Light-chain multiple myeloma in a cat.

A diagnosis of light-chain multiple myeloma was made in an 11-year-old male American Shorthair cat. The cat showed atypical plasma cell infiltration in the bone marrow, biclonal gammopathy caused by polymerization of myeloma protein (M-protein), and Bence-Jones proteinuria. The M-protein in the serum of the cat was analyzed by using 12% sodium dodeyl sulfate (SDS) polyacrylamide gel electrophoresis with Coomassie brilliant blue staining. An intense band with a size of 27 kDa, the size of the immunoglobulin light chain, was clearly observed, whereas the band corresponding to the immunoglobulin heavy chain (59 kDa) was undetectable. The 27-kDa band was confirmed to be an immunoglobulin light chain by Western blotting by using antibodies for feline immunoglobulin. These data suggested that the neoplastic plasma cells produce light chain only, leading to the diagnosis of light-chain multiple myeloma in the cat.     

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.     

Acute monocytic leukaemia in a cat

A three-year-old cat with lymphadenopathy, non-regenerative anaemia and marked leucocytosis (171.3 x 10(9) white blood cells/l) was diagnosed with monocytic leukaemia and treated with a combination of anticancer drugs. A number of mature and immature monocyte-like cells were detected in the peripheral blood and bone marrow; they proved to be monocytic cells by cytochemical examination and an analysis of their cell surface phenotype, indicating that the cat suffered from acute myeloid leukaemia, subclassified as monocytic leukaemia (M5). Treatment with cytarabine, doxorubicin, vincristine and prednisolone greatly reduced the number of blast cells in the cat's peripheral blood and bone marrow. The cat was in partial remission for 67 days and survived for 95 days after it was first examined.     

Multiple myeloma with central nervous system involvement in a cat

CASE DESCRIPTION: A 1.5-year-old spayed female domestic shorthair cat was admitted for hind limb locomotor difficulties and signs of pain along the lumbar portion of the vertebral column. At the time of referral, the cat was paraparetic with deficits in the spinal reflexes of the hind limbs. Neuroanatomic localization was at the L6-S2 spinal cord segments, corresponding approximately to the region of the L4-L6 vertebral bodies. CLINICAL FINDINGS: Radiography revealed a mixed osteolytic-proliferative lesion within the body of L5 involving the cranial end plate, as well as punctate radiolucencies in the distal portion of the femur. Magnetic resonance imaging revealed an intramedullary spinal cord lesion along with extensive meningeal and nerve root lesions in the area of the L4-L6 vertebral bodies. Cytologic analysis of a bone marrow aspirate from the right trochanteric fossa revealed a substantial plasma cell infiltrate. Analysis of CSF revealed a high protein concentration and morphologically abnormal plasma cells. Urine, but not serum, protein electrophoresis revealed a sharp gamma-globulin peak consistent with a monoclonal band of Bence-Jones proteins. The diagnosis was multiple myeloma. TREATMENT AND OUTCOME: The cat was treated with melphalan and prednisolone. A rapid clinical response was reported, and by week 3 after diagnosis, the cat's locomotion and behavior had normalized. However, by month 4, multifocal neurologic deficits were evident. The cat was euthanized at 9 months because of tetraparesis and substantial weight loss. CLINICAL RELEVANCE: To our knowledge, this is the first report of myeloma in a cat that had electrophoretically detectable light chain proteinuria but lacked a detectable serum monoclonal gammopathy.     

Serum hyperviscosity syndrome associated with multiple myeloma in two cats.

Serum hyperviscosity syndrome was diagnosed in 2 cats with multiple myeloma. Clinical signs included pale mucous membranes, dehydration, retinal hemorrhages, dilated and tortuous retinal vessels, seizures, head-tilt, nystagmus, systolic murmur, and gallop rhythm. Laboratory abnormalities included hyperglobulinemia, azotemia, hyperphosphatemia, nonregenerative anemia, and thrombocytopenia. Both cats had IgG monoclonal gammopathy, Bence Jones proteinuria, increased numbers of bone marrow plasma cells, and high values for relative serum viscosity. Renal disease was suspected in both cats. Cardiac hypertrophy was documented in 1 cat and was suspected in the other cat. Chemotherapy, using melphalan, prednisone, and vincristine, caused short-term remission in both cats, and plasmapheresis was used to lower serum protein concentration in 1 cat. Serum hyperviscosity syndrome rarely develops in cats, but should be suspected when monoclonal gammopathy exists with signs of neurologic, cardiac, or retinal disease.     

