Clinical and anatomical features of lymphosarcoma in 118 cats

Objective To determine patients' characteristics and anatomical distribution of lesions in cats with lymphosarcoma. Design Prospective multi-institutional study of naturally occurring feline lymphosarcoma. Methods Veterinarians in Sydney were provided with free diagnostic laboratory services for suspect cases of feline lym-phosarcoma. Lymphosarcoma was diagnosed based on physical findings, radiographic and/or ultrasonographic images and results of cytological or histopathological examination. When owners were not interested in pursuing an antemortem diagnosis, suspect cases were collected for necropsy. Patients' characteristics and physical findings were recorded. A modified scheme for anatomical classification of lesions was devised including a ‘mixed’ category for cases which involved two or more anatomical forms. Results One hundred and eighteen cases were accrued over an 18 month period. The median age was 120 months and range 5 to 212 months. Age distribution was bimodal, with a small peak for cats less than 24 months, and a normal distribution centred on 97 to 120 months. Eighty cats were domestic crossbreds, 22 were Siamese or Oriental cats (including crosses), 6 were Burmese, 5 were purebred longhairs and the remaining 5 were one of a number of purebred shorthaired breeds. In comparison to 1017 consecutive cases admitted to our hospital for conditions other than lymphosarcoma, Siamese/Oriental cats were over-represented amongst lymphosarcoma cases (P = 0.0006). Male cats were also over-represented, accounting for 72 of 118 cases (P = 0.05). Abdominal lymphosarcoma was the most common anatomical form (43 cats), followed by mixed (39), nodal (20), mediastinal (9) and atypical (involving non-lymphoid organs, 7) forms. When analysed for specific organ involvement, 29 (25%) had mediastinal involvement, 71 (60%) had abdominal involvement including 60 (51%) with involvement of the intestinal tract and/or mesenteric lymph nodes and 36 (31%) with bilateral renal involvement, and 47 (40%) had peripheral lymph node involvement. No case of primary lymphoid leukaemia was identified. A noticeable subgroup of cats younger than 24 months had involvement of the anterior mediastinum with or without concurrent enlargement of cervical or axillary lymph nodes; Siamese/Oriental cats were over-represented in this subgroup. Among cases with nodal involvement, lymph nodes of the head and neck were frequently involved, mandibular nodes most commonly, followed by superficial cervical nodes. In seven cases a solitary node was affected. Conclusions Compared with similar surveys overseas, our cats were older and male cats were over-represented. There was a notable subgroup of young cats with mediastinal involvement. Siamese/Oriental cats were over-represented in this subgroup as well as in the larger population of cats with lymphosarcoma. Compared with overseas surveys, renal involvement, mixed cases and atypical cases (including nasal lymphosarcoma) were more common. A new subcategory of nodal lymphosarcoma, with involvement restricted to node(s) of head and neck, was identified.     

Distinctive peripheral lymph node hyperplasia of young cats

Peripheral lymph node enlargement was found in 14 of a series of 132 feline lymph node biopsy specimens. Six of nine cats tested had antibodies for feline leukemia virus (FeLV). Half of the cats were clinically normal while the remainder had fever, lethargy, anorexia, and hepatosplenomegaly. There was severe distortion of lymph nodal architecture with variable loss of discernible follicles and sinuses. Histiocytes, lymphocytes, immunoblasts, and plasma cells were present in expanded paracortical regions which encroached on, and occasionally effaced, lymphoid follicles. Postcapillary venules were numerous and prominent throughout the paracortex. The lymphadenopathy was most commonly transient (86% of cases) with subsequent development of lymphoma in one cat. Lymph nodes from seven kittens with experimental FeLV infection were compared with spontaneously enlarged lymph nodes; four of seven had B and T lymphocyte hyperplasia with normal nodal architecture. Three had partial loss of nodal architecture as a result of expanded paracortical regions populated largely by histiocytes and lymphocytes. Proliferation of postcapillary venules was not prominent in nodes from FeLV-infected cats. The cause of spontaneous lymph node hyperplasia of young cats was not determined. However, the similarity of lesions to those of kittens with experimental FeLV infection and the association with FeLV by serologic tests in six of nine cats suggest that this retrovirus may be involved in the pathogenesis of the lesion.     

