Journal of Feline Medicine and Surgery Open Reports最新文献

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.

Case summary: A 1-year-old male castrated Savannah cat presented with chronic recurrent lethargy, stiffness, right pelvic limb lameness and spinal hyperaesthesia. Eight months before referral, the cat was treated with prednisolone, remdesivir and a 1-week course of amoxicillin/clavulanic acid and marbofloxacin for suspected feline infectious peritonitis. Multiple recurrences were reported after initial presentation, and were treated with 1-week courses of amoxicillin/clavulanic acid. Neurological examination did not reveal further findings. Haematology showed neutrophilia/monocytosis. Spinal, limb and thoracic radiographs revealed irregular endplates and narrowing of T12-T13 and L7-S1 intervertebral disc spaces, metaphyseal lesions of multiple long bones with heterogeneous medullary bone and reduced corticomedullary distinction, and two areas of increased opacity in the left lung lobes. Feline leukaemia virus, feline immunodeficiency virus, toxoplasma serology and urine culture were negative. Blood culture was positive for Salmonella species. Amoxicillin/clavulanic acid (20 mg/kg q12h) was started with clinical improvement, but no resolution of haematological/imaging changes. Relapse occurred 7 months into treatment. Blood culture showed Phocaeicola massiliensis, a suspected contaminant. Metronidazole (11 mg/kg q12h) was added based on sensitivity, with clinical improvement but relapse after discontinuation 4 months later. Neutrophilia and monocytosis were again identified, alongside hyperproteinaemia and globulinaemia. Recheck radiographs showed a worsening of the osteomyelitis but an improvement of the discospondylitis. Salmonella species were cultured again from blood and bone biopsies. Marbofloxacin (4.5 mg/kg q24h) was initiated. At the 6-month follow-up, complete resolution of clinical and laboratory findings was documented alongside radiographic improvement of the previous lesions. Treatment was discontinued with no relapses over the 10-month follow-up.

Relevance and novel information: To our knowledge, this is the first reported case of feline discospondylitis and osteomyelitis caused by Salmonella species. Marbofloxacin, but not amoxicillin/clavulanic acid, led to resolution of the infection.

Case summary: A 3-year 10-month-old spayed female domestic shorthair cat was presented for subacute progressive hyporexia, vomiting and lethargy. On presentation, the cat was dyspnoeic, and venous blood gas analysis revealed metabolic acidosis, hypercalcaemia (both total and ionised), hyperlactaemia and hyperglycaemia. Physical examination identified a 2 × 3 cm crusted cutaneous lesion on the cranium, reduced mentation, mild tachycardia, harsh bronchovesicular sounds and approximately 5% dehydration. Owing to welfare concerns, the owners elected euthanasia. Post-mortem examination revealed moderate autolytic changes. The organs most affected by vascular lesions included the heart, brain, kidneys, liver and pancreas. Histopathology revealed mild to severe multifocal intraluminal and mural proliferations of atypical endothelial cells, accompanied by multifocal thrombosis and mild perivascular oedema. Immunohistochemistry showed that the proliferating cells were negative for alpha-smooth muscle actin, and quantitative PCR for Bartonella species was also negative. However, 50% of the proliferating cells were positive for factor VIII. These findings supported a diagnosis of feline systemic reactive angioendotheliomatosis.

Relevance and novel information: In the authors' opinion, this case contributes to the growing body of literature on this rare condition and raises the possibility of an association with hypercalcaemia.

Case summary: An 8-year-old female neutered domestic shorthair cat was referred for further investigations of lethargy, polyuria, polydipsia, hyporexia and weight loss. One month prior, the cat had been diagnosed with normotensive and non-proteinuric chronic kidney disease and a single small well-defined splenic nodule thought to represent a benign process. Specialist abdominal ultrasonography documented changes suggestive of pyelonephritis alongside a solitary splenic mass (2 cm in size). Follow-up imaging 4 weeks later showed progression of the splenic mass (3.5 cm) and a novel marked anaemia. Splenectomy and histopathology were performed, which confirmed a diagnosis of splenic haemangiosarcoma. The cat was started on metronomic thalidomide (5 mg/kg PO q24h; BOVA) 16 days postoperatively. The cat re-presented to the referring veterinary practice 169 days after splenectomy (153 days after starting metronomic thalidomide) owing to lethargy and hyporexia. Abdominal ultrasound identified a solitary hepatic mass and free peritoneal fluid; the cat was subsequently euthanased without further investigations.

Relevance and novel information: This is the first published case report documenting the management of splenic haemangiosarcoma in a cat with splenectomy and metronomic thalidomide. Our observations indicate that survival time falls in line with other chemotherapeutic protocols and that thalidomide side effects were limited to mild polyphagia and moderate sedation, which was tolerated well if the drug was administered in the evening.

Case series summary: Three adult cats were successfully treated for severe anaemia caused by a bleeding hard palate ulcer with a temporary palatal guard. Each cat required a blood transfusion and underwent surgical implantation of a customised temporary guard to protect the hard palate mucosa from ongoing irritation. The palatal guards were made from radiographic film in two cases and an acetate sheet in the third. Cats received varied concurrent treatments in conjunction with surgery, including amoxicillin/clavulanate or doxycycline, cyclosporine and prednisolone. Complete resolution of the hard palate ulceration and anaemia was observed in all three cases.

