Feline lymphangiosarcoma--definitive identification using a lymphatic vascular marker

Abstract   Three cases of feline exudative dermatitis associated with lymphangiosarcoma are described. The animals, an 11-year-old, neutered male and two 10-year-old, neutered female short hair European cats, presented with a 2-month history of transparent liquid oozing from the skin of the groin and caudal abdomen. On physical examination the neutered male cat and one of the females were slightly depressed and showed loss of weight. Skin lesions were similar in all cats and characterized by the presence of alopecia and moist dermatitis in the ventral abdomen, groin and inner thigh. The hair at the periphery appeared matted by the fluid. In all three cases, histopathological examination of skin biopsies from the abdomen identified poorly defined neoplasia involving dermis and subcutis, characterized by proliferation of spindle cells aligned along pre-existing collagen bundles. The dissection of collagen bundles gave rise to irregular shaped anastomosing, often blind-ending vascular channels and trabeculae. Vascular spaces were mostly optically empty. These histological features were strongly suggestive of lymphangiosarcoma. Neoplastic cells were positive for the blood vascular marker Von Willebrand factor, and a lymphatic vascular marker LYVE-1 (Lymphatic Vessel Endothelial receptor – 1), demonstrating the mixed vascular origin of the tumour. Ultrastructural findings confirmed the final diagnosis of lymphangiosarcoma.     

Dyspnoea and pulmonary consolidation in a cat with T-cell lymphoma

A 13-year-old male neutered domestic shorthair cat presented with an acute onset of dyspnoea. Thoracic radiographs revealed marked, bilateral, caudal lung lobe consolidation. A diagnosis of anatomically mixed T-cell lymphoma with pulmonary, renal and alimentary involvement was confirmed on histopathology. Pulmonary involvement in cases of feline lymphoma is uncommon and the radiographic appearance of pulmonary lymphoma is highly variable. Lung lobe consolidation has been described with primary lung tumours in cats, but not previously in association with pulmonary lymphoma. This unusual presentation serves to alert practitioners to the possibility of lymphoma as a cause of severe bronchopulmonary disease in the cat.     

Chronic progressive polyarthritis in a domestic shorthair cat

A 6-year-old, neutered male, domestic shorthair cat was presented with shifting leg lameness and palpable effusion of the carpal and tarsal joints. Blood work, arthrocentesis, and radiographs identified an immune-mediated erosive polyarthritis. The cat was positive for feline syncytia-forming virus, and with his signalment, was diagnosed with feline chronic progressive polyarthritis.     

Central hemimaxillectomy and reconstruction using a superficial temporal artery axial pattern flap in a domestic short hair cat

A 2-year-old, neutered male domestic short hair cat presented with a large mass involving the right upper lip and underlying gingiva. A previous attempt at mass excision had failed, and the histopathological diagnosis was reported to be a fibrosarcoma. The cat was otherwise in good health.A central hemimaxillectomy was performed with extensive soft-tissue dissection and maxillofacial reconstruction achieved using an axial pattern flap based on the superficial temporal artery. This is the first reported clinical case of the use of the superficial temporal artery axial pattern flap in the cat. Histopathology identified a periodontal fibromatous epulis.     

Feline porphyria associated with anemia, severe hepatic disease, and renal calculi

A 13-year-old, neutered male domestic cat presented with signs of weight loss, anemia, and hepatomegaly. Pathognomonic signs of porphyria were identified. Charcoal-like renal calculi and severe liver changes were observed, neither of which has been previously reported in association with feline porphyria.     

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.     

Congenital duplex gallbladder and biliary mucocele associated with partial hepatic cholestasis and cholelithiasis in a cat

A 6-year-old neutered male domestic shorthair cat was presented for acute onset of vomiting. Exploratory laparotomy identified a duplex gallbladder and left cholecystectomy was performed. Histopathology confirmed biliary mucocele and hepatic cholestasis. While rare, biliary mucoceles should be considered as a differential diagnosis for feline extrahepatic bile duct obstruction.     

