Atypical manifestations of feline inflammatory polyps in three cats

Inflammatory polyps of the feline middle ear and nasopharynx are non-neoplastic masses that are presumed to originate from the epithelial lining of the tympanic bulla or Eustachian tube. The exact origin and cause are unknown, however, it is thought that inflammatory polyps arise as a result of a prolonged inflammatory process. It is unclear whether this inflammation initiates or potentiates the development and growth of inflammatory polyps. Cats with inflammatory polyps typically present with either signs of otitis externa and otitis media or with signs consistent with upper airway obstruction. Traditional diagnostics involve imaging of the tympanic bulla either with skull radiographs or computed topography (CT). Treatment consists of traction and avulsion of the polyp with or without ventral bulla osteotomy (VBO) to remove the epithelial lining of the tympanic bulla. The three cases described here are unusual manifestations or presentations of feline inflammatory polyps that address the following issues: (1) concurrent otic and nasopharyngeal polyps, (2) potential association with chronic viral infection, (3) polyp development in the contralateral middle ear, (4) CT appearance of the skull following VBO, and (5) development of secondary pulmonary hypertension.     

Nasopharyngeal polyps in cats

Nasopharyngeal polyps are non-neoplastic, inflammatory growths that arise from the middle ear or the eustachian tube and extend into the pharynx. The exact etiology of nasopharyngeal polyps is unclear; proposed etiologies include a response to chronic upper respiratory tract infection, chronic otitis media, ascending infection from the nasopharynx, or a congenital origin. Clinical signs usually relate to obstruction of the nasopharynx, with Horner's syndrome and head tilt being consistent with otitis media and otitis interna, respectively. Diagnostic tools include digital or visual examination above the soft palate, flexible fiberoptic caudal rhinoscopy, radiography, computed tomography, and magnetic resonance imaging. Ventral bulla osteotomy combined with traction removal of the polyp is the recommended treatment, although traction only followed by prednisolone therapy can be considered in some cases, especially when there is no evidence of otitis media.     

Ileal polyps in Siamese cats

Intestinal obstruction occurred in a 2-year-old Siamese cat with a mucosal polyp in the lower ileum. A daughter of this cat also developed an intestinal obstruction at 21/2 years of age; a similar lesion was found on her ileum. The cause of these polyps is not known, but the familial occurrence in young animals suggests an hereditary influence.     

Analysis of auditory and neurologic effects associated with ventral bulla osteotomy for removal of inflammatory polyps or nasopharyngeal masses in cats

OBJECTIVE: To determine whether cats undergoing ventral bulla osteotomy (VBO) for removal of inflammatory polyps or nasopharyngeal masses have altered ability to hear and whether polyp or mass removal affects auditory function as measured via air-conducted brainstem auditory evoked response (BAER). DESIGN: Prospective case series. ANIMALS: 21 cats. PROCEDURES: Cats were sedated and had otic-oral examinations to confirm presence of nasopharyngeal masses; BAER testing was done immediately prior to and following the completion of a VBO and polyp or mass removal. Recheck examination, including otic examination and BAER in sedated cats, was performed when possible. Results-17 cats met final inclusion criteria, and long-term follow-up was available for 15. Six of 17 had deafness as measured via air-conducted BAER prior to surgery. Mean followup time was 161 days, and there was no change from presurgical status in auditory ability in any cat. Eleven of 17 developed ipsilateral Horner syndrome in the immediate postoperative period, and 1 of 16 had polyp regrowth. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that in cats, VBO for removal of inflammatory polyps or masses is unlikely to affect hearing as measured via air-conducted BAER. Most cats developed short-term Horner syndrome. Cats with deafness prior to surgery did not regain auditory function. Ventral bulla osteotomy to remove nasopharyngeal polyps or masses provided no functional advantage with regard to restoration of hearing, compared with other surgical techniques. Polyp recurrence and long-term adverse effects were uncommon.     

Resection of inflammatory polyps in dogs using laparoscopic-assisted cystoscopy

Inflammatory polyps in the urinary bladder of two dogs were removed via laparoscopic-assisted cystoscopy. In addition, one dog had a calculus removed and liver biopsies taken using the same two trocar sites. The laparoscopic-assisted cystoscopic technique provided clear surgical margins and permitted a thorough examination of the inside of the bladder and urethra. The technique was minimally invasive, produced little abdominal injury, and limited urine contamination of the abdomen.     