Relevance and novel information: Excessive licking can lead to mucosal erosion of the hard palate, delayed healing and severe haemorrhage. When a palatine ulcer is refractory to medical management or the anaemia is severe, surgical intervention may be required. Techniques previously described include electrocautery, horizontal mattress sutures and ligation of the palatine artery combined with a bipedicle mucoperiosteal flap. These techniques typically require advanced surgical skills or access to specific equipment, may involve repeat surgeries to correctly isolate the palatine artery, and may leave a secondary wound that could prolong anorexia or risk becoming a new site of haemorrhage. Placement of a temporary customised palatal guard is a novel surgical technique for the treatment of bleeding palatine ulcers that does not require isolation of the palatine artery, involves minimal tissue handling, provides immediate control of oral pain, encourages immediate return to appetence and prevents ongoing trauma to the area during healing.

Case summary: A 1-year-old intact female domestic shorthair cat presented for evaluation of worsening respiratory distress and tachypnoea. The cat had been diagnosed with spontaneous pneumothorax 4 days earlier by the primary clinician and treated with therapeutic thoracocentesis. On physical examination, the patient exhibited decreased lung sounds, tachypnoea and increased breathing effort. Recurrent spontaneous pneumothorax was confirmed via thoracic radiography, and therapeutic thoracocentesis was repeated. Lung ultrasound performed after thoracocentesis revealed lung consolidation, pulmonary nodules and multiple cyst-like lesions with irregularly thickened echogenic walls and anechoic centres. Repeat thoracic radiography showed a diffuse moderate bronchointerstitial pattern with multifocal soft tissue nodules. A thorough faecal examination revealed ova resembling those of Paragonimus species, and subsequent molecular analysis confirmed Paragonimus westermani. The cat was initially treated with fenbendazole alone, which resulted in limited improvement and recurrent spontaneous pneumothorax. A second course of fenbendazole combined with praziquantel led to clinical improvement. The cat remained free of clinical signs and was doing well, with no identifiable lung nodules on thoracic radiography 2 years after diagnosis.

Relevance and novel information: This report describes a novel cyst-like lung ultrasound finding characterised by an irregularly thickened echogenic wall and anechoic centre, associated with P westermani infection in a cat presenting with recurrent spontaneous pneumothorax. The report also highlights a successful treatment approach resulting in long-term resolution. The identification of this novel lung ultrasound finding can facilitate early diagnosis and treatment of Paragonimus species infection in cats, especially for those presenting with respiratory distress and pneumothorax.

Case summary: A 1-year-old spayed female mixed-breed cat presented with chronic large bowel diarrhoea. The cat was treated with various antibiotics, prednisolone and dietary supplements without significant improvement. Endoscopic examination revealed an irregular colonic mucosa with multifocal erosion and haemorrhage. Impression smears of the colonic mucosa contained large numbers of unicellular round-to-oval organisms and macrophages. Histologically, granulomatous inflammation with numerous organisms was observed in the lamina propria of the colonic mucosa. The organisms had a cell wall and internal segmentation, which were positive on periodic acid-Schiff and Grocott's methenamine silver staining. Immunohistochemically, CD204-positive macrophages had accumulated in the lesions. Ultrastructural examination revealed dense bodies and starch granules, and the absence of chloroplasts in the cytoplasm of the organisms. PCR and a sequence analysis detected the Prototheca bovis 18S rRNA gene in formalin-fixed, paraffin-embedded colonic mucosa tissue. Based on these findings, the cat was diagnosed with granulomatous colitis associated with P bovis infection.

Relevance and novel information: This first report of feline intestinal protothecosis suggests that Prototheca species infection should be considered in the differential diagnosis of cats with treatment-resistant chronic large bowel diarrhoea.

Case summary: A 7-year-old female spayed domestic shorthair cat presented with respiratory distress. Initial diagnostics revealed a large cystic mass in the mediastinum and moderate hyperglobulinaemia. Additional abnormalities were ruled out through thoracic and abdominal CT. The mass was surgically removed, and antibiotic treatment was started based on cytological findings of intralesional bacteria. Histopathology and microbiology confirmed a severe inflammatory reaction pattern compatible with feline eosinophilic sclerosing fibroplasia (FESF) associated with Staphylococcus aureus. After surgery and antibiotic therapy, clinical signs and related abnormalities fully resolved. At the time of writing, 24 months postoperatively, the patient shows no evidence of relapse.

Relevance and novel information: FESF, initially described as an inflammatory condition affecting the gastrointestinal tract, has also been anecdotally reported in other locations, including the retroperitoneum, retropharyngeal region and mediastinum. This report is the second to document a mediastinal presentation without concurrent abdominal involvement, and the first to achieve long-term remission without the use of immunosuppressants. It supports the hypothesis that FESF may represent a characteristic pattern of inflammation secondary to a range of triggers rather than a distinct disease process, indicating that treatment should probably target the specific underlying cause.