Tracheal rupture associated with intubation in cats: 20 cases (1996-1998)

OBJECTIVE: To characterize clinical features of tracheal rupture associated with endotracheal intubation in cats and to evaluate the most appropriate treatment for this condition. DESIGN: Retrospective study. ANIMALS: 20 cats with a history of endotracheal intubation that subsequently developed dyspnea or subcutaneous emphysema. PROCEDURE: Medical records of cats with a presumptive diagnosis of tracheal rupture associated with intubation were reviewed. Clinical and clinicopathologic data were retrieved. RESULTS: Cats were evaluated 5 hours to 12 days after a surgical or medical procedure requiring general anesthesia with intubation had been performed. Fourteen (70%) cats were evaluated after dental prophylaxis. All cats radiographed had pneumomediastinum and subcutaneous emphysema. Eighteen of 19 cats were initially treated medically. Duration of medical treatment for cats that did not have surgery ranged from 12 to 72 hours. Cats that had surgery received medical treatment 3 to 24 hours prior to the surgical procedure. Medical treatment alone was administered to 15 cats that had moderate dyspnea, whereas surgical treatment was chosen for 4 cats that had severe dyspnea (open-mouth breathing despite treatment with oxygen) or worsening subcutaneous emphysema. Eighteen cats had improvement of clinical signs, 1 cat died after surgery, and 1 cat died before medical or surgical intervention. CONCLUSIONS AND CLINICAL RELEVANCE: Most cats with tracheal rupture associated with intubation can be treated medically. Cats with worsening clinical signs (severe dyspnea, suspected pneumothorax, or worsening subcutaneous emphysema) should have surgery performed immediately to correct the defect.     

Ocular lesions associated with systemic hypertension in cats: 69 cases (1985-1998)

OBJECTIVE: To characterize clinical and clinicopathologic findings, response to treatment, and causes of systemic hypertension in cats with hypertensive retinopathy. DESIGN: Retrospective study. ANIMALS: 69 cats with hypertensive retinopathy. PROCEDURE: Medical records from cats with systemic hypertension and hypertensive retinopathy were reviewed. RESULTS: Most cats (68.1%) were referred because of vision loss; retinal detachment, hemorrhage, edema, and degeneration were common findings. Cardiac abnormalities were detected in 37 cats, and neurologic signs were detected in 20 cats. Hypertension was diagnosed concurrently with chronic renal failure (n = 22), hyperthyroidism (5), diabetes mellitus (2), and hyperaldosteronism (1). A clearly identifiable cause for hypertension was not detected in 38 cats; 26 of these cats had mild azotemia, and 12 did not have renal abnormalities. Amlodipine decreased blood pressure in 31 of 32 cats and improved ocular signs in 18 of 26 cats. CONCLUSIONS AND CLINICAL RELEVANCE: Retinal lesions, caused predominantly by choroidal injury, are common in cats with hypertension. Primary hypertension in cats may be more common than currently recognized. Hypertension should be considered in older cats with acute onset of blindness; retinal edema, hemorrhage, or detachment; cardiac disease; or neurologic abnormalities. Cats with hypertension-induced ocular disease should be evaluated for renal failure, hyperthyroidism, diabetes mellitus, and cardiac abnormalities. Blood pressure measurements and funduscopic evaluations should be performed routinely in cats at risk for hypertension (preexisting renal disease, hyperthyroidism, and age > 10 years). Amlodipine is an effective antihypertensive agent in cats.     

Bacteria associated with pyothorax of dogs and cats: 98 cases (1989-1998)

OBJECTIVE: To determine the organisms most commonly isolated from pleural fluid from dogs and cats with pyothorax. DESIGN: Retrospective study. ANIMALS: 51 dogs and 47 cats. PROCEDURE: Results of bacteriologic culture of pleural fluid samples obtained by means of thoracentesis were obtained from medical records. To obtain information on in vitro antimicrobial susceptibility of organisms commonly isolated from dogs and cats, records of all dogs and cats examined during 1998 were reviewed, and information was obtained on identity and in vitro antimicrobial susceptibility of aerobic organisms isolated from samples other than urine or urinary tract samples. RESULTS: Median ages of dogs and cats were 4 years. Bacteria were isolated from pleural fluid samples from 47 of 51 (92%) dogs and 45 of 47 (96%) cats. Obligate anaerobic bacteria were isolated from 28 dogs and 40 cats. A mixture of obligate anaerobic and facultative bacteria was isolated from 17 dogs and 20 cats. Samples from cats most often yielded a member of the nonenteric group (most commonly members of the genus Pasteurella), whereas those from dogs more often yielded a member of the family Enterobacteriaceae (most commonly E coli). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that antimicrobial agents chosen for the initial treatment of dogs and cats with pyothorax should be active against a mixture of obligate anaerobic and facultative bacteria.     

