Orofacial manifestations of high-rise syndrome in cats: a retrospective study of 84 cases

Medical records of cats with high-rise trauma were reviewed to document the prevalence and clinical manifestations of orofacial injury. Cats were presented over a 10-year period from January 2000 to December 2009. Signalment, weight, number of stories fallen, and survival data were recorded in 84 cats and physical examination findings were obtained from 83 cats. Fourteen of these cats were examined by veterinarians of the Dentistry and Oral Surgery Service. Mean age was 37-months. Mean distance fallen was 2.65 stories, and in the majority of cases the substrate the cat fell on was not recorded Overall, survival was 94.0% when including euthanasia as a cause of death and 98.8% when excluding euthanized patients. Orofacial findings included bilateral epistaxis, hard palate fracture +/- tear of palatal soft tissue, palatal soft tissue bruising, mandibular fracture, mandibular symphyseal separation, tongue injury, facial soft tissue injury, dental trauma, and other oral soft tissue injury. Sixty-six percent of cats suffered some degree of orofacial injury. The population was analyzed for the prevalence of each type of injury. An oronasal fistula was seen in one cat as a complication of an untreated hard palate fracture. Possible etiology of the injuries and treatment options are discussed.     

Hyperadrenocorticism in four cats

Summary

This paper describes four cats with hyperadrenocorticism. Cat 1 showed polydipsia and polyphagia. Diabetes mellitus was initially diagnosed As the animal appeared to be insulin resistant, pituitary and adrenocortical function tests were performed and the diagnosis of hyperadrenocoricism was made. Resistance to the high‐dose dexamethasone suppression test was noticed in this cat. Pathological examination revealed a pituitary chromophobe adenoma.

Cat 2 presented with diabetes mellitus, which was treated with insulin. The animal had a pendulous abdomen and its coat was in a poor condition. The low‐dose dexamenthasone suppression test demonstrated hyperadrenocorticism. Necropsy findings of pituitary tumour and hyperplasia of the adrenal cortex confirmed the diagnosis.

Cat 3 showed clinical abnormalities indicative of hyperadrenocorticism, for instance, muscle weakness, alopecia, multiple abcesses. The diagnosis of hyperadrenocorticism was confirmed by the results of the lowe‐dose dexamethasone suppression test. Pathological examination revealed an adrenocortical carcinoma.

Cat 4 presented with polydipsia. The cause of this symptom was not found initially. One and a half years later additional symptoms, such as nephritis and polyphagia developed Hyperadrenocorticism was diagnosed because of a palpable mass cranial to the left kidney. The diagnosis was confirmed by the results of the lowe‐dose dexamethasone suppression test and the necropsy findings     

Spontaneous hepatic rupture in six cats with systemic amyloidosis

Spontaneous hepatic rupture, secondary to the accumulation of hepatic amyloid, was diagnosed in six cats over a two-year period. Previous reports of feline hepatic amyloidosis have documented clusters of cases from breeding catteries. Most affected cats have been Siamese or a related breed and the disease is generally regarded as familial. In contrast, the cases presented here were sporadic, with relatives and other cats in the household not clinically affected. They included a Devon rex, a breed not previously reported with this condition, and a domestic shorthair. Clinical signs in three of these cases had, prior to referral, been misinterpreted as resulting from blunt trauma, immune-mediated haemolysis or a coagulopathy. Antemortem diagnostic features, including new data on the value of hepatic ultrasonography and fine-needle aspirate cytology, are reported. These cases illustrate how the course of this disease can vary between individuals and that, despite the dramatic underlying pathology, hepatic amyloidosis can present a diagnostic challenge and should be suspected in any young adult cat with consistent clinical signs, irrespective of breed or environment.     

Nasopharyngeal stenosis in four cats

Nasopharyngeal stenosis secondary to chronic upper respiratory tract infection is described in four cats. The stenosis is caused by a thin but tough inflammatory membrane which develops across the proximal nasopharynx, partly or completely occluding it. Diagnosis is aided by use of a dental mirror for caudal rhinoscopy, together with test passage of a fine catheter through the ventral nasal meatus. All four cases were treated successfully by surgical resection of the membrane through an incision in the soft palate. Nasopharyngeal stenosis should be considered in the differential diagnosis of all chronic upper respiratory disease in cats.     

