Thrombocytopenia in Cats: A Retrospective Study of 41 Cases

The prevalence of feline thrombocytopenia (<200,000 platelets/L) at North Carolina State University, College of Veterinary Medicine Teaching Hospital, from January 1985 to March 1990, was 1.2% (41/3300). Cats were divided into six categories based on clinical diagnoses: 29% (12/41) had infectious disease, 20% (8/41) had neoplasia, 7% (3/41) had cardiac disease, 2% (1/41) had primary immune-mediated disease, 22% (9/41) had multiple diseases, and 20% (8/41) had disorders of unknown etiology. The mean platelet count for all thrombocytopenic cats was 52,000/μL ± 46,000/μL (1 SD) with a range of 1000–190,000/μL. No significant differences were found between groups with respect to platelet count, packed cell volume, or white blood cell count, though anemia and leukopenia were common among the cats as a whole. Bleeding disorders (hemorrhage or thrombosis) were observed in 29% (12/41) of thrombocytopenic cats and were more likely to be associated with neoplasia, cardiac disease, and platelet counts less than or equal to 30,000/μL. Disseminated intravascular coagulopathy was diagnosed in 12% (5/41) of the cats. Infections and/or neoplasia affecting the bone marrow were the most common diseases associated with thrombocytopenia. Feline leukemia virus and myeloproliferative neoplasia accounted for approximately 44% (18/41) of the specific diagnoses in thrombocytopenic cats. (Journal of Veterinary Internal Medicine 1993; 7:261–265. Copyright © 1993 by the American College of Veterinary Internal Medicine.)     

Hypofractionated Radiation Therapy of Brain Masses in Dogs: A Retrospective Analysis of Survival of 83 Cases (1991–1996)

There are few reports of radiation treatment for brain tumors in dogs, and the optimal treatment protocol has yet to be established. We completed a retrospective analysis of the survival times of a series of 83 dogs with intracranial masses that were treated by hypofractionated megavoltage radiation therapy. A total tumor dose of 38 Gray was given over 5 weeks as once weekly fractions via 3 perpendicular portals. The median survival time from the start of radiotherapy for the whole cohort was 43.7 weeks (range, 0.1-172 weeks). Extra-axial masses had a better survival time (49.7 weeks) than did other intracranial masses (intra-axial, 40.4 weeks; pituitary, 21.0 weeks). Delayed radiation toxicity was suspected as the cause of death or reason for euthanasia in 12 dogs. The hypofractionated radiation protocol resulted in survival times similar to those obtained using more conventional multifractionated regimens, and this protocol may be a useful, less intensive alternative treatment for brain tumors in dogs.     

Portal Vein Thrombosis in Cats: 6 Cases (2001–2006)

Background: Portal vein thrombosis (PVT) in cats is sparsely reported.
Purpose of Study: To evaluate the clinical signs and diseases associated with PVT in cats.
Animals: 6 client-owned cats.
Methods: Medical records for cats with a portal vein thrombus diagnosed on abdominal ultrasound or at necropsy were reviewed. Signalment, historical data, underlying disorders, clinical findings, clinicopathologic and histopathologic data, diagnostic imaging findings, treatment, and outcome were recorded.
Results: All 6 cats identified with PVT also had hepatic disease. Evidence of a congenital portosystemic shunt was present in 3/6 cats. Two cats had primary or metastatic hepatic neoplasia. One cat had acute cholangitis, acute pancreatitis, and locally extensive acute centrilobular hepatic necrosis. Two cats were suspected to have acute thrombi and 4 cats had chronic thrombi.
Conclusion and Clinical Significance: PVT might be an important concurrent finding in cats with hepatic disease.     

Nasopharyngeal and Middle Ear Polypoid Masses in Five Cats

Five cats with nasopharyngeal and middle ear polypoid masses are presented. The clinical signs included nasal discharge, sneezing, labored breathing, swallowing difficulty, and voice changes. Diagnosis was made by radiography and oropharyngeal examination. Surgical mangement consisted of local nasopharyngeal polyp resection in all cats, combined with ventral bulla osteotomy in three cats. Recurrence resulted in two of the five cats in which incomplete nasopharyngeal removal was performed initially, but not in the cats treated by bulla osteotomy. Four of the five cats were clinically normal 7 to 14 (median 13) months following surgery. The fifth cat had mild upper respiratory airway noise at 7 months. The histopathologic diagnosis of these growths was inflammatory tissue.     

