Minimal change glomerulopathy in a cat

A 6-year-old domestic shorthair male castrated cat was evaluated for sudden onset of vomiting and anorexia. A diagnosis of hypereosinophilic syndrome (HES) was made, and the cat was treated with imatinib mesylate. The cat had an initial clinical improvement with the normalization of the peripheral eosinophil count. After approximately 8 weeks of treatment, lethargy and anorexia recurred despite the normal eosinophil count and a significant proteinuric nephropathy was identified. Treatment with imatinib was discontinued. Ultrasound guided renal biopsies exhibited histologic, ultrastructural, and immunostaining changes indicative of a minimal change glomerulopathy (MCG) which has not previously been reported in the literature in a cat. The proteinuria and HES initially improved while the cat was treated with more traditional medications; however, both the problems persisted for 30 months that the cat was followed subsequently. Previous studies demonstrating the safety and efficacy of imatinib in cats do not report any glomerular injury or significant adverse drug reactions, and the exact cause of this cat's proteinuric nephropathy is uncertain. Nonetheless, the possibility of an adverse drug reaction causing proteinuria should be considered when initiating treatment with imatinib in a cat.     

Severe cardiovascular depression in a cat following a mandibular nerve block with bupivacaine

ObservationsA 12 year old cat was presented for anaesthesia to remove a mandibular squamous cell carcinoma. After intramuscular premedication with dexmedetomidine and methadone, anaesthesia was induced with alfaxalone, administered intravenously (IV) to effect, and maintained with isoflurane vaporized in oxygen, following oro-tracheal intubation. Approximately 5 minutes after performing a mandibular nerve block with 1.16 mg kg^?1 of bupivacaine, the cat developed severe cardiovascular depression. Anaesthetic delivery was discontinued and cardiopulmonary resuscitation instituted. Drug administration consisted of atropine (0.02 mg kg^?1 IV, repeated three times), followed by atipamezole (0.08 mg kg^?1 IV). Dobutamine was subsequently administered (1 μg kg^?1 minute^?1 IV) until cardiovascular performance was considered satisfactory. During recovery from anaesthesia the cat exhibited seizure-like activity, which was controlled by a variable rate infusion of propofol. The cat made an uneventful recovery following discontinuation of propofol infusion, without residual neurological signs, and the surgical procedure was postponed.ConclusionsThis clinical report describes successful management of cardiovascular and neurological complications following a mandibular nerve block with bupivacaine in a cat. Although treatment was successful, the role played by the drugs administered during resuscitation remains uncertain.     

Fournier's gangrene in a cat

Objective – To describe the clinical course of a cat diagnosed with Fournier's gangrene.
Case Summary – A 2-year-old castrated male cat was presented to an emergency hospital for evaluation of acute onset of lethargy, mucoid anal discharge, and fever. During hospitalization, with provision of supportive care, an area of necrotizing fasciitis around the prepuce and anus developed and surgical debridement was performed. Severe sepsis developed secondary to the necrotizing fasciitis and the cat was eventually euthanized.
New Information Provided – The purpose of this report is to document the first case of Fournier's gangrene in a cat that presented for mucoid anal discharge, lethargy, and mild ataxia, and to alert emergency clinicians to this disease process. Early detection of the disease with prompt, aggressive supportive care and surgical debridement is necessary for successful treatment.     

Bartonella spp infection as a possible cause of uveitis in a cat

A 6-year-old castrated mixed-breed cat was evaluated because of unilateral anterior uveitis. The cat was seronegative for antibodies to Toxoplasma gondii, coronaviruses, and feline immunodeficiency virus, and antigens for FeLV p27 and Cryptococcus neoformans. Antibodies to Bartonella spp were detected in serum and aqueous humor. The antibody coefficient (C value) for IgG antibodies to Bartonella spp in the aqueous humor was 4.42; values > 1 suggest ocular production of antibodies and supports a diagnosis of ocular infection. Topical administration of prednisolone and oral administration of prednisone failed to induce a response; however, the uveitis resolved rapidly after the cat was given doxycycline orally. Clinical or laboratory evidence of immunodeficiency in this cat was not detected. Detection of a serum IgG antibody titer to Bartonella spp and ocular production of IgG antibodies to Bartonella spp, exclusion of other causes of uveitis, and response to doxycycline suggests that the cat may have had bartonellosis resulting in uveal tract inflammation.     