Response of feline eosinophilic plaques and lip ulcers to amoxicillin trihydrate-clavulanate potassium therapy: a randomized, double-blind placebo-controlled prospective study

In this study, we evaluated the treatment of feline eosinophilic plaques and lip ulcers with amoxicillin trihydrate–potassium clavulanate (Clavamox^®; Pfizer Animal Health). Nineteen cats with clinical and cytological findings consistent with eosinophilic plaques and/or lip ulcers were enrolled. Lesions were photographed and their areas measured in square centimetres before and after 21 days of therapy with either flavoured amoxicillin‐clavulanate suspension or flavoured placebo suspension. Sixteen cats completed the study, with nine plaque lesions (four treatment and five placebo) and eight lip ulcer lesions (four treatment and four placebo) included in the analysis. All lesions were shown to have infection, with bacterial phagocytosis present on cytological examination. Coagulase‐positive staphylococci were the most commonly isolated bacteria. The amoxicillin‐clavulanate‐treated eosinophilic plaque group had a statistically significant 96.2% reduction in mean lesion size (?7.60 cm², P = 0.0078) and an 80% reduction in mean percentage of microscopic fields demonstrating evidence of bacterial infection (P < 0.0001), whereas the placebo group did not. The amoxicillin‐clavulanate‐treated lip ulcer group had a 42.6% decrease in mean lesion size (?0.25 cm², P = 0.4125) and the placebo group a 36.6% increase (+0.49 cm², P = 0.1575), although neither change was statistically significant. The amoxicillin‐clavulanate‐treated lip ulcer group had a statistically significant 65.0% reduction in mean percentage of microscopic fields demonstrating evidence of bacterial infection (P < 0.0001), while no significant reduction was observed in the placebo group. A suspension of amoxicillin trihydrate–potassium clavulanate is an effective monotherapy for the treatment of feline eosinophilic plaques.     

SPINAL SUBARACHNOID CYST IN A CAT

A 7-year-old neutered female domestic short hair cat was presented with hind limb ataxia. A subarachnoid cyst in the T10-T11 spinal cord region was identified by myelography as a collection of contrast medium in the subarachnoid space.     

Cutaneous lymphoid hyperplasia mimicking cutaneous lymphoma in a hyperthyroid cat

A 12-year-old neutered male domestic shorthair cat presented for chronic, localized, swelling and crusting of the left upper lip, weight loss, sporadic vomiting, and focal alopecia between the scapulae was diagnosed with hyperthyroidism and regional eosinophilic lymphadenitis. Treatment with methimazole exacerbated an underlying hypersensitivity disorder leading to marked generalized lymphadenopathy that histologically mimicked lymphoma.     

Defaecation syncope and pulmonary thromboembolism in a cat

A 7-year-old male neutered domestic shorthair cat was referred for worsening gastrointestinal and haematologic abnormalities. Physical status deteriorated further despite intravenous crystalloids, blood transfusion and nutritional support. Cardiorespiratory signs developed and the cat died suddenly while straining to defaecate. Diffuse thrombosis, pulmonary thromboembolism, metastatic pancreatic carcinoma and histologic evidence of cardiomyopathy were present at necropsy. This is the first reported case of feline pulmonary thromboembolism associated with defaecation syncope. Predisposing factors for thrombotic disease in this case and aspects of human defaecation syncope are discussed. The risk of clot dislodgement by the Valsalva manoeuvre in patients with a thrombotic tendency is highlighted.     

Generalized alopecic and cystic dermatosis in a cat: a counterpart to the hairless mouse phenotype or a unique congenital dermatosis?