Obstructive inflammatory laryngeal disease in three cats

Three cats with upper respiratory tract obstruction due to laryngeal inflammation are presented. Cervical radiography showed the presence of a soft tissue mass in the laryngeal region in all cases, and laryngoscopy allowed direct visualization of a mass associated with the larynx. Laryngeal samples were obtained by a combination of fine needle aspiration, cutting biopsy forceps, by ventral laryngotomy, and at post-mortem. Histopathology of the laryngeal samples showed the presence of a predominantly granulomatous inflammation, with macrophage and lymphocyte infiltration. One case was euthanased due to severe dyspnoea. The remaining two cases underwent combined medical (corticosteroid and antibiotic) and surgical (permanent tracheostomy or excision of laryngeal tissue by ventral laryngotomy) treatment. One case died of an undetermined cause 15 weeks after surgery while the other case remains clinically well 20 months after diagnosis. Recognition of the existence of granulomatous laryngitis is important as clinical signs and radiographic findings are indistinguishable from laryngeal neoplasia.     

A retrospective study of inflammatory colorectal polyps in miniature dachshunds

Medical records of dogs with colorectal polyps were retrospectively reviewed, and clinical presentation of inflammatory colorectal polyps in miniature dachshunds was evaluated. Of 33 dogs found to have colorectal polyps, miniature dachshunds were markedly over-represented with 16 dogs (48%), of which 12 (75%) were found to have inflammatory polyps. Multiple polyps localized between the rectum and the descending colon was the most common finding in miniature dachshunds with inflammatory polyps. Twenty dogs (80%) out of 25 miniature dachshunds with inflammatory colorectal polyps responded to immunosuppressive therapy using prednisolone and cyclosporine. The results of this study indicate that miniature dachshunds are predisposed to develop inflammatory colorectal multiple polyps, for which immunosuppressive therapy may be a treatment option.     

Toxoplasmosis in two cats with inflammatory intestinal disease

Lymphocytic-plasmacytic enteritis, a chronic inflammatory intestinal disease, was diagnosed in 2 cats. In 1 cat, recurrence of clinical signs after initiating treatment was attributed to relapse of the inflammatory intestinal disease, but was found to be attributable to relapsing toxoplasmosis secondary to immunosuppressive drug therapy. Treatment with clindamycin resolved the recurrent toxoplasmosis. In the second cat, clinical signs of toxoplasmosis did not develop, but serologic testing yielded evidence of active toxoplasmosis. Treatment with clindamycin caused the titers to decrease. Relapsing toxoplasmosis may be responsible for apparent resistance to treatment in cats for inflammatory intestinal disease being treated with immunosuppressive drugs.     

Recurrent demyelination and remyelination in 37 young Bengal cats with polyneuropathy

Background: With the exception of diabetic neuropathy, polyneuropathy associated with hyperchylomicronemia, and a few inherited polyneuropathies, peripheral neuropathies are poorly characterized in cats. A chronic polyneuropathy is described in a cohort of young Bengal cats. Objective: To characterize the clinical and histopathological features of a chronic‐relapsing peripheral neuropathy in young Bengal cats. Animals: Thirty‐seven young Bengal cats with clinical weakness consistent with peripheral neuropathy. Methods: Bengal cats were included in this study after a diagnosis of polyneuropathy was confirmed by muscle and peripheral nerve biopsy specimens. Pathological changes were characterized at the light and electron microscopic level and by morphometry. Clinical information and long‐term outcome from case records of Bengal cats with histologically confirmed peripheral neuropathy were then assessed. Results: Nerve fiber loss within distal intramuscular nerve branches was a consistent finding in young Bengal cats with polyneuropathy. The most common abnormalities in peripheral nerve biopsies included inappropriately thin myelin sheaths and thinly myelinated fibers surrounded by supernumerary Schwann cell processes, indicative of repeated cycles of demyelination and remyelination. Recovery was common. Response to treatment could not be determined. Conclusions and Clinical Importance: A chronic‐relapsing form of polyneuropathy associated primarily with episodes of demyelination and remyelination was identified in young Bengal cats. The prognosis for recovery is good, although relapses are possible and there can be residual motor deficits.     

