Use of a biodegradable self-expanding stent in the management of a benign oesophageal stricture in a cat

An 11-year-old domestic shorthair cat presented with a six-week history of regurgitation following a dental procedure. Endoscopy identified a single oesophageal stricture in the cervical oesophagus. Stricture reformation occurred following endoscopic balloon catheter dilation on two occasions. Following a third balloon dilation a biodegradable polydioxanone self-expanding stent was placed across the stricture site. Following the implantation the cat was able to eat soft canned food orally without regurgitation. Fluoroscopic examination performed four months after placement indicated that the stent was no longer present and the cervical oesophagus was able to pass boluses of canned food with no signs of obstruction.     

Use of a self-expanding metallic stent for the treatment of a urethral stricture in a young cat

A 4-month-old intact male domestic shorthair cat was evaluated for urinary outflow obstruction after several weeks of medical management for traumatic urethral rupture. Positive-contrast retrograde urethrography and anterograde cystoscopy performed 4 weeks after the initial urethral injury confirmed a stricture approximately 1cm distal to the bladder trigone at the site of the initial urethral tear. A self-expanding metallic urethral stent (SEMS) was placed under fluoroscopic guidance to relieve the urethral stricture and re-establish luminal patency. After stent placement, the cat was able to void urine normally with minimal urinary incontinence noted. This resolved several months post-stent placement. No known clinical complications persisted other than mild intermittent hematuria.     

Hyperactivity and alopecia associated with ingestion of valproic acid in a cat

A 1-year-old castrated male cat was evaluated because of alopecia of approximately 4 to 5 months' duration as well as hyperactive behavior. It was later determined that the cat was ingesting valproic acid by eating food to which it had been added for daily administration to a child in the household who had cerebral palsy. The clinical signs slowly resolved after the source of valproic acid was removed. This emphasizes the sensitivity of cats to drugs that are commonly used in humans. It was not determined whether the clinical signs that developed in this cat were caused by an adverse reaction or from toxicosis as a result of prolonged hepatic elimination of valproic acid, which requires glucuronide metabolism for disposition. However, the cat recovered completely following removal of the drug and prevention of further exposure. This report emphasizes the importance of obtaining a careful and complete history from the owner regarding an animal and its environment. In the cat of this report, the owner had not considered the impact of the presence of the drug in the child's food.     

Oesophageal ectasia as a cause of dysphagia and milk regurgitation in a neonatal foal

Dysphagia and milk regurgitation are relatively infrequently observed clinical signs in neonatal foals but, when present, can commonly arise from anatomic or functional disorders of the upper airway. Less commonly, milk regurgitation can be caused by anatomic or neuromuscular disorders of the oesophagus. In the report presented here, a neonatal foal was examined for milk regurgitation at 4 days of age and was diagnosed with transient oesophageal ectasia via oesophagoscopy and contrast radiography. Aspiration pneumonia was treated with broad-spectrum antimicrobials and the owner was instructed to intermittently elevate the forelimbs to facilitate passage of milk out of the dilated oesophagus. The milk regurgitation resolved and reassessment of the foal at 6 weeks of age documented the absence of oesophageal ectasia and resolution of aspiration pneumonia. The foal was reported to be healthy and consuming food normally 6 months after initial examination and was in good body condition. This case is unique in that the oesophageal ectasia improved with time; furthermore, other potential causes of dysphagia and milk regurgitation of oesophageal origin in neonatal foals are discussed.     

Chylothorax associated with dirofilariasis in a cat

A 4-year-old castrated domestic shorthair cat was referred for treatment of chylothorax. Thoracic duct lymphangiography revealed partial obstruction of the cranial vena cava, as evidenced by filling of mediastinal lymphatics with dye instead of all of the dye entering the vena cava. The thoracic duct was ligated via left 10th intercostal space thoracotomy. Immediate postligation lymphangiography revealed successful duct ligation. Results of a serum ELISA for adult heartworm antigen that was performed before surgery were positive. Drug treatment for the heartworm disease was not recommended, because the pleural effusion had ceased (as determined by radiographic examination 3.5 and 9 months after surgery) and the cat was doing well clinically. Sixteen months after surgery, the owner reported that the cat was doing well and did not have signs of respiratory problems.     

Pyometra in a 13-year-old neutered queen

A 13-year-old female domestic shorthair cat was examined because of weight loss over 4 months. The history included being neutered when a kitten and no signs of estrus recognized by the owner since this surgery. A mid-abdominal mass was palpated. Ultrasonographic abdominal evaluation revealed a tubular fluid-filled mass. The cat underwent surgery to remove the mass, which was one horn of the uterus. The patient made a full recovery.     