Spinal lymphoma in cats: 21 cases (1976-1989).

Medical records of 21 cats with spinal lymphoma were reviewed. All cats were evaluated for neurologic deficits, although 85% of cats necropsied had multicentric disease. Eighty-one percent of cats had hind limb paresis. Results of FeLV tests were positive in 84.2% (16/19) of the cats, and 68.7% (11/16) of the cats had leukemic bone marrow. Spinal lymphoma was confirmed by necropsy in 13 cats, by examination of a biopsy specimen in 1 cat, and by examination of cells aspirated from an epidural lesion in 2 cats. In the remaining 5 cats, a presumptive diagnosis was made on the basis of neurologic examination findings, positive FeLV test results, and leukemic bone marrow. Nine cats were treated with chemotherapy alone. The complete remission rate was 50% in 6 cats given cyclophosphamide, vincristine, and prednisone. The median duration of complete remission was 14 weeks. Complete remissions were not observed in 3 cats given only corticosteroids. A single cat treated by laminectomy and postoperative chemotherapy had a prolonged remission (62 weeks). At necropsy, lymphoma of the CNS was limited to the vertebral canal in 10 of 13 cats; 2 cats had malignant tissue in the brain and vertebral canal, and in the remaining cat, the tumor extended into the brachial plexus. Most tumors extended over multiple vertebral bodies, and 4 cats had more than 1 level of spinal cord involvement. The lymphoma was high-grade lymphoblastic or immunoblastic type in all cats.     

Use of human immunoglobulin for treatment of severe erythema multiforme in a cat

A 5-month old female domestic shorthair cat developed lethargy and severe ulcerative skin lesions that covered more than half of its body after routine administration of rabies vaccine, anthelmintic, and ear medication. Clinical and histologic findings were consistent with a severe cutaneous drug reaction or erythema multiforme. The cat's condition continued to deteriorate despite drug withdrawal and supportive care. Administration of human intravenous immunoglobulin was well tolerated by the cat and led to rapid resolution of ulcerative cutaneous lesions, accompanied by substantial improvement in the cat's demeanor within 8 days. Human intravenous immunoglobulin appears to be a novel promising treatment for life-threatening cutaneous drug reactions.     

Erythrophagocytic multiple myeloma in a cat

A 7-year-old neutered male domestic shorthair cat was presented to the Veterinary Medical Teaching Hospital at the University of Georgia for further evaluation of a suspected osteolytic lesion of the left 10th rib. Results of a CBC and biochemistry profile revealed mild nonregenerative anemia, hyperproteinemia, hyperglobulinemia, and hypercalcemia. Serum protein electrophoresis was consistent with a monoclonal gammopathy. Marked proteinuria with an increased urine protein to creatinine ratio was found. Cytologic examination of the liver, spleen, and bone marrow revealed numerous plasma cells, many of which were erythrophagocytic. Within the bone marrow, the plasma cells contained phagocytosed metarubricytes in addition to phagocytosed erythrocytes. A diagnosis of erythrophagocytic multiple myeloma was made and treatment with prednisone and melphalan was begun. Four weeks after presentation, the cat was euthanized due to clinical deterioration. A complete necropsy was performed. The distal one-third of the left 10th rib was completely absent. Histologically, there was no evidence for osteolysis or neoplastic cells in the remaining portion of the rib. However, large sheets of plasma cells were found infiltrating the spleen and bone marrow. Moderate erythrophagocytosis by the plasma cells was observed in both organs. The plasma cells, including the erythrophagocytic cells, were positive for CD79alpha by immunohistochemical staining. Erythrophagocytosis by plasma cells as a cause of anemia is uncommon in people with multiple myeloma and is rare in animals. To our knowledge, this is the first report of erythrophagocytic plasma cells in a cat with multiple myeloma.     