A 2-year-old, male neutered, domestic semi-long-haired cat was presented with a 1.5-year history of progressive, initially nonpruritic alopecia and malodorous greasy exudate affecting the distal extremities, trunk and neck but sparing the head and tail. The extensive alopecia and 'seborrhoea' were associated with severe thickening of the skin and fold formation on the dorsal head and distal extremities as well as the lateral thorax and abdomen. The hair was easily epilated, numerous milia were seen on the ventral abdomen and the caudal and lateral thighs, and mild paronychia was present. Histopathological examination of skin biopsies revealed marked cystic dilation of hair follicles and sebaceous glands with follicular hypoplasia, infundibular hyperkeratosis and variable associated inflammation. Systemic glucocorticoid therapy in combination with topical washes with chlorhexidine and miconazole resulted in a marked improvement and some hair regrowth, but the cat was subsequently lost to follow-up. The dermatosis resembles a number of conditions in other species, but it is not clear whether it is a counterpart to the hairless mutant mouse or is a unique dermatosis.     

Hypereosinophilic paraneoplastic syndrome in a cat with intestinal T cell lymphosarcoma

A 10-year-old, neutered female, domestic shorthair cat was presented with a recent history of weight loss, polydipsia, diarrhoea and vomiting. On physical examination, intestinal thickening and mesenteric lymph node enlargement were apparent. Clinical investigations revealed peripheral blood eosinophilia, eosinophilic abdominal effusion and eosinophilic mesenteric lymphadenitis. There was a temporary response to treatment with glucocorticoids but signs progressed and the cat was euthanased. On histology, there was eosinophilic infiltration and fibroplasia of intestine and mesenteric lymph nodes. Large aggregates of neoplastic round cells in the intestine and lymph nodes were identified as T lymphocytes using immunohistochemistry. A diagnosis of intestinal T cell lymphosarcoma was made. This case demonstrates that hypereosinophilic paraneoplastic syndrome may occur in cats with lymphosarcoma. Eosinophil chemotaxis may be a response to the production of interleukin-5 by neoplastic lymphocytes.     

Feline demodicosis caused by an unnamed species

A case of feline demodicosis is described in this report. A 13-year-old spayed female domestic short hair cat weighing 4.5 kg was being treated with cefovecin and alternately with prednisone or methylprednisolone. On further physical examination, the cat showed mild erythema and hair loss on the bridge of the nose, around the eyes, on the chin, on the side part of the breast and on the abdomen. A large number of Demodex mites were found in deep skin scrapings from the affected areas. The cat was then treated with ivermectin at 600 μg/kg administered SC daily. After 4 weeks of treatment, the cat was clinically normal with no mites detected in the skin scrapings from the face or breast areas. The mite responsible may represent a previously seen but as yet unnamed new species. This is third report that describes a case of feline demodicosis caused by a different, unnamed mite species that has different morphological characteristics to those of known Demodex mites and may represent a previously seen but as yet unnamed species.     

Acute monoblastic leukemia in a FeLV-positive cat

A 1.6-year-old male domestic short hair cat was brought to the Veterinary Medical Teaching Hospital, Kasetsart University, with signs of severe anemia, depression, and general lymph node enlargement. Complete blood count revealed leukocytosis and massive undifferentiated blasts. Testing for antibodies specific to feline leukemia virus (FeLV) was positive, and FeLV nucleic acid was confirmed by nested polymerase chain reaction. Base on cytochemistry and ultrastructure, the cat was diagnosed with acute monoblastic leukemia.     

Nasopharyngeal trichobezoar foreign body in a cat

CASE SUMMARY: A 5-year-old male neutered indoor cat presented for evaluation and treatment of an acute onset of nasal discharge and open-mouth breathing of 3 days' duration. He had been treated for asthma prior to presentation, but his clinical signs were more consistent with upper airway disease. Thoracic radiographs were suggestive of asthma. However, a soft tissue mass was noted in the nasopharynx on a lateral cervical radiograph. Nasopharyngeal examination revealed the mass to be a trichobezoar (hair ball) lodged in the nasopharynx, removal of which led to resolution of clinical signs. The cat re-presented with a second nasopharyngeal trichobezoar approximately 1 year later, which was also successfully removed. CLINICAL SIGNIFICANCE: Nasopharyngeal disease has myriad potential infectious, inflammatory and neoplastic etiologies. However, simpler causes such as foreign bodies can be considered in cases of acute-onset nasopharyngeal disease. To the authors' knowledge, this is the first reported case of a nasopharyngeal trichobezoar foreign body in a cat.     

