Journal of Feline Medicine and Surgery Open Reports最新文献

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.

Case summary: A 4-year-old castrated male domestic shorthair cat was presented with lethargy, anorexia and vomiting that did not improve with symptomatic treatment. Blood tests revealed markedly elevated liver enzymes. Abdominal ultrasound showed gallbladder abnormalities, including a small gallbladder, indistinct fundus, a continuous spiral-shaped morphology forming C- and reverse C-shaped curves, and hyperechoic fat surrounding the gallbladder. An exploratory laparotomy revealed gallbladder torsion without hepatic lobe torsion. Cholecystectomy was performed, and the prognosis was favourable.

Relevance and novel information: Gallbladder torsion without hepatic lobe torsion has not been previously reported in cats. The clinical signs, diagnostic imaging features and intraoperative findings differed from those reported in humans and dogs. The unique ultrasonographic appearance seen in this case may assist with future diagnoses of this rare condition in cats.

Case summary: Meningoencephalitis of unknown origin (MUO) is a term encompassing non-infectious inflammatory brain diseases with no identifiable underlying cause, widely studied in dogs but rarely in cats. This case describes a 9-year-old male castrated domestic shorthair cat diagnosed with feline MUO (FMUO). The cat presented with progressive vestibulocerebellar signs refractory to immunosuppressive treatment. MRI revealed multifocal, symmetrical intra-axial cerebellar lesions that were isointense to mildly hyperintense on T2-weighted and fluid-attenuated inversion recovery images, mildly hyperintense on T1-weighted images and enhanced with contrast. Cerebrospinal fluid analysis showed elevated protein concentration and lymphocytic pleocytosis. A post-mortem examination revealed widespread inflammatory infiltration affecting the frontal cortex, thalamus, parietal cortex and cerebellum in a bilateral and random distribution. Immunohistochemistry for common viral and protozoal pathogens was negative.

Relevance and novel information: This case illustrates the heterogeneity of FMUO, highlighting MRI and histo-pathological features that deviate from previously reported patterns. The findings highlight the need to include FMUO in the differential diagnosis for progressive vestibulocerebellar signs in cats, despite its rarity. Further research is necessary to better characterise FMUO and refine diagnostic and therapeutic approaches.

Case series summary: Medical records of two cats with chronic calcaneal wounds, managed using a single pedicle advancement flap combined with transarticular external skeletal fixation (TESF), were reviewed. Clinical presentation, surgical technique, and short- and long-term follow-up were documented. Both cats presented with chronic, non-healing wounds over the calcaneal tuberosities. After surgical debridement, a single pedicle advancement flap was harvested from the lateral distal tibia and sutured over the wound. A type I TESF using epoxy resin as the connecting bars was applied medially to stabilize the joint. In both cases, complete wound healing was achieved.

Relevance and novel information: These two cases demonstrate the successful use of a single pedicle advancement flap combined with a type I TESF for managing chronic calcaneal wounds in cats. The technique reduces flap tension and may enhance healing outcomes in anatomically difficult regions. This approach may be beneficial for treating chronic wounds over bony prominences in cats.