Journal of Feline Medicine and Surgery Open Reports最新文献

Case summary: A 2-month-old kitten was presented for ataxia and depressed mental status after implantation of a pet identification microchip. Radiographs were taken immediately by the referring veterinarian and showed a longitudinal metallic foreign body (electronic microchip) within the cervical vertebral canal at the craniocervical junction. A CT examination 2 days after the incident showed cranial migration of the microchip ventrally to the caudal brainstem. Ventral basioccipital craniectomy was immediately performed to retrieve the microchip by a ventral approach to the caudal brainstem. Postoperative recovery was uneventful and the cat was discharged 2 days later. At the 2-week follow-up, neurological examination of the cat was normal. No long-term complications were reported.

Relevance and novel information: This case report describes the intradural migration of a microchip and surgical removal via ventral basioccipital craniectomy.

Case summary: Feline megaesophagus (ME) is a rare failure of esophageal motility leading to regurgitation, weight loss and sometimes death in cats. It has been identified secondarily to neurologic and neuromuscular disorders, mechanical obstruction of the esophagus (eg, vascular ring anomalies, esophageal stricture) and upper airway obstruction among others; when no cause is found, it is considered idiopathic. Videofluoroscopic swallow studies (VFSSs), especially using an unrestrained free-feeding protocol, are underutilized for comprehensive evaluation of cats with regurgitation, including identifying the etiology of ME. In this case report, a 3-month-old male intact domestic shorthair cat with a history of regurgitation since weaning and radiographic evidence of ME had VFSS features compatible with a functional obstruction of the lower esophageal sphincter (LES) consistent with LES achalasia-like syndrome. Medical management with sildenafil failed to improve clinical signs, and surgical correction of LES achalasia using a Heller myotomy and Dor fundoplication was declined. As a result of caregiver compassion fatigue from persistent regurgitation, euthanasia was elected.

Relevance and novel information: Videofluoroscopic documentation of functional obstruction of the LES (ie, LES achalasia-like syndrome) can identify a novel etiology of feline ME. Free-feeding unrestrained VFSS protocols are recommended to allow physiologic assessment of swallowing disorders with no higher risk of aspiration than eating and drinking at home. Recognition of LES achalasia-like syndrome may lead to further study of directed treatments targeting the functional obstruction as has been carried out in humans and dogs.

Case summary: An 8-month-old male castrated domestic shorthair cat was presented for acute stranguria, pollakiuria and vocalization. The patient was diagnosed with urethral obstruction and hospitalized for medical management. At 36 h after discharge, the cat started passing severely hemorrhagic urine and was diagnosed with a uroperitoneum and uroretroperitoneum. An abdominal ultrasound and fluoroscopic retrograde positive contrast cystourethrogram did not identify a source of urinary tract rupture. An exploratory laparotomy revealed urine leakage from both kidneys, with evidence of rupture involving both the renal pelvis and parenchyma. It is suspected that sterile pyelonephritis and renal hemorrhage resulted in bilateral ureteral obstruction, and subsequent uroretroperitoneum, extending to cause uroperitoneum. Left ureteronephrectomy and right subcutaneous ureteral bypass placement was offered as a salvage procedure; however, euthanasia was elected intraoperatively because of a poor prognosis.

Relevance and novel information: Renal pelvic and parenchymal rupture is a poorly reported cause of uroabdomen in the cat. Furthermore, although severe renal hemorrhage has not been described in cats, it may lead to bilateral ureteral obstruction and uroabdomen.

Case summary: A 4-year-old spayed female domestic shorthair cat was presented for evaluation of multiple abdominal masses and hyperglobulinemia. Thoracic radiographs and abdominal ultrasonography revealed a cranial abdominal mass with extension through the aortic hiatus of the diaphragm and into the caudodorsal mediastinum. A diagnosis of feline eosinophilic sclerosing fibroplasia (FESF) with intralesional methicillin-resistant Staphylococcus aureus (MRSA) was obtained based on necropsy results.

Relevance and novel information: To the authors' knowledge, this case report is the first to describe extension of a primary FESF lesion through the diaphragm and is the first confirmed case of intralesional MRSA in an FESF lesion. In addition, this case is one of a growing number of reports of FESF lesions that do not involve the gastrointestinal tract. This case further contributes to the growing evidence that FESF should be considered as a differential diagnosis, in addition to neoplasia, feline infectious peritonitis or abscessation, in cats with masses, especially when there is concurrent hyperglobulinemia, a low albumin:globulin ratio and/or eosinophilia. This case also highlights the importance of considering this differential for masses outside the abdominal cavity, those involving both the chest and the abdomen, and those that do not involve the gastrointestinal tract.

Case summary: An 8-year-old castrated male mixed-breed cat was presented with recurrent vomiting, weight loss and abdominal distension. Blood work revealed hyperbilirubinaemia and elevated liver enzyme activities. Abdominal ultrasound and CT showed marked dilation and obstruction of the common bile duct (CBD) due to chronic cholecystitis and cholangiohepatitis. The cat was diagnosed with CBD obstruction secondary to chronic cholecystitis and cholangiohepatitis and was initially treated with antibiotics and prednisolone. Surgical intervention was performed because of complete CBD obstruction and worsening icterus that was unresponsive to medical management. A choledochoduodenostomy was performed using a simple side-to-side anastomosis between the CBD and the duodenum. The patient recovered uneventfully after surgery without significant complications. At the last follow-up, 6 months postoperatively, the cat remained clinically stable.

