UNILATERAL PERINEPHRIC PSEUDOCYST OF UNDETERMINED ORIGIN IN A DOG

Unilateral perinephric pseudocyst of undetermined origin was diagnosed in a 13^1/2 year old dog with a history of recurrent urinary tract infections. A presumptive diagnosis of pseudocyst was based on radiographic and sonographic findings. In survey radiographs, asymmetrical unilateral renomegaly was seen. The mass was anechoic. There was absence of opacification of the mass during excretory urography. A celiotomy was performed for removal of the perinephric mass, and histologic review of this structure confirmed it to be a pseudocyst. Perinephric accumulation of fluid is a rare condition in domestic animals. Seven examples of perinephric pseudocysts have been previously reported in the cat. Predominant clinical findings include progressive abdominal distension and nonspecific signs of renal disease. The presence of unilateral or bilateral renomegaly is a characteristic radiographic feature. This clinical report describes the first case of perinephric pseudocyst diagnosed in the dog.     

Pancreatic Pseudocysts in 4 Dogs and 2 Cats: Ultrasonographic and Clinicopathologic Findings

Pancreatic pseudocysts were diagnosed in 4 dogs and 2 cats based on ultrasonographic and clinicopathologic findings. All 6 animals had a clinical diagnosis of pancreatitis. Five of 6 pseudocysts were in the left pancreatic limb, and in 1 cat the pseudocyst was in the pancreatic body region. Cyst size ranged from 2 x 2 cm to 7 x 6 cm. All pseudocysts had anechoic regions that were aspirated using ultrasound guidance for diagnostic and therapeutic purposes. No morbidity was associated with the aspiration procedures. Cytologically the pseudocyst fluid was aseptic in all patients and had low numbers of inflammatory cells in 5 of 6 patients. All animals had high lipase activity in the pseudocyst fluid and in 2 dogs and 1 cat the lipase activity in the fluid was greater than in serum. Three of the 4 dogs were managed medically. In the 1 dog that had long-term follow-up ultrasound examination, the pseudocyst persisted for several days following aspiration and had disappeared 8 months after diagnosis. All 3 of these dogs were clinically normal 1.5-4 years after presentation. The 4th dog underwent surgical exploration and was euthanized shortly thereafter because of bronchopneumonia and chronic pancreatitis. The 2 cats died 10 days and 2 months, respectively, following initial diagnosis of the pseudocyst, but necropsies were not performed in either case. Ultrasound-guided fine-needle aspiration of pancreatic pseudocysts and clinicopathologic evaluation of cystic fluid are useful for diagnosis of pancreatic pseudocysts.     

IMAGING OF A CAT WITH PERIRENAL PSEUDOCYSTS

A 16-year-old, neutered male, domestic short hair cat had abdominal distension and systemic hypertension. Radiography, ultrasonography, excretory urography, and renal scintigraphy were performed to establish the diagnosis and implement appropriate treatment. Bilateral perirenal pseudocysts were confirmed surgically and histopathologically. Following bilateral renal capsulectomy, systemic hypertension decreased and global glomerular filtration rate improved to normal limits. Multiple imaging modalities helped establish the diagnosis and guided implementation of appropriate treatment.     

BILATERAL PERINEPHRIC PSEUDOCYSTS AND POLYCYSTIC KIDNEYS IN A FERRET

A 3-year-old castrated male domestic ferret was evaluated for abdominal distention. Survey lateral and dorsoventral abdominal radiographs were made. There were two soft tissue radiopacities consistent with grossly enlarged kidneys displacing small bowel and colon cranially, ventrally and caudally. Abdominal ultrasound was performed and revealed bilateral perinephric pseudocysts and polycystic kidneys. The perinephric pseudocysts were found to be dilated renal capsules on exploratory surgery and were drained. On follow up examinations, the pseudocysts were drained by ultrasound-guided paracentesis. The perinephric cyst fluid was distinguished from urine by measuring creatinine concentration and plans were made to resect the renal capsules due to rapid re-accumulation of pseudocyst fluid. The ferret's condition deteriorated and euthanasia was performed. Post-mortem examination was declined by the owner. Perinephric pseudocysts are rare and this is the first published report in a ferret. Ultrasound examination is the most rapid, accurate and non-invasive method for diagnosis of perinephric pseudocysts.     

