcaemia. Exploratory surgery was elected as a result of the lack of clinical improvement, despite supportive treatment and suspected retrograde migration of the spindle-shaped structure. Two grass awns were extracted at the junction of an extrahepatic duct and the common bile duct via choledochotomy using intraoperative ultrasound guidance. A stent was then placed in the bile duct to prevent subsequent bile leakage. Histopathology of the liver revealed a moderate neutrophilic and lymphoplasmacytic inflammation with rare bacterial colonies. Escherichia coli was cultured from a bile sample. No specific cause of hypercalcaemia was identified. The cat recovered uneventfully from surgery. Hepatic enzyme activities and hypercalcaemia progressively decreased within a few weeks after surgery and remained within the reference intervals without treatment. Therefore, hypercalcaemia was suspected to be secondary to a foreign body-related granulomatous reaction.

Relevance and novel information: To our knowledge, only one other feline case report of biliary tract obstruction secondary to a biliary foreign body has been described in the literature. This is also the first case reporting the use of intraoperative ultrasound to localise a vegetal foreign body within the biliary tract of a cat. This case is also unique because of the onset of hypercalcaemia suspected to be secondary to a foreign body-related granulomatous reaction.

Case summary: An 8-month-old spayed female cat presented with a 7-week history of progressive dyspnoea, dysphagia and regurgitation. Plain radiography revealed megaoesophagus with a large, rounded, soft tissue opacity laryngeal mass. Endoscopic examination revealed a fluid-filled lesion, which was lanced and drained completely. As a result of recurrence of the mass and infection 2 days later, the mass was surgically excised. The mass was diagnosed as a laryngomucocele based on clinical and histopathological findings. Clinical signs resolved immediately after removal of the mass, the megaoesophagus resolved a couple of days postoperatively and no relapse was noted over the following 3 years.

Relevance and novel information: To the author's knowledge, this is the first case of laryngomucocele described in a cat. This cause should be included in the differential diagnosis of respiratory obstruction and acquired megaoesophagus in cats. This report demonstrates that megaoesophagus resulting from a respiratory obstruction resolves spontaneously after removal of the obstruction; therefore, respiratory tract assessment should be recommended in cats with signs of megaoesophagus because the prognosis could be good compared with other causes of megaoesophagus.

Case summary: A female kitten with two ectopic supernumerary pelvic limbs arising from the umbilicus was born in our clinic. Five weeks after the kitten's birth, she showed an acute deterioration in condition, with clinical signs of an ileus in the intestines entering the supernumerary body part. We then performed a surgical separation of the supernumerary limbs and intestines. Based on clinical findings and radiography, the kitten was classified as a case of parasitic twinning-omphalopagus or a subtype of asymmetrical caudal duplication, rather than a case of polymelia. Parasitic twinning and caudal duplication are rare congenital malformations in many animal species and in humans, which can often have a poor outcome. Almost 1 year after the separation, the cat appeared to be living a normal life without complications.

Relevance and novel information: A good outcome is rare in parasitic twinning because many of these animals present with other concurrent health issues, such as congenital heart malformation or cleft palate, or they are stillborn. However, this pathological entity is scarce in small animal medicine, and there is no documented survival rate. To our knowledge, this is the first officially documented case of parasitic twinning-omphalopagus in a cat in the past decade.

Case summary: A 9-year-old, spayed, female domestic shorthair cat presented with an open wound approximately 1 cm in size with exposure of the left subcutaneous ureteral bypass (SUB) shunting port that was placed approximately 11 months before presentation. Primary closures were attempted twice before local wound management with omentalisation and repositioning of the port. The exposed port was lavaged topically with a polyhexanide and propylbetaine wound irrigation solution before omentalisation and repositioning, resulting in successful retention of the implant. Five months after revision and omentalisation, there was complete coverage and healing of the wound.

Relevance and novel information: Adequate topical treatment, repositioning and omentalisation could be a successful treatment option for the uncommon complication of SUB shunting port extrusion secondary to resistant local infection originating from the urinary tract.

Case summary: A 5-month-old male castrated domestic shorthair cat was evaluated for acute onset of emesis. Abdominal radiographs identified a suspected colonic foreign body and abdominal-focused assessment with sonography for trauma, triage and tracking (AFAST) evaluation revealed a large amount of peritoneal effusion. Cytology of the peritoneal effusion was consistent with a septic exudate. An exploratory celiotomy identified a ruptured ileocecocolic mass and a resection and anastomosis was performed. No foreign material was identified and histopathology confirmed that the ruptured mass was a colonic duplication cyst. Recurrent septic peritonitis was diagnosed based on cytologic evaluation of fluid from a silicone bulb reservoir of a closed suction drain. No abnormalities were surgically identified, the cat recovered without complication, was discharged at 7 days postoperatively and has continued to remain healthy 8 months after surgical intervention.

Relevance and novel information: To our knowledge, this is the first known instance of a histopathologically confirmed non-communicating colonic duplication cyst causing septic peritonitis in the veterinary literature.

Case summary: This report describes the diagnostic findings, natural history and genetic analysis of the candidate gene Forkhead Box F1 (FOXF1) in a young cat with developmental lung disease and high probability of pulmonary hypertension. A 1-year-old male entire Chartreux cat was referred for cardiac murmur investigation and exercise intolerance. Echocardiography identified a high-velocity tricuspid regurgitant jet with right-sided cardiac changes, supporting a high probability of pulmonary hypertension. No congenital cardiac shunts or left-sided cardiac changes were found to support a primary cardiac cause of pulmonary hypertension. Extensive laboratory work, thoracic radiographs and CT were performed. Histopathological characterisation (lung biopsy and later post mortem) was necessary to reach the final diagnosis. Eight months after diagnosis, the cat developed right-sided congestive heart failure, eventually leading to euthanasia. Survival from diagnosis to death was 12 months.

Relevance and novel information: Developmental lung disease belongs to a group of diffuse lung diseases in humans associated with pulmonary hypertension. The veterinary literature describing lung growth disorders in cats is sparse, and the present report provides information on clinical presentation and progression alongside a thorough diagnostic workup, which may aid clinicians in identifying this condition. Lung biopsy was pivotal in reaching the final diagnosis. No causal variants in FOXF1 were identified.