Presumptive acute lung injury following multiple surgeries in a cat

A 12-year-old, 3.5-kg spayed female domestic shorthair cat had a tracheal mass identified as malignant B-cell lymphoma. The cat had tracheal resection and subsequently developed laryngeal paralysis. Due to multiple episodes of respiratory distress the cat subsequently had tracheal surgeries. Finally, the cat had a sudden onset of severe respiratory distress and collapsed. Computed tomography imaging and arterial blood gas analysis supported a diagnosis of acute lung injury.     

Nodular immunocyte-derived (AL) amyloidosis in the trachea of a dog

A 7-year-old castrated male Miniature Schnauzer was examined because of labored breathing and episodes of respiratory distress that progressed to collapse. On cervical radiographs, a focal soft tissue mass in the caudal cervical portion of the trachea was observed, and during tracheoscopy, a 1 x 1 cm, pedunculated, multinodular, pink, intraluminal mass extending from the dorsal tracheal membrane and obstructing approximately 80% of the tracheal lumen was seen. Tracheal resection and anastomosis was performed to remove the mass, and the dog recovered without complications. On histologic examination, the mass consisted of a large accumulation of homogeneous, faintly fibrillar eosinophilic material admixed with a predominantly plasma cell infiltrate; examination of sections stained with thioflavin T and Congo red stain confirmed that the eosinophilic material was amyloid. A diagnosis of nodular, immunocyte-derived (AL) amyloidosis was made. Seventeen months after surgery, the dog had a relapse of respiratory distress because of an extramedullary plasmacytoma involving the trachea.     

Tracheal rupture in a native pony mare associated with a condition resembling tracheobronchopathia osteochondroplastica

A 5‐year‐old pony presented with sudden onset of severe respiratory distress associated with tracheal rupture and peritracheal emphysema. Subsequent endoscopic examination revealed multiple mucosal nodules protruding into the tracheal lumen. Biopsy of the tracheal wall revealed well‐demarcated submucosal cartilagenous/osseous nodules. The appearance was considered to resemble tracheobronchopathia osteochondroplastica.     

Cervical neoplasia originating from the vagus nerve in a dog

An eight-year-old intact male Bernese mountain dog was referred with a history of chronic vomiting, coughing and signs of respiratory distress. Other historical findings included lethargy, weight loss and choking. On presentation, clinical findings were Horner's syndrome, ipsilateral laryngeal hemiplegia, coughing, gagging, respiratory distress and vomiting. Lateral cervical radiographs showed ill-defined mineralisation in the soft tissue ventral to the third cervical vertebra, while ultrasonography of the neck revealed a well marginated heterogeneous mass with focal hyperechogenic lesions and acoustic shadowing. Results of an ultrasound-guided fine needle aspirate suggested neoplasia. At necropsy, a large tumour was detected in the ventral cervical region, originating from the right vagosympathetic trunk. In view of the infiltrating pattern, the cellular pleomorphism and the numerous mitoses on histopathological examination, the tumour was classified as a malignant peripheral nerve sheath tumour.     

PCR for antigen receptor rearrangement (PARR) clonality testing in a horse with a solitary retropharyngeal lymphoma

A 19-year-old Quarter Horse gelding was evaluated for respiratory distress and a rapidly enlarging retropharyngeal mass. Initial evaluation revealed severe respiratory distress, and a large, firm mass, visibly appreciable as 12 × 12 cm, in the left retropharyngeal and perilaryngeal region, with surrounding left and right retropharyngeal swelling. No significant abnormalities were present on complete blood count and serum biochemistry analyses. Endoscopy revealed severe pharyngeal collapse restricting airflow without gross abnormalities of the pharyngeal mucosa other than inflammation and irritation. A multilobular retropharyngeal mass, diffusely heterogeneous in echogenicity, was present adjacent to, but not occluding, the carotid artery as assessed by ultrasonography. Initial needle aspirate suggested lymphoma. Tissue biopsy and histopathology confirmed a round cell tumour. A temporary tracheotomy was performed to provide respiratory relief, and the horse was managed on oral antibiotics and anti-inflammatory medications while awaiting histopathological results. The decision was made to humanely euthanise the horse after biopsy results indicated lymphoma. Definitive diagnosis of T cell rich, large B cell lymphoma was made by combination of cytology, immunohistochemistry and molecular clonality PCR (PARR) testing. Lymphoma should be considered in horses with focal masses of the retropharyngeal region. Although treatment was not pursued, PARR testing was successful in this case and may be helpful for accurate characterisation of lymphoma in horses to more precisely determine prognosis and the most effective treatment plans, as it has been in human patients and small animals.     

