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Craig R Breheny, Victoria Fox, Alice Tamborini, Conor O’Halloran, Elise Robertson, Paola Cazzini, Daniela Birn-Jeffery, Julia Henkin, Tobias Schwarz, Tim Scase, Roger Powell, Danièlle Gunn-Moore
This case series discusses novel characteristics identified in two cases of cowpox. One presented with upper airway signs, and was identified to have a focal laryngeal lesion. The other had central neurological signs at the terminal stages, with intracytoplasmic inclusion bodies identified within the cerebral hemispheres on histopathology.
Relevance and novel information
Currently, cowpox would be an unlikely consideration in patients with neurological signs or upper respiratory noise. These cases both document novel presentations of cowpox infection, which clinicians should be aware of and consider as differential diagnoses in patients with these atypical presentations.
Herein a drug-resistant IgG-lambda-type multiple myeloma associated with probable phaeochromocytoma in a cat is described. A 12-year-old cat presented with weakness, weight loss, progressive blindness and open-mouth breathing, in addition to polyuria and polydipsia of 2 months’ duration. Abdominal ultrasonography revealed a left adrenal mass. Phaeochromocytoma was suspected on the basis of cytology and was associated with systemic hypertension. Biochemistry showed hyperproteinaemia. Serum protein electrophoresis revealed a narrow spike in the gamma region, identified as IgG lambda type at immunoelectrophoresis. Bone marrow cytology revealed an infiltrate with numerous mature plasma cells. The cat was resistant to two different drugs for multiple myeloma and was euthanased 6 months later because of anorexia and persistent poor general condition.
Relevance and novel information
This is the first clinical description of multiple myeloma associated with a suspected phaeochromocytoma in a cat.
This paper describes the clinical presentation, diagnostic imaging findings and outcome in four cats with confirmed joint-associated tuberculosis. The cats were 2–6 years of age, and immune competent. Three cases had tuberculosis affecting only one joint, whereas one case had at least three joints affected. Two cases were caused by Mycobacterium bovis, and the other two were caused by Mycobacterium microti. Radiological findings included osteolysis, periosteal reaction and associated soft tissue swelling. Two cases were euthanased and two cases responded well to amputation and follow-on antibiotic therapy.
Relevance and novel information
To our knowledge, this is the first publication of a series of cats with joint-associated tuberculosis. Although tuberculosis is not common, a high degree of suspicion is needed to avoid delayed diagnosis. This case series highlights the importance of considering mycobacterial disease as a differential for joint disease in cats.
Laura A Heaps, Christopher J Scudder, Vicky J Lipscomb, Sarah ML Steinbach, Simon L Priestnall, Henny Martineau, Balazs Szladovits, Robert C Fowkes, Oliver A Garden
A 15-year-old female cat was presented for investigation of progressive behavioural changes, polyuria, polydipsia and periuria. An ovarian granulosa cell tumour was identified and the cat underwent therapeutic ovariohysterectomy (OHE). The cat’s clinical signs resolved, but 6 months later it was diagnosed as having an anaplastic astrocytoma and was euthanased. Serum anti-Müllerian hormone (AMH) concentration prior to OHE was increased vs a control group of entire and neutered female cats. Following OHE, serum AMH concentration decreased to <1% of the original value.
Relevance and novel information
Serum AMH measurement may represent a novel diagnostic and monitoring tool for functional ovarian neoplasms in cats.
A 5-year-old male neutered domestic shorthair cat was presented to our referral centre with a 13 month history of chronic tenesmus due to malunion of the right caudal iliac body. Constipation and pelvic canal stenosis were initially addressed by the referring veterinarian with a right femoral head and neck excision and a right acetabulectomy without observable clinical improvement. At admission, abdominal radiographs revealed severe colonic distension and a narrowed pelvic canal caused by the right proximal femur. Rectal examination and colonography revealed a dynamic compression of the rectum, which worsened with femoral abduction and improved with femoral adduction. A right hindlimb amputation was performed to relieve the obstruction. The cat defaecated 2 days postoperatively and was discharged uneventfully. Neither faecal tenesmus nor dyschaezia were observed over the following 10 months.