Evaluation of the effects of nephrotomy on renal function in clinically normal cats

OBJECTIVE: To evaluate the effects of nephrotomy on renal function in clinically normal cats. ANIMALS: 20 specific-pathogen-free, 9- to 11-month-old female mixed-breed cats. PROCEDURE: Serum chemistry analyses, CBC determinations, urinalyses, microbiologic urine cultures, renal ultrasonography, abdominal radiography, and single-kidney and total glomerular filtration rate (GFR) determinations by use of renal scintigraphy and measurements of plasma disappearance of technetium 99m-diethylenetriaminepentaacetic acid were performed before surgery and at 3, 12, 26, 52, and 78 weeks after surgery in 10 cats that underwent unilateral nephrotomy and in 10 control cats that underwent a sham surgical procedure. RESULTS: Two cats (1 from each group) did not complete the study, and their data were eliminated from analyses. Unilateral nephrotomy resulted in a 10% to 20% reduction in mean single-kidney GFR, compared with that of nephrotomy contralateral control kidneys. However, mean total GFR in nephrotomy-group cats was not significantly different from that of sham-group cats. Over the 78 weeks of study, mean total GFR declined 34% and 40% in nephrotomy- and sham-group cats, respectively. Adverse events associated with nephrotomy included persistent microscopic hematuria, renal pelvis hyperechogenicity with distant shadowing on ultrasonographic evaluation, dilatation of renal pelves, and hydronephrosis. CONCLUSIONS AND CLINICAL RELEVANCE: Nephrotomy in normal functioning feline kidneys results in a modest relative reduction in renal function, compared with contralateral kidney controls, but has minimal effect on total GFR when compared with sham-operated control cats. However, any detrimental effects of nephrotomy may be magnified in cats with diseased kidneys, which may have little or no capacity for repair or compensation.     

ULTRASONOGRAPHY OF ALIMENTARY LYMPHOSARCOMA IN THE CAT

Clinical, radiological and ultrasonographic findings from 22 cats with gastrointestinal lymphosarcoma were reviewed. The most common clinical findings were anorexia, weight loss, vomiting, lethargy, depression, fever, anemia and a palpable abdominal mass. Abdominal radiographs of 12 cats revealed a mass associated with the gastrointestinal tract and/or mesentery, and decreased serosal detail, suggestive of peritoneal effusion. The most common ultrasonographic finding was transmural gastric or intestinal thickening associated with loss of normal wall layering, reduced wall echogenicity and localized hypomotility. As is noted in people, other patterns such as transmural-segmental, transmural-nodular, transmural-bulky and mucosal infiltration were represented. In 3 cats, mesenteric lymph-adenopathy was responsible for most of the mass-effect. Fine-needle aspiration biopsy, automated microcore biopsy, endoscopic biopsy or necropsy confirmed the diagnosis of lymphosarcoma in all cats. Chemotherapy was instituted in 19 cats. Only 6 cats had a complete response to treatment. The results of this study indicate that ultrasonography is a valuable tool for the diagnosis of feline alimentary lymphosarcoma and that biopsies can be obtained under ultrasonographic guidance.     

Correlation of cytologic and histopathologic findings with perinodal echogenicity of abdominal lymph nodes in dogs and cats

Abdominal lymphadenopathy in dogs and cats is routinely investigated with ultrasound. As the determination between benign and neoplastic etiologies of lymphadenopathy affects patient management, specific sonographic characteristics associated with both benign and neoplastic lymph nodes have been suggested. However, a significant overlap between these characteristics exists, necessitating a cytologic or histopathologic diagnosis in most instances. The objectives of this retrospective, cross‐sectional study were to evaluate whether echogenicity of perinodal fat could be a discriminator between benign and neoplastic abdominal lymphadenopathy and to assess if additional sonographic features associated with malignancy could be identified in lymph nodes with hyperechoic perinodal fat. Small animal patients (257 dogs and 117 cats) with sonographic evidence of abdominal lymphadenopathy and a cytological or histopathological diagnosis were evaluated for differences in the proportions of sonographic features between benign and neoplastic groups. Greater maximum long axis diameter (in dogs and cats) and a greater number of abnormal lymph nodes (in cats) were associated with malignancy in lymph nodes with hyperechoic perinodal fat. Canine lymph nodes with round cell neoplasia were significantly more likely to have hyperechoic perinodal fat. Lymph nodes affected with other neoplasia or with lymphadenitis were equally likely to have normal or hyperechoic perinodal fat. Reactive lymph nodes were significantly less likely to have hyperechoic perinodal fat in both species. These results suggest that though echogenicity of perinodal fat is a nonspecific finding, abdominal lymph nodes with hyperechoic perinodal fat are less likely to be reactive and sampling of these lymph nodes may be indicated.     

