Vitamin D-dependent rickets type 2 in a four-month-old cat

Vitamin D-dependent rickets type 2 in a four-month-old cat A 4-month-old male domestic shorthair cat was examined because of lethargy, vomiting, diarrhea, muscle tremors, and mydriasis. Laboratory evaluation revealed hypocalcemia, hyperphosphatemia, and high intact parathormone and calcitriol concentrations. Findings were compatible with a diagnosis of vitamin D-dependent rickets type 2. Treatment consisted of oral administration of calcium and calcitriol supplements. During the subsequent 18 months, the cat remained clinically normal. Treatment with oral calcium supplements was eventually discontinued, and the cat was able to maintain serum calcium concentrations within reference limits.     

Paracetamol toxicity in a cat

Paracetamol, a common human analgesic, is potentially fatal in the cat unless specific therapy is started early. A cat two and one half years old was referred for treatment 14 h after paracetamol had been administered (173 mg/kg). The cat was moribund and cyanotic and subsequently became anaemic and icteric. Treatment consisted of N-acetylcysteine, ascorbic acid and DL-methionine to decrease toxic effects of the paracetamol and intravenous fluids, blood transfusion and amoxycillin as supportive treatment. The cat recovered clinically during the following 12 days, but some laboratory abnormalities were still present 3 weeks later.     

Opportunistic mycobacterial granuloma in a cat associated with a member of the Mycobacterium terrae complex

An 18-month-old domestic short-haired neutered male cat presented with a nodular dermal thickening on a digit. Biopsy demonstrated pyogranulomatous inflammation with moderately frequent acid-fast bacilli. A member of theMycobacterium terrae complex was isolated. There was no evidence of systemic involvement. Treatment was initiated with enrofloxacin, rifampicin and clarithromycin. After 2 months there was no longer any clinically apparent dermal thickening. Treatment was continued for a further 3 months using enrofloxacin and rifampicin.     

Left principal bronchus rupture in a cat

A two-year-old neutered male domestic shorthaired cat was referred with respiratory compromise. Investigations included thoracic radiography and tracheal endoscopy. Findings were consistent with a traumatic avulsion injury to the left principal bronchus. Treatment involved the resection of the ruptured and stenosed left principal bronchus segment via a fifth right intercostal lateral thoracotomy. Once the damaged portion of bronchus had been removed, bronchial repair was achieved by end-to-end anastomosis. A full recovery was made and, at the time of writing (16 months postoperatively), the cat was clinically normal.     

Lead poisoning in a cat

Lead poisoning was suspected in a 3-year old Persian cat with depression, anorexia and sporadic vomiting. Laboratory tests disclosed an increased urinary delta aminolevulinic acid (δ-ALA) concentration but normoblastaemia or basophilic stippling of erythrocytes. Treatment for lead poisoning with calcium ethylenediamine tetraacetate for 5 days brought clinical improvement and reduction of urinary δ-ALA concentration but signs of toxicosis recurred in the next week. Repeated chelation therapy brought prompt improvement. A dog and another cat in the household had increased urinary δ-ALA concentrations, indicating metabolic effects of lead exposure, but were clinically well and were not treated. The source of lead was believed to be old paint.     

Fungal rhinitis and sinusitis in three cats

Localized infection of the nasal or paranasal cavities caused by Aspergillus spp or Penicillium spp was diagnosed in 3 cats. Clinical signs included chronic mucopurulent nasal discharge, epistaxis, and mandibular lymphadenopathy. Rhinoscopic and diagnostic imaging findings were compatible with severe inflammation of the nasal mucosa and destruction of the turbinates. Fungal plaques were observed rhinoscopically in 2 cats, and histologic examination of biopsy specimens revealed fungal colonies with surrounding inflammatory infiltrates in all 3. Results of fungal culture were negative for all 3 cats. Results of serum immunoelectrophoresis for antibodies against Aspergillus spp were positive in 2 cats. Treatment with itraconazole was effective in controlling clinical signs in 1 cat, but hepatotoxicosis developed. A single intranasal infusion of clotrimazole subsequently led to long-term resolution of clinical signs in this cat. Localized aspergillosis-penicilliosis is clinically indistinguishable from other pathologic conditions of the nasal and paranasal cavities in cats and should be considered when examining cats with chronic nasal discharge.     