Chylothorax in cats: 37 cases (1969-1989)

Case records of 37 cats with chylothorax examined at 2 institutions were retrospectively evaluated. Dyspnea and coughing were the most common abnormalities noticed by the owners, and most cats were dyspneic on initial examination. There was no statistically significant difference in the gender distribution of cats studied when compared with reference populations; however, purebred cats appeared to be overrepresented in the study population. Four of the cats had unilateral pleural effusion (2 left side, 2 right side) and 9 cats had effusions that were primarily, but not exclusively, on the right side. Surgery was performed on 20 cats. Fifteen cats underwent thoracic duct or cisterna chyli ligation; 20% had complete resolution of pleural fluid. There was no significant difference in the survival rate of cats that underwent thoracic duct ligation and those that were treated by other means. Six cats had mesenteric lymphangiography performed; 2 cats had normal results, and the remainder had various degrees of thoracic lymphangiectasia. Two cats in which pleuroperitoneal shunts were placed and 2 of 3 cats that underwent pleurodesis were euthanatized or died after surgery.     

Management of acute illness in cats

Pleural effusions can cause dyspnea and cyanosis, and are caused by cardiomyopathy, pyothorax, FIP, FeLV-related disease and trauma. Thoracentesis is used to obtain fluid samples for cytologic examination and culture. Radiographs made after thoracentesis may reveal the cause. Lymphosarcoma causes a sterile exudate containing neoplastic cells. Congestive cardiomyopathy causes a transudate or modified transudate. The sterile exudate of FIP has a proteinaceous background on cytologic examination. The exudate of pyothorax is septic. Treatment depends on the cause but generally includes thoracentesis and supportive care. Cardiomyopathy causes dyspnea, cyanosis, murmurs, gallop rhythms and other arrhythmias. Radiography reveals a globoid heart in the congestive form and a "valentine-shaped" heart in the hypertrophic form. Treatment of congestive cardiomyopathy involves use of furosemide, but is usually unrewarding. Hypertrophic cardiomyopathy is treated with propranolol. Fever may be caused by infection, immune-mediated disease, neoplasia and unknown causes. Treatment is aimed at removal of the underlying cause.     

Orbital inflammatory disease and pseudotumor in dogs and cats

Orbital disease is common in dogs and cats. Clinical signs include exophthalmos, protrusion of the third eyelid, and resistance to retropulsion of the globe. This article discusses diagnostic work-up for dogs and cats with signs suggestive of orbital disease. Diagnosis and treatment of nonneoplastic orbital diseases follows. Congenital diseases are discussed first, followed by inflammatory diseases of the orbit including orbital pseudotumor. Lastly, other less common orbital conditions are addressed.     

Management of spinal trauma in 69 cats

This study sought to evaluate a series of clinical and radiological findings on spinal trauma in cats and the outcome that emerged from conservative or surgical treatment using 2 types of spinal stapling: stabilization using a Steinmann pin and coated polypropylene. Case records were reviewed for their diagnostic approaches on the basis of physical and neurological conditions, and concurrent disorders in addition to spinal trauma. Radiological examinations of the vertebral column were carried out using survey radiography, myelography and epidurography. All cases were classified according to etiopathogenesis of the disease. Surgical treatment consisted of decompression (laminectomy, hemilaminectomy and durotomy), or decompression with stabilization which was performed by one of two methods. The first one was the employment of translaminar stapling at the base of a spinous process and the other involved spinal stapling at the spinous process. The spinal lesions were identified as cervical (n = 2), thoracic (n = 35), lumbar (n = 22), sacral and caudal (n = 10). While 19 out of 30 conservatively managed cases recovered, the rest had persistent residual paresis and ataxia. Complete recovery was seen in 4 cats that underwent hemilaminectomy and 3 subjected to laminectomy. Partial recovery was observed in 5 cases involving laminectomy; however, there was no improvement observed in another 2 cases. Each animal was followed for at least a 3-month period to evaluate the clinical assessment of the results following treatment. The results of conservative and operative management of spinal trauma indicated that the type and degree of spinal cord degradation strongly influenced any prognosis. The results emerging from decompressive procedures seemed satisfactory for those cases where instability was not an issue. Both stabilization techniques were not ideal in terms of their methodological versatility or regarding weaknesses of bone structure observed in intra- and postoperative periods. However, translaminar stapling at the base of a spinous process was deemed to be the superior technique.     