Relevance and novel information
The dynamic nature of the rectal obstruction most likely prevented the development of an irreversible colonic dilatation leading to a megacolon. This is the first report describing a chronic dynamic rectal compression, which was successfully managed with a right hindlimb amputation without the need for subtotal colectomy.
A 5-year-old intact female Maine Coon cat presented with a 2 day history of lethargy, anorexia and anaemia. The cat had bred 60 days previously and jumped from a height 3 days earlier, which was followed by a worsening of its condition. Ultrasonography revealed that two fetuses had died and one remained alive. Urgent surgical intervention was deemed necessary, and the cat underwent a blood transfusion and laparotomy. The right uterine horn was dark red in appearance and had rotated 360° in the clockwise direction at its base. Subsequently, an ovariohysterectomy and caesarean section were performed, and the fetus in the left uterine horn initially survived. Although the cat appeared to recover from anaemia and physical injury, the kitten died on postoperative day 1.
Relevance and novel information
In cases involving only one twisted uterine horn, the fetuses located in the contralateral horn could potentially survive; however, many such fetuses do not survive, and only a few reports have described fetal survival in a pregnant cat with uterine torsion. In the present case, early surgical intervention and blood transfusion allowed us to save the cat. Our findings demonstrate the life-saving abilities of initial support treatment and early surgical intervention for both the pregnant cat and fetuses in cases of acute abdomen caused by uterine torsion.
A 14-year-old cat presented with bilateral patellar fractures and radiographically thickened tibial cortices. This cat had been treated with alendronate for 8 years prior to presentation. To remove the subjectivity of the radiographic evaluation, tibial radiographs from 35 apparently healthy geriatric cats were used for comparison. Cortical and diaphyseal thickness were measured at the proximal and distal thirds of the tibia. Our cat had increased cortical bone thickness compared to that of the control cats.
Relevance and novel information
Treatment with bisphosphonates can lead to brittle bones and fractures after prolonged use in humans. This is the first description of fractures and cortical bone changes that may have been associated with prolonged bisphosphonate use in a cat. Radiographic measurements of cortical bone thickness may identify cats that are at increased risk for bone pathology secondary to prolonged alendronate use.
Sandrina M Vieira, Rui R F Ferreira, Augusto JF de Matos, Inês M Cardoso, Rita M C Graça, Ana RPB Soares, Carles Blasi-Brugué, Ignacio M Sánchez, Rafael R Gopegui
The objective of this study was to document the prevalence of feline blood types in the Iberian Peninsula and to determine the potential risk of incompatibility-related transfusion reactions in unmatched transfusions and the potential risk of neonatal isoerythrolysis (NI) in kittens born to parents of unknown blood type.
Methods
Blood samples were obtained from blood donors of the Animal Blood Bank (BSA-Banco de Sangue Animal). Blood typing was performed using a card method (RapidVet-H Feline Blood Typing; MDS).
Results
The studied population comprised 1070 purebred and non-purebred cats from Portugal and Spain aged between 1 and 8 years. Overall, frequencies of blood types A and B were 96.5% and 3.5%, respectively. No AB cats were found. Based on these data, the potential risks of NI and transfusion reactions in unmatched transfusions were calculated to be 6.8% and 2.8%, respectively.
Conclusions and relevance
Unlike previous studies, no type AB cats were found in this study. Although the calculated potential risks of transfusion reaction in unmatched transfusions and neonatal isoerythrolysis were low, blood typing prior to blood transfusion and blood typing of cats for breeding purposes are highly recommended.
The objectives were to collect baseline data on the occurrence, testing and vaccination practices, and clinical outcomes of feline leukaemia virus (FeLV) and feline immunodeficiency virus (FIV) in New Zealand
Methods
A cross-sectional survey of 423 veterinary practices in New Zealand was performed to collect data on FeLV and FIV testing and vaccination during the 2015 calendar year. Clinical records from 572 cats tested using a point-of-care ELISA at a first-opinion veterinary practice between 7 April 2010 and 23 June 2016 were also obtained and multivariable logistic regression models were constructed to identify risk factors for test positivity. Survival times were estimated using Kaplan–Meier methods.
