Journal of Feline Medicine and Surgery Open Reports最新文献

Case summary: An unowned, entire male domestic shorthair cat was surrendered to a rescue centre. On physical examination, poor body condition (score 3/9) and pigmented mass lesions on the lateral aspects of the upper gingivae were noted. The oral lesions were identified as haematomas only after examination under sedation. A diagnosis of probable primary immune thrombocytopenia (pITP) was made based on profound thrombocytopenia, rapid response to glucocorticoid therapy and the absence of identified triggers for secondary immune thrombocytopenia. The patient was treated with glucocorticoids and remained in remission 18 months from diagnosis.

Relevance and novel information: pITP is infrequently reported in cats and oral haematomas have not previously been documented as a presenting clinical sign. This case report serves to raise awareness of feline ITP and highlights the availability of evidence-based diagnostic and therapeutic guidelines that were published after the case was treated. While pITP can be refractory to treatment and can be associated with treatment-related morbidity, this case report demonstrates that an acceptable outcome can be achieved, albeit with a requirement for long-term treatment and regular monitoring.

Case summary: A 6-year-old female spayed domestic shorthair cat was presented for abdominal distension and weight loss. Abdominal radiographs and ultrasound revealed two cranial abdominal masses and another mass adjacent to the jejunum. Cytologic features of the cranial abdominal masses were consistent with exocrine pancreatic tissue. Four months later, a repeat abdominal ultrasound revealed progressive enlargement of the abdominal masses and medial iliac lymphadenopathy. On exploratory laparotomy, two abdominal masses were associated with the pancreas and incorporated large blood vessels supplying the liver, pancreas and spleen. The masses were non-resectable and incisional biopsies were obtained. The histologic features were diagnostic for a hyalinizing subtype of exocrine pancreatic adenocarcinoma. Chemotherapy was not pursued. Over 28 months after the initial detection of abdominal masses, the cat was still alive and reportedly doing well.

Relevance and novel information: To the authors' knowledge, this is the first report of a hyalinizing subtype of pancreatic adenocarcinoma in a cat. This subtype is considered to behave less aggressively in dogs, and this case may support that a similar, more indolent behavior may be seen in cats.

Case summary: A 4-year-old male castrated domestic shorthair cat presented with a 3-month history of coughing and progressive dyspnea. The cat was diagnosed with idiopathic chylothorax after serum biochemistry, thoracocentesis, cytology of pleural effusion, echocardiography and thoracic imaging were performed. After failure to respond to medical management with repeated thoracocenteses, the oral administration of rutin and a low-fat diet, the cat underwent staged interventions consisting of CT lymphangiogram, subtotal pericardiectomy and pleural access port (PAP) placement, followed by thoracic duct ligation (TDL) and cisterna chyli ablation (CCA) 2 months later. The cat made a clinical recovery based on resolution of chylous pleural effusion 1 month after TDL and CCA, and the PAP was removed 1 month later. The cat remained free of clinical signs 3 years postoperatively.

Relevance and novel information: This is the first report documenting the use of a PAP for the management of feline chylothorax to disease resolution. Employing this device enabled frequent, low morbidity drainage of the pleural effusion as an alternative to repeated thoracocenteses and facilitated staging the interventions throughout management of idiopathic chylothorax in a cat. PAPs can be used successfully in the management of chylous pleural effusion in cats.

Case summary: A 5-year-old British Shorthair cat was diagnosed with pemphigus foliaceus (PF) and was initially treated with methylprednisolone (0.7 mg/kg q12h), which possibly resulted in congestive heart failure (CHF). Treatment was switched to dexamethasone (0.09 mg/kg q24h) and mycophenolate mofetil (MMF) (10 mg/kg q12h) was added as a steroid-sparing agent. Although dexamethasone was slowly tapered off, MMF alone successfully maintained PF in remission. After 15 weeks of treatment, blood tests showed neutropenia and thrombocytopaenia. MMF dose reduction (10 mg/kg q24h) resulted in the normalisation of haematological parameters, although a mild flare of PF occurred. The reintroduction of dexamethasone (0.09 mg/kg twice weekly) rapidly restored disease control. MMF (10 mg/kg q24h) and dexamethasone (0.045 mg/kg twice weekly) were continued as maintenance therapy. After 36 weeks, the cat remained in clinical remission without further complications.

Relevance and novel information: To the best of the authors' knowledge, this is the first case report to describe the use of MMF in a cat with PF. MMF was well tolerated and it was able to manage clinical signs even after the discontinuation of corticosteroids. Since mild and reversible haematological abnormalities were observed, careful monitoring during MMF administration is recommended. In this case, MMF dose reductions led to flares requiring a temporary reintroduction of corticosteroids to maintain disease control. MMF could be useful as an alternative treatment in cats affected by comorbidities where corticosteroid monotherapy would pose risks.

Case series summary: Factor XII (FXII) deficiency is a rare autosomal recessive genetic disorder in cats, leading to singular prolonged activated partial thromboplastin clotting time (aPTT) without increased bleeding risk. This case series describes two cats diagnosed with FXII deficiency using the ClotPro system, a point-of-care viscoelastic coagulation test. Both cats exhibited significantly prolonged aPTT and intrinsic pathway clotting time but maintained normal clot strength, as indicated by thromboelastography (TEG). FXII deficiency was confirmed through quantitative ELISA measurement. Despite prolonged clotting times, the cats did not demonstrate clinical bleeding, suggesting that FXII deficiency does not increase bleeding risk. However, larger controlled studies are necessary to further investigate the utility of TEG in cats with FXII deficiency or other coagulation disorders.