Proliferative and necrotizing otitis externa in four cats

Proliferative and necrotizing feline otitis externa is a rare disorder of unknown aetiology. This condition was diagnosed by skin biopsy in three adult domestic shorthair cats (3-5 years old) and one kitten (6 months old). The affected cats had large tan to dark brown-black coalescing plaques covering the concave surface of the pinnae and external ear canals. Friable material from the plaques and a thick exudate occluded the ear canals. The cats had a secondary bacterial and/or yeast otitis. Prior to the histopathological diagnosis, all cats received numerous otic preparations as well as oral antibiotics and corticosteroids without resolution. Histologically, all cases had strikingly similar changes; acanthosis with pronounced hair follicle outer root sheath hyperplasia and neutrophilic luminal folliculitis, follicular keratosis and individually necrotic keratinocytes in the outer root sheath of hair follicles. One case was documented via skin biopsy to have persisted for 4 years. The adult cats were treated with topical 0.1% tacrolimus and all showed marked improvement although one cat was lost to follow up. The lesions completely resolved with topical tacrolimus alone in one cat and topical tacrolimus in addition to oral prednisolone in another cat.     

Cerebral vascular hamartoma in a geriatric cat

An 11-year-old castrated male domestic medium hair cat was presented with neurological signs consistent with a right thalamocortical lesion. Computed tomography (CT) images revealed a heterogeneously, hyperattenuating, poorly contrast enhancing intra-axial mass within the right lateral ventricle. The histological diagnosis at post-mortem examination was vascular hamartoma with hemorrhage and necrosis. This is the first report of a vascular hamartoma affecting the thalamocortex in a geriatric cat. Also, this is the first time that CT images of a feline cerebral vascular hamartoma have been reported.     

Vancomycin for multi-drug resistant Enterococcus faecium cholangiohepatitis in a cat

A 12-year-old, neutered male domestic shorthair cat was evaluated with a life-long history of intermittent, predominantly small bowel diarrhea and a 3 day history of hematochezia. At presentation, the cat had increased liver enzyme activities and an inflammatory leukogram. Histopathology demonstrated inflammatory bowel disease (IBD), cholangiohepatitis and pancreatitis. The cholangiohepatitis was associated with a multi-drug resistant Enterococcus faecium. Gallbladder agenesis was also documented. Treatment with vancomycin was safely instituted for 10 days. Clinical signs resolved, however, cure of the bacterial cholangiohepatitis was not achieved. The risk of vancomycin resistant enterococci (VRE) in human and veterinary medicine is discussed.     

CUTANEOUS BOTRYOMYCOSIS IN TWO PET RABBITS

A 5-year-old male neutered rabbit was presented for assessment of multiple abscesses, which had appeared suddenly over the ventrum, perineum, and hindlimbs over the past few days. Thirteen abscesses were surgically excised. Culture revealed Pseudomonas aeruginosa and histopathological examination confirmed a diagnosis of botryomycosis. However, despite follow-up antimicrobial treatment and repeat surgeries, lesions continued to recur. The second case, a 3-year-old male neutered rabbit presented for routine vaccination. On physical examination, multiple small nodules were palpated over the right shoulder region. Surgical excision was performed and histopathology again yielded a diagnosis of botryomycosis. So far, no recurrence has been seen in this case. Botryomycosis is a rare chronic pyogranulomatous infection and naturally occurring disease has not been previously reported in pet rabbits. These cases highlight the challenges of treatment and the importance of prompt diagnosis.