ASSOCIATION BETWEEN MALIGNANCY AND SONOGRAPHIC HETEROGENEITY IN CANINE AND FELINE ABDOMINAL LYMPH NODES

Abdominal lymph node enlargement is frequently noted sonographically. Certain sonographic features can be used to suggest whether lymphadenopathy is more likely benign or malignant. Specific changes in size, shape, echogenicity, and Doppler flow patterns have an association with malignancy. In this retrospective case-control study, the association between abdominal lymph node heterogeneity and malignancy was evaluated. Twenty-three canine and 18 feline patients with ultrasonographically heterogeneous abdominal nodes were evaluated for presence of benign or malignant lymphadenopathy. Controls were animals with lymph node enlargement of uniform echogeneity. Twenty-one (91%) of heterogeneous canine lymph nodes were malignant, and there was a significant association between heterogeneity and malignancy in canine abdominal lymph nodes (P= 0.024). Seven (63%) heterogeneous feline lymph nodes were malignant, with no significant association between heterogeneity and malignancy (P = 0.537).     

Laboratory profiles in cats with different pathological and immunohistochemical findings due to feline infectious peritonitis (FIP)

Blood was collected from 55 cats with feline infectious peritonitis (FIP) and from 50 control cats in order to define whether differences in pathological findings and in distribution of feline coronaviruses (FCoV) can be associated with changes in haemograms, serum protein electrophoresis, and antibody titres. Compared to controls, the whole group of FIP-affected cats had blood changes consistent with FIP. Based on the pathological findings or on the immunohistochemical distribution of viral antigen, FIP-affected cats were divided in the following groups: subacute against acute lesions; low against strong intensity of positivity; intracellular against extracellular positivities; positive against negative lymph nodes. Lymphopenia was more evident in cats with acute forms, strong intensity of positivity, extracellular antigen and negative lymph nodes. Cats with positive lymph nodes had the most evident changes in the protein estimations. These results suggest that differences in pathological findings might depend on different reactive patterns to the FCoVs.     

Characterization of morphologic changes and lymphocyte subset distribution in lymph nodes from cats with naturally acquired feline immunodeficiency virus infection.

Lymph nodes were collected at biopsy or necropsy from 18 cats with naturally acquired symptomatic feline immunodeficiency virus (FIV) infection and from 18 seronegative cats. Thirty-five of the cats were domestic shorthairs and one was a Persian cross. The cats ranged from 7 months to 16 years of age and were mainly obtained from California veterinary practitioners, a California cattery, and a Veterinary Teaching Hospital. Based on clinical signs present at tissue collection, ten FIV-infected cats fell into the acquired immunodeficiency syndrome (AIDS)-related complex (ARC) clinical stage and eight in the terminal (AIDS) stage of FIV disease. All cats were FeLV negative by antigen ELISA. Histologic sections of lymph nodes from each cat were examined blindly and were categorized as hyperplastic, involuting, mixed hyperplastic and involuting, depleted, or normal based upon subjective evaluation of follicles and paracortex. The relative abundance of plasma cells was evaluated in methyl green pyronin (MGP) and hematoxylin and eosin-stained sections. Similar numbers of FIV-seropositive and -seronegative cats fell into each lymph node category. The only difference evident between FIV-infected cats and control cats was in the degree of plasmacytosis present; moderate to marked plasmacytosis was present in 13/18 FIV-infected cats but in only 3/18 control cats.(ABSTRACT TRUNCATED AT 250 WORDS)     

Quantification of the effect of various patient and image factors on ultrasonographic detection of select canine abdominal organs.