Retrospective study of the perioperative management and complications of ureteral obstruction in 37 cats

ObjectivesTo describe perioperative management and complications, risk factors and mortality rates in cats anaesthetized for treatment of ureteral obstruction.Study designRetrospective, clinical, cohort study.AnimalsThirty-seven client-owned cats anaesthetized for ureteral surgery.MethodsRecords with sufficient data for cats treated between March 2010 and March 2013 were examined for breed, age, gender, history, concurrent diseases, pre- and post-anaesthetic biochemical and haematological parameters, American Society of Anesthesiologists classification, anaesthetic protocol, surgical technique, surgeon, perioperative complications and mortality within 48 hours after extubation. Associations between risk factors and outcome variables were evaluated using univariable analysis. Odds ratios and 95% confidence intervals were calculated for significant parameters. Sensitivity and specificity using receiving operator characteristic curve analysis were calculated for creatinine, potassium level and standard base excess (SBE) to denote survival or non-survival.ResultsPreoperatively, all cats were azotaemic: mean ± SD urea was 31.6 ± 26.9 mmol L⁻¹ and median (range) creatinine was 562 μmol L⁻¹ (95 μmol L⁻¹ to off scale). Thirteen cats were hyperkalaemic (K⁺ > 6.5 mmol L⁻¹). Anaesthesia-related complications included bradycardia (n = 8, 21.6%), hypotension (n = 15, 40.5%) and hypothermia (n = 32, 86.5%). Seven cats (18.9%) died postoperatively. Non-survivors were significantly (p = 0.011) older (9.8 ± 1.9 years) than survivors (6.4 ± 3.1 years) and had higher potassium concentrations (p = 0.040). Risk factors associated with mortality were ASA classes IV and V (p = 0.022), emergency procedures (p = 0.045) and bicarbonate administration (p = 0.002). Non-survivors had higher creatinine concentrations (p = 0.021) and lower SBE (p = 0.030).Conclusion and clinical relevanceIntraoperative anaesthetic complications were common; increased age, poor health status, preoperative bicarbonate administration, hyperkalaemia and increased creatinine were associated with increased risk for death and can be used to predict risk for complications.     

A review of anaemia of inflammatory disease in dogs and cats

Anaemia of inflammatory disease is a common cause of anaemia in routine veterinary practice. It is most often mild to moderate, normocytic, normochromic and non‐regenerative. Shortened red cell life span, inhibition of iron metabolism and impaired bone marrow response to erythropoietin all contribute to its development. Although anaemia of inflammatory disease is a well‐known cause of anaemia in dogs and cats, there is a lack of epidemiological information because specific diagnostic criteria have not been established in veterinary species. Anaemia of inflammatory disease is associated with a poor outcome in various disease states in human medicine; however, its clinical significance and treatment in veterinary medicine are not well understood. This review article describes anaemia of inflammatory disease in dogs and cats and considers its potential significance.     

Comparisons between cats with normal and increased fPLI concentrations in cats diagnosed with inflammatory bowel disease

Objectives : The aim of this study was to compare age, serum albumin and cobalamin concentrations, serum alanine amino transferase and alkaline phosphatase activities, feline inflammatory bowel disease clinical disease activity index, pancreatic ultrasound findings, intestinal histopathology scores, outcome, treatment and clinical response between cats diagnosed with inflammatory bowel disease with normal or increased serum feline pancreatic lipase immunoreactivity concentrations. Methods : Medical records for 23 cats diagnosed with inflammatory bowel disease and with serum feline pancreatic lipase immunoreactivity concentrations available were reviewed. Three groups were compared; cats with serum feline pancreatic lipase immunoreactivity concentrations 2·0 to 6·8 µg/l (group A), 6·9 to 11·9 µg/l (group B) and ≥12·0 µg/l (group C). Results : Sixteen of the 23 cats had increased serum feline pancreatic lipase immunoreactivity concentrations; 9 cats in group B and 7 cats in group C. The remaining seven cats were in group A. Cats with serum feline pancreatic lipase immunoreactivity concentrations ≥12·0 µg/l had significantly lower median serum albumin and cobalamin concentrations. No significant differences were identified between the three groups for age, serum alanine amino transferase and alkaline phosphatase activities, feline inflammatory bowel disease clinical disease activity index, pancreatic ultrasound findings, intestinal histopathology scores, clinical outcome, treatment or clinical response. Clinical Significance : Hypoalbuminaemia and hypocobalaminaemia were more frequently observed in cats with serum feline pancreatic lipase immunoreactivity concentrations ≥12·0 µg/l.