Multiple myeloma in 16 cats: a retrospective study

BACKGROUND: There is limited published information regarding feline multiple myeloma. Diagnostic criteria are derived from canine studies and to our knowledge, have not been critically reviewed for cats. OBJECTIVE: To evaluate the clinical and laboratory findings in cats with multiple myeloma and appraise diagnostic criteria. METHODS: Retrospective evaluation of medical records was performed. Inclusion required an antemortem diagnosis of multiple myeloma using 2 of 4 criteria: 1) >or=20% plasma cells in the bone marrow, or >or=10% if atypical plasma cells; 2) paraproteinemia; 3) radiographically-evident osteolysis; 4) light chain proteinuria. Alternatively, a postmortem diagnosis was based on the findings of multiple plasma cell neoplasms, with marrow involvement. RESULTS: Sixteen cats were diagnosed with multiple myeloma between 1996 and 2004, with a median age of 14.0 years; 9 of 16 (56%) were castrated males, and 7 of 16 (44%) were spayed females. Laboratory abnormalities included hyperglobulinemia (14/16, 87.5%), with 11/14 (78.5%) monoclonal and 3/14 (21.4%) biclonal gammopathies; hypoalbuminemia (4/16, 25%); light chain proteinuria, (4/9, 44.4%); hypocholesterolemia (11/16, 68.7%); hypercalcemia, (3/15, 20%); nonregenerative anemia, (11/16, 68.7%); regenerative anemia, (1/16, 6.2%); neutropenia (5/15, 33.3%); thrombocytopenia (8/16, 50%); and marrow plasmacytosis (14/15, 93.3%). Plasma cells were markedly immature, atypical, or both in 10 of 12 (83.3%) cats. Focal or multifocal osteolysis was noted in 6 of 12 (50%) cats for which radiographs were available for review; generalized osteopenia was found in 1 (8.3%) cat. Noncutaneous, extramedullary tumors were found in all cats assessed, 7/7 (100%), including spleen (6), liver (3), and lymph nodes (4). The disease in 1 of 2 cats with cutaneous tumors progressed to plasmacytic leukemia. CONCLUSIONS: Common findings in feline multiple myeloma include atypical plasma cell morphology, hypocholesterolemia, anemia, bone lesions, and multi-organ involvement. Based on the results of this study, we advocate modifying diagnostic criteria in cats to include consideration of plasma cell morphology and visceral organ infiltration.     

Anaplastic atypical myeloma with extensive cutaneous involvement in a dog

A 7-year-old, male, mixed breed dog was referred to the Veterinary Teaching Hospital at Kitasato University because of anorexia, lameness and multiple cutaneous lesions. Observation of bone marrow plasmacytosis, osteolytic bone lesions, serum myeloma protein and cutaneous infiltration of myeloma cells led us to a diagnosis of multiple myeloma (MM) with cutaneous involvement. Polymerase chain reaction and sequence analysis for the rearranged genes of immunoglobulin and T-cell receptor demonstrated that the neoplastic cells found in skin lesions or bone marrow are of B-lymphocyte lineage and share a common original precursor cell. The dog was treated with UW-Madison protocol or melphalan/prednisone protocol and survived 175 days. This is rare case of anaplastic MM with cutaneous involvement in dog.     

Erythremic myelosis (AML6er) in a cat

A 4-year-old male European domestic cat was presented with dysorexia, weakness and depression. Normocytic normochromic non-regenerative anaemia, leucopaenia and thrombocytopenia were detected. Rubriblasts were detected both in the blood and in the bone marrow. Tests of blood chemistry revealed no alterations of renal and hepatic function and a positive reaction to FeLV antigen was detected in the cat's serum. Neoplastic cells did not show positive to cytochemical reactions against granulocytes, monocytes and lymphocytes. According to haematological and bone marrow cytological findings, a diagnosis of erythremic myelosis (AML6er) was made. Histopathology showed extramedullary haematopoiesis in the liver, spleen, kidney and lymph nodes and chronic nephropathy and degenerative signs in the liver.     