We assessed factors that affected ultrasonographic visualization of the pylorus, duodenal papilla, pancreas, adrenal glands, and jejunal and medial iliac lymph nodes in the dog. An abdominal ultrasonographic examination was performed on 100 canine patients, equally divided between two facilities. The pylorus was visible in 64% of the dogs, the major duodenal papilla in 42%, the left pancreatic lobe in 56%, the body of the pancreas in 60%, the right pancreatic lobe in 87%, the left adrenal gland in 91%, the right adrenal gland in 86%, the medial iliac lymph nodes in 54%, and the jejunal lymph nodes in 51%. The parameters that negatively influenced the visibility of these organs were the presence of air or food in the gastrointestinal tract (pancreas, duodenal papilla), age (lymph nodes), and body weight (pancreas, duodenal papilla). The parameters that positively influenced their visibility were the presence of air or food in the gastrointestinal tract (lymph nodes), body weight (lymph nodes), body condition score (right adrenal gland), and inherent image quality (left pancreatic lobe). There was a significant difference between the two institutes for the visualization of the pylorus, pancreas, and lymph nodes, which was probably related to different body positions used for scanning in each institution.     

ULTRASONOGRAPHIC EXAMINATION OF ABDOMINAL LYMPH NODES IN THE DOG

Ultrasonography is a valuable diagnostic tool for examination of the abdomen. Normal lymph nodes are often indistinct during routine abdominal ultrasonographic examination. Lymph nodes altered by infiltrative or inflammatory processes may become sonographically visible due to enlargement and/or altered echogeńicity. A working knowledge of the anatomic distribution of lymph nodes and the scheme of lymphatic drainage is important for increasing the sensitivity and specificity of abdominal lymph node assessment during ultrasonographic examination.     

Abscess-forming inflammatory granulation tissue with Gram-positive cocci and prominent eosinophil infiltration in cats: possible infection of methicillin-resistant Staphylococcus

We occasionally encounter feline cervical or mesenteric lesions diagnosed histopathologically as abscess or inflammatory granulation tissue with eosinophil infiltration. Gram-positive cocci accompany the lesions. In the present study, such lesions obtained from 27 cats were examined to evaluate the histopathologic features and the nature of the causative bacteria. The average age was 7.3 +/- 3.5 years. No sex predilection was observed. Most frequent locations of the lesions included the abdominal cavity with/without mesenteric lymph nodes (11/27, 41%) and subcutaneous tissue or lymph nodes of the neck (9/27, 33%). Common clinical presentation was a localized mass. Grossly, the lesions contained abscesses in the center and were surrounded by fibrous tissue. Microscopically, the necrotic zone contained bacterial colonies. Large numbers of eosinophils and macrophages infiltrated the area surrounding the necrotic tissue. The surrounding connective fiber-rich granulation tissue demarcated the eosinophilic abscess. The bacteria were Gram-positive cocci in 23 of the 27 cats and were positive for anti-staphylococcus antiserum in 19 of the 23 cats. In 15 out of 17 lesions, the colonies expressed immunoreactivity to penicillin-binding protein 2', which is a drug-resistance gene product of methicillin-resistant Staphylococcus (MRS) species. These findings suggest strongly that MRS causes this type of infectious lesion.     

Influence of thymectomy on the susceptibility of cats to feline leukemia virus and lymphosarcoma.

Twelve cats were thymectomized at 5 weeks of age. Six of these cats were inoculated at 8 weeks of age and 6 at 4 months of age with the Rickard (R) strain of feline leukemia virus (FeLV), which produces a high incidence of thymic lymphosarcoma. Two groups of age-matched nonthymectomized cats were inoculated with the same FeLV-R stock. Thymectomy prior to FeLV infection had no influence on the induction of viremia or the incidence of lymphosarcoma. In the FeLV-inoculated nonthymectomized cats, lymphosarcoma developed in the thymus. In the thymectomized cats, lymphosarcoma developed in the intestine, mesenteric lymph nodes, and bone marrow, but the malignant lymphoblasts had surface markers characteristic of feline T lymphocytes. It was concluded that the presence of the thymus per se is not required for infection and oncogenesis by FeLV and that feline T lymphocytes may be transformed after peripheralization to other tissues.     