Prepubic urethrostomy and vaginoplasty in a female cat

A 1-year-old, intact female, domestic shorthaired cat was presented for dysuria resulting from perineal scarring subsequent to injuries incurred during a cat fight. A prepubic urethrostomy was performed to manage the dysuria. Eleven months later, the cat was re-presented with a 3-day history of pyrexia and inappetence. A pinpoint opening extending 0.5 cm ventral to the anus on midline, exuding a clear discharge, was noted in the perineal region. A contrast fistulogram was performed, and a vaginoperineal fistula was diagnosed. The fistulous tract was a result of vulvar stricture from the trauma of the cat fight. A vaginoplasty was performed to create an opening for vaginal secretions. This is the first published report of a prepubic urethrostomy performed in a female cat.     

Gastro-oesophageal reflux during thiopentone or propofol anaesthesia in the cat

Lower oesophageal pH was monitored in 50 cats anaesthetized with either thiopentone or propofol. Gastro-oesophageal reflux, as evidenced by a decrease in lower oesophageal pH to less than 4.0 or an increase to more than 7.5, occurred in 16% (4/25) and 12% (3/25) of the cats anaesthetized with thiopentone and propofol, respectively, the difference between the two groups being non-significant. Reflux usually occurred shortly after the induction of anaesthesia and had a mean duration of about 23 min. The refluxate was always acidic (pH < 4.0). Gastric contents of pH below 2.5 were refluxed on three occasions, two in the thiopentone group and one in the propofol group. Regurgitation and flow of gastric contents from the mouth occurred in only one cat anaesthetized with propofol. None of the cats that exhibited reflux developed any signs of postanaesthetic oesophagitis or stricture formation.     

Palatal erosion and oronasal fistulation following covered nasopharyngeal stent placement in two dogs

Treatment options for dogs with nasopharyngeal stenosis include fluoroscopic placement of metallic stents. Reported complications include entrapment of hair and food, obstruction and persistent nasal discharge. Two toy breed dogs were examined for persistent nasal discharge and halitosis at 4 and 20 months after placement of permanent metallic stents for acquired nasopharyngeal stenosis. Full thickness defects were found in the palate of both dogs, with extensive communication between the mouth and the nasal passages. Portions of the metal stent were observed within the lesion in both patients. Additional treatment was declined by the owner of one dog; the stent was removed through the fistula in the other dog. Palatal erosion with secondary oronasal fistulation is a potential complication of nasopharyngeal stent placement in dogs.     

Suspected clindamycin-associated oesophageal injury in cats: five cases

The clinical findings, treatment and outcome of suspected clindamycin-associated oesophageal injury in five cats are reported. All cats were treated with one 75 mg clindamycin capsule twice daily (dose range 12-19 mg/kg). Capsules were administered without food or a water bolus. Dysphagia, regurgitation, choking or gagging were seen 3-9 days after starting clindamycin. On oesophagoscopy, three cats had oesophagitis, one of which progressed to stricture formation. Two cats had an oesophageal stricture at first presentation. This is the first report of suspected clindamycin-associated oesophageal injury in cats. It serves to further alert practitioners to the potential for drug-induced oesophageal disorders (DIOD) in cats treated with oral medications and to urge prevention by promoting a change in dosing practices.     

Wedge meatoplasty as a treatment for stricture of the urethral meatus in a cat

A three-and-a-half-year-old male neutered Siamese cat presented with idiopathic feline lower urinary tract inflammation and dysuria, which appeared to be caused by stricture of the urethral meatus. Wedge meatoplasty was performed, which relieved the cat's dysuria and restored a normal urine stream. To my knowledge, this is the first report of meatoplasty as a treatment for stricture of the urethral meatus in a cat.     

Multiple crusted cutaneous plaques in a cat

A 12-year-old castrated male, domestic shorthaired cat was presented with multiple skin lesions. The cat lived mainly indoors and was regularly vaccinated against feline herpes-, calici- and parvo-viruses. It had also been vaccinated against feline leukaemia virus 18 months previously and the owner claimed that the skin lesions had developed after that vaccination.     