Relevance and novel information: This study addresses the diagnostic challenges associated with FXII deficiency, a condition that can lead to misinterpretation of coagulation results and unnecessary treatments. It highlights the application of the ClotPro system in feline medicine, providing deeper insights into coagulation dynamics and confirming that FXII deficiency does not inherently increase bleeding risk despite prolonged clotting times.

Case summary: A 4-year-old male castrated Ragdoll cat presented for generalised seizures. The cat displayed hyporexia, lethargy and hiding behaviour 24-48 h before presentation. The cat had a chronic history of daily vomiting and tachypnoea for 12 months. Severe hypoglycaemia was noted at 1.8 mmol/l (reference interval 4.11-8.84) on initial presentation. The hypoglycaemia persisted despite multiple glucose boluses, resulting in the cat being treated with a glucose and glucagon continuous rate infusion. The cat underwent extensive diagnostic evaluation during hospitalisation, consisting of serial venous blood gas assessment, haematology and biochemistry analysis, urinalysis, serum insulin assay, resting cortisol, adrenocorticotropic hormone (ACTH) stimulation test, abdominal and thoracic imaging, and airway culture. A resting cortisol level of <14 nmol/l was obtained on day 2 of hospitalisation with a follow-up ACTH-stimulation test reporting a baseline cortisol of <28 nmol/l and a 1 h post-ACTH cortisol of 7 nmol/l, supporting a diagnosis of hypoadrenocorticism. The cat was successfully treated with glucocorticoid therapy and discharged home 8 days after initial presentation.

Relevance and novel information: There are limited cases of feline hypoadrenocorticism present in the literature, most of which describe cats with both glucocorticoid and mineralocorticoid deficiency. Only two previous case reports of feline atypical hypoadrenocorticism exist. Only one of these case reports describes hypoglycaemia with signs of neuroglycopaenia on initial presentation. To the author's knowledge, this is the first successfully treated case of atypical hypoadrenocorticism presenting with hypoglycaemic seizures in a cat, demonstrating successful long-term management.

Case summary: A 6-year-old male castrated Maine Coon cat was presented with a 3-day history of lethargy, hyporexia and weight loss. Abdominal ultrasonography demonstrated a double intestinal intussusception with the colon intussuscepting a thickened ileal segment, which was in turn intussuscepting the jejunum. A jejunal prolapse through the anus occurred 3 days later as a complication of the double intussusception, at which time the cat underwent surgery. Manual reduction of part of the intussusception was achieved, while the remaining 30 cm, including of the ileocaecocolic junction, was resected followed by functional end-to-end anastomosis. The cat recovered uneventfully without any reported long-term gastrointestinal complications.

Relevance and novel information: Double intussusception is rare in cats. To the best of the authors' knowledge, this is the first case to describe ultrasonographic features of double intussusception in a cat.

Case summary: In cats, polyuria (PU) and polydipsia (PD) are defined as a urine specific gravity (USG) consistently <1.035 and water consumption >100 ml/kg/day. A 2-year-old castrated male domestic shorthair cat with PU/PD was brought to our hospital. Diagnostic tests for PU/PD included physical examination, blood analyses (complete blood count, serum chemistry profile, electrolytes, ionised calcium, symmetric dimethylarginine and thyroxine concentration), thoracic radiography, abdominal ultrasound examination, urinalysis, urine cortisol:creatinine ratio, urine protein:creatinine ratio and urine culture. A modified water deprivation test resulted in a USG >1.036 and cranial MRI did not identify any abnormalities. Therefore, the cat was administered desmopressin, which failed to decrease water consumption or increase the USG above the untreated level; thus, primary PD was confirmed.

Relevance and novel information: This rare case of feline primary PD is the first reported that did not identify evidence of structural pathology of the pituitary gland.

Case summary: A 4-month-old Maine Coon kitten was presented for the surgical correction of pectus excavatum (PE). Originally presenting with progressive respiratory distress, the cat underwent video-assisted thoracoscopic surgery (VATS) for stabilisation using a locking compression plate. Postoperative complications included two separate episodes of infection, which ultimately resolved after implant removal. The cat showed gradual improvement and exhibited no clinical signs related to PE at the 12-month follow-up.

Relevance and novel information: The VATS approach may provide a useful technique to help reduce intraoperative risk during PE correction in cats.

Case summary: A 2-year-old female spayed domestic shorthair cat with a 1-week history of lethargy and dysorexia was presented to a veterinary teaching hospital. Physical examination identified severe left nephromegaly, hyperthermia and abdominal pain. Abdominal ultrasound revealed a left ureteral dilation due to obstruction by a ureterolith, associated with marked subcapsular effusion. Urinalysis showed alkaline urine with crystals of struvite. Culture of urine from the renal pelvis and the urinary bladder was positive for Staphylococcus pseudintermedius. An infected struvite ureterolith due to the presence of urease-producing bacteria was suspected. The ureterolith was removed via ureterotomy and a temporary ureteral stent was positioned in an antegrade fashion. Results of infrared spectroscopy showed pure struvite urolithiasis. The stent was removed via cystoscopy 35 days after surgery. The cat was still doing well at the 6-month follow-up.

Relevance and novel information: To the best of the authors' knowledge, this is the first case of a struvite ureterolith due to ureolytic pyelonephritis in a cat.