Results
The survey was completed by 112 clinics (26.4%) of which 72 performed in-house testing. Of the 2125 tests performed, 56 (2.6%) were positive for FeLV and 393 (18.5%) were positive for FIV. Fewer than 1% of cats were vaccinated for FeLV, with veterinarians citing low perceived prevalence as the primary reason for not vaccinating. Being male compared with being female and having clinical evidence of immunosuppression were significant risk factors for both FeLV and FIV test positivity. The median survival times of FeLV and FIV test-positive cats were 10 days (95% confidence interval [CI] 0–16) and 650 days (95% CI 431–993), respectively.
Conclusions and relevance
Testing and vaccination for FeLV and FIV in New Zealand appears targeted towards high-risk animals, which may bias prevalence estimates. Baseline data should be monitored for changes in FeLV epidemiology now commercial vaccines are no longer available.
An approximately 3-year-old, male domestic longhair cat was presented to a mobile veterinary unit for routine neuter. Preoperative physical examination revealed an approximately 5 cm × 2 cm scab on the craniolateral portion of the left antebrachium. The cat was anesthetized for the neuter using an injectable anesthesia protocol. After castration, the wound area on the antebrachium was clipped, copiously lavaged and the wound edges were surgically debrided. Injectable antibiotics and analgesic management were instituted. The wound was conservatively managed using sugar bandaging and antibiotic dressings until the progression of healing plateaued. Procedures for closing the defect were explored, and it was decided that a single-pedicle hinge flap would be ideal. The procedure was performed on the mobile veterinary unit and managed postoperatively with pain control and biweekly bandage changes. After 3 weeks, the single-pedicle hinge flap was released to create a skin graft, which successfully filled the defect.
Relevance and novel information
Single-pedicle hinge flaps performed in feline patients have been minimally reported. This case report serves to provide detailed information on the surgical procedure and aftercare required for a successful outcome. Furthermore, this procedure was performed by a shelter medicine team in a mobile veterinary unit with no specialty equipment or instruments. This report documents an alternative procedure that may be used in a shelter environment for distal forelimb wounds rather than amputation or euthanasia.
A 14-year-old neutered male Siamese cat was presented with a 3 month history of lethargy, inappetence, dehydration, hindlimb ataxia and intermittent proprioceptive deficits in the hindlimbs. Physical examination revealed low body condition score (1.75/5), pallor and bilateral basilar grade II/VI systolic heart murmur. Neurological examination revealed hindlimb ataxia, severe atrophy of the hindlimb musculature, intermittent hindlimb proprioceptive deficits and normoreflexia. Clinicopathological investigations revealed non-regenerative anaemia (haematocrit 0.17 l/l; reference interval [RI] 0.24–0.45 l/l) and increased feline pancreatic lipase concentration (Spec fPL test [IDEXX] 8.3 µg/l; RI 0.1–3.5 µg/l). Feline leukaemia virus antigen and feline immunodeficiency virus antibody tests were negative. Thoracic and abdominal imaging revealed a soft tissue structure in the area of the thoracoabdominal aorta. CT confirmed a periaortic contrast-enhancing mass extending from the level of T9–L2, with associated intervertebral infiltration at the level of T11–T12. Post-mortem examination confirmed the presence of a solid, white, multinodular, well-demarcated mass encircling the aorta extending from T9–L2. Based on histopathology and immunohistochemistry, a diagnosis of B-cell lymphoma was made. Lymphoma was also identified histopathologically within the kidneys and spleen. Evidence of mild Wallerian degeneration was present within the spinal cord, indicating compression at the level of the periaortic mass.
Relevance and novel information
To our knowledge, this is the first report of periaortic lymphoma in the cat. Although periaortic tumours are exceptionally rare in veterinary medicine, lymphoma should be considered as a differential in cats.
The objective of this study was to evaluate the effectiveness of balloon dilation for the treatment of nasopharyngeal stenosis in cats.
Methods
The medical records of seven cats with nasopharyngeal stenosis treated with balloon dilation were reviewed. The most common presenting clinical signs included upper airway noise, sneezing, nasal and/or ocular discharge. All seven cats were confirmed to have nasopharyngeal stenosis via nasopharyngeal endoscopy and were treated with balloon dilation under endoscopic guidance.