Simultaneous occurrence of inflammatory bowel disease and trichomonosis in a Maine coon cat

A 2-year-old, 4.2 kg, spayed female, Maine coon cat was referred to the veterinary hospital for evaluation of hyporexia, slow growth, and chronic, intermittent, mucoid, bloody, voluminous, and fetid diarrhea. The diarrhea had been observed since the cat was acquired from a cattery at 4 months of age; with acute worsening in the 5 d before presentation. Abdominal palpation revealed moderate pain. Ultrasonographic examination showed thickening of the jejunal wall and ileal loops, increased echogenicity of the jejunal mucosa, and enlargement of the jejunal and ileocolic lymph nodes. Histopathology of full-thickness intestinal biopsies showed moderate, diffuse, lymphoplasmacytic, erosive enteritis with hemorrhage and edema. Diffuse, lymphoplasmacytic, erosive colitis with mild, interstitial fibrosis and hemorrhage was also noted. The ileocecal lymph node biopsy showed eosinophilic lymphadenitis. Based on the immunohistochemical evaluation of intestinal samples with CD3 and CD79a antibodies, a diagnosis of lymphoma was ruled out. Fecal polymerase chain reaction testing was positive for Tritrichomonas foetus. Based on these results, inflammatory bowel disease and trichomonosis were diagnosed. Treatment for the cat included a hypoallergenic diet and an oral omega-3 fatty acid supplement, in conjunction with prednisolone, to manage the inflammatory bowel disease. Ronidazole was administered to target the Tritrichomonas foetus. The cat was clinically normal during a follow-up examination after 6 months of treatment.     

CHEMOTHERAPY FOLLOWED BY ABDOMINAL CAVITY IRRADIATION FOR FELINE LYMPHOBLASTIC LYMPHOMA

Combination chemotherapy is standard care for feline lymphoma, although clinically relevant improvements in remission duration are unlikely to result from manipulations of chemotherapy agents alone. Lymphopoietic tissues generally are sensitive to radiation, and support for chemoradiotherapy as a treatment for lymphoma is found in both humans and dogs. The goal of this prospective pilot study was to determine the normal tissue tolerance to 15 Gy total abdomen fractionated radiation therapy following induction chemotherapy in cats with lymphoblastic lymphoma. Eight cats with lymphoblastic gastrointestinal or multicentric lymphoma confined to the abdominal cavity were treated with a 6‐week combination chemotherapy protocol followed 2 weeks later by whole‐abdomen radiation therapy consisting of 10 daily fractions of 1.5 Gy. Treatment was well tolerated; renal insufficiency documented in one cat at the start of radiation therapy progressed to stable chronic renal failure. One cat not in complete remission at the time of radiation therapy relapsed 2 weeks later, one cat with multicentric lymphoma relapsed with hepatic large granular lymphoma, and one cat was euthanatized 3 weeks following completion of radiation therapy for other reasons; no evidence of lymphoma or radiation toxicoses was identified on post mortem evaluation. The remaining five cats remain in remission at least 266 days after starting therapy; median remission duration has not been reached (range, >266 to >1332 days). Results of this study suggest that 15 Gy total abdomen fractionated radiation therapy after induction chemotherapy is tolerated satisfactorily. This protocol is suitable for further testing to quantify efficacy.     

Pyruvate kinase deficiency in a Somali cat in Australia

A 7-year-old neutered male Somali cat, bred in Western Australia, was presented for investigation of jaundice and severe anaemia. Splenomegaly and hepatomegaly were evident on physical examination. Severe anaemia, along with leukopenia and increased liver enzymes, were present on laboratory evaluation. Clinical investigation identified cholangitis and treatment for this resolved the jaundice but failed to resolve the anaemia. Treatment for Mycoplamsa haemofelis was administered concurrently. Genetic testing was then performed and pyruvate kinase deficiency was identified, the first time this has been reported in an Australian cat. Treatment with immunosuppressive medication was not successful.     