Dermatophytic pseudomycetomas in four cats

The aim of this retrospective study was to describe the clinical characteristics and treatment of four cats with dermatophytic pseudomycetoma. Four Persian cats, one female and three males, with age ranging from 1.4 to 5 years, were diagnosed with dermatophytic pseudomycetoma by histological examination and fungal culture. Wood's lamp examination revealed positive fluorescence of hairs in all four cats. Characteristic skin lesions consisted of multifocal, raised, firm and nodular to dome-shaped lesions varying in size from 1 to 8 cm in diameter, with ulcers or fistulas in some of the lesions. One cat was treated and cured with 3 months of oral itraconazole; lesions completely regressed, and at the time of writing there has been no recurrence. One cat was treated with surgical excision alone, and recurrence of lesions occurred after a disease-free interval of 15 months. Two cats were treated with surgical excision and systemic itraconazole therapy. Itraconazole therapy was started 1-2 months before surgery and continued for 3 months after surgery. Surgical margins were wide in both cats, and underlying adipose tissue and/or deeper fascia was removed. One cat relapsed, but had a disease-free interval of 18 months. The other cat has been disease free for 32 months. This case series suggests that aggressive, wide surgical excision and concurrent oral itraconazole are highly beneficial in treating dermatophytic pseudomycetoma in cats.     

Hyperadrenocorticism in four cats.

This paper describes four cats with hyperadrenocorticism. Cat 1 showed polydipsia and polyphagia. Diabetes mellitus was initially diagnosed. As the animal appeared to be insulin resistant, pituitary and adrenocortical function tests were performed and the diagnosis of hyperadrenocorticism was made. Resistance to the high-dose dexamethasone suppression test was noticed in this cat. Pathological examination revealed a pituitary chromophobe adenoma. Cat 2 presented with diabetes mellitus, which was treated with insulin. The animal had a pendulous abdomen and its coat was in a poor condition. The low-dose dexamethasone suppression test demonstrated hyperadrenocorticism. Necropsy findings of pituitary tumour and hyperplasia of the adrenal cortex confirmed the diagnosis. Cat 3 showed clinical abnormalities indicative of hyperadrenocorticism, for instance, muscle weakness, alopecia, multiple abscesses. The diagnosis of hyperadrenocorticism was confirmed by the results of the lowe-dose dexamethasone suppression test. Pathological examination revealed an adrenocortical carcinoma. Cat 4 presented with polydipsia. The cause of this symptom was not found initially. One and a half years later additional symptoms, such as nephritis and polyphagia developed. Hyperadrenocorticism was diagnosed because of a palpable mass cranial to the left kidney. The diagnosis was confirmed by the results of the lowe-dose dexamethasone suppression test and the necropsy findings.     

Hindlimb skin loss associated with urethral rupture in two cats

The clinical and radiographic features of two cats in which hindlimb skin loss was associated with traumatic urethral rupture (in one case iatrogenic) are described. Both cases were managed successfully but illustrate the need for careful catheterisation of cats and early treatment of urethral trauma.     

Acute renal failure in four cats treated with paromomycin

Acute renal failure was diagnosed in 4 cats receiving paromomycin orally for treatment of infectious enteritis. All 4 cats responded to fluid therapy and recovered normal or near-normal renal function; however, 3 of the cats subsequently became deaf and developed cataracts. Toxicoses were attributed to a combination of an excessive dosage of paromomycin and absorption of the drug across injured intestinal mucosal epithelium. Pharmacokinetic studies are needed to further define the disposition of paromomycin after oral administration to cats.     

Primary intratracheal lymphosarcoma in four cats

Four cats presented with clinical signs suggestive of respiratory disease, including dyspnea, wheezing, cyanosis, inspiratory stridor, coughing, and gagging. Radiographs revealed intratracheal masses. Bronchoscopy allowed for lesion localization and collection of samples for cytopathological and histopathological evaluation, which confirmed a diagnosis of lymphosarcoma. Cats treated with systemic chemotherapy or radiation were able to achieve complete remission and long-term resolution of clinical signs.     

Preparturient hypocalcemia in four cats.

Preparturient hypocalcemia was identified in 4 cats in a specific pathogen-free colony between 1995 and 1996. All cats had an acute onset of clinical signs, 3 to 17 days prior to parturition. Signs of depression, weakness, tachypnea, and mild muscle tremors were the most common clinical signs, following by vomiting and anorexia. Additional abnormalities included hypothermia, third eyelid prolapse, dehydration, pallor, lethargy, flaccid paralysis, and hyperexcitability. Hematologic abnormalities included leukocytosis with neutrophilia and lymphopenia. Hypocalcemia was documented in each queen. Common serum biochemical abnormalities included high aspartate aminotransferase and creatine kinase activities. All cats responded to IV or SC administration of 10% calcium gluconate. Queens were then given calcium orally prior to and following parturition. The queens did not have additional complications for the duration of the gestational or lactational periods.     