Results
All seven cats had acceptable short-term control (median 14 days) of clinical signs after the procedure. Two of six cats had successful long-term control (median 34 days) of clinical signs after one balloon dilation and an additional 2/6 cats had acceptable long-term control of clinical signs after a second balloon dilation procedure. The most significant complication of balloon dilation was the recurrence of stenosis.
Conclusions and relevance
The findings of this study indicate that balloon dilation is a safe and effective treatment option for the relief of clinical signs associated with nasopharyngeal stenosis in cats. Multiple procedures may be necessary for the best chance of long-term success.
A 5-year-old male neutered domestic shorthair cat was referred with a history of persistent pyrexia, pica, soft faeces, inappetence, intermittent vomiting, mild-to-moderate granulocytosis and mild hypercalcaemia. No significant improvement was noted after antibiotic and corticosteroid treatment, except that the hypercalcaemia resolved. Physical examination, including thoracic auscultation, and abdominal and peripheral lymph node palpation, were unremarkable. On admission, haematology revealed moderate leukocytosis (36.8 × 109/l) with moderate-to-marked eosinophilia (21.3 × 109/l) and marked basophilia (4.04 × 109/l), the latter identified microscopically. Lymphocytes were markedly decreased (0.37 × 109/l). Blood smear examination revealed 58% eosinophils, 28% neutrophils, 11% basophils, 2% monocytes, 1% lymphocytes and marked, diffuse platelet clumping. Biochemistry abnormalities indicated mild pancreatitis, dehydration and anorexia with mildly increased pancreatic lipase, mild hypernatraemia (157 mmol/l), a moderate decrease in urea (3.1 mmol/l) and a slight decrease in phosphate (1.32 mmol/l). Ultrasound and radiographic imaging revealed enlargement of the mesenteric lymph nodes. Fine-needle aspiration, a Tru-cut biopsy and immunohistochemistry were performed. Cytological examination revealed ~65–75% lymphocytes (~80% were larger than a neutrophil), ~25–35% eosinophils and occasional basophils. Lymphocytes had single, small (<1/3 red blood cells), prominent nucleoli and increased pale, mildly vacuolated cytoplasm. On histopathology, cells were monomorphic, large, with prominent nucleoli, and mild, multifocal, staining for T-cell marker CD3. Smaller cells were strongly CD3-positive. Cells were negative for B-cell marker CD45R.
Relevance and novel information
This is the most severe case of paraneoplastic basophilia reported with feline alimentary T-cell lymphoma with accompanying eosinophilia and lymph node infiltration. Feline basophil prevalence is reported for the first time.
To address the lack of up-to-date published data, the present study evaluates the PCR-based prevalence of Cryptosporidium species infection and molecular characteristics of isolates among household cats and pet shop kittens in Japan.
Methods
A total of 357 and 329 fresh faecal samples were collected from household cats and pet shop kittens, respectively, with or without clinical signs of infection. A nested PCR assay targeting the 18S rRNA gene was employed for the detection of Cryptosporidium species. After specific DNA fragments (approximately 826 base pairs) were confirmed, the amplicons were sequenced to determine species.
Results
Seven (2.0%) household cats and one (0.3%) pet shop kitten tested positive for the presence of Cryptosporidium species. In household cats, there was a significant difference in prevalence between cats aged <1 year (4.6%) and those aged ⩾1 year (0.4%). No significantly different prevalence was observed with regard to faecal condition in either household cats or pet shop kittens. A total of eight Cryptosporidium species isolates, seven from household cats and one from a pet shop kitten, were identified as Cryptosporidium felis.
Conclusions and relevance
The present study demonstrates the risk of zoonotic transmission of Cryptosporidium species from household cats and pet shop kittens to humans is low in Japan.
This report describes a 4-year-old cat with chronic intermittent haematochezia and faecal incontinence of 7 months’ duration. Investigation revealed severe colonic multifocal mucosal ulcerations and infiltration of the mucosal lamina propria by large numbers of periodic acid–Schiff-positive macrophages. Fluorescence in situ hybridisation analysis of colonic biopsies revealed multifocal clusters of intracellular Escherichia coli. Treatment with fluoroquinolones for 6 weeks led to a complete resolution of clinical signs.