Infectious peritonitis in a cat that subsequently developed a myeloproliferative disorder

The effusive form of feline infectious peritonitis was diagnosed clinically and serologically in a 3-year-old male domestic cat. The cat responded to treatment for 9 months, then developed a myeloproliferative disorder with cytologic characteristics of reticuloendotheliosis.     

Syndrome of inappropriate antidiuretic hormone secretion in a cat

A 3-year-old, spayed female, domestic shorthaired cat was presented for evaluation of liver disease. Following anesthesia, laparoscopy, and medical therapy, the cat developed severe hyponatremia that was unresponsive to fluid therapy. Further evaluation of serum and urine osmolality determined that the cat fulfilled the criteria for syndrome of inappropriate antidiuretic hormone secretion. Treatment with fluid restriction resulted in resolution of the hyponatremia and clinical signs associated with the electrolyte imbalance.     

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.     

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.     

Treatment of an acromegalic cat with the dopamine agonist L-deprenyl

Acromegaly was diagnosed in a 14-year-old domestic short hair cat presented for investigation and management of apparently insulin-resistant diabetes mellitus. Treatment with L-deprenyl and high doses of insulin was commenced. The L-deprenyl did not reduce the requirement for high doses of insulin and did not appear to reduce the clinical signs associated with the disease. The cat was euthanased one year after initial presentation.     

Duodenal gangliosidosis in a cat: ultrastructural study.

Ultrastructural changes similar to those seen in gangliosidosis in man were detected in the duodenal mucosa of a cat (cat 1). The N-acetylneuraminic acid concentration was determined from the duodenum of cat 1 and from a clinically normal cat (cat 2). The total amount of gangliosides in the duodenum of cat 1 was 100 times greater than in the duodenum of cat 2 per unit wet weight. The lyophilizate from the intestines of both cats gave a blue-violet color that was regarded as qualitatively positive for N-acetylneuraminic acid determination. In cat 1, membranous cytoplasmic bodies were in all cell types of the duodenal mucosa.     

Suppurative colitis in a cat

A young cat with chronic large bowel diarrhea was found to have suppurative colitis. Treatment with sulfasalazine resulted in prompt clinical improvement, although histologic abnormalities persisted. Three months later, the cat was euthanatized because of effusive feline infectious peritonitis. Histologic examination revealed a normal colon.     

Disseminated Mycobacterium avium infection in a cat

A domestic shorthair cat was presented for lethargy and ataxia. Clinical findings included an abdominal mass, lumbosacral pain, ataxia. Aspirates from the liver and lymph nodes revealed intracellular, negative-staining rods. Treatment for presumptive mycobacterium infection was unsuccessful and the cat was euthanized. Disseminated Mycobacterium avium was confirmed on culture.     

Multiple myelomas in cats

Multiple myelomas are uncommon neoplasms of the bone marrow of cats [Weber NA, Tebeau CS (1998) An unusual presentation of multiple myeloma in two cats. Journal of the American Animal Hospital Association34 (6), 477-483]. Nine cats diagnosed with multiple myelomas were retrospectively identified over a 16-year period (1986-2002). Cats with multiple myelomas were older than 7 years (mean age 11.7 years); six males and three females were affected (2.1), but no breed predisposition was evident. Treatment of multiple myelomas consisted of supportive management in the nine cats and anti-neoplastic therapy in eight cats. Supportive treatment consisted of maintaining hydration, renal function and antimicrobial therapy even when there was no sign of infection. Anti-neoplastic therapy with melphalan and prednisolone was carried out in eight cats. Three failed to respond to treatment and five responded to treatment, but the response was only partial and temporary in one cat. The five cats that responded were improved clinically and had reduced serum protein levels. Five out of eight cats (63%) responded to chemotherapy, and it appeared to be complete in four cats and partial in one cat. Survival time in those cats was 15, 4, 17 and 24 months.     

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.     

Intravenous leiomyoma of the bladder in a cat.

An intravenous leiomyoma was diagnosed in a 5-year-old male cat that had a history of listlessness, dysuria, and hematuria. The cat has been clinically normal for 25 months after excision of the neoplasm.