Localised tetanus in two cats after ovariohysterectomy

Localised tetanus was diagnosed in two cats 14 and 21 days after ovariohysterectomy by a left flank surgical approach. The diagnosis in each case was based on their history, clinical signs and diagnostic investigations which excluded other possible diagnoses. Both cats showed scoliosis of the lumbar spine and left hind limb spasticity. One cat's clinical signs were exacerbated after the administration of corticosteroids. One cat was treated with oral amoxycillin and diazepam, and the second cat received penicillin, tetanus antitoxin, methocarbarnol and diazepam. Both cats improved after treatment but recovery was prolonged and the spasticity did not resolve until 12 weeks after diagnosis in one cat. The second cat was lost to follow up after 8 weeks.     

Clinical and lymphohematologic responses after bone marrow transplantation in sibling and unrelated donor-recipient pairs of cats

Conditions necessary for establishment of a graft, posttransplant supportive care and complications, and lymphohematopoietic reconstitution after bone marrow transplantation were evaluated in 7 cats. Donor-recipient pairs were selected on the basis of low mutual reactivity in one-way mixed lymphocyte reactions. Before transplantation, cats were given marrow ablative (7 Gray) total-body gamma irradiation. Cyclosporine A was administered to cat 7, which was given marrow from an unrelated donor. Rapid hematologic recovery was attained in 5 of 5 (cats 1 to 5) sibling bone marrow recipients and 1 (cat 7; cyclosporine A-treated) of 2 recipients from unrelated donors. Lymphocyte recovery was prolonged, requiring up to 100 days to attain reference concentrations. Lymphocyte blastogenic responses were below reference range in 2 of 3 cats (cats 1 and 3) examined approximately 1 to 3 months after transplantation. Serum IgG concentrations determined 1 to 6 months after transplantation were within reference range in cats 1 to 5 which were given sibling bone marrow. Fatal infections did not develop in cats that had established grafts. Antimicrobial-responsive fevers did develop, but were generally detected only when granulocyte counts were low (less than 1 x 10(9) cells/L). Clinical signs of disease in the immediate posttransplant period consisted of hepatic lipidosis (fatal) in cat 4, hepatitis (mild graft-vs-host disease) in cat 3, and immune-mediated hemolytic anemia and thrombocytopenia in cat 7. Cats with hepatitis and immune-mediated disease responded to immunosuppressive therapy.     

Hypereosinophilic syndrome in cats: a report of three cases.

The clinical, clinicopathological and pathological findings in three cats with hypereosinophilic syndrome are described. The cats chosen for the study had marked eosinophilia and evidence of tissue infiltration by eosinophils. Necropsies were performed on two cats, biopsy and blood samples were provided for the third cat. At necropsy, there was diffuse reddening of femoral bone marrow with ulceration and thickening of the duodenum. The livers had an enhanced lobular pattern with multiple, white, 1-3 mm nodules throughout the parenchyma. One cat had splenomegaly and the other had several enlarged, white, firm lymph nodes. Histopathologically, there was eosinophil infiltration of intestine, lymph nodes, liver, spleen, adrenal medulla and beneath the endocardium. Ultrastructurally, the eosinophils from lymph node and bone marrow of cat II were morphologically normal. The rigid criteria for eosinophilic leukemia were not fulfilled by these cases and the etiology of the eosinophilia in each case is not known. Possible pathogenic mechanisms are discussed.     

Chemical reactions in cells from leukemic cats

Cytochemical staining for leukocyte alkaline phosphatase(LAP), nonspecific esterase (NSE), nonspecific esterase with fluoride inhibition (NSE-F), periodic acid Schiff (PAS) reactivity, and peroxidase (PO) was valuable in identification of the neoplastic cell type in 10 leukemic cats. Staining both blood and bone marrow smears was often necessary for making the correct diagnosis. Cytochemical staining resulted in changing the morphologic diagnosis of leukemia in two of the 10 cats. Also, increased LAP activity, probably a marker for myelocytic leukemia in the cat, was observed in bone marrow cells from three nonleukemic, FeLV-positive cats.     