Angioinvasive pulmonary carcinoma with posterior segment metastasis in four cats

The objective of the research was to characterize the clinical, fluorescein angiographic, pathologic and microscopic features of feline pulmonary carcinoma with ocular metastasis that resulted in ischemic chorioretinopathy. Four cats with confirmed or presumed primary pulmonary neoplasia with posterior segment metastasis were studied. The medical records from four cats with a diagnosis of bronchogenic carcinoma and intraocular metastasis were reviewed. Physical and ophthalmic examinations and thoracic radiographs were performed in all cases, and fluorescein angiography was performed in two cases. Classification of the neoplasms was determined by fine-needle aspiration and biopsies of peripheral metastatic lesions, and/or complete necropsies. All four cases had unilateral or bilateral blindness and ophthalmoscopic lesions characterized by a wedge-shaped, tan discoloration in the tapetal fundus, variable but mild serous exudation under the retina, and profoundly attenuated retinal vasculature. Painful swelling and necrosis of the distal extremities and/or mass lesions in the appendicular musculature were also present. Clinical findings, along with microscopic findings from biopsy specimens or complete postmortem examination, documented widespread metastasis of variably differentiated, neoplastic, columnar epithelial cells presumed to be of bronchial origin. Tumor cells were predominately located within the systemic vasculature, consistent with classification of angioinvasive pulmonary carcinoma. Fluorescein angiographic and histopathologic findings in the affected globes suggested that the posterior segment lesions resulted from invasion and growth of neoplastic cells within the chorioretinal vasculature, resulting in secondary ischemic necrosis of the retina and choroid. Ischemic chorioretinopathy and necrosis of the distal extremities, associated with primary bronchogenic carcinoma, appear to be a unique neoplastic syndrome in the domestic cat.     

Hyponatremia and hyperkalemia associated with peritoneal effusion in four cats

Four cats with considerable peritoneal effusion and corresponding hyponatremia and hyperkalemia were evaluated. The Na:K ratio in all cats was < 25, which is suggestive of adrenal insufficiency. An ACTH stimulation test was performed on 3 cats for evaluation of adrenal gland function. Serum cortisol and aldosterone concentrations did not support a diagnosis of adrenal gland insufficiency. In 1 cat, histologic evaluation of the adrenal glands at necropsy also failed to support a diagnosis of hypoadrenocorticism. On the basis of these findings, and because hyponatremia and hyperkalemia could not be readily explained by another cause, the electrolyte abnormalities were presumed to be secondary to peritoneal effusion.     

High-rise syndrome in cats

High-rise syndrome was diagnosed in 132 cats over a 5-month period. The mean age of the cats was 2.7 years. Ninety percent of the cats had some form of thoracic trauma. Of these, 68% had pulmonary contusions and 63% had pneumothorax. Abnormal respiratory patterns were evident clinically in 55%. Other common clinical findings included facial trauma (57%), limb fractures (39%), shock (24%), traumatic luxations (18%), hard palate fractures (17%), hypothermia (17%), and dental fractures (17%). Emergency (life-sustaining) treatment, primarily because of thoracic trauma and shock, was required in 37% of the cats. Nonemergency treatment was required in an additional 30%. The remaining 30% were observed, but did not require treatment. Ninety percent of the treated cats survived.     

Presumed primary immune-mediated thrombocytopenia in four cats

Feline primary immune-mediated thrombocytopenia (pIMT) is a rare hematological disorder. Platelet-bound antibody assays for cats have variable specificity and sensitivity and are not widely available. Diagnosis of pIMT is made on the basis of exclusion of other identifiable causes of thrombocytopenia and the response to immunosuppressive therapy. This report describes four cats with severe thrombocytopenia and no detectable underlying disease. One cat was euthanased because of pulmonary hemorrhage, while the other cats had frequent relapses, two of these cats developed diabetes mellitus due to long-term corticosteroid therapy. In these cats IMT had a chronic course and responded poorly to therapy with prednisolone. Alternative immunomodulatory drugs may be considered in the treatment of feline IMT.     

High rise syndrome with impalement in three cats

Three cats were presented for management of impalement injuries sustained following falls from second storey windows onto spiked metal railings. Two cats presented with penetrating thoracic wounds and extensive pulmonary parenchymal trauma, while one presented with abdominal impalement and splenic rupture. Following stabilisation, all three cats underwent exploratory surgery. A good outcome was achieved in two of the cats: one with thoracic and one with abdominal penetration. Impalement injury secondary to free fallis a previously unreported variation of 'high rise syndrome' in cats.