Adenosquamous Carcinoma of the Trachea in a Domestic Ferret (Mustela putorius furo)

A 4-year-old, castrated, male domestic ferret (Mustela putorius furo) was evaluated for a possible upper respiratory tract infection and wheezing for approximately 3 weeks. Supportive care for a suspected upper respiratory tract infection was initiated; however, the patient became progressively more dyspneic over the next 48 hours. A possible tracheal mass was identified upon thoracic radiographic imaging of the ferret. Tracheoscopy and a computed tomography scan of the neck and thorax confirmed the presence of a tracheal mass approximately 3 cm from the larynx obstructing 80% of the tracheal lumen. Rather than pursuing surgical resection, the owners elected humane euthanasia. An adenosquamous carcinoma of the trachea was diagnosed after histologic analysis. This tumor type has been diagnosed in the lungs of ferrets that were experimentally exposed to carcinogens found in cigarette smoke; however, there are no previous reports of this or any other tumor type associated with the ferret trachea. A tracheal mass causing a partial upper airway obstruction should be considered within the differential disease diagnosis list when a ferret is presented with dyspnea.     

Tracheal stenosis following endotracheal intubation in a dog

A 2-month-old intact female Rottweiler was presented for investigation of coughing and respiratory distress 9 d after an exploratory laparotomy for intestinal foreign body removal. Tracheal stenosis was suspected by radiography and confirmed with computed tomography (CT) and tracheoscopy. After 1 wk of medical management, clinical signs had resolved and the severity of the tracheal narrowing was markedly improved, as confirmed by radiography and tracheoscopy. Tracheal stenosis is a considerable complication of endotracheal intubation in veterinary medicine and may be medically managed, depending on the severity of the tracheal injury.Key clinical message:To our knowledge, this is the first clinical case report of tracheal stenosis resulting from endotracheal intubation in a dog and its resolution after medical management.     

Acute tracheal obstruction associated with anticoagulant rodenticide intoxication in a dog

An adult female neutered crossbred dog was referred in respiratory distress. Thoracic radiographs revealed tracheal narrowing with a soft tissue opacity dorsal to the trachea, near the thoracic inlet, and a patchy interstitial pulmonary infiltrate. The tracheal narrowing was thought to be due to a combination of intraluminal haemorrhage and mediastinal haemorrhage resulting from a coagulopathy caused by anticoagulant rodenticide intoxication. Treatment included supportive care and administration of vitamin K1, and the dog showed a complete resolution of the clinical signs.     

Recurrent Obstructive Fibrinous Tracheal Pseudomembranes in a Young English Bulldog

Endotracheal intubation is a common procedure, rarely associated with life‐threatening complications (e.g., tracheal rupture, necrosis, foreign body). A 1.5‐year‐old English Bulldog was presented for respiratory distress, with increased respiratory efforts and stridor, 2 days after endotracheal intubation. Cervical and thoracic radiographs disclosed a severe narrowing of the tracheal lumen associated with an intraluminal soft‐tissue structure at the thoracic inlet. Tracheoscopy confirmed the presence of an obstructive fibrinous tracheal pseudomembrane (OFTP) creating a 1‐way valve obstruction. Removal of the OFTP dramatically improved the dog's respiratory function, but the lesion reformed twice despite corticosteroid and antibiotic therapy PO, warranting repeated endoscopic removal of the OFTP. No additional recurrences were observed after treatment with inhaled heparin and N‐acetylcysteine q4h. No respiratory signs were reported 9 months after discharge. Postintubation OFTP has been reported rarely in humans and never described in dogs. Unexplained signs of upper airway obstruction shortly after endotracheal intubation should prompt consideration of OFTP in dogs, even if intubation was uneventful. Unlike its counterpart in humans, OFTP in dogs can reoccur after endoscopic removal, warranting repeated endoscopic extraction. A combination of corticosteroid therapy PO and heparin and N‐acetylcysteine inhalation q4h may be attempted if recurrence is observed.     