Tracheostomy in cats: 23 cases (1998-2006)

Tracheostomies can be used to provide a patent airway in animals with upper airway obstruction but have been reported to be more difficult to manage in cats than in other animals. The purpose of this study is to retrospectively describe the indications, complications and outcome of cats undergoing tracheostomy. Twenty-three cats underwent tracheostomy for laryngeal mass (n=13), trauma (n=5) and upper airway swelling (n=5). Major and minor complications were recorded in 10 and 17 cats, respectively. Seventeen cats were discharged to home, four cats were euthanased and two cats died in hospital. Complications with stoma healing were reported in one cat. Of seven cats discharged with a permanent tracheostomy, one cat is alive and six cats survived at home for between 2 and 281 days. Although complications are common, temporary tracheostomies can be beneficial for conditions in which the underlying cause can be treated. Despite risk of occlusion, permanent tracheostomies can be effective palliative procedures for cats with severe upper airway disease.     

Peripheral nerve injury associated with fracture or fracture-dislocation of the pelvis in dogs and cats: 34 cases (1978-1982)

Peripheral nerve injury was associated with fracture or fracture-dislocation of the pelvis in 23 dogs and 11 cats. In most cases, peripheral nerve injury resulted from ilial fracture with craniomedial displacement of bone fragments, or from sacroiliac fracture-dislocation with cranial displacement of the ilium. Sciatic nerve injury was associated with fracture of the acetabulum in 2 dogs. A combination of sensory, voluntary motor, and reflex abnormalities were observed in the ipsilateral extremity of affected animals. Signs of severe pain were noticed in 4 of the dogs and in 1 cat. Eight of the animals died or were euthanatized for reasons not directly related to the severity of peripheral nerve injury. Of the remaining 26 animals, 21 (81%) had good or excellent limb function 16 weeks after peripheral nerve injury was sustained. Limb function was lost or self-mutilation occurred in 4 (15%) of the animals.     

Tracheal rupture in cats: 16 cases (1983-1998)

OBJECTIVE: To determine causes of tracheal rupture in cats and the mechanism of injury. DESIGN: A retrospective study was conducted to identify cats with tracheal rupture. A second study was conducted to establish mechanism of injury, and a third study was conducted to determine volume of air needed to obtain an airtight seal when inflating the cuff of an endotracheal tube in a cat. ANIMALS: 16 cats with clinical signs of tracheal rupture, 10 cat cadavers, and 20 clinically normal cats that were undergoing anesthesia. PROCEDURES: Details were extracted from medical records of 16 cats with tracheal rupture (9 treated surgically and 7 treated conservatively). For the cadaver study, the trachea of each cat cadaver was intubated and observed during overinflation of the endotracheal tube cuff. For clinically normal cats, volume of air needed to obtain an airtight seal for the endotracheal tube was recorded. RESULTS: Most ruptures were associated with cats anesthetized for dental procedures. Clinical signs associated with tracheal rupture included subcutaneous emphysema, coughing, gagging, dyspnea, anorexia, and fever. Tracheoscopy was the method of choice for documenting tracheal rupture. Surgical and conservative management were successfully used, unless the injury extended to the carina. In the cadaver study, overinflation of the endotracheal tube cuff with > 6 ml of air resulted in tracheal rupture in 7 of 10 cadavers. For clinically normal cats, the volume of air (mean +/- SD) needed to obtain an airtight seal was 1.6 +/- 0.7 ml. CLINICAL IMPLICATIONS: Overinflation of an endotracheal tube cuff may result in tracheal rupture in cats.     

Severe sepsis in cats: 29 cases (1986-1998)

OBJECTIVE: To document the clinical, clinicopathologic, and pathologic findings in cats with severe sepsis, identify abnormalities unique to this species, and identify criteria that could be used antemortem to diagnose the systemic inflammatory response syndrome in cats. DESIGN: Retrospective study. ANIMALS: 29 cats confirmed to have severe sepsis at necropsy. PROCEDURE: Pertinent history, physical examination findings, and results of hematologic and biochemical testing were extracted from medical records. RESULTS: Clinical diagnoses included pyothorax, septic peritonitis, bacteremia secondary to gastrointestinal tract disease, pneumonia, endocarditis, pyelonephritis, osteomyelitis, pyometra, and bite wounds. Physical examination findings included lethargy, pale mucous membranes, poor pulse quality, tachypnea, hypo- or hyperthermia, signs of diffuse pain on abdominal palpation, bradycardia, and icterus. Clinicopathologic abnormalities included anemia, thrombocytopenia, band neutrophilia, hypoalbuminemia, low serum alkaline phosphatase activity, and hyperbilirubinemia. Necropsy findings included multi-organ necrosis or inflammation with intralesional bacteria. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that severe sepsis in cats is characterized by lethargy, pale mucous membranes, signs of diffuse abdominal pain, tachypnea, bradycardia, weak pulses, anemia, hypoalbuminemia, hypothermia, and icterus. Recognition of this combination of clinical findings should facilitate the diagnosis of severe sepsis in cats.     

