Journal of Feline Medicine and Surgery Open Reports最新文献

Case summary: A 4-year-old cat was presented with acute onset of lateralised neurological central nervous system (CNS) signs and seizures. Haematological and serum biochemical parameters were within normal limits. Imaging diagnostics revealed severe CT and MRI abnormalities of the right brain, similar to Dyke-Davidoff-Masson syndrome (DDMS) in human medicine. This syndrome includes cerebral hemiatrophy with compensatory calvarial hyperostosis and ventriculomegaly. Such changes have previously been reported only once in a single feline case of approximately the same age. In humans, DDMS is described as an embryonic and perinatal developmental disturbance or an acquired injury in early childhood.

Relevance and novel information: This case report shows that without further imaging diagnostics, congenital disorders can be overlooked in some rare cases of adult cats with later onset of their first clinical signs.

Case summary: An 11-year-old neutered male Turkish Angora cat was referred for obstructive feline lower urinary tract disease (FLUTD). On physical examination, the penis was curved at the tip and had a smaller than normal urethral opening proximal to the end, consistent with singular glandular hypospadias with a dorsal penile curvature. Because of its recurrent obstructive FLUTD history and inability to catheterise the urethra, a preputial urethrostomy (PRU) was performed. The PRU resolved the clinical signs with no clinical recurrence and no short- or long-term complications.

Relevance and novel information: To the authors' knowledge, this is the first description of singular glandular hypospadias in a cat. In addition, this is the first time feline hypospadias has been reported to occur with obstructive FLUTD and to be treated by preputial urethrostomy.

Case summary: A 2-year-old spayed female domestic shorthair cat presented with tetraparesis after being involved in a road traffic accident. Survey spine radiographs revealed a C2-C3 cervical subluxation, which was confirmed by a CT scan. Surgical stabilisation was performed using screws and polymethyl methacrylate (PMMA) via a ventral approach. A postoperative CT scan demonstrated correct implant positioning and good reduction of the subluxation. After surgery, the cat rapidly recovered to a neurologically normal status.

Relevance and novel information: Trauma-induced cervical subluxation is an uncommon occurrence in cats but should be considered in the differential diagnosis. This report describes the surgical management of a C2-C3 cervical subluxation in a cat using screws and PMMA. This is the first case report of a surgically treated subaxial cervical subluxation in a cat.

Case summary: A 5.5-year-old male neutered domestic shorthair cat was presented with a 2-year history of progressive chronic kidney disease. Abdominal ultrasonography revealed bilateral chronic renal degeneration, nephrolithiasis, cortical hyperechogenicity and infarction. Left orthotopic renal transplantation was performed using the Synovis vascular coupling system for end-to-end anastomosis of the renal arteries and veins. Two months after transplantation, renal values were elevated, and abdominal ultrasonography revealed hydronephrosis and hydroureter of the transplanted kidney. Fluoroscopic antegrade pyelography identified a proximal ureteral stricture. Proximal neoureterocystostomy was performed and renal values normalized postoperatively. The cat was re-evaluated for acute stranguria and severe azotemia 12 months later. Contrast-enhanced CT revealed severe hydronephrosis of the transplanted kidney, obstruction of the proximal ureter and adhesions to the urinary bladder. Upon exploration, retroperitoneal fibrosis was found covering the transplanted kidney. Given the clinical situation, a subcutaneous ureteral bypass device (SUB) was placed. Clinicopathologic analyses, trough cyclosporine levels, aerobic urine cultures and ultrasonographic evaluations of the transplanted kidney were monitored every 1-3 months. Patency of the SUB was reassessed every 3-6 months. At 15 months after placement, the SUB occluded due to kinking of the cystostomy catheter and was replaced. At 28 months after SUB placement, renal function and clinical status deteriorated, and the cat was euthanized.

Relevance and novel information: To the authors' knowledge, this is the first report of a SUB device being used for management of ureteral obstruction in a transplanted kidney in a cat.

Case summary: A 2-year-old domestic longhair crossbred female cat was referred for a second opinion on a non-healing surgical wound after left eye enucleation. In addition to the left orbital lesion, ulcerative granular masses protruding from the left nostril and on the base of the left ear were noted. A diagnosis of cryptococcosis was established using histopathological examination and a latex cryptococcal antigen agglutination test. The cat was successfully treated with itraconazole.

Relevance and novel information: Cryptococcosis, commonly reported in Australia, western Canada and the western USA, is rarely reported in companion animals in Europe. This marks the first report of cryptococcosis in cats in Bosnia and Herzegovina, emphasising the need to raise awareness within the veterinary community, both local and regional, about this disease.

Case summary: A 4-year-old female neutered Scottish Fold shorthair cat was presented for further investigation of circling towards the right. MRI of the brain revealed an extensive, right-sided temporal muscle lesion with associated frontotemporal bone osteolysis, intracranial, extra-axial extension along the calvarial convexity with severe pachy- and leptomeningeal thickening and contrast enhancement, and an intra-axial space-occupying lesion in the right piriform lobe. The regional lymph nodes were moderately enlarged. Cytology of the right parotid lymph node and the temporal muscle was performed and histiocytic sarcoma (HS) was diagnosed. The owners elected euthanasia.

Relevance and novel information: HS of the central nervous system (CNS) is a very rare neoplastic condition in cats. Although a few case reports mention MRI, to our knowledge, the characterisation of MRI features of feline CNS HS have not been investigated in detail. Therefore, the aim of this case report was to describe the MRI characteristics in a feline HS involving not only the CNS, but also the fronto-temporal bone, temporal muscle and the regional lymph nodes. In particular, aggressive neoplastic bone invasion was a novel finding.

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.