Relevance and novel information
The findings reveal that mucosally invasive E coli can also be associated with granulomatous colitis in cats and indicate the need for diagnostic testing of mucosal samples for E coli and other infectious agents.
A 33-month-old, spayed female domestic shorthair cat was referred to the Animal Health Trust for the investigation of urinary incontinence and straining to urinate. A membrane-like structure was detected in the bladder neck, which caused partial obstruction of the urinary bladder. A combination of different imaging techniques, including ultrasonography, radiography, CT and fluoroscopy, was essential in the diagnosis, surgical planning and treatment of this intravesicular stricture. During retrograde vaginourethrocystogram, unexpected subcapsular accumulation of contrast medium was seen around both kidneys on radiographs and confirmed with CT. Three different treatments were performed, including surgical debridement, balloon dilatation and placement of a self-expanding metallic stent across the stricture. Histopathology of the membrane was unable to differentiate whether the lesion was congenital or acquired. No urinary incontinence was observed 5 months after placement of the metallic stent.
Relevance and novel information
This is the first reported case using fluoroscopic-guided balloon dilatation of the bladder neck for the treatment of a bladder neck stricture. Presence of renal subcapsular contrast medium secondary to a retrograde vaginourethrocystogram due to partial obstruction at the bladder neck in a cat has not been previously described.
An 11-year-old spayed female domestic shorthair cat with a history of laryngospasm at induction of general anesthesia presented for dental evaluation and treatment. The cat was premedicated with hydromorphone (0.05 mg/kg) and alfaxalone (0.5 mg/kg) intravenously, pre-oxygenated for 5 mins (3 l/min, face mask) and anesthesia was induced with alfaxalone (to effect) intravenously. Lidocaine (0.1 ml, 2%) was applied topically to the arytenoid cartilages following loss of jaw tone. Laryngospasm was not noted during or immediately following lidocaine application. However, after waiting 60 s for the onset of effect of the topical lidocaine, laryngospasm was apparent. Orotracheal intubation by direct visualization was unsuccessful after four attempts by three anesthetists (with increasing levels of experience). At this point, a failed intubation was declared and the non-depolarising neuromuscular blocking agent rocuronium (1 mg/kg IV) given, resulting in arytenoid abduction and appropriate conditions for intubation. Successful intubation occurred 9 mins after induction of anesthesia. Oxygen was continuously supplemented throughout and arterial hemoglobin saturation with oxygen was never <94%.
Relevance and novel information
To the authors’ knowledge, this is the first report of the use of high-dose rocuronium to successfully resolve prolonged laryngospasm at induction of general anesthesia in a cat. Despite laryngospasm and a delay in achieving orotracheal intubation, low values for arterial hemoglobin saturation with oxygen (indicative of hypoxemia) were not observed, highlighting the benefits of pre-oxygenation and apneic oxygenation. The principles of the Difficult Airway Society 2015 guidelines were followed in managing this difficult intubation.
A 4-year-old female spayed, indoor/outdoor domestic mediumhair cat presented with multiple bleeding puncture wounds and hemorrhagic shock. The cat was diagnosed with suspected pit viper envenomation based on the location and appearance of the bite wounds, as well as the presence of severe coagulopathy with prolonged activated coagulation time (762 s), which responded to antivenom administration. The clinical course of the cat was unique owing to the prolonged clinical signs of envenomation that appeared as intermittent coagulopathy and hemorrhage over a 2 week period. Five vials of antivenom were administered and three units of packed red blood cells were transfused over a 7 day period. The cat made a complete recovery with cessation of hemorrhage and normalization of clotting times.
Relevance and novel information
This is the first report of persistent pit viper venom-induced coagulopathy in the feline veterinary literature.
