Refeeding syndrome in a cat with hepatic lipidosis

Refeeding syndrome is characterized by severe hypophosphatemia occurring in patients given enteral or parenteral nutrition after severe weight loss. There are few veterinary reports that describe this syndrome but it is well documented in human medicine. This report describes a case of a domestic shorthair cat diagnosed with hepatic lipidosis following a 4-week history of decreased appetite and weight loss and in whom refeeding syndrome was documented after initiation of enteral nutrition. Clinical findings, blood work abnormalities and disease progression in this patient are described from the time of diagnosis through to recovery. A review of the current literature pertinent to this clinical syndrome is included.     

Budd-Chiari-like syndrome associated with an adrenal phaeochromocytoma in a dog

A nine-year-old dog was presented with sudden-onset ascites and a history of two previous syncopal episodes. Diagnostic tests pointed to a Budd-Chiari-like syndrome, with obstruction of the caudal vena cava between the liver and heart. The ascites was refractory to treatment and the dog was euthanased. On postmortem examination, a phaeochromocytoma of the left adrenal gland was present, with contiguous invasions into the caudal vena cava, extending cranially as far as the cavoatrial junction. To the authors' knowledge, this is the first reported case of a Budd-Chiari-like syndrome associated with a phaeochromocytoma in a dog.     

Idiopathic thrombocytopenic purpura in a cat

An 11-year-old, castrated, male domestic shorthair cat was presented for hematuria and pollakiuria. The cat had a marked thrombocytopenia, and a bone-marrow core biopsy demonstrated megakaryocytic hyperplasia with many megakaryocyte-associated neutrophils (i.e., emperipolesis). On peripheral blood, collected at initial presentation, what appeared to be platelets were noted to be within or adherent to occasional neutrophils. The thrombocytopenia was idiopathic in that no definitive cause could be found. However, platelet concentrations appeared to increase and decrease in response to changes in prednisone and cyclosporine therapy, suggesting a possible immune-mediated pathogenesis. As tests to detect increased feline platelet-associated antibodies are unavailable, immune-mediated thrombocytopenia can only be tentatively diagnosed in cats by exclusion and response to therapy.     

Idiopathic hypertrophic osteopathy in a cat

This report describes the first case of idiopathic hypertrophic osteopathy (HO) in a cat. No causes for the bone pathology were found following evaluation of the physical and laboratory examinations (complete blood count, albumin, creatinine, urea, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase and gamma-glutamyltransferase and urinalysis), and after histopathological evaluation of organs at necropsy. Based on the radiographic, clinical and anatomopathological findings, idiopathic HO was diagnosed.     

Idiopathic complex polysaccharide storage disease in an abyssinian cat

A glycogen storage disease affecting primarily the skeletal muscle and, to a lesser degree, the cardiac muscle, spinal cord, and brain was diagnosed in a 10-year-old neutered Abyssinian cat with a 4-year history of paresis progressing to acute paralysis. Microscopically, these tissues contained inclusions that were pale basophilic in hematoxylin and eosin-stained slides, diastase resistant, periodic acid-Schiff positive, and blue-to-almost black with iodine stain. By transmission electron microscopy, the inclusions consisted of cytosolic, usually sharply demarcated, nonmembrane-bound deposits of finely granular and filamentous material. On the basis of the structural and histochemical staining characteristics, the inclusions were believed to be aggregates of abnormally stored, unbranched glycogen. A defect in glucose metabolism is suspected to be the underlying pathologic process, but an exact cause remains elusive.     

Expansile, inflammatory middle ear disease causing nasopharyngeal obstruction in a cat

A 7-year-old, entire female, domestic shorthair cat presented with recurrent upper respiratory tract problems. Infectious otitis media caused expansion of the middle ear which ultimately resulted in complete obstruction of the nasopharynx. A ventral bulla osteotomy was successful in relieving the clinical signs.     