Prostatic Masses in Geldings: Two Cases

Prostatic masses were detected in two geldings that were presented to our referral hospital for evaluation of dysuria. The masses were detected during transrectal palpation and ultrasonography of the prostate gland and were further evaluated using urethral endoscopy. A 10-year-old gelding underwent intraurethral debulking of the prostatic mass. Histopathological diagnosis was prostatic cystadenoma. The mass regrew within 9 months, and the horse was euthanized due to deteriorating clinical control of urinary continence. In another case, a 12-year-old gelding was scheduled for transurethral debulking; however, the owners decided against treatment and the horse was euthanized due to progression of clinical disease. Postmortem examination revealed the prostate to be nearly completely obliterated by the mass. Histopathological diagnosis was adenocarcinoma incorporated into a spindle cell population of unknown histogenesis. To our knowledge, these represent the first reported cases of equine prostatic cystadenoma and adenocarcinoma. In both horses, referring complaint was dysuria, and identification of the prostatic mass was made on palpation and ultrasonographic examination per rectum. Treatment options for prostatic masses in horses are limited because of the difficulty of obtaining prostatic tissue via biopsy, the surgical inaccessibility of the gland, and the apparent low incidence of occurrence. We have subsequently identified prostatic masses in two additional geldings, both also presenting for dysuria. However, the exact nature of these two apparent prostatic masses has not been definitively diagnosed with histopathological examinations to date. The prostate should be evaluated in male horses presenting for dysuria.     

Amputation and Carboplatin for Treatment of Dogs With Osteosarcoma: 48 Cases (1991 to 1993)

Forty-eight dogs with histologically confirmed appendicular osteosarcoma (OSA) entered a prospective clinical trial evaluating treatment with amputation and up to 4 doses of carboplatin given every 21 days. The median disease-free interval (DFI) was 257 days, with 31.2% of the dogs disease-free at 1 year. The median survival time was 321 days, with 35.4% of the dogs alive at 1 year. Dogs with proximal humeral OSA had shorter DFI (P = .016) and survival (P = .037) times than dogs with OSA at other locations. Dogs with lower body weights (40 kg) had longer DFI (P = .0056) and survival (P = .007) times than larger dogs. Survival times for dogs that received carboplatin were statistically longer than those previously reported for amputation alone (P < .001). DFI and survival times are similar to those previously reported for 2 to 4 doses of cisplatin. Carboplatin appears to be a well-tolerated chemotherapeutic drug that can be given safely every 21 days at a dose of 300 mg/m². Neutropenia was the dose-limiting toxicity in this study. J Vet Intern Med 1996_;10:76–81. Copyright © 1996 by the American College of Veterinary Internal Medicine .     

Linear-Accelerator-Based Modified Radiosurgical Treatment of Pituitary Tumors in Cats: 11 Cases (1997–2008)

Objective: Determine the efficacy and safety of a linear-accelerator-based single fraction radiosurgical approach to the treatment of pituitary tumors in cats.
Design: Retrospective study.
Animals: Eleven client-owned cats referred for treatment of pituitary tumors causing neurological signs, or poorly controlled diabetes mellitus (DM) secondary either to acromegaly or pituitary-dependent hyperadrenocortism.
Procedures: Cats underwent magnetic resonance imaging (MRI) of the brain to manually plan radiation therapy. After MRI, modified radiosurgery was performed by delivering a single large dose (15 or 20 Gy) of radiation while arcing a linear-accelerator-generated radiation beam around the cat's head with the pituitary mass at the center of the beam. Eight cats were treated once, 2 cats were treated twice, and 1 cat received 3 treatments. Treated cats were evaluated for improvement in endocrine function or resolution of neurological disease by review of medical records or contact with referring veterinarians and owners.
Results: Improvement in clinical signs occurred in 7/11 (63.6%) of treated cats. Five of 9 cats with poorly regulated DM had improved insulin responses, and 2/2 cats with neurological signs had clinical improvement. There were no confirmed acute or late adverse radiation effects. The overall median survival was 25 months (range, 1–60), and 3 cats were still alive.
Conclusions and Clinical Importance: Single fraction modified radiosurgery is a safe and effective approach to the treatment of pituitary tumors in cats.     

Feline Cutaneous Melanocytic Neoplasms: A Retrospective Analysis of 43 Cases (1979–1991)