Chronic nasal discharge in cats: 75 cases (1993-2004)

OBJECTIVE: To identify the most common etiologic diagnosis and any historical, physical, or other diagnostic variables associated with a definitive etiologic diagnosis for chronic nasal discharge in cats. Design-Retrospective case series. ANIMALS: 75 cats with nasal discharge of >/= 1 month's duration. PROCEDURES: Medical records of affected cats were reviewed for information on signalment, clinical signs, duration and type of nasal discharge, results of clinical examination, laboratory findings, and advanced imaging findings. RESULTS: A specific etiologic diagnosis for nasal discharge was identified in only 36% of cats. Neoplasia (carcinoma or lymphoma) was the most common etiologic diagnosis. Character and location of nasal discharge did not contribute greatly toward a specific etiologic diagnosis. Sneezing and vomiting were the most common concurrent clinical signs. Routine CBC, serum biochemical panel, and urinalysis did not contribute to a specific etiologic diagnosis. An etiologic diagnosis was more likely in older cats and cats that underwent advanced imaging studies and nasal biopsy. CONCLUSIONS AND CLINICAL RELEVANCE: Although advanced diagnostic testing, including imaging studies and biopsy, increases the likelihood of achieving an etiologic diagnosis, the cause of chronic nasal discharge in cats often remains elusive.     

Primary renal tumours in cats: 19 cases (1992-1998)

A search from databases of four veterinary colleges and one private referral practice between January 1992 and April 1998 provided 20 cases diagnosed with primary renal neoplasia. Review of these cases revealed 19 primary renal tumours, excluding lymphoma. Of the 20 histologically reviewed cases, the diagnosis was amended in eight. There were 13 renal carcinomas (11 tubular and two tubulopapillary), three transitional cell carcinomas, one malignant nephroblastoma, one haemangiosarcoma and one adenoma. The haemangiosarcoma is, to our knowledge, the first reported case of this tumour type as a primary renal tumour in the cat. Most cats were presented for non-specific clinical signs such as anorexia and weight loss. One cat presented with tumour-associated polycythaemia which has not, to our knowledge, been reported previously. The metastatic rate for cats with complete staging was 64%, and 100% for transitional cell carcinomas.     

Endogenous lipid pneumonia in cats: 24 cases (1985-1998)

OBJECTIVE: To determine clinical signs, radiographic and histologic abnormalities, and concurrent diseases in cats with endogenous lipid pneumonia (EnLP) and to determine the pathologic importance of EnLP in cats. DESIGN: Retrospective study. ANIMALS: 24 cats. PROCEDURE: Medical records of cats in which EnLP was confirmed by histologic examination of necropsy specimens were reviewed. Information collected from the medical records included signalment, body weight, clinical signs, and results of clinicopathologic tests. Thoracic radiographs were reviewed by a radiologist; histologic specimens were reviewed by a pathologist. RESULTS: All cats had nonspecific clinical abnormalities, such as lethargy, anorexia, or weight loss; 16 had signs of respiratory tract disease. All cats had concurrent systemic diseases, and clinicopathologic abnormalities were reflective of these conditions. Nonspecific abnormalities were detected on thoracic radiographs from 9 of 11 cats. Most cats had macroscopic, multifocal, subpleural lesions; inflammatory infiltrates, cholesterol clefts, and multinucleated giant cells were common. Ten cats had an underlying obstructive pulmonary disease that was the likely cause of EnLP. Lesions of EnLP were not considered to be severe enough or extensive enough to be the cause of death in any of these cats. CONCLUSIONS AND CLINICAL RELEVANCE: EnLP is an uncommon respiratory tract disorder of cats with no pathognomonic clinical, laboratory, or radiographic findings. Although EnLP was not the cause of death in any of these cats, results of the present study do suggest that EnLP may be a marker for potentially severe underlying obstructive pulmonary disease.     