HYDROTHORAX SECONDARY TO A PERINEPHRIC PSEUDOCYST IN A CAT

Hydrothorax was identified in a 14-year-old Siamese cat with a pre-existent perinephric pseudocyst. The pleural fluid was classified as a low-protein transudate. Intrapseudocystic scintigraphy confirmed a direct communication between the pseudocyst and the pleural space. The hydrothorax resolved following pseudocystectomy and unilateral nephrectomy, demonstrating that the psendocyst caused the hydrothorax.     

PERIRENAL EFFUSION IN DOGS AND CATS WITH ACUTE RENAL FAILURE

Perirenal fluid accumulation has been described as an ultrasonographic feature of urine leakage, hemorrhage, abscessation, or neoplasia. The purpose of this retrospective study was to report perirenal effusion as an additional ultrasonographic finding in canine and feline patients with acute renal failure. The causes of acute renal failure in 18 patients included nephrotoxicity (4), leptospirosis (3), ureteral obstruction (2), renal lymphoma (2), ureteronephrolithiasis (2), prostatic urethral obstruction (1) and interstitial nephritis and ureteritis (1). An underlying cause was not identified in three patients. The sonographic finding of perirenal fluid was bilateral in 15 patients. Unilateral perirenal fluid was identified ipsilateral to the site of ureteric obstruction in two patients. Large effusions extended into the caudal retroperitoneal space. Additional sonographic findings suggestive of renal parenchymal disease included mild (5), moderate (5) or severe (2) pyelectasia, increased renal echogenicity (11), increased (9) or decreased renal size (2) and ureteral and/or renal calculi (3). There did not appear to be an association between the volume of perirenal fluid and the severity of renal dysfunction. All patients with large effusions underwent euthanasia. Perirenal fluid developing in acute renal failure is thought to be an ultrafiltrate associated with tubular back-leak into the renal interstitium that overwhelms lymphatic drainage within the perirenal and retroperitoneal connective tissues although obstruction to urine flow may also play a role. Localized perirenal retroperitoneal free fluid may be a useful ultrasonographic feature to assist with the characterization of, and determination of prognosis in, patients with suspected renal disease.     

Third-degree atrioventricular block in 21 cats (1997-2004)

The effect of 3rd-degree atrioventricular block on long-term outcome in cats is unknown. Clinical findings and long-term outcome of 21 cats with 3rd-degree atrioventricular block were studied retrospectively. Median age of cats studied was 14 years (range 7-19 years). Presenting signs included respiratory distress or collapse, but 6 cats had no clinical signs of disease. Eight cats had congestive heart failure (CHF) at the time that 3rd-degree atrioventricular block was detected. Heart rates ranged from 80 to 140 beats per minute (bpm; median 120 bpm) with no difference in heart rate between cats with and those without CHF. Eleven of 18 cats that had echocardiograms had structural cardiac disease, and 6 cats had cardiac changes consistent with concurrent systemic disease. No atrioventricular nodal lesions were detected by echocardiography. One cat had atrioventricular nodal lesions detected on histologic examination. Median survival of 14 cats that died or were euthanized was 386 days (range 1-2,013 days). Survival did not differ between cats with or without CHF or between cats with or without structural cardiac disease. Thirteen cats with 3rd-degree atrioventricular block survived > 1 year after diagnosis, regardless of presenting signs or underlying cardiac disease. Third-degree heart block in cats is often not immediately life threatening. Survival was not affected by the presence of underlying heart disease or congestive heart failure at the time of presentation. Even cats with collapse might survive > 1 year without pacemaker implantation.     

Feline exocrine pancreatic carcinoma: a retrospective study of 34 cases

Thirty‐four cases were reviewed in this retrospective study for information on clinical presentation, prognostic indicators, survival time and response to various therapies. The most common presenting clinical signs were weight loss, decreased appetite, vomiting, palpable abdominal mass and diarrhoea. Metastatic disease was confirmed in 11 cats. The overall median survival was 97 days. The median survival times for patients who received chemotherapy or had their masses surgically removed was 165 days. Those patients who had an abdominal effusion present at the time of diagnosis survived a median of 30 days. Cats that received non‐steroidal anti‐inflammatory drug therapy had a median survival of 26 days. This study confirms that exocrine pancreatic carcinoma in cats is an aggressive tumour with a high metastatic rate and poor prognosis, although three patients survived over 1 year. Fifteen percent of the patients were diabetic, which raises the question as to what the link between diabetes and pancreatic cancer in people and cats may be.     