Microchip-associated fibrosarcoma in a cat

A 9-year-old, neutered male cat was presented for a subcutaneous mass on the neck. After surgical removal of the mass, a pet identification microchip was found within the tumour. Histological examination of the mass revealed typical features of the feline postinjection sarcoma. The cat had never received injections at the tumour site; all routine vaccinations were administered in the hindlimbs. Few cases of sarcomas developing at the site of microchip application have been reported in animals, although the contributory role of vaccine administrations has not been ruled out. This is the first report of a microchip-associated fibrosarcoma in a cat. Adherence to American Association of Feline Practitioners vaccination guidelines, avoiding the interscapular area, enabled confirmation of the definitive aetiology of the neoplasia.     

Extraskeletal fibroblastic osteosarcoma in a rabbit (Oryctolagus cuniculus)

A seven-year-old rabbit was presented with a non-painful mass in the right upper lip. Tissue samples from the mass at three different stages of the disease process were diagnosed sequentially as an osteogenic sarcoma, a fibroblastic tumour with rudimentary osteoid formation and, lastly, a fibrosarcoma. No bone involvement or metastatic disease was found. The final diagnosis was of an extraskeletal fibroblastic osteosarcoma, which is, to the authors' knowledge, the first reported such case in a domestic rabbit. Without the first two tissue samples, an incorrect diagnosis would have been reached; therefore, this disease may be underrepresented in the literature.     

The Safety and efficacy of a new self-expandable intratracheal nitinol stent for the tracheal collapse in dogs

To evaluate the potential utility of a self-expandable intratracheal nitinol stent with flared ends for the treatment of tracheal collapse in dogs, endotracheal stenting therapy was performed under fluoroscopic guidance in four dogs with severe tracheal collapse. During the 4 to 7 month follow-up, after stent implantation, clinical signs, including dyspnea and respiratory distress, dramatically improved in all dogs. The radiographs showed that the implanted stents improved the tracheal collapse, and there were no side effects such as collapse, shortening or migration of the stents. In conclusion, the self-expandable intratracheal nitinol stents provided adequate stability to the trachea and were effective for attenuating the clinical signs associated with severe tracheal collapse.     

Metastatic carcinoma in the ulna of a cat secondary to a suspected pulmonary tumour

A 14-year-old male neutered Burmese cat presented for investigation of right fore limb lameness that was non-responsive to anti-inflammatory drugs and opioids. Thoracic radiography showed multiple pulmonary soft tissue nodules and a larger cavitated mass. Right elbow radiographs revealed marked peri-articular proliferation of new bone and periosteal reaction primarily affecting the ulna. Histopathological examination of an incisional biopsy of the right ulna revealed neoplastic proliferation of epithelial cells; this was confirmed as a poorly differentiated carcinoma with immunohistochemistry. Amputation of the right fore limb was performed at the owner's request. After surgery, radiographs of the limb showed progression of bone proliferation. Repeat pathological analysis confirmed a metastatic carcinoma. The cat deteriorated 3 days after surgery and was euthanased a week later as a result of severe respiratory distress. This case represents an unusual case of metastasis of a suspected primary lung tumour to the ulna in a Burmese cat.     

Reversible pulmonary hypertension in a cat

A 13-year-old, neutered female domestic shorthair cat was presented for sudden respiratory distress following palliative radiotherapy and the combined administration of a single dose of carboplatin for the treatment of recurrent fibrosarcoma. Clinical and radiographic findings were suggestive of pleural effusion. Echocardiography revealed marked right-sided cardiac enlargement associated with tricuspid regurgitation and Doppler evidence of pulmonary hypertension. After 25 days of treatment for congestive heart failure and suspected pulmonary thromboembolism, clinical signs and echocardiographic and Doppler evidence of right-sided cardiac enlargement and pulmonary hypertension had completely resolved. To the best of the authors' knowledge, this is the first report of reversible pulmonary hypertension, likely secondary to pulmonary thromboembolism, in a cat.     