A 10-year-old neutered male domestic shorthair cat was evaluated because of signs of stertorous breathing and reverse sneezing of 8 months’ duration. A CT scan performed 1 week before evaluation indicated nasopharyngeal stenosis or collapse. Increased respiratory effort, stertorous breathing, coughing, reverse sneezing, bilateral black ocular discharge and mucoid left nasal discharge were noted. Rhinoscopy suggested possible nasopharyngeal stenosis. Balloon dilation was attempted but unsuccessful. Ventral rhinotomy was performed the following day using a spring-loaded mouth gag to access the surgical site. After rhinotomy, the patient had neurologic signs attributed to global cerebral ischemia that progressed to respiratory arrest, subsequently resulting in euthanasia.
Relevance and novel information
While ischemic brain injury has been associated with the use of a spring-loaded mouth gag in cats, to our knowledge this is the first reported instance where use resulted in respiratory arrest culminating in euthanasia.
A 6-year-old female neutered domestic shorthair cat from Cyprus was presented with multiple ulcerated skin nodules. Cytology and histopathology of the lesions revealed granulomatous dermatitis with intracytoplasmic organisms, consistent with amastigotes of Leishmania species. Biochemistry identified a mild hyperproteinaemia. Blood extraction and PCR detected Leishmania species, Hepatozoon species and ‘Candidatus Mycoplasma haemominutum’ (CMhm) DNA. Subsequent sequencing identified Hepatozoon felis. Additionally, the rRNA internal transcribed spacer 1 locus of Leishmania infantum was partially sequenced and phylogeny showed it to cluster with species derived from dogs in Italy and Uzbekistan, and a human in France. Allopurinol treatment was administered for 6 months. Clinical signs resolved in the second month of treatment with no deterioration 8 months post-treatment cessation. Quantitative PCR and ELISA were used to monitor L infantum blood DNA and antibody levels. The cat had high L infantum DNA levels pretreatment that gradually declined during treatment but increased 8 months post-treatment cessation. Similarly, ELISA revealed high levels of antibodies pretreatment, which gradually declined during treatment and increased slightly 8 months post-treatment cessation. The cat remained PCR positive for CMhm and Hepatozoon species throughout the study. There was no clinical evidence of relapse 24 months post-treatment.
Relevance and novel information
To our knowledge, this is the first clinical report of a cat with leishmaniosis with H felis and CMhm coinfections. The high L infantum DNA levels post-treatment cessation might indicate that although the lesions had resolved, prolonged or an alternative treatment could have been considered.
An 8-year-old female spayed Siamese indoor cat presented with a 3 week history of inspiratory dyspnoea, stridor and open-mouth breathing after exercise. Laryngoscopy, tracheoscopy, bronchoscopy and retroflexed nasopharyngoscopy were performed, and identified a multilobulated intraluminal mass within the trachea. Brush cytology was performed on the mass but was inconclusive in providing a definitive diagnosis. A CT scan of the neck failed to identify an obvious intraluminal mass and was negative to contrast uptake. Surgery was performed and seven rings of the trachea were removed to enable the complete excision of the mass. Histopathology of the excised mass was consistent with B cell lymphoma. After surgery, chemotherapy treatment was started. At the time of writing, 20 months since diagnosis, the cat remained clinically well, with no clinical signs or recurrence of macroscopic disease on endoscopic evaluation.
Relevance and novel information
Upper airway endoscopy was considered to be an essential diagnostic tool in this case presenting with signs of upper respiratory dyspnoea. Moreover, combined surgery and chemotherapy were considered effective treatments and positively affected the long-term prognosis of this patient.
A 12-year-old domestic shorthair cat was presented with acute non-painful hindlimb proprioceptive ataxia localising to T3–L3 spinal cord segments. MRI revealed paravertebral muscular hyperintensity on T2-weighted images at the level of T7–T8 vertebrae. The cat improved on conservative management but deteriorated 3 months later. Repeated MRI showed meningeal enhancement at the same level and hyperintensity of the paravertebral musculature extending to the right thoracic wall and pleural space on short tau inversion recovery images. Thoracic CT showed mineralised lesions of the right lung, restricted pleural effusion and expansile bone lesions affecting multiple ribs. The cat had been treated for pyothorax 5 years earlier but manifested no current respiratory signs. Cerebrospinal fluid (CSF) examination showed lymphocytic pleocytosis but no neoplastic cells. Biopsy of the affected muscles and cytology of the lung and pleural lesions suggested a malignant epithelial cell tumour. Post-mortem examination confirmed a pulmonary adenocarcinoma locally infiltrating the thoracic wall, T7–T8 vertebrae and the spinal cord white matter. Meningeal carcinomatosis was detected with neoplastic cells invading the ventral median fissure of the spinal cord. No metastases were observed in other organs, indicating that neoplastic cells reached the spinal cord by direct extension.