Abstract— Forty-three cases of cutaneous melanocytic neoplasia in cats were reviewed. Twenty-eight of the 43 neoplasms were histologically benign and 15 were malignant. Behavior was independent of site except that tumors of the eyelid were malignant. Histologic findings of epidermal ulceration, cleanliness of tissue borders, degree of melanization, tumor cell type, and the presence or absence of theques did not differentiate benign from malignant tumors. Junctional activity indicated a high probability of benign behavior while malignant behavior was predicted by a high mitotic index and infiltration of the tumor by lymphoid cells. Résumé— Quarante trois cas de tumeurs mélaniques félines ont été revus. Vingt huit de ces 43 tumeurs étaient histologiquement bénignes et 15 malignes. Le comportement était indépendant de la localisation de la tumeur, à l'exception des tumeurs des paupières, toujours malignes. L'observation histologique d'ulcération épidermique, de propreté des bords des tissus, du degré de mélanisation, du type cellulaire et de la presence ou de l'absence de thèques ne différait pas qu'il s'agisse de tumeur bénigne ou maligne. L'activité jonctionnelle indiquait une forte probabilité de bénignité, alors qu'un comportement malin était prédit par un index mitotique élevé et une infiltration de la tumeur par des cellules lymphoïdes. Zusammenfassung— Es wird ein überlick über 43 Fälle von kutanen melanozytären Neoplasien bei Katzen gegeben. Achtundzwanzig der 43 Neoplasmen waren histologisch gutartig, 15 waren bösartig. Das Verhalten der Tumore war unabhängig von der Lokalisation, abgesehen von Tumoren der Augenlider, die stets maligne waren. Histologische Befunde wie epidermale Ulzeration, scharfe Begrenzung der Gewebsränder, Grad der Melanisierung, Tumorzelltyp und Vorhandensein oder Fehlen von Thequen unterschieden die benignen von den malignen Tumoren nicht. Verbindungsaktivität bedeutete eine hohe Wahrscheinlichkeit für gutartiges Verhalten, während bösartiges Verhalten durch einen hohen Mitoseindex und Infiltration des Tumors mit lymphoiden Zellen vorhersagbar war. Resumen En éste artículo se analizan cuarenta y tres casos de neoplasia melanocítica cutánea en gatos. Veintiocho de loa cuarenta y tres casos, resultaron cánceres benignos histológicamente y quince, malignos. El grado de malignidad no tenia relación con el sitio de procedencia con la excepción de que los tumores de párpados que resultaron malignos. Las características histológicas de las ulceraciones epidérmicas, limpieza de tejidos circundantes, grado de melanización, tipo de célula tumoral, y presencia o ausencia de the zeques, no sirvió para la diferenciación entre maligno y benigno. La actividad de la zona delimitante fué un indicador de alta probabilidad de benignidad, mientras que la el tipo maligno se predijo por un índice mitótico alto e infiltración del tumor por celulas de tipo linfoide.     

The Role of Bronchoscopy in Foreign Body Removal in Dogs and Cats: 37 Cases (2000–2008)

Background: Foreign body aspiration is a differential diagnosis for acute or chronic cough that requires medical or surgical management in animals. Hypothesis: Success of bronchoscopy in airway foreign body removal is dependent on the size of the animal, duration of clinical signs, and location of the foreign body. Animals: Thirty‐two dogs and 5 cats with airway foreign bodies identified at the UC Davis Veterinary Medical Teaching Hospital. Methods: Retrospective case study evaluating the role of duration of clinical signs and body size in successful bronchoscopic removal of foreign bodies. In addition, radiographic localization of disease was compared with bronchoscopic identification. Bronchoalveolar lavage (BAL) culture and cytologic findings are reported. Results: Bronchoscopy was successful for removal of airway foreign bodies in 76% of animals (24/28 dogs and 2/5 cats), and in dogs was independent of duration of clinical signs or body size. One‐third of thoracic radiographs lacked distinctive features of an airway foreign body, and therefore radiography was unable to predict the affected site. BAL fluid at the site of the foreign body contained more neutrophils and more often had intracellular bacteria than lavage fluid from a separate site. Conclusions and Clinical Importance: Bronchoscopy was successful in removing airway foreign bodies regardless of animal size or long duration of clinical signs. Results of this study confirm the utility of bronchoscopy with lavage in management of suspected foreign bodies, even in the absence of localizing radiographic findings.     

Endoscopic Aspiration of Intestinal Contents in Dogs and Cats: 394 Cases

Medical records from 394 dogs and cats that had endoscopic aspiration of intestinal contents for identification of Giardia sp. trophozoites were retrospectively reviewed. The most common indications for endoscopy were chronic vomiting (152), chronic diarrhea (108), chronic vomiting and diarrhea (58), and acute vomiting (33). Metronidazole had been previously administered to 111 animals (28.2%), and to 58.6% of those with chronic diarrhea. Six aspirate samples (1.5%) were positive for Giardia sp. In 3 of these cases a single fecal flotation identified Giardia cysts before endoscopy. The authors conclude that intestinal aspiration in animals from a primarily referral population undergoing upper gastrointestinal endoscopy rarely identifies Giardia and should not be routinely performed. However, animals in which zinc sulfate flotation was not performed or those that did not previously receive metronidazole might benefit from intestinal aspiration.     