Diagnostic challenges: Equine thoracic neoplasia

The diagnosis of thoracic neoplasia in the horse can be difficult due to the nonspecific nature of the clinical signs and their overlap with other pulmonary diseases. Haematological and serum biochemical evaluation, thoracic ultrasonography, radiography, endoscopic examination, and, where appropriate, thoracocentesis and pleural fluid cytology may all be helpful in reaching a diagnosis. Granular cell tumours are the most frequently reported primary pulmonary tumours of horses. They occur as single or multiple masses adjacent to bronchi and bronchioles, and the mass typically extends into the airway, resulting in partial or complete occlusion of the lumen. Thymic tumours are classified as benign or metastatic, based on evidence of tissue invasiveness, even though they uniformly appear benign histologically. These tumours are derived from epithelial reticular cells of the thymus and are rare in horses. Other primary thoracic neoplasms originate from various pulmonary tissues and are primarily reported as single case reports: pulmonary and bronchial carcinoma and adenocarcinoma, bronchogenic squamous cell carcinoma, bronchial myxoma, pulmonary chondrosarcoma, pulmonary leiomyosarcoma and pleuropulmonary blastoma. Clinical signs of these primary pulmonary neoplasms are dependent on the tumour type and location, but commonly include chronic cough, weight loss, anorexia, fever and respiratory difficulty; ventral oedema, pleural effusion and epistaxis are also frequently observed. Mesothelioma is a rare primary pleural tumour arising from the mesothelium of the pleura, pericardium and peritoneum. The clinical presentation in horses includes weight loss, respiratory difficulty and large volume pleural effusion. The tumour appears ultrasonographically as multiple small nodules on a thick serosal surface and pleural biopsy is diagnostic. Lymphoma is the most common haematopoietic neoplasm in horses, which can present with 4 main manifestations of lesions: mediastinal, multicentric, alimentary and cutaneous. Common clinical features include chronic weight loss, lethargy, anorexia, subcutaneous oedema, lymphadenopathy, colic, bleeding tendency and diarrhoea. Coughing and laboured respiratory effort are often apparent in individuals suffering from mediastinal masses. In such instances, pleural effusion may result in severe pulmonary atelectasis and pulmonary function is significantly compromised. Haemangiosarcoma is the second most common metastatic thoracic neoplasm in horses. Disseminated haemangiosarcoma is aggressive and rapidly progressive. The clinical presentation often includes tachypnoea, pale or icteric mucous membranes, respiratory distress, epistaxis, and subcutaneous, cutaneous or intramuscular masses. Other tumour types that metastasise to the thoracic cavity include adenocarcinoma, squamous cell carcinoma, fibrosarcoma, metastatic melanoma, mastocytoma and undifferentiated sarcoma. The clinical features of these tumours are generally nonspecific and often relate more to the primary site of tumour formation.     

Metastasizing fibrosarcoma in a Wistar rat--case report

A 19-month-old male control Wistar rat from a 30-month inhalation study showed a subcutaneous greyish-white mass extending from the throat to the thoracic cavity. The rat had been euthanized because of its poor general condition. Histologically, the mass was diagnosed as a fibrosarcoma infiltrating the masseter muscle with metastases in the lungs, liver and heart. The primary tumour was characterized by fusiform spindle cells producing various amounts of interlacing bundles of collagen. The cells formed a characteristic herringbone pattern and mitotic figures were frequent. The histological parameters of the metastases were practically identical to those seen in the primary tumour. The diagnosis was confirmed by trichrome staining and positive immunostaining for vimentin and was differentiated from leiomyosarcomas by its negative immunostaining for desmin, from schwannomas by its negative immunostaining for S-100 and from malignant fibrous histiocytomas by the absence of giant cells. The incidence of fibrosarcomas in Wistar rats is very low (up to 3%) and metastasis is rarely observed.     

Uterine fibrosarcoma in a Warmblood mare

This paper describes a case of uterine fibrosarcoma in an 18-year-old Warmblood mare. The mare had exhibited bloody fluid accumulation inside the uterus and vaginal haemorrhagic discharge since the previous foaling. The mare was euthanized, and on pathological examination, in addition to the uterine neoplasia, multiple metastases were found in the lungs, liver and spleen. The histological and immunohistochemical examination determined that the tumour was a fibrosarcoma. To our knowledge, this is the first paper to describe a uterine fibrosarcoma in a mare.     

Treatment of fibrosarcoma in a maned wolf (Chrysocyon brachyurus) by rostral maxillectomy.

A 12-yr-old captive intact male maned wolf (Chrysocyon brachyurus) was diagnosed with a fibrosarcoma of the incisive bones. The mass was excised by rostral maxillectomy, and the wolf remained normal and on display with good function and cosmetics for 7 mo. Subsequently, it became weak, ataxic, and dyspneic and was euthanatized. At necropsy, there was a small regrowth of the maxillary tumor, a metastatic mediastinal mass, and multiple metastatic lung masses, suggesting that oral fibrosarcoma in maned wolves behaves similarly to oral fibrosarcoma in domestic canines. Aggressive surgical treatment of oral fibrosarcoma in this species can achieve good functional and cosmetic results.