Relevance and novel information
Spinal meningeal carcinomatosis has not been reported in dogs or cats with extraneural tumours but is a well-recognised condition in humans. A metastatic cause of meningeal enhancement should be considered in patients with neurological signs of unknown origin. Imaging findings and CSF results can be non-specific.
An 11-year-old neutered male domestic longhair cat was diagnosed with histoplasmosis from fine-needle aspirates of an abdominal lymph node. Lymph node size initially decreased with fluconazole therapy (11.8 mg/kg PO q12h); however, after 13 months of continuous fluconazole therapy, lymphadenomegaly worsened and samples were collected for culture and antifungal susceptibility. The Histoplasma capsulatum isolate had a very high fluconazole minimum inhibitory concentration (MIC) of 64 µg/ml and an itraconazole MIC of 0.06 µg/ml. The owner declined a change to itraconazole and, ultimately, the cat developed neurologic signs and was euthanized. Owing to the initial response to fluconazole followed by treatment failure and high MIC value, acquired fluconazole resistance was suspected. Clinical breakpoints for fluconazole for the dimorphic fungi are not available to define true antifungal resistance.
Relevance and novel information
This is the first published report of reduced susceptibility to fluconazole in a cat being treated for histoplasmosis. Fluconazole failure and increases in MIC between pretreatment and long-term treatment isolates are known to occur in humans with histoplasmosis. Practitioners should be aware of this possibility when treating cats with fluconazole (particularly in cases with long-term [>1 year] fluconazole therapy or in cases with disease recrudescence).
This case series describes two young sibling cats and an additional unrelated cat, from two separate households, that developed hypercalcaemia associated with hypervitaminosis D. Excessive vitamin D concentrations were identified in a natural complementary tinned kitten food that was fed to all three cats as part of their diet. In one of the cases, there was clinical evidence of soft tissue mineralisation. The hypercalcaemia and soft tissue mineralisation resolved following withdrawal of the affected food and medical management of the hypercalcaemia.
Relevance and novel information
This case series demonstrates the importance of obtaining a thorough dietary history in patients presenting with hypercalcaemia and the measurement of vitamin D metabolites when investigating such cases. Complementary foods may have the potential to induce nutritional toxicity even when fed with complete, nutritionally balanced diets.
A queen, tom and four 1-year-old female offspring presented for routine neuter. Two of the littermates (cats 1 and 2) were diagnosed with a uterine abnormality during surgery. The left uterine horn of both cats appeared as a thin, solid, cord-like structure, whereas the right uterine horn of both cats appeared to have intermittent bulges consistent with pregnancy. The two other littermates, queen and tom were reproductively normal. The uteruses of the affected cats were nearly identical with a gross and histopathologic diagnosis of uterus unicornis with concurrent pregnancy. Ovaries were present, bilaterally. An oviduct was present only on the single normally developed and pregnant uterine horn in both cats. At a postoperative follow-up evaluation, abdominal ultrasound was performed on the two cats with uterine abnormalities. Cat 1 was ultrasonographically within normal limits. Cat 2 was diagnosed with ipsilateral renal agenesis on the same side as the absent uterine horn.
Relevance and novel information
The complexity of uterus unicornis and renal aplasia is demonstrated by this unique presentation of five related cats for ovariohysterectomy. This report raises questions regarding the genetic, environmental, hormonal or other underlying causes of this anatomic abnormality in cats that may spur additional research. This is the first publication describing uterus unicornis in gravid feline littermates, with one of the cats having ipsilateral renal agenesis. This is also the first publication to describe oviduct agenesis on the affected uterine horn in feline uterus unicornis.