Conservative Versus Surgical Management of Gastrointestinal Linear Foreign Bodies in the Cat

Twenty-four cases of gastrointestinal linear foreign bodies (LFB) in cats were reviewed. Nine cats were successfully managed conservatively, with passage of the LFB occurring 1 to 3 days after presentation. Ten cats that were initially managed conservatively were subsequently treated surgically. The decision to operate was based on worsening of clinical signs and failure to pass the LFB. Five cats were initially treated surgically. The cats that were managed successfully via conservative treatment had a shorter duration of clinical signs before presentation, decreased incidence of abdominal pain and palpable intestinal plication, and less severe hematologic abnormalities. Radiographic signs were of little benefit in deciding whether to treat the cats conservatively or surgically. None of the cats died.     

Feline cerebrovascular disease: clinical and histopathologic findings in 16 cats

Sixteen cats with cerebrovascular disease confirmed via histology to be of nontraumatic and nonneoplastic origins are described. In addition, the anatomy of the arterial supply of the cat's brain is reviewed. It is suggested that this unique arterial design may influence the incidence of cerebrovascular accidents in this species. Of the 16 cats reviewed, seven cats had ischemic infarctions, five had hemorrhagic infarctions, and four were diagnosed with intracranial hemorrhage. The median age was 8 yr and 9.5 yr in cats with infarctions and intracranial hemorrhages, respectively. Clinical signs were severe, acute, consistent with the localization of the cerebrovascular lesion, and influenced by underlying pathology. Four cats with infarction showed lateralized neurologic signs. Four cats with infarctions were diagnosed with pulmonary disease antemortem and three cats had hyperthyroidism. Cerebrospinal fluid analysis and computed tomography scans were available in two cats. None of the infarctions were grossly visible. All cats with hemorrhagic infarcts had severe liver pathology and nephritis was identified in four cats. Hypoxia was a feature in four cats and one cat suffered cardiac failure. In conclusion, the clinical picture is influenced by the type of cerebrovascular disease, the localization of the intracranial lesions, and any underlying pathology.     

Acute Hepatic Necrosis And Liver Failure Associated With Benzodiazepine Therapy In Six Cats, 1986–1995.

A retrospective analysis was conducted of all feline necropsies performed during a nine year period to identify cases of sever, acute, centrilobular (periacinar), hepatic necrosis (ACHN). After exclusion of cats with anemia, a series of seven cases of ACHN was identified. In addition, two similar cases were identified from tissue submitted for histopathology following, and eight had bile duct hyperplasia. Seven of the nine cats received diazepam prior to dath, and one received zolazepam. Of the seven cats that received diazepam, five were healthy prior to treatment and received oral diazepam for the treatment of inappropriate urination, intercat aggression, or skin disease. Two cats which received diazepam exhibited other clinical signs: one had chronic vomiting, and the other received diazepam after biochemical evidence of hepatocellular necrosis was present. Onset of clinical sings in cats receiving oral diazepam occurred 7–13 days following the initiation of treatment. Clinical signs and clinical biochemical analysis were compatible with severe hepatocellular necrosis and acute liver failure. All cats had lesions in other organs: five had pancreatic disease, five had cardiac disease, and five had renal disease. All cats died, or were euthanized, within 4 dyas of the onset of clinical signs and 2 days after presentation to a veterinarian. Fatal, acute, centrilobular hepatic necrosis appears to be a serious adverse reaction to diazepam therapy in certain cats.     

Clinical application of plasma clearance of iohexol on feline patients

Glomerular filtration rate (GFR) was estimated by plasma clearance of iohexol (PCio) in 52 conscious cats presented for a variety of reasons to Angel Animal Hospital over a 2-year period. Cats were divided into four groups according to their clinical conditions and reasons for measuring PCio. The median PCio (ml/min/kg) was 3.68 in normal cats (NM), 2.39 in cats with suspected renal disease (SP), 1.35 in cats referred to confirm renal dysfunction (RD), and 0.84 in cats with apparent clinical signs of renal failure (RF). There was a significant difference between the results for each group. The respective medians of blood urea nitrogen (BUN) and plasma creatinine concentration (Pcr) (mg/dl) were 15 and 1.40 in NM cats, 21 and 1.71 in SP cats, 30 and 2.20 in RD cats, and 48 and 3.30 in RF cats. The reference values of BUN and Pcr were 21 +/- 7 mg/dl and 1.5 +/- 0.4 mg/dl (mean +/- SD). Diminished renal function could not be detected in SP cats by either BUN or Pcr, while a marked decrease of GFR was demonstrated before BUN and Pcr increased, indicating the insensitivity of BUN and Pcr in detecting renal dysfunction in cats. PCio can be performed non-invasively in conscious cats, which improves the veterinarian's ability to detect early stages of chronic renal disease.     