Evaluation of serum feline pancreatic lipase immunoreactivity and helical computed tomography versus conventional testing for the diagnosis of feline pancreatitis

Serum feline trypsinogen-like immunoreactivity (fTLI) concentrations and abdominal ultrasound have facilitated the noninvasive diagnosis of pancreatitis in cats, but low sensitivities (33% and 20–35%, respectively) have been reported. A radioimmunoassay has been validated to measure feline pancreatic lipase immunoreactivity (fPLI), but the assay's sensitivity and specificity have not been established. In human beings, the sensitivity of computed tomography (CT) is high (75–90%), but in a study of 10 cats, only 2 had CT changes suggestive of pancreatitis. We prospectively evaluated these diagnostic tests in cats with and without pancreatitis. In all cats, serum was obtained for fTLI and fPLI concentrations, and pancreatic ultrasound images and biopsies were acquired. Serum fPLI concentrations ( P <.0001) and ultrasound findings ( P = .0073) were significantly different between healthy cats and cats with pancreatitis. Serum fTLI concentrations ( P = .15) and CT measurements ( P = .18) were not significantly different between the groups. The sensitivity of fTLI in cats with moderate to severe pancreatitis was 80%, and the specificity in healthy cats was 75%. Feline PLI concentrations were both sensitive in cats with moderate to severe pancreatitis (100%) and specific in the healthy cats (100%). Abdominal ultrasound was both sensitive in cats with moderate to severe pancreatitis (80%) and specific in healthy cats (88%). The high sensitivities of fPLI and abdominal ultrasound suggest that these tests should play an important role in the noninvasive diagnosis of feline pancreatitis. As suggested by a previous study, pancreatic CT is not a useful diagnostic test for feline pancreatitis.     

ULTRASONOGRAPHIC CHARACTERIZATION OF FELINE ILEOCECOCOLIC ABNORMALITIES

The clinical signs of 29 cats with ultrasonographic abnormalities at the ileocecocolic junction were reviewed. Twenty‐eight cats had gastrointestinal signs, with acute vomiting and diarrhea being most prevalent. Eighteen of 29 cats had enlarged cecal lymph nodes. Focal hyperechoic mesenteric fat was noted in 18 of 29 cats, and mild focal fluid accumulation was seen in seven of 29 cats. Six cats had a round cecum, and eight cats had cecal content. The cecal wall was thickened in 19 cats, and the ileal wall was mildly thickened in six cats. Three cats had changes involving the ascending colon adjacent to the ileocecocolic junction. Fourteen cats had no ultrasonographic evidence of changes in the remainder of the gastrointestinal tract, and 13 of these 14 cats were symptomatic for gastrointestinal disease. Four cats with resolution of the ultrasonographic changes also had resolution of clinical signs. These results suggest that ultrasonographic abnormalities at the level of the ileocecocolic junction in cats are clinically significant and are seen in cats with acute vomiting or diarrhea. Fine‐needle aspirates and biopsies of the ileocecocolic area had a low diagnostic yield. When no other gastrointestinal abnormalities are detected, we therefore recommend follow‐up ultrasound examinations of these patients.     

Prevalence of the polycystic kidney disease and renal and urinary bladder ultrasonographic abnormalities in Persian and Exotic Shorthair cats in Italy

The ultrasonographic findings of kidneys, liver and urinary bladder of 288 Persian and 44 Exotic Shorthair clinically normal cats that underwent screening for polycystic kidney disease (PKD) between July 2003 and December 2005 were reviewed. Cats were divided into two groups, one including cats aged <9 months (group 1) and one cats aged >/=9 months (group 2). Cats were classified as PKD-positive when at least one renal cyst was found. One hundred and thirty-six cats (41.0%) had more than one cyst in at least one kidney. The prevalence of PKD was similar in both groups. Eight PKD-positive cats had cystic livers (5.9%). Other renal abnormalities included a pelvic calculus and a medullary rim sign (MRS). The difference in prevalence of an MRS in group 2 compared to group 1 and the difference between PKD-positive and -negative cats in group 2 were not significant. There was no difference in mean kidney length between PKD-positive and -negative cats in group 2. Urinary bladder anomalies were principally represented by urinary sediment, with prevalence significantly higher in group 2. No difference was detected in group 2 between PKD-positive and -negative cats. In conclusion feline PKD is common in Italy. The ultrasonographic findings of MRS and urinary bladder sediment did not correlate with feline PKD. Urinary bladder sediment is common in Persians and Exotic Shorthairs and more likely in adults.     