Horner's syndrome in dogs and cats: 49 cases (1980-1986)

Medical records of 49 dogs and cats with Horner's syndrome were reviewed. Causes included head, neck, and chest trauma, chronic otitis, cranial thoracic mass, and injury attributable to cleaning of the external ear canal. Cause could not be delineated in 54.5% of the dogs. Numerous diagnostic tests and pharmacologic challenge exposure with epinephrine were used to localize the site of injury. Resolution of all clinical signs was observed in 36 animals and required a mean of 7.7 weeks.     

Radiographic patterns of periodontitis in cats: 147 cases (1998-1999)

OBJECTIVE: To determine patterns of alveolar bone loss (periodontitis) and other lesions evident on full-mouth survey radiographs of cats. DESIGN: Retrospective study. ANIMALS: 147 cats. PROCEDURE: Full-mouth radiographs were evaluated for evidence and severity of alveolar bone loss, odontoclastic resorption lesions (ORL), retained roots, missing teeth, signs of endodontic disease secondary to periodontitis, and apical resorption. RESULTS: 106 (72%) cats had some degree of periodontitis, 100 (68%) were missing teeth, 98 (67%) had ORL, 78 (53%) had expansion of the buccal alveolar bone at 1 or more canine teeth, 75 (51%) had retained roots, 48 (33%) had apical resorption, and 12 (8%) had signs of endodontic disease secondary to periodontitis. Cats < 4 years old were not significantly more likely than the general population to have normal alveolar bone height. Prevalence of ORL increased with age, but cats > or =13 years old were less likely than the general population to have moderate or severe generalized periodontitis. Purebred cats were not significantly more likely to have periodontitis or ORL than mixed-breed cats. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that periodontitis is common in cats and that horizontal bone loss is the most common radiographic pattern of alveolar bone loss. Purebred cats were not more likely than mixed-breed cats to have ORL or periodontitis, but when they did have periodontitis, it was more likely to be moderate to severe. Cats with ORL were less likely than cats without ORL to have normal alveolar bone height and more likely to have severe focal vertical bone loss.     

Locked jaw syndrome in dogs and cats: 37 cases (1998-2005)

A consecutive series of cases of dogs and cats with locked jaw syndrome (inability to open or close the mouth) are reported in this study. Dogs were significantly overrepresented (84.0%) and adult dogs were more frequently affected (81.0%). Temporomandibular joint ankylosis due to fracture was the most common cause (54.0%) of locked jaw syndrome. Additional potential causes of locked jaw syndrome are masticatory muscle myositis, neoplasia, trigeminal nerve paralysis and central neurological lesions, temporomandibular joint luxation and dysplasia, osteoarthritis, retrobulbar abscess, tetanus, and severe ear disease. Treatment of locked jaw is directed towards the primary cause. It is important to treat the tonic spasm in order to minimize periarticular fibrosis. Surgical intervention is recommended for temporomandibular joint ankylosis. Masticatory muscle myositis treatment is initiated by gradually opening the mouth, with medical treatment based on immunosuppressive therapy. Fracture and masticatory muscle myositis are associated with a relatively good prognosis in regard to short-term outcome as compared to animals with central neurologic lesions or osteosarcoma which have a poor prognosis.     

Evaluation of complications and prognostic factors associated with administration of total parenteral nutrition in cats: 75 cases (1994-2001)

OBJECTIVE: To determine frequency and types of complications, prognostic factors, and primary diseases affecting clinical outcome associated with administration of total parenteral nutrition (TPN) in cats. DESIGN: Retrospective study. ANIMALS: 75 cats that received TPN for > or = 12 hours. PROCEDURE: Medical records were reviewed, and information was obtained on signalment, history, problems at initial evaluation, physical examination findings, weight and changes in weight while receiving TPN, duration in the hospital before initiation of TPN, the type of TPN catheter used, duration of TPN administration, and final diagnosis. Laboratory results obtained immediately prior to TPN and at 24 and 96 hours following initiation of TPN administration were compared. RESULTS: Reports of weight loss at initial evaluation, hyperglycemia at 24 hours, or diagnosis of chronic renal failure were significantly associated with increased mortality rate. Greater serum albumin concentrations prior to and at 96 hours following TPN administration were significantly associated with decreased mortality rate. Mechanical and septic complications were infrequent and not associated with increased mortality rate. Most cats had multiple diseases. The overall mortality rate was 52%; among 75 cats, 36 recovered, 23 were euthanatized, and 16 died as a result of their primary illness or complications associated with their illness. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated high mortality rate in cats maintained onTPN that had multiple concurrent diseases associated with a poor prognosis. Indicators of poor prognosis included a history of weight loss, hyperglycemia at 24 hours following TPN administration, hypoalbuminemia, and chronic renal failure.     