Idiopathic sclerosing orbital pseudotumor in seven cats

OBJECTIVE: To review the clinical presentation and histopathologic findings on a series of cats with orbital fibrotic disease and compare the data to that of humans with sclerosing orbital pseudotumor. ANIMALS: A retrospective study was undertaken, which identified tissue samples from seven cats between 1997 and 2002 with a history of orbital mass effect and pathology characterized by fibrous tissue proliferation. PROCEDURE: Information was obtained from medical records for affected cats, including age, sex, clinical signs, management, and outcome, with histopathology re-examined. RESULTS: Six of seven cats presented with unilateral orbital involvement that progressed to bilateral orbital disease despite treatment. Onset was insidious, evolving over weeks to months and was associated with fixation of orbital structures. Owners of six of the cats opted for euthanasia because of disease progression and pain. Histopathology of affected orbital tissue included extensive fibrosis with encapsulation of normal tissues without characteristics of neoplasia. CONCLUSIONS: Clinical findings and histopathology of globes and orbital tissues in cats bore many similarities to idiopathic sclerosing orbital pseudotumor in humans. In cats, the prognosis for the globe appears to be poor but an elucidation of the pathogenesis and earlier diagnosis coupled with more aggressive treatment modalities as indicated in humans may be beneficial.     

Feline histoplasmosis: a retrospective study of 22 cases (1986-2009)

Twenty-two cases of feline histoplasmosis seen at the Virginia-Maryland Regional College of Veterinary Medicine Teaching Hospital between 1986 and 2009 were reviewed. The median age of affected cats was 9 yr (mean, 8.8 yr). Female domestic shorthairs were more commonly affected. The clinical presentation of most cases was nonspecific. The most common presenting complaints included weakness, lymphadenopathy, weight loss, and anorexia. Less frequent clinical signs included vomiting, diarrhea, blindness, and lameness. Less than half of the cats had clinical evidence of pulmonary disease on admission. Anemia and hypoalbuminemia were common laboratory abnormalities. An interstitial pattern was the most common radiographic pattern observed with pulmonary disease. Diagnosis was based on identification of the organism on cytology or histopathology. Fifteen of the 22 cats were treated, and itraconazole was the most common antifungal agent prescribed. Median duration of the antifungal treatment was 5 mo for cats that survived to discharge. Overall survival at time of discharge for cats in this study was 55%.     

Acute intrinsic renal failure in cats: 32 cases (1997-2004)

OBJECTIVE: To determine patient demographics, clinicopathologic findings, and outcome associated with naturally acquired acute intrinsic renal failure (ARF) in cats. DESIGN: Retrospective case series. ANIMALS: 32 cats with ARF. PROCEDURES: Cats were considered to have ARF if they had acute onset of clinical signs (< 7 days), serum creatinine concentration > 2.5 mg/dL (reference range, 0.8 to 2.3 mg/dL) and BUN > 35 mg/dL (reference range, 15 to 34 mg/dL) in conjunction with urine specific gravity < 1.025 or with anuria or increasing serum creatinine concentration despite fluid therapy and normal hydration status, and no signs of chronic renal disease. Cases were excluded if cats had renal calculi or renal neoplasia. RESULTS: Causes of ARF included nephrotoxins (n = 18 cats), ischemia (4), and other causes (10). Eighteen cats were oliguric. For each unit (mEq/L) increase in initial potassium concentration, there was a 57% decrease in chance of survival. Low serum albumin or bicarbonate concentration at initial diagnosis was a negative prognostic indicator for survival. Initial concentrations of BUN, serum creatinine, and other variables were not prognostic. Seventeen (53%) cats survived, of which 8 cats had resolution of azotemia and 9 cats were discharged from the hospital with persistent azotemia. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that survival rates of cats with ARF were similar to survival rates in dogs and that residual renal damage persisted in approximately half of cats surviving the initial hospitalization.     