Hematologic abnormalities preceding myeloid leukemia in three cats.

Cytopenia were recognized in three cats infected with feline leukemia virus. In one cat, marrow blast cells were increased in number, and a diagnosis of aleukemic leukemia was made. The disease progressed slowly for 3 1/2 months before terminating in acute myelomonocytic leukemia, recognized as a blast crisis in blood. In the other two cats, neutropenia and altered granulopoiesis in bone marrow preceded development of myeloid leukemia.     

Intraocular extramedullary plasmacytoma in a cat

An 8-year-old, castrated male Domestic Short-haired cat was referred for evaluation of a possible intraocular neoplasm following previous ocular trauma. The eye was blind, and uveitis and an iridal mass were noted on examination. An enucleation was performed and the mandibular lymph node excised. Histopathologic examination revealed neoplastic proliferation of plasma cells in the iris and lymph node. No other evidence of disseminated disease was detected. This is the first case reported of an intraocular extramedullary plasmacytoma in the cat. The variation in clinical manifestations and potential association with multiple myeloma are not known at this time. Disseminated metastasis from a primary plasmacytoma of the uveal tract could also involve the bone marrow and be indistinguishable from multiple myeloma. Early enucleation, as in trauma-associated sarcomas, may be indicated to prevent metastasis. Periodic systemic evaluation for evidence of multiple myeloma should be performed.     

Detection of feline leukaemia virus in blood and bone marrow of cats with varying suspicion of latent infection

The purpose of this study was to determine if polymerase chain reaction (PCR) could be used to detect FeLV proviral DNA in bone marrow samples of cats with varying suspicion of latent infection. Blood and bone marrow samples from 50 cats and bone marrow from one fetus were collected, including 16 cats with diseases suspected to be FeLV-associated. Serum enzyme-linked immunosorbent assay (ELISA), blood and bone marrow immunofluorescent antibody test (IFA), and blood and bone marrow PCR were performed on each cat, and IFA and PCR on bone marrow of the fetus. Forty-one cats were FeLV negative. Five cats and one fetus were persistently infected with FeLV. Four cats had discordant test results. No cats were positive on bone marrow PCR only. It appears persistent or latent FeLV infection is not always present in conditions classically associated with FeLV.     

Hypereosinophilia associated with transitional cell carcinoma in a cat.

A 14-year-old spayed female domestic shorthair cat was evaluated because of an abdominal mass and eosinophilia. Widely disseminated, transitional cell carcinoma of the urinary bladder was diagnosed histologically. To further characterize the eosinophilia, eosinophils were separated from other leukocytes and cultured in vitro. Harvested cells were evaluated for density and for in vitro survivability. Results of these tests, hyperplasia of bone marrow eosinophil precursors, and lack of tumor tissue eosinophilic infiltrates suggested that an eosinophilopoietic stimulus of undetermined origin was likely the cause of this cat's hypereosinophilia.     

Cyclic hematopoiesis associated with feline leukemia virus infection in two cats

Cyclic oscillations in the numbers of blood elements were detected in 2 cats with FeLV infection. Periodic neutropenia, followed by a return to normal neutrophil numbers, was detected in both cats. The mean cycle duration was 11.8 days, with a range of 8 to 14 days. Just before the return of normal neutrophil numbers, monocytosis developed. In 1 cat, cyclic variations in the number of reticulocytes and platelets also were detected. Bone marrow aspirates obtained during periods of neutropenia had a predominance of progranulocytes in the myeloid cell line. myeloid hyperplasia, with numerous segmented neutrophils, was seen in bone marrow aspirates obtained during periods of normal neutrophil numbers. Oral administration of prednisolone resulted in cessation of the cyclic oscillations of blood elements in 1 cat. Cyclic hematopoiesis appeared to be another non-neoplastic manifestation of FeLV infection.