Prognosis Factors for Survival in Cats After Removal of a Primary Lung Tumor: 21 Cases (1979–1994)

Objective —To identify possible prognostic factors for survival time in cats with a primary lung tumor after surgical excision.
Study Design —Retrospective clinical study.
Animal Population —21 cats with histologically confirmed primary lung tumors removed surgically.
Methods —Medical records for cats treated between 1979 and 1994 at 14 participating veterinary referral hospitals were reviewed.
Results —After surgical resection and recovery, 18 cats died from metastatic disease with a median survival time of 115 days (range, 13 to 1,526 days). Three cats were lost to follow-up at 119 days, 251 days, and 410 days after the surgical procedure. Contingency table analysis to determine if an association existed between clinical findings (breed, age, gender, body weight, clinical signs, duration of clinical signs, and radiographic findings) or histological features and survival time was performed. Only histological morphology of the primary lung tumor showed a significant association with survival time. Twelve cats with moderately differentiated tumors had a significantly longer survival time (median, 698 days; range, 19 to 1,526 days) than the nine cats with poorly differentiated tumors (median, 75 days; range, 13 to 634 days).
Conclusions —Surgical resection of a solitary primary lung tumor in cats is indicated.
Clinical Relevance —A poor prognosis for long-term survival is warranted for those cats having a poorly differentiated primary lung tumor.     

Applications and Outcome of Hemodialysis in Cats: A Review of 29 Cases

Hemodialysis (HO) has been used in the management of renal failure in dogs, but its feasibility has not been reported for uremic cats. Therefore, we investigated the technical possibility, efficacy, and complications of intermittent HD in cats with severe uremia. A total of 160 HD treatments were performed on 29 cats with acute renal failure (ARF) (n = 15), chronic renal failure (CRF) (n = 6), or acute on CRF (n =8) between November 1993 and June 1996. Hemodialysis treatments were performed with transcutaneous dialysis catheters using a bicarbonate-based delivery system, sodium modeling, and volumetric-controlled ultrafiltration. Presenting serum chemistries (mean ± SD) for all cats were creatinine, 16.4 ± 7.5 mg/dL; blood urea nitrogen (BUN), 229 ± 87 mg/dL; phosphate, 15.4 ± 5.4 mg/dL; potassium, 6.0 ±1.6 mEq/L; and HCO^-₃, 16.0 ± 4.4 mEq/L. For intensive HD treatments, pre-HD versus post-HD creatinine changed from 10.3 ± 4.4 to 1.6 ± 0.9 mg/dL and BUN from 105 ± 33 to 8 ±10 mg/dL. One or more adverse events occurred during 111 (69%) treatments. Dialysis-related events included hypotension, dialysis dysequilibrium, clotting, and bleeding. Nine of 15 (60%) cats with ARF and 1 cat with CRF recovered sufficiently to survive without ongoing need for HD. For the remaining cats, the proximate causes of death were dialysis related in 9 cats, uremia related in 6 cats, and iatrogenic or unknown in 4 cats. Hemodialysis is technically feasible and effectively controls the biochemical disturbances of uremic cats. It is especially valuable for the management of severe ARF, permitting recovery in a large number of cats refractory to conventional therapy. Technical complications and chronic debility, however, may limit its usefulness for cats with advanced CRF.     

Tracheobronchial Brush Cytology and Bronchoalveolar Lavage in Dogs and Cats with Chronic Cough: 45 Cases (2012–2014)

Background

Animals with chronic cough can have normal bronchoalveolar lavage fluid cytology when small airway disease is absent. Cytology of a tracheobronchial brushing can detect inflammation in larger airways; however, evaluation of this technique has been limited in veterinary medicine.

Objective

To compare airway brush cytology to bronchoalveolar lavage fluid analysis in dogs and cats with chronic cough.

Animals

Forty dogs and five cats undergoing bronchoscopic investigation of chronic cough.

Methods

Prospective study. Bronchoscopy and bronchoalveolar lavage were performed followed by tracheobronchial brushing of central airways. Results of cytologic assessment of BAL fluid and brush cytology were compared for the presence or absence of inflammation and concordance of inflammatory cell type.

Results

Brush cytology detected central airway inflammation in 34 of 40 (85%) dogs with inflammatory BAL fluid. However, the type of inflammation reported differed in 23 of 34 dogs. In five cats with inflammation in BAL fluid, brush cytology detected inflammation in four; the type of inflammation was discordant in all cats.

Conclusions and clinical relevance

Brush cytology has good agreement with BAL regarding the presence of inflammation, although the type of inflammation detected with the different sampling techniques commonly varies. Brush cytology can provide supplementary information to BAL, and additional studies will provide further information on the role of tracheobronchial brush cytology in the diagnosis and management of respiratory conditions.