Relevance and novel information: There is limited information on choledochoduodenostomy in cats. This is the first veterinary report describing a simple side-to-side anastomosis between the CBD and the duodenum to resolve severe extrahepatic biliary obstruction secondary to chronic cholangitis and cholecystitis. As a result of the dilation and thickening of the CBD wall, this technique was feasible. This case study lacks information on long-term prognosis and continued monitoring is important.

Case summary: Major avulsion of the triceps tendon insertion was diagnosed in a 7-year-old domestic shorthair cat 3 weeks after developing sudden severe weightbearing lameness of the left thoracic limb. Diagnosis was confirmed with orthopaedic, radiographic and ultrasonographic examinations. The absence of adequate bone stock prevented the use of conventional techniques for tendon reinsertion. Instead, the tendon was reattached using an ultra-high molecular weight polyethylene (UHMWPE) ExtraTape prosthesis. It was stitched into the triceps tendon and superficial fascia, then passed through a bone tunnel drilled in the olecranon and secured with a preassembled cortical button. No external coaptation was used. Although the cat experienced temporary mild lameness, pain-free and satisfactory use of the left thoracic limb was observed 4 weeks postoperatively. By 12 weeks, the cat's gait had returned to normal, with no gap between the tendon and the olecranon. The cat resumed normal gait and range of motion 8 months postoperatively.

Relevance and novel information: Triceps tendon disruption is difficult to manage. Conventional repair techniques consist of suturing the tendon ends and prolonged immobilisation with an external fixator, which may cause postoperative complications. This option is particularly difficult to implement in cats, which represents a challenge in postoperative management. The successful outcome obtained here suggests that surgical repair using the ExtraTape prosthesis, without external coaptation, may be a viable alternative for similar cases.

Case summary: A 2-month-old male British Shorthair cat was referred with suspected atresia ani. Physical examination revealed an imperforate anus and dribbling of faecal discharge through the penis. Radiographic findings, along with a retrograde urethrogram, confirmed the diagnosis of type II atresia ani with a urethrorectal fistula. Surgical anoplasty was performed and the patient recovered well. At 8 months of age, surgical treatment for the congenital urethrorectal fistula was carried out via a single perineal approach, including fistulectomy and castration through the same incision. Postoperative short-term outcomes were excellent, with normal defecation and urination.

Relevance and novel information: Atresia ani is a rare congenital anomaly, particularly in male cats. Despite advancements in surgical techniques, this case represents the first successful staged surgical management of urethrorectal fistula with type II atresia ani in a male kitten, potentially influencing future surgical approaches for similar congenital anomalies.

Case summary: The cat described in this case report presented with progressive non-ambulatory tetraparesis. It was diagnosed with an occipitoatlantoaxial malformation (OAAM), which resulted in severe compressive myelopathy. This condition was caused by a flattening of the occipital condyles and shortening of the vertebral body of the axis. In addition, there was dysplasia in the atlantoaxial joint, which was observed on CT. The cat was treated surgically using a plate, which was custom-made with the help of a three-dimensional model of the malformation. Three weeks after surgery, the cat was able to walk without assistance; 5 years after surgery, the cat showed a normal neurological examination.

Relevance and novel information: Surgical planning using three-dimensional technology was useful in a complex case of OAAM. This is the first documented feline case that uses this type of technology for this condition.

Case summary: A 16-year-old female spayed domestic shorthair cat presented with an acute mass-like outpouching of abdominal viscera unilaterally in the right caudal abdominal ventrum without history of trauma. This abnormality was not identified on prior diagnostic investigations for hyporexia up to 3 weeks prior. A CT examination revealed a protrusion of the viscus through an area of anomalous abdominal wall thinning associated with the discontinuation of the transverse abdominis muscle in this region, rather than a true hernia. Exploratory celiotomy confirmed these findings, with the external rectus sheath and parietal peritoneum remaining intact without an overt hernia ring identified. Abdominal wall augmentation and reconstruction using internal abdominal oblique advancement and fold-over external rectus sheath imbrication resulted in complete resolution without recurrence on subsequent follow-ups. Despite gastrointestinal and muscle biopsies showing no evidence of neoplasia on histopathology, the patient developed an abdominal effusion and was diagnosed with granular lymphocyte lymphoma 4 weeks postoperatively, leading to euthanasia.

Relevance and novel information: This case describes a non-traumatic abdominal wall pseudohernia in a geriatric cat, a condition which has not previously been reported. A novel reconstruction technique was used to correct the body wall anomaly, with a good short-term outcome without recurrence.

Case summaryA 4-year-old male castrated domestic shorthair cat presented with a 2 cm painful cutaneous mass on its right lateral abdominal wall. The cat inflicted self-trauma to the lesion site causing secondary ulceration and mild haemorrhage. Fine-needle aspiration or incisional biopsy was advised, along with diagnostic imaging; however, excisional biopsy was preferred by the owners. The mass was surgically removed with 1 cm lateral margins and a deep fascial plane. The histopathological features were most consistent with a diagnosis of a glomus tumour; the diagnosis was supported by subsequent immunohistochemistry. The tumour was completely removed and there were no signs of recurrence at the 6-month follow-up. In this case, surgery is expected to be curative. Relevance and novel information To the authors' knowledge, this is the first report of a glomus tumour of the body wall in a cat and its association with pain and self-trauma. This report aims to add more data to the diagnosis and presentation of glomus tumours in animals.