Journal of Feline Medicine and Surgery Open Reports最新文献

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.

Case summary: A 10-month-old male neutered Dwelf cat with bilateral thoracic angular limb deformity secondary to chondrodystrophism presented with an acute onset of left thoracic lameness due to elbow subluxation and radial head displacement. Financial restrictions limited treatment to a single surgical procedure consisting of a left ulnar osteotomy, radioulnar polypropylene toggle placement and two temporary radioulnar transosseous K-wires. The lameness resolved but a degree of radial head subluxation persisted, radiographically similar in degree to the contralateral limb.

Relevance and novel information: Chondrodystrophism is not common in cats. Inbreeding and chondrodystrophism is likely to result in the diagnosis of musculoskeletal diseases that have not previously been reported in this species. To the authors' knowledge, this is the first case report of a developmental radial head subluxation in a chondrodystrophic cat.

Case summary: A 6-month-old male British Longhair cat presented with acute neurological signs, ocular changes, massive ascites and laboratory parameters consistent with feline infectious peritonitis (FIP). Systemic and neurological signs fully resolved with initial treatment (GS-441524; BOVA UK [15 mg/kg PO q24h for 42 days], levetiracetam [20 mg/kg q8h] and prednisolone [1 mg/kg q24h until day 21]). Lethargy and fever reappeared 17 days after treatment. Four days later, severe multifocal neurological signs re-emerged. High-field MRI revealed multifocal intra-axial and intramedullary lesions in the brainstem and cervical spinal cord, severe meningitis and generalised mild ventriculomegaly. Feline coronavirus (FCoV) RNA was detected in the cerebrospinal fluid by reverse transcription quantitative PCR (RT-qPCR). Abdominal effusion was absent. Serum alpha-1-acid glycoprotein (AGP) was again elevated. FIP re-emergence was suspected, and antiviral treatment was resumed. After 1 day of GS-441524 treatment (15 mg/kg PO q24h), severe hypoventilation developed, requiring intubation and mechanical ventilation for 1.5 days. Treatment was switched to remdesivir (16.7 mg/kg IV q24h, Veklury; Gilead) for 4 days. Oral GS-441524 was then reintroduced (10 mg/kg q12h) and continued until day 84. Treatment resulted in partial recovery with moderate ataxia and reduced left-sided menace response remaining 181 days after starting the second treatment.

Relevance and novel information: This case illustrates the complexity of diagnosing and treating re-emerging FIP-associated neurological signs. AGP monitoring offers a promising non-invasive approach for early detection of relapse. By adapting short- and long-term antiviral treatment and providing intensive care, excellent long-term outcomes can be obtained for cats with severe relapsing FIP-related neurological signs.

Case summary: A spayed female British Shorthair cat aged 1 year and weighing 2.6 kg presented with a 5-day history of vomiting and anorexia. Physical examination revealed icterus, and serum biochemistry showed markedly elevated bilirubin and liver enzyme levels. Abdominal ultrasonography revealed a dilated common bile duct (4 mm), mild gallbladder wall thickening and a round, hyperechoic foreign body located at the major duodenal papilla. A contrast-enhanced CT scan confirmed the presence of a 1.9 cm doughnut-shaped foreign body in the proximal descending duodenum, causing extramural compression of the common bile duct. Exploratory laparotomy and enterotomy were performed to remove the object. The cat recovered uneventfully, with normalisation of biliary parameters within 48 h and resolution of clinical signs by postoperative day 4.

Relevance and novel information: This case highlights a rare but surgically treatable cause of extrahepatic biliary obstruction (EHBO) in cats caused by a duodenal foreign body exerting extraluminal compression without intraluminal migration or mucosal invasion. It emphasises the value of cross-sectional imaging and timely surgical intervention in achieving favourable outcomes. To the authors' knowledge, this is the first peer-reviewed report of feline EHBO caused by extramural duodenal compression that was successfully resolved without biliary tract incision.

Case summary: A 10-year-old female spayed domestic shorthair cat was evaluated for a 6-week history of abnormal tail carriage and constipation. Examination revealed tail paresis and pain over the lumbosacral and sacrocaudal articulations and on tail manipulation. MRI revealed a contrast-enhancing mass within the vertebral canal over the lumbosacral disc space, compressing the cauda equina. The mass filled the epidural space, resulting in complete attenuation of the cerebrospinal fluid signal. Laminectomy and durotomy were performed over L7-S1, revealing white, firm material within the subarachnoid space. Microscopically, the material was consistent with degenerative intervertebral disc material. Postoperatively, the clinical signs resolved completely.