Ultrasonography and noncontrast computed tomography of medial retropharyngeal lymph nodes in healthy cats

Objective-To determine various measurements of medial retropharyngeal lymph nodes (MRPLNs) in healthy cats via ultrasonography and CT. Animals-45 cats (age range, 2 to 8 years). Procedures-Cats underwent CT of the head and ultrasonography of the cervical region. Various measurements of MRPLNs were obtained, and parenchymal heterogeneity, presence of a hilus, appearance of margins, and attenuation of MRPLNs were determined. Results-Data for 7 cats were excluded because they did not meet inclusion criteria; data for 38 cats were evaluated. Measurements of left and right MRPLNs were not significantly different. Mean length × rostral height × rostral width dimensions of MRPLNs were 20.7 × 12.4 × 3.7 mm and 20.7 × 13.1 × 4.7 mm in ultrasonographic and CT images, respectively. Maximum MRPLN dimensions were approximately 32 × 20 × 7 mm. Mean attenuation of MRPLNs was 40.2 Hounsfield units. Parenchyma of MRPLNs was mildly (via CT) to moderately (via ultrasonography) heterogeneous. A hilus was identified in 95% (via ultrasonography) and 24% or 92% (via CT [depending on criteria used to define a hilus]) of MPRLNs. Lymph node margins were smooth in CT images and mildly irregular in ultrasonographic images. A negative linear correlation was detected between age of cat and MRPLN volume. Conclusions and Clinical Relevance-MRPLNs in cats were easily imaged via ultrasonography and CT. Left and right MRPLNs were symmetric, and MRPLNs were larger in young adult cats versus old cats. Data were intended to serve as references for evaluation of MRPLNs in healthy cats.     

CORRELATIVE ULTRASOUND ANATOMY OF THE FELINE BRACHIAL PLEXUS AND MAJOR NERVES OF THE THORACIC LIMB

Brachial plexus avulsions commonly occur in cats due to traumatic injuries involving the shoulder. Ultrasound may be an effective method for detecting injured nerves. Additional applications may include characterization of brachial plexus neoplasms and guidance of anesthetic nerve blocks. Aims of this study were to describe ultrasonographic approaches and the normal appearance of this plexus and other major nerves of the thoracic limb in cats. Eight feline cadavers were used to determine anatomic landmarks, obtain cross‐sectional anatomic images of the target nerves, and compare these with ultrasound images. An ultrasonographic study was performed in five fresh feline cadavers to assess the brachial plexus and its major components at the levels of the axilla and proximal, middle and distal (lateral and medial approaches) humeral regions. Five healthy adult cats were recruited for an in vivo ultrasonographic study using the same protocol described for the cadaver ultrasonographic study. The roots of the brachial plexus appeared as a cluster of small, round hypoechoic structures surrounded by a hyperechoic rim in the axillary approach. The radialis, medianus, and ulnaris nerves were individually visualized on proximal and middle humeral approaches. The medianus and ulnaris nerves were easily identified on the medial aspect of the humerus in the distal approach. The superficial branch of radialis nerve was seen on the lateral aspect of the distal humerus approach. The nerves appeared as oval‐to‐round hypoechogenic structures with a hyperechogenic rim. Future studies are needed to compare findings from this study with those in cats with confirmed brachial plexus injuries or other lesions.     

Effect of nephrotomy on renal function and morphology in normal cats

OBJECTIVE: To assess effects over 12 weeks of bisection nephrotomy on renal function, size, and morphology in cats. STUDY DESIGN: Controlled, randomized, blinded experiment. SAMPLE POPULATION: Ten adult female cats. METHODS: Glomerular filtration rate (GFR), determined by quantitative renal scintigraphy using (99m)Technetium-diethylenetriamine-pentaacetic acid, urinalysis, urine culture, and ultrasonographic measurement of renal size were performed preoperatively. Left or right nephrotomy (5 cats/group) was performed. Total and individual kidney GFRs were determined at 2, 28, and 84 days, ultrasonographic measurements at 28 and 86 days, and ultrasound-guided biopsy at 86 days. RESULTS: No significant differences in mean GFR and kidney size of operated versus unoperated kidneys were observed. Individual GFR and renal size of all except 1 cat remained within normal limits. Two cats had evidence of transient ureteral obstruction in the immediate postoperative period. No significant, generalized histologic abnormalities were observed. CONCLUSIONS: Bisection nephrotomy in normal cats does not adversely affect renal function or morphology during the initial 12 weeks. CLINICAL RELEVANCE: Bisection nephrotomy can be safely performed in normal feline kidneys without causing a significant deleterious effect on renal function. Studies in cats with pre-existing renal insufficiency are needed to ensure adverse effects would not occur in clinical cases where this surgical procedure is warranted.