Acquired arachnoid cyst in a cat

A 5-year-old Birman cat presented with paraparesis associated with a fracture of the third thoracic vertebra and was managed conservatively. Voluntary function was regained over the next 6 months, but the cat was referred 4 years after the trauma because of recurrence of hindlimb paresis and ataxia. Magnetic resonance imaging (MRI) showed a spinal arachnoid cyst at the level of the fourth thoracic vertebra, which was treated surgically by dorsal laminectomy and durectomy, and hindlimb function subsequently recovered. The cat re-presented 4 years later for recurrent hindlimb paresis. Myelography and computed tomography–myelography (CT-M) showed dorsolateral pooling of cerebrospinal fluid (CSF) at the previous laminectomy site. The neurological signs after the second surgery improved, but not as much as after the first surgery and the cat remained ataxic with moderate paresis. Seven months later repeat CT-M revealed an atrophic spinal cord, but negligible pooling of CSF at the previous site of the arachnoid cyst. The cat could walk, but was being treated for self-induced trauma of the left hindlimb that was thought to be related to paraesthesia. The neurological signs gradually deteriorated over 3 months and the cat was euthanased.     

Intraocular melanoma with multiple metastases in a cat

An 11-year-old cat with an intraocular melanoma was treated for 2 years for the secondary effects of the tumor (glaucoma, exposure keratitis) before enucleation was required. One year after enucleation, the cat was examined because of labored breathing. The cat was thin, appeared depressed, and had signs of respiratory compromise secondary to pleural effusion. Treatment was not instituted, and the cat was euthanatized. Metastasis of the primary melanoma to the lungs, pericardium, parietal pleura, mediastinum, hilar lymph nodes, diaphragm, liver, and omentum was confirmed at necropsy. Intraocular melanomas in the cat have been implicated to have a greater malignant potential than those in the dog; however, few cases have been reported with long-term follow-up information.     

Ocular metastasis of a vaccine-associated fibrosarcoma in a cat

A 6‐year‐old, neutered male domestic shorthair cat was evaluated for a recurrent vaccine‐associated fibrosarcoma. The cat had three excisions of the tumour prior to presentation and was referred for radiation therapy. Ten months following treatment with radiation therapy, the cat was presented again for a cloudy appearance to the eye. An exenteration was performed, and biopsy revealed fibrosarcoma. At the same time, two discrete pulmonary nodules were identified on thoracic radiographs. Two doses of doxorubicin (20 mg/m²) and cyclophosphamide (100 mg/m²) were administered intravenously 3 weeks apart. Despite treatment, the pulmonary nodule doubled in size. This case represents the first antemortem report of ocular metastasis of a vaccine‐associated sarcoma and supports the highly aggressive nature of these tumours.     

Spinal cord granuloma due to Coccidioides immitis in a cat

A6-year-old 5.5-kg female spayed domestic short-haired cat from Tucson, AZ, presented with an ˜5-day history of progressive pelvic limb weakness. The owners had returned from a weekend away to find the cat unable to use her left pelvic limb. Approximately 2 months previously, the cat had a cough and was treated for presumptive asthma with 5 mg prednisone PO q24h. The cat had a similar cough 1 year previously and seasonal allergy was suspected. The cough resolved and prednisone treatment was discontinued. Other past pertinent history included a skin problem ˜4 years previously that was described as alopecia, erythema, and pruritus of a pelvic limb. This problem had been diagnosed as an allergy and had since resolved. The cat was housed exclusively indoors and had been adopted as a kitten from a local retail store. Viral titers (FeLV and FIV) were negative, and regular vaccinations and veterinary examinations had been completed     

Dural tear and myelomalacia caused by an airgun pellet in a cat

An 8-year-old cat was presented with severe neurological deficits secondary to a traumatic cervical spinal cord injury caused by an airgun pellet. This report describes, for the first time, the myelographic findings of a dural rupture in a cat and also describes a bilateral Horner’s syndrome in a cat.     