Relevance and novel information: Intervertebral disc herniation (IVDH) is uncommon in cats, with most cases involving extradural compression of nervous tissue. Reports describing intramedullary intervertebral disc extrusions in cats are rare. To the authors' knowledge, the present case is the first reported intradural-extramedullary intervertebral disc extrusion in a cat. Although MRI can often delineate extradural lesions, it can be insensitive in differentiating intradural-extramedullary from intramedullary lesions. In the present case, the location of the lesion within the vertebral canal at the lumbosacral disc space made the determination of the lesion's location with respect to the meninges challenging. Moreover, the strong contrast enhancement of the lesion raised an index of suspicion for neoplasia. Surgical intervention and histopathology confirmed an intradural-extramedullary IVDH. The present case adds to a growing body of literature regarding IVDH in cats and details the imaging findings of intradural-extramedullary IVDH in a cat.

Case summary: An 11-year-old male neutered domestic longhair cat was presented to an emergency referral hospital after sustaining severe injuries isolated to the thorax after a dog attack. Initial stabilisation included oxygen supplementation, intravenous fluid therapy, point-of-care ultrasound (POCUS), serial blood gas analyses, thoracic and abdominal radiographs, opioid analgesics and broad-spectrum antibiotics. CT revealed multiple internally displaced rib fractures that punctured through the mediastinum and were in intimate proximity to the cranial vena cava and proximal aortic arch. Video-assisted thoracoscopic surgery (VATS) was performed using a 2.7 mm 0° short laparoscope to place a custom-made fibre glass splint via percutaneous suturing to accurately reduce the rib fracture fragments without further damage to the intrathoracic structures. The splint remained in place for 6 weeks. At the 8-week recheck, the cat had no evidence of cardiovascular or respiratory compromise and was able to resume normal activity. A long-term follow-up phone call was conducted at 14 months postoperatively. The owner reported that the patient has continued to do well without any complications.

Relevance and novel information: To the authors' knowledge, this is the first report using VATS for the reduction of traumatic rib fractures in a cat. This case highlights the feasibility and success of this method and is a viable option in future clinical cases.

Case series summary: A 1.5-year-old male neutered domestic shorthair cat presented with an acute onset of lethargy and difficulty jumping. Prior medical history included a restrictive perimembranous ventricular septal defect and mild mitral regurgitation. Neurologic examination showed left hemiparesis and absent menace in the left eye. MRI revealed a lesion in the right frontal lobe and caudate nucleus with intralesional hemorrhage and restricted diffusion consistent with hemorrhagic infarct. A 6-year-old male neutered domestic shorthair cat presented with three neurologic episodes over 3 months, one consisting of circling to the right, absent menace in the right eye and right-sided postural reaction deficits, and the other two consisting of vestibular signs. MRI revealed a chronic hemorrhagic infarct of the left caudate nucleus. Both cats demonstrated favorable recovery, with cat 2 experiencing a fourth event 9 months after MRI.

Relevance and novel information: This case series details the first two cases of feline hemorrhagic infarct with ante-mortem diagnosis, MRI findings and recovery with a good long-term outcome. Hemorrhagic infarcts, uncommonly reported in companion animals, are a subtype of stroke involving hemorrhage resulting from reperfusion or collateral circulation into an ischemic area of brain tissue. This report discusses typical MRI findings in humans, including differentiation from intracerebral hemorrhage, and the potential role of comorbidities on the development and outcome of hemorrhagic infarcts in cats.

Case summary: A 10-year-old female neutered domestic shorthair cat presented with stranguria. The cat was bradycardic and had a firm urinary bladder on physical examination. On initial laboratory testing, the cat had severe azotemia with a creatinine of 15.8 mg/dl (reference interval [RI] 1.1-2.2), blood urea nitrogen of 217 mg/dl (RI 18-33) and potassium of 8.9 mmol/l (RI 3.5-5.0). Abdominal radiography revealed three cystoliths, with one cystolith suspected of being lodged within the trigone. Ultrasound of the abdomen showed marked suspended echogenic debris within the urinary bladder. Corynebacterium urealyticum was isolated from aerobic bacterial urine culture. A cystotomy was performed, and crystallographic analysis of the removed cystoliths showed they were composed of 94% struvite and 6% calcium phosphate. The cat recovered well and was discharged 2 days postoperatively. Three weeks postoperatively, the cat showed resolution of all clinical signs and azotemia.

Relevance and novel information: Urethral obstruction is common in male cats because of the narrow diameter of their urethra. In contrast, it is rare for female cats to experience lower urinary tract obstruction (LUTO). Identifying the underlying cause of LUTO is crucial for providing appropriate and targeted treatment. This case report describes a unique cause of LUTO resulting from C urealyticum associated with struvite urolithiasis in a female cat.