Two cats aged between 1 and 2 years were presented for paraparesis, general discomfort, back pain and urinary retention. Extradural spinal cord compression at the level of T4 and T8 was evident on CT examination and on MRI. Hemilaminectomy and partial corpectomy were performed to achieve spinal cord decompression. Histopathology of the abnormal bone tissue was suggestive of vertebral angiomatosis. After initially worsening, both cats recovered their normal gait and functional urination. Both cats have been followed-up for >1 year, without any recurrence.
Relevance and novel information
This is the first report of vertebral angiomatosis with complete data (CT, MRI, surgical procedures, histopathology and >1 year follow-up) and provides important information about the prognosis of this rare vascular malformation.
Systemic arterial hypertension is commonly reported in middle-aged-to-older cats. Amlodipine is recommended as the initial antihypertensive drug in cats. In this case report, gingival hyperplasia secondary to the use of amlodipine in a cat is described. Benazepril as a monotherapy was unsuccessful in reducing blood pressure in this cat. After replacement of benazepril by telmisartan, gingival hyperplasia disappeared and blood pressure was well controlled.
Relevance and novel information
This case report describes the first reported case of reversible gingival hyperplasia as a result of the treatment with amlodipine. It also contains the first published data on the effect of telmisartan in a hypertensive cat.
The present study reports the multilocus genotyping of Giardia duodenalis isolates from cats maintained in breeding catteries in Japan and discusses their potential for zoonotic transmission.
Methods
A total of 41 faecal samples positive for Giardia-specific antigen were procured from cats maintained in five breeding catteries and subjected to PCR to amplify four gene loci, namely small subunit ribosomal RNA (SSU rRNA), glutamate dehydrogenase (gdh), beta-giardin (bg) and triose phosphate isomerase (tpi ). The PCR-amplified DNA fragments were sequenced to determine the G duodenalis genotypes (synonym for assemblages).
Results
The most commonly occurring single assemblage was assemblage F (68.3%; n = 28/41), followed by assemblage A (12.2%; n = 5/41) and assemblage C (2.4%; n = 1/41). The mixed assemblages were identified as follows: assemblages F and A (9.8%; n = 4/41), assemblages F and C (4.9%; n = 2/41) and assemblages C and D (2.4%; n = 1/41). Additional sub-genotyping of assemblage A isolates based on three of the sequenced loci (gdh, bg and tpi ) revealed that all eight isolates were identified as sub-assemblage AI and/or AII.
Conclusions and relevance
The present study is the first to report the detection of dog-adapted assemblages C and D in feline isolates from Japan. In addition, zoonotic sub-assemblage AI and human-adapted sub-assemblage AII were also identified. Thus, we concluded that the risk of transmission of G duodenalis from breeding cattery cats to humans is considerable and cannot be ignored.
Cranial ventral midline hernias, most often congenital, can be associated with other congenital abnormalities, such as sternal, diaphragmatic or cardiac malformations. A 4-year-old multiparous queen with a substernal hernia was admitted for evaluation of a mammary mass. During CT examination, a bifid sternum, the abdominal hernia containing the intestines, spleen, omentum, three fetuses, a mammary mass and an incidental peritoneopericardial diaphragmatic hernia were identified. Surgery consisted of a standard ovariohysterectomy and repair of the peritoneopericardial hernia. Primary closure of the abdominal hernia was attempted but deemed impossible even after the ovariohysterectomy, splenectomy and a partial omentectomy. An external abdominal oblique muscle flap was used to close with no tension on the cranial part of the hernia. One month postoperatively, the queen had no respiratory abnormalities and the herniorrhaphy was fully healed.
Relevance and novel information
This case is the first description of a 4-year-old multiparous pregnant queen with complex congenital malformations and surgical correction of a peritoneopericardial hernia and a 6 × 8 cmsubsternal hernia with an external abdominal oblique muscle flap. Life-threatening sequelae associated with large abdominal hernias can be attributed to space-occupying effects known as loss of domain and compartment syndrome, which is why a muscle flap was used in this case. The sternal cleft was not repaired because of the size of the cleft and the age of the cat.
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