Idiopathic neurogenic diabetes insipidus in a cat

SUMMARY A 5-year-old, domestic long-haired cat was presented for examination because of polydipsia, polyuria and inappropriate urination of 3 months' duration. Neurogenic diabetes insipidus was diagnosed, based on hyposthenuria with failure to concentrate urine in response to water deprivation and positive response to antidiuretic hormone administration. Treatment with hydrochlorothiazide or chlorpropamide orally gave inadequate antidiuresis, but response to injections of vasopressin tannate in oil was sufficient for satisfactory management.     

Idiopathic localized eosinophilic synovitis in a cat

Abstract: A 4-year-old male castrated Seal Point Himalayan cat was presented for evaluation of right thoracic limb lameness of 6 weeks duration. Synovial fluid analysis of the swollen right carpal joint revealed a mixed cell synovitis, with a total nucleated cell count of 13,200/μL and 34% eosinophils. A diagnosis of idiopathic localized eosinophilic arthritis was made. Additional clinical and diagnostic findings included mild lym-phadenopathy with lymphoid hyperplasia and an antinuclear antibody titer of 1:320. Lack of multisystem involvement made systemic lupus erythematosis unlikely. Immunosuppressive therapy with oral prednisone alleviated the lameness. Eosinophilic synovitis has not previously been reported in cats. An immune-mediated mechanism was likely in this case; however, the exact etiology remains unknown.     

Retrobulbar teratoma causing exophthalmos in a cat

A 3-year female-neutered domestic shorthair cat presenting with exophthalmos and an ipsilateral subzygomatic soft tissue mass lesion is described. Magnetic resonance imaging of the mass was performed followed by complete surgical excision. The mass was determined to be a retrobulbar teratoma and complete resection was curative. Teratomas are rare germ-cell tumours that uncommonly form in extragonadal sites. A retrobulbar location has not been previously reported in the cat and should be considered a rare cause of exophthalmos in this species.     

Hyperviscosity syndrome with IgM monoclonal gammopathy and hepatic plasmacytoid lymphosarcoma in a cat

A 19-month-old cat investigated because of depression, anorexia, polyuria, and polydipsia was found to have hepatomegaly, retinal haemorrhages, and distended tortuous retinal veins. Prolonged bleeding occurred after venipuncture, and serum was hyperviscous due to an immunoglobulin M monoclonal gammopathy. Prothrombin and activated partial thromboplastin times were prolonged, thrombin clotting time was only slightly prolonged and the activities of coagulation factors VII, VIII and IX were normal. The cat died suddenly before the origin of the immunoglobulin could be determined. Hepatic plasmacytoid lymphosarcoma was found at post-mortem examination. The pathophysiology of hyperviscosity syndrome is discussed and the observations in this cat are compared with those reported in the dog.     

Skin fragility syndrome in a cat with feline infectious peritonitis and hepatic lipidosis

A 6-year-old spayed female domestic shorthair cat with a 3-week history of inappetence, weight loss, and hiding was examined. A palpable abdominal fluid wave, dehydration, and a small tear on the left flank were noted during initial examination. When the cat was gently restrained for blood sampling, the skin on the dorsal neck tore, leaving a 15 cm x 7 cm flap of skin. Clinicopathological abnormalities included nonregenerative anaemia, hypoalbuminaemia, increased globulin concentration, and mildly elevated aspartate aminotransferase and alkaline phosphatase activities. Abdominal fluid was viscous and had a total protein of 5.3 g dL(-1) with 316 cells microL(-1), consistent with a modified transudate. Cytology of the abdominal fluid revealed 86% nondegenerate neutrophils, 13% macrophages, and 1% small lymphocytes. Histopathological evaluation and indirect immunohistochemistry confirmed a diagnosis of feline infectious peritonitis, hepatic lipidosis and feline skin fragility syndrome. Feline skin fragility syndrome has not previously been reported in association with feline infectious peritonitis (FIP). Its inclusion as a clinical sign associated with FIP may facilitate a diagnosis.     

Intracranial meningioma causing partial amaurosis in a cat

Objective To describe a case of intracranial meningioma causing visual impairment in a cat, successfully treated by surgery. Procedures An adult neutered male domestic cat was referred with a 10‐month history of progressive visual impairment and altered behavior. Investigations included physical, ophthalmologic and neurological examinations as well as hematology, serum biochemistry and CT scan of the head. Results The menace response was absent in the left eye and decreased in the right eye. Electroretinograms were normal on both eyes, as was ophthalmic examination, ruling out an ocular cause and allowing a presumptive diagnosis of partial amaurosis due to a post‐retinal lesion. CT scan demonstrated a large sessile extra axial mass along the right parietal bone and thickening of the adjacent bone. Cerebrospinal fluid was not collected because high intracranial pressure represented a risk for brain herniation. A right rostrotentorial craniectomy was performed to remove the tumor. Ten days after surgery, vision was improved, neurological examination was normal and normal behavior was restored. Ten months after surgery, ophthalmological examination showed no visual deficit and CT scan did not reveal any sign of recurrence. Conclusion Advanced imaging techniques allow veterinarians to detect early cerebral diseases and to provide specific treatment when it is possible. In cases of feline amaurosis due to intracranial meningioma, the vital prognosis is good while the visual prognosis is more uncertain, but recovery of normal vision and normal behavior is possible as demonstrated in the present case.     

Intrapericardial cyst causing cardiac tamponade in a cat

A two-year-old cat with episodic dyspnea was diagnosed with an intrapericardial cyst via two-dimensional echocardiography. The cyst directly compressed the right ventricle, resulting in cardiac tamponade. Centesis of the cyst was performed to reduce tamponade prior to surgery. At surgery, a large, fluid-filled cystic structure was found within the pericardium. The cystic structure was continuous with a pedicle of liver that passed through a small peritoneopericardial diaphragmatic hernia. Surgical resolution was achieved by median sternotomy, midline pericardotomy, resection of the cyst, and diaphragmatic herniorrhaphy.     

Idiopathic megaoesophagus and intermittent gastro-oesophageal intussusception in a cat

An eight-month-old domestic shorthair cat was presented with chronic vomiting for three months, with an acute increase in frequency during the past two days. A diagnosis of megaoesophagus was made by chest radiography. Diagnostic work-up for megaoesophagus was performed. A gastro-oesophageal intussusception was identified during endoscopy. Medical and nutritional therapy was instituted with a good response to the treatment.     

Spinal dural ossification causing neurological signs in a cat

A six-year-old Ragdoll cat underwent examination due to a six-month history of slowly progressive gait abnormalities. The cat presented with an ambulatory tetraparesis with a neurological examination indicating a C1-T2 myelopathy. Radiographs of the spine showed a radiopaque irregular line ventrally in the vertebral canal dorsal to vertebral bodies C3-C5. In this area, magnetic resonance imaging revealed an intradural extramedullary/extradural lesion compressing the spinal cord. The spinal cord was surgically decompressed. The cause of the spinal cord compression was dural ossification, a diagnosis confirmed by histopathological examination of the surgically dissected sample of dura mater. The cat gradually improved after the procedure and was ambulating better than prior to the surgery. The cat’s locomotion later worsened again due to ossified plaques in the dura causing spinal cord compression on the same cervical area as before. Oral prednisolone treatment provided temporary remission. Ten months after surgery, the cat was euthanized due to severe worsening of gait abnormalities, non-ambulatory tetraparesis. Necropsy confirmed spinal cord compression and secondary degenerative changes in the spinal cord on cervical and lumbar areas caused by dural ossification. To our knowledge, this is the first report of spinal dural ossification in a cat. The reported cat showed neurological signs associated with these dural changes. Dural ossification should be considered in the differential diagnosis of compressive spinal cord disorders in cats.