Surgical closure of an atrial septal defect using cardiopulmonary bypass in a cat

Objective: To describe surgical repair of a large atrial septal defect (ASD) in a cat. Study Design: Clinical report. Animal: A 3‐year‐old, 3.3 kg, intact male Japanese domestic short‐haired cat. Methods: A 10.2‐mm‐diameter ASD detected by echocardiography was surgically corrected because pulmonary vascular resistance‐to‐systemic vascular resistance ratio (Q_p/Q_s) was 3.2. Using cardiopulmonary bypass (CPB), open surgical repair was achieved with an expanded polytetrafluoroethylene (e‐PTFE) graft. The priming volume of the CPB circuit was minimized by cutting the CPB tubing, and partially replacing the priming fluid with whole cat blood. To prevent hemodilution associated with use of cardioprotective agents, surgery was performed on the beating heart. Results: At 1‐year echocardiographic evaluation, the repair was intact, and at 3 years, the cat was alive without need of medication. Conclusions: Large ASD in a cat can be repaired using e‐PTFE under CPB.     

Intra‐operative hyperthermia in a cat with a fatal outcome

HistoryA four year old male neutered Domestic Short Hair cat presented for general anaesthesia for hind limb orthopaedic surgery. The cat had been anaesthetized four days previously with propofol and isoflurane and made an uneventful recovery.Physical Examination and ManagementOn pre-anaesthetic examination the cat had a temperature of 38.9 °C and was otherwise healthy. After a premedication of acepromazine and pethidine, anaesthesia was induced with thiopental and maintained with isoflurane in oxygen 50% and nitrous oxide 50%. Increases in heart rate, respiratory rate, end tidal carbon dioxide tension and temperature were observed, occurring sequentially, from 110 to 175 minutes after anaesthetic induction. Despite ceasing all warming measures and attempting to cool the patient, body temperature continued to rapidly rise, reaching 42.5 °C and limb rigidity was observed. Isoflurane administration was stopped and esmolol was administered. Cardiac arrest occurred. Cardio-pulmonary cerebral resuscitation was commenced and a lateral thoracotomy was performed to allow cardiac compressions and internal defibrillation. Atropine, adrenaline, glucose and dopamine were administered and cold saline was instilled into the thoracic cavity.Follow-upResuscitation was unsuccessful and the cat died.ConclusionsA presumptive diagnosis of malignant hyperthermia was made. Malignant hyperthermia should be considered, even if prior exposure to volatile inhalational anaesthesia was uneventful, and prompt and aggressive therapy instituted.     

Spinal epidural empyema concurrent with sequestrum in a cat: a case report

A 5-month-old intact female mixed cat presented with repetitive paraplegia and drainage of pus from the back despite continuous antibiotic medication. Neurologic examination was consistent with below T3-L3 myelopathy. Computed tomography and magnetic resonance imaging revealed a contrast-enhanced mass in the L1-3 spinal canal, and bone fragments in the T13 and L1 spinal canal. Spinal epidural empyema was suspected, and hemilaminectomy was performed for T12-L2 on the right side and T11-12 on the left side. Bone fragments were diagnosed as sequestrum infected with Bacteroides sp. The cat recovered enough to ambulate next day. One month after surgery, there was no deficit in neurological function. This is the first report of spinal epidural empyema concurrent with sequestrum in a cat.     

Mycobacterial neuritis in a cat

A 2-year-old spayed female domestic shorthair cat was referred for evaluation of rapidly progressive lameness of the right hind limb, which was paralyzed. Histologic examination of biopsy specimens revealed pyogranulomatous inflammation affecting the sciatic, common peroneal, and tibial nerves, and slender, beaded, acid-fast bacilli within macrophages, nerve fibers, and degenerate axons. A diagnosis of mycobacterial neuritis was made and the cat was treated with clofazimine and enrofloxacin for extended periods. Treatment was partially effective; the goal of returning normal function to the limb was not achieved, but disease progression was halted and the cat remained a viable pet.     

Pancytopenia in a cat with visceral leishmaniasis

Abstract: A 4‐year‐old, domestic shorthair, female spayed cat was presented for decreased appetite and depression. Severe pancytopenia with erythrocyte autoagglutination was found. The cat was seronegative for feline immunodeficiency and leukemia viruses. Immune‐mediated hemolytic anemia was suspected but no response to treatment with a blood transfusion, enrofloxacin, and prednisone was observed. Blood and bone marrow smears obtained 11 days later contained Leishmania amastigotes in the cytoplasm of neutrophils and macrophages, respectively. Serologic and PCR testing of peripheral blood confirmed infection with Leishmania infantum. Despite treatment, the cat worsened clinically and was euthanized. At necropsy, visceral dissemination of the parasite was confirmed. The findings in this case indicate that visceral leishmaniasis should be considered as a differential diagnoses in cats with pancytopenia in areas endemic for Leishmania. In addition, amastigotes may be observed in peripheral blood neutrophils.     