Cryptorchidism and monorchism in cats: 25 cases (1980-1989).

Of 1,345 cats admitted for orchiectomy during a 10-year period, 23 (1.7%) were cryptorchid and 2 (0.1%) were monorchid. Persian cats were over-represented in the cryptorchid population (P = 0.01). Cats were more likely to be unilaterally than bilaterally cryptorchid (P = 0.01). A predisposition for location of undescended testes (abdominal vs inguinal or right vs left side) was not identified in unilateral cryptorchids. All bilateral cryptorchids had abdominally located testes. The most common surgical approaches used for orchiectomy of cryptorchid cats were a caudal ventral midline incision for inguinal testes and a caudal ventral midline celiotomy for abdominal testes.     

Epizootiologic patterns of diabetes mellitus in cats: 333 cases (1980-1986)

Medical records from 333 cats with diabetes mellitus were studied retrospectively, using epidemiologic methods to determine the incidence of and risk factors for diabetes mellitus in this species. Abstracts were derived, using the Veterinary Medical Data Program with its 17 participating academic institutions in the United States and Canada. A reference population of 135,651 cats was derived from the same hospital population and time span (July 1980 to June 1986). The incidence of diabetes mellitus in cats was determined to be 2.45 cases/1,000 cat-years-of-risk during the 6-year study period. Breed had no detectable effect on risk for diabetes mellitus. In contrast, body weight, age, gender, and neutering had a significant (P less than or equal to 0.01) effect. Body weight of cats was categorized as being less than or greater than or equal to 6.8 kg. The higher body weight, probably indicating obesity, contributed a 2.2-fold increase in risk, even after adjustment for age and gender (adjusted odds ratio). The etiologic fraction for high body weight was 3.8%, suggesting that an estimated 3.8% of cases of diabetes mellitus was attributable to this factor alone. Over 50% of diabetic cats were greater than 10 years old, and the etiologic fraction for age greater than 7 years alone was 73.5%. Age was a significant (P less than 0.001) and the most important single risk factor for development of the disease in cats, with adjusted odds ratios of 8.3 and 14.4 for age 7 to 10 years and greater than 10 years, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)     

Extensive small bowel resection in dogs and cats: 20 cases (1998-2004)

OBJECTIVE: To determine outcome in dogs and cats that underwent extensive (ie, > 50%) resection of the small intestine and identify factors associated with outcome. DESIGN: Retrospective case series. ANIMALS: 13 dogs and 7 cats. PROCEDURE: Medical records were reviewed, and follow-up information was obtained. RESULTS: In all 7 cats and in 8 of the 13 dogs, extensive intestinal resection was performed because of a foreign body. Mean+/-SD estimated percentage of intestine that was removed was 68+/-14% (range, 50% to 90%). Two dogs were euthanized 3 days after surgery because of dehiscence of the surgical site and development of septic peritonitis; 1 dog died of acute respiratory distress syndrome 5 days after surgery. The remaining 10 dogs and 7 cats were discharged from the hospital, and follow-up information was available for 15 of the 17. Median survival time was 828 days, and 12 of the 15 animals for which long-term follow-up information was available had good outcomes. However, none of the factors examined, including percentage of intestine resected, were significantly associated with outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Most dogs and cats that underwent extensive resection of the small intestine had a good outcome. The amount of intestine resected was not associated with outcome. These data may be useful in providing prognostic information in cases of extensive small intestinal resection.     

Ocular lesions associated with coccidioidomycosis in dogs: 35 cases (1980-1985)

Thirty-five dogs with ocular lesions associated with coccidioidomycosis were examined. Serologic and/or histologic evaluation confirmed the diagnoses of coccidioidomycosis. The disease most frequently associated with signs referable to the anterior segment of the eye, such as iritis and granulomatous uveitis. Histologic evaluation of the eye revealed a primary posterior segment disease, such as chorioretinitis or retinal separation, with an extension into the anterior segment of the eye.     

Laryngeal, laryngotracheal, and tracheal masses in cats: 27 cases (1998-2003)

Medical records of 27 cats with masses of the larynx and trachea were examined. Six cats had inflammatory masses, and 21 cats had neoplastic lesions. A definitive diagnosis was reached in 22 cats with a single biopsy. The median age of the cats was 12.0 years (range 6 to 20 years). Dyspnea was the most common clinical sign. Accurate diagnoses were best obtained through direct laryngeal or tracheal examination combined with histological examination of tissue biopsies. Kaplan-Meier survival data for all inflammatory and neoplastic lesions showed a median survival of 5 days, with 7.4% of cats alive at 1 year.