Feline pituitary-dependent hyperadrenocorticism and insulin resistance due to a plurihormonal adenoma

A 12-year-old female spayed domestic short-haired cat presented for lethargy, poor hair coat, alopecia, difficulty walking, and mild polyuria/polydipsia. The cat's skin tore easily in the neck area during routine restraint for blood draw. Physical examination, blood analysis, and ultrasound imaging were all consistent with pituitary-dependent hyperadrenocorticism (PDH) with secondary insulin-resistant diabetes mellitus, which was nonketotic. Insulin therapy, fluids, and diet change were initiated for the diabetes mellitus and the owner reported improvement in clinical signs although the blood glucose measurements remained elevated. Surgical repair of the torn skin was successful. Although a guarded prognosis was given to the owner because of an advanced stage of hyperadrenocorticism, and the limited treatment options currently available for feline PDH, trilostane was agreed on as an initial therapeutic option. The day trilostane was to be initiated, the cat presented with dyspnea and the owner chose to euthanize. Because of the rarity of hyperadrenocorticism disease in the cat, permission was obtained by the owner for a necropsy to confirm suspected PDH as the underlying cause for insulin resistance and skin fragility syndrome.     

Heterologous penetrating keratoplasty for treatment of a corneal sequestrum in a cat

A corneal sequestrum was diagnosed in an 8-year-old, neutered male Burmese cat. A heterologous penetrating keratoplasty (PK) (fresh canine corneal tissue) was performed to restore a clear visual axis. A heterograft was selected in order to decrease the risk of viral transmission as a screened donor was not available. One month postoperatively the graft was vascularized and opaque. The owner failed to return for recheck examinations until 16 months postoperatively at which time only a faint central nebula remained.     

Surgical removal of an intramedullary chopstick fragment penetrating the spinal cord in a cat

A 3-year-old male domestic shorthair cat presented with sudden ataxia. Neurologic examination showed complete loss of proprioception in the thoracic and pelvic limbs. Computed tomography and magnetic resonance imaging revealed a non-metallic foreign body penetrating the spinal cord. The foreign body was removed by the ventral approach to the atlanto-occipital junction. Mild improvement of proprioception was observed the day after surgery. In a follow-up two months after surgery, the owner reported a complete recovery of the patient, showing a normal gait. To the author’s knowledge, this is the first case report describing successful removal of an intramedullary foreign body penetrating cervical spinal cord by ventral approach in a cat.     

Successful surgical management of a perforating oesophageal foreign body in a cat

CASE PRESENTATION AND SURGICAL INTERVENTION: a 3-year-old cat was presented with a recent history of dysphagia and intermittent regurgitation. Radiography revealed a bony oesophageal foreign body at the level of the thoracic inlet. Endoscopic retrieval was attempted but resulted in severe dyspnoea due to the development of pneumomediastinum, pneumothorax and subcutaneous emphysema secondary to perforation of the oesophageal wall. Immediate surgical exploration was carried out. Extensive necrosis of the oesophagus resulting from the presence of the foreign body led to a decision to perform an oesophageal resection and anastomosis. CLINICAL RELEVANCE: this is the first clinical report of a cat treated successfully by oesophagectomy following oesophageal perforation due to an obstructive foreign body. The authors suggest that prompt surgical intervention, the ability to convert to a surgical procedure under the same anaesthetic as a non-surgical retrieval, placement of a gastrostomy tube and the availability of advanced anaesthetic and critical care support are important factors to consider when managing feline patients with a perforating oesophageal foreign body.     

Congenital triple oesophageal stricture and megaoesophagus in a neonatal colt

Congenital oesophageal stenosis is rarely described in horses. This case report describes a neonatal colt with signs of a milky nasal discharge and cervical swelling present from birth. The diagnostic evaluation revealed a triple oesophageal stricture, identified as congenital fibromuscular oesophageal stenosis. A megaoesophagus was seen cranial to the strictures, but its aetiology remains unexplained. To the authors’ knowledge, multiple oesophageal stenosis together with megaoesophagus has not previously been described in the horse.     

Suspected clostridial myositis in a domestic cat

Extract

Sir:- A long-haired domestic cat. aged two years, appeared normal when fed by the owner, at 9.00am. At 3.00pm the cat arrived home walking on three legs. The other leg appeared very painful. The owner brought the cat to the clinic immediately as she thought it has been hit by a car.     

Conservative treatment of acquired oesophageal strictures by endoscopic‐guided balloon dilation in two horses

Oesophageal stricture is an uncommon condition in horses that results in an obstructive syndrome with regurgitation of food and possible aspiration pneumonia. Currently, in both human and small animal practice, one of the preferred treatment options for oesophageal strictures consists of pneumatic or hydrostatic balloon dilation. The aim of this article is to report 2 cases of severe oesophageal stricture in the horse, successfully treated with endoscopic‐guided hydrostatic balloon dilation.