Darier's sign associated with a cutaneous mast cell tumour in a cat with multiple neoplasms

A cutaneous mast cell tumour associated with Darier's sign in a cat with multiple neoplasms is described. A 14-year-old cat with multiple neoplasms, one of which was a mast cell tumour developed marked subcutaneous oedema and erythema following palpation. The phenomenon is similar to Darier's sign described in people with mast cell tumours. The pathology of the Darier's sign is discussed.     

Pancreatic cyst in a cat

CASE HISTORY: A 5-year-old neutered male Cornish Rex cat was presented for evaluation with a history of vomiting over the previous 5 days.

CLINICAL FINDINGS: An abdominal mass was palpated, which was shown to be cystic by ultrasound examination. Exploratory surgery revealed this to be associated with the pancreas and it was duly resected. Histopathology was performed on the cystic mass.

DIAGNOSIS: Pancreatic cyst with associated chronic active infl ammation.

CLINICAL RELEVANCE: This is the first report of a true pancreatic cyst in a cat.     

Nodular presentation of Dirofilaria repens infection in a cat mimicking a fibrosarcoma

A cat with multiple subcutaneous nodules suggesting a soft tissue sarcoma by physical and computed tomographic examination was diagnosed as being affected by subcutaneous filariosis based on cytologic and ultrasonographic assessments. Nodules were surgically removed and extracted nematodes were identified by PCR as Dirofilaria repens. Furthermore, DNA of Dipetalonema dracunculoides (syn. Acantocheilonema dracunculoides) was detected by PCR, with no evidence of circulating microfilariae. To the best of the authors' knowledge, this represents the first report describing adults of D repens in multiple subcutaneous nodules in a cat. Cytopathologic examination allowed characterization of the parasitic nature of the nodules. Veterinary practitioners should be aware of the possible nodular presentation of D repens in cats and should include D repens in the differential diagnosis of subcutaneous neoformations in the cat.     

Gallbladder mucocoele and concurrent hepatic lipidosis in a cat

A 3-year-old Domestic Shorthair cat was presented with weight loss, anorexia and icterus. Feline hepatic lipidosis and gallbladder mucocoele were diagnosed; this is the first report of gallbladder mucocoele in the cat. The case was managed successfully with cholecystojejunostomy, gastrostomy tube placement and tube feeding for 3 months. The cat has survived over the long term with minimal complications.     

Eosinophilic enteritis in a specific-pathogen-free cat

Moderate to severe, chronic, segmental eosinophilic enteritis was diagnosed histopathologically in a 2-year-old, specific-pathogen-free cat. Peripheral eosinophilia was not observed, although eosinophilic infiltrates were found in mesenteric lymph nodes. Typical gastrointestinal signs characteristic of this disease (diarrhea, vomiting, and anorexia) were not seen; only weight loss was observed. Treatment was not instituted. Previously reported cases of feline eosinophilic enteritis have been associated with several domestic breeds having a diversity of backgrounds. The cat of this report had a known genealogy and disease-free history, was reared under barrier conditions, and was fed a restricted diet. The cause of the disease in this cat was not determined.     

Pulmonary fibrosis after high cumulative dose nitrosourea chemotherapy in a cat

Small to intermediate cell alimentary lymphoma was diagnosed in a cat after abdominal exploratory surgery with no prior history of pulmonary disease. Initial response to several chemotherapy regimens was poor, but a long‐term remission was achieved with CCNU (lomustine) and corticosteroid therapy. After receiving a total cumulative CCNU dose of 552 mg m^?2 over 12 months, an acute episode of respiratory distress occurred and the cat died. Necropsy identified severe diffuse pulmonary fibrosis and no signs of lymphoma. This is the first report of pulmonary fibrosis following high cumulative dose nitrosourea chemotherapy in a cat.