Long-term outcome of cats treated conservatively or surgically for peritoneopericardial diaphragmatic hernia: 66 cases (1987-2002)

OBJECTIVE: To determine long-term outcome of cats treated conservatively or surgically for peritoneopericardial diaphragmatic hernia (PPDH). DESIGN: Retrospective study. ANIMALS: 67 cats with PPDH. PROCEDURE: Medical records of cats with a diagnosis of PPDH made from 1987 through 2002 were reviewed. Information regarding long-term outcome was obtained from owners. RESULTS: Prevalences of PPDH in domestic longhair and Himalayan cats were significantly greater and prevalence of PPDH in domestic shorthair cats was significantly lower than prevalence of PPDH in the hospital cat population over the 15-year study period. Historical problems most commonly related to the respiratory and gastrointestinal tracts. Peritoneopericardial diaphragmatic hernia was the primary diagnosis in 40 cats and an incidental finding in 27 cats. One cat died prior to arrival at the Veterinary Medical Teaching Hospital. Thirty-seven of 66 cats were treated surgically, and 29 were treated conservatively. The postoperative mortality rate was 14%. Postoperative complications developed in 29 of 37 cats, the most common of which was hyperthermia. Two of 22 conservatively treated cats had progression of clinical signs necessitating surgical intervention or resulting in death. Owner satisfaction with treatment choice and long-term outcome was rated as very satisfied by 88% of owners of surgically treated cats and 68% of owners of conservatively treated cats. CONCLUSIONS AND CLINICAL RELEVANCE: Cats with overt clinical signs attributable to PPDH are good candidates for surgical herniorrhaphy. Postoperative complications may develop but are generally minor and self-limiting. Long-term outcome of cats treated conservatively or surgically was rated as very good by most owners.     

Retrospective evaluation of sildenafil citrate as a therapy for pulmonary hypertension in dogs

Pulmonary arterial hypertension (PH) is a pathologic condition in dogs characterized by abnormally high pressures in the pulmonary circulation and has been associated with a poor outcome. Sildenafil is a type V phosphodiesterase inhibitor that produces nitric oxide mediated vasodilatation. Sildenafil treatment decreases pulmonary arterial pressure and pulmonary vascular resistance in people with PH. The purpose of this study was to describe the clinical characteristics and outcome of dogs with PH treated with sildenafil. The cardiology database was searched for dogs with PH treated with sildenafil. PH was defined as systolic pulmonary arterial pressure (PAPs) > or = 25 mmHg at rest. Medical records were reviewed for the following information: signalment, duration and type of clinical signs before treatment, underlying disease, estimated or measured PAPs, dosage and dosing interval of sildenafil, and the effect of treatment on clinical signs and pulmonary arterial pressure and survival time. Thirteen affected dogs were identified. Clinical signs included collapse, syncope, respiratory distress, and cough. Duration of clinical signs before presentation ranged from 3 days to 5 months. An underlying cause was identified in 8 dogs. The median sildenafil dosage was 1.9 mg/kg. Ten dogs received concurrent medications. Median PAPs was 90 mmHg; 8 dogs were reevaluated after therapy, and the median decrease in PAPs was 16.5 mmHg. The median survival time of all dogs was 91 days. Sildenafil appeared to be well tolerated in dogs with PH and was associated with decreased PAPs and amelioration of clinical signs in most. Sildenafil represents a reasonable treatment option for dogs with pulmonary hypertension.     

Aetiology and outcome in 90 cats presenting with dyspnoea in a referral population

O bjectives : Dyspnoea is an unspecific severe presenting sign, which can be life threatening and requires prompt treatment. Dyspnoeic cats often have significant underlying disease. Underlying aetiologies in cats that presented with dyspnoea were reviewed, and associations with patient signalment and outcome were investigated.
M ethods : The case records of 90 dyspnoeic cats were retrospectively reviewed and separated into different groups depending on aetiology (cardiac, respiratory, neoplastic and trauma). Duration of clinical signs, presentation, hospitalisation length and survival were analysed.
R esults : Cardiac (38 per cent), respiratory (32 per cent) and neoplastic (20 per cent) diseases were common causes of feline dyspnoea. Cats with respiratory causes had longer duration of clinical signs (P<0·001) before presentation. Cats with neoplasia were significantly older (P<0·001). No significant difference in respiratory rates was present between the groups (P = 0·154). High heart rates (P<0·001) and abnormalities on cardiac auscultation were more likely in the cardiac group.
Clinical Significance: Frequent causes of dyspnoea in cats were cardiac disease followed by respiratory causes and neoplastic conditions. Heart rate on presentation and presence of heart murmurs or gallops are useful to identify cardiac causes. Improved proportion surviving was found in the respiratory group (P = 0·027), whereas